British Columbia’s Index of Multiple Deprivation for Community Health Service Areas

Abstract

Area-based socio-economic indicators, such as the Canadian Index of Multiple Deprivation (CIMD), have been used in equity analyses to inform strategies to improve needs-based, timely, and effective patient care and public health services to communities. The CIMD comprises four dimensions of deprivation: residential instability, economic dependency, ethno-cultural composition, and situational vulnerability. Using the CIMD methodology, the British Columbia Index of Multiple Deprivation (BCIMD) was developed to create indexes at the Community Health Services Area (CHSA) level in British Columbia (BC). BCIMD indexes are reported by quintiles, where quintile 1 represents the least deprived (or ethno-culturally diverse), and quintile 5 is the most deprived (or diverse). Distinctive characteristics of a community can be captured using the BCIMD, where a given CHSA may have a high level of deprivation in one dimension and a low level of deprivation in another. The utility of this data as a surveillance tool to monitor population demography has been used to inform decision making in healthcare by stakeholders in the regional health authorities and governmental agencies. The data have also been linked to health care data, such as COVID-19 case incidence and vaccination coverage, to understand the epidemiology of disease burden through an equity lens.

Clinical severity of Omicron subvariants BA.1, BA.2, and BA.5 in a population‐based cohort study in British Columbia, Canada

“…Models were adjusted for age, sex, the provincial health authorities, vaccination status, comorbidities (see supplements for details on selected conditions from the provincial chronic disease registry), and area level measures of social determinants of health (SDOH) incorporated using the Canadian Index of Multiple Deprivation adapted to the province of BC (BCCIMD) spanning four dimensions including ethno-cultural composition, economic dependency, residential instability, situational vulnerability. 6 For detailed information on data sources and laboratory methodology, refer to additional methods in the Supplementary Information.…”

“…Overall, this investigation reports consistent trends previously identified at earlier stages in the pandemic: rate of hospitalization (1) is greater among males than females, (2) increases incrementally with age, and (3) decreases proportionately with two and 3+ doses of the COVID‐19 vaccine. Recognizing the disproportionate effects of the COVID‐19 pandemic on marginalized groups, we have incorporated the population‐specific finely tuned measures of equity (BCCIMD) into our analysis and report that the risk of more severe disease coincides with several dimensions of SDOH 6 …”

Estimating the impacts of nonoptimal temperatures on mortality: A study in British Columbia, Canada, 2001–2021

“… 12 , 13 BC comprises four ecoregions characterized by unique microclimates 15 and a wide range of socioeconomic and demographic structures. 37 For example, among the five RHAs in BC, Island has a large percentage of the population experiencing both high social deprivation and living with at least one chronic disease (Table 1 ), which could explain the higher fraction of attributable deaths. However, the temperature–mortality relationship is very complex and cannot be interpreted the same across all RHAs.…”

Cross-disciplinary rapid scoping review of structural racial and caste discrimination associated with population health disparities in the 21stCentury

“…Health disparities within and between populations, across geographic regions, demographic groups such as age and sex, and due to socio-economic factors such as income, education, employment, complex indices of material and social deprivation, and environmental factors have been well documented in peer-reviewed literature (Zhang et al, 2015;Zandy et al, 2019;GBD US, 2022;Relova et al, 2022) and gray literature (CDC, 2011;Rasali et al, 2016;Rasali et al, 2019). In the United States (US), Global Burden of Disease and US Health Disparities Researchers have found that life expectancy disparities between racial-ethnic groups are widespread and persistent and have stressed that analysis of local-level data is vital to address the root causes of poor health and premature death among disadvantaged groups and to eliminate health disparities (GBD US, 2022).…”