How does area-level deprivation depress an individual's self-rated health and life satisfaction? Evidence from a nationwide population-based survey in Japan

Area-level deprivation and handwashing behavior during the COVID-19 pandemic: A multilevel analysis on a nationwide survey in Korea

This study investigated the association between area deprivation level and performance of handwashing behavior during the COVID-19 pandemic in Korean adults. This study used data from the 2015 Population and Housing Census data to measure area deprivation level. The 2020 Korea Community Health Survey was used for all other variables, including hand hygiene behavior (August through November 2020). The association between area deprivation level and practice of handwashing behavior was examined using multilevel logistic regression analysis. The study population comprised 215,676 adults aged 19 years or above. Compared to the least area deprived group, the most deprived group was more likely to not wash hands after using the restroom (OR 1.43, 95% CI 1.13-1.82), after coming home (OR 1.85, 95% CI 1.43-2.39), and using soap (OR 1.55, 95% CI 1.29-1.84). The findings suggest the importance of considering area deprivation in implementing policies that promote handwashing, particularly during a pandemic.

Is fear of COVID-19 higher in individuals residing in more deprived areas? A nationwide study

BACKGROUND

This study investigated the association between various types of coronavirus disease 2019 (COVID-19)-related fear and the level of area deprivation in Korea.

METHODS

Different types of COVID-19-related fear were examined, namely fear of infection, fear of dying from infection, fear of public criticism, fear of a family member getting infected and fear of economic loss. The level of area deprivation was measured based on the Area Deprivation Index, which was calculated based on population census data. The association between various types of COVID-19-related fear and the level of area deprivation was analyzed using multivariable logistic regression analysis.

RESULTS

This study included 199 859 individuals from the 253 administrative divisions in South Korea. Findings indicated that fear was most common in individuals residing in the most deprived areas, followed by those in the mediocre and least deprived areas (fear of infection: odds ratio (OR) 1.05, 95% confidence interval (CI) 1.01-1.09; fear of dying from infection: OR 1.23, 95% CI 1.19-1.28; fear of public criticism: OR 1.20, 95% CI 1.15-1.24; fear of a family member getting infected: OR 1.12, 95% CI 1.07-1.18).

CONCLUSIONS

The findings suggest the need to monitor and account for area deprivation in managing the psychological health effects of the COVID-19 crisis.

Measuring disadvantage: A systematic comparison of United States small-area disadvantage indices

Extensive evidence demonstrates the effects of area-based disadvantage on a variety of life outcomes, such as increased mortality and low economic mobility. Despite these well-established patterns, disadvantage, often measured using composite indices, is inconsistently operationalized across studies. To address this issue, we systematically compared 5 U.S. disadvantage indices at the county-level on their relationships to 24 diverse life outcomes related to mortality, physical health, mental health, subjective well-being, and social capital from heterogeneous data sources. We further examined which domains of disadvantage are most important when creating these indices. Of the five indices examined, the Area Deprivation Index (ADI) and Child Opportunity Index 2.0 (COI) were most related to a diverse set of life outcomes, particularly physical health. Within each index, variables from the domains of education and employment were most important in relationships with life outcomes. Disadvantage indices are being used in real-world policy and resource allocation decisions; an index's generalizability across diverse life outcomes, and the domains of disadvantage which constitute the index, should be considered when guiding such decisions.

The association between the socioeconomic deprivation level and ischemic heart disease mortality in Japan: an analysis using municipality-specific data

OBJECTIVES

Geographical variation in the standardized mortality ratio (SMR) for ischemic heart disease (IHD) among municipalities has not been assessed in Japan. Additionally, associations between area-level socioeconomic deprivation indices and IHD mortality have not been identified in Japan. The present study investigated this association.

METHODS

Information on IHD mortality was extracted from Vital Statistics data from 2018 to 2020 for each municipality in Japan. The socioeconomic deprivation level was derived from multiple socioeconomic characteristics. We classified municipalities into quintiles based on the deprivation level and investigated the association between the deprivation level and the SMR of IHD. Additionally, a Bayesian spatial regression model was used to investigate this association, adjusting for other municipal characteristics.

RESULTS

Geographical variation in the SMR of IHD was revealed, and municipalities with high SMRs were spatially clustered. There was a weak negative correlation between the socioeconomic deprivation level and the SMRs (correlation coefficient, -0.057 for men and -0.091 for women). In contrast, the regression analysis showed a statistically significant positive association between deprived areas and the IHD mortality rate, and the relative risks for the most deprived municipalities compared with the least deprived municipalities were 1.184 (95% credible interval [CrI], 1.110 to 1.277) and 1.138 (95% CrI, 1.048 to 1.249) for men and women, respectively.

CONCLUSIONS

A weak negative correlation between the socioeconomic deprivation level and the SMR was observed in the descriptive analysis, while the regression analysis showed that living in deprived areas was statistically positively associated with the IHD mortality rate.