Improved Community Health Depends on Knowing the Extent of Social Deprivation

FOR IMMEDIATE RELEASE: Wednesday, Nov. 9, 2016

Leslie Champlin
Senior Public Relations Strategist
(800) 274-2237, Ext. 5224 

WASHINGTON, DC — U.S. health policy makers could capitalize on the work of the United Kingdom and New Zealand in collecting data to improve community health, according to researchers at the Robert Graham Center for Policy Studies in Primary Care and Family Medicine.

Writing in “How Other Countries Use Deprivation Indices – and Why the U.S. Desperately Needs One(” in the November issue of Health Affairs(, researchers Winston Liaw, MD, and his colleagues noted U.S. health researchers and policy makers have focused on gathering and using social determinants of health for clinical, public health and policymaking purposes. However, the United States has no uniform data collection and aggregation system to meet national goals.

The research was published in the November issue of Health Affairs. Liaw will describe the Robert Graham Center paper during the Nov. 10 Health Affairs briefing, “The Culture of Health,”( at the Capital Hilton.

“Efforts to capture, aggregate, display, and analyze community data in the U.S. are noteworthy but not sufficient,” Liaw writes.

The United States has several data sets that measure social and economic conditions that affect health. Currently, these databases are pieces of a larger puzzle in identifying the social and economic conditions within a community. However, they are not synthesized into a single index of standardized factors. Moreover, they have not been tested for their ability to predict future health needs or guide policymakers in allocating resources.

“There’s very little cross-talk between them or harmonization among them,” Liaw said of the various efforts to capture community metrics in the United States. “An index is one way to get the agencies and providers and public health officials to speak the same language, to agree on a single metric that will capture deprivation. That standardization is important before we can start working together on specific projects, deciding how we assess whether our community is getting better or worse. How do we agree on the neighborhoods, communities that need more resources? Before we can answer those questions, we need to speak same language and an index is one tool that will allow us do that.”

Equally important, universal definitions of social determinants of health will enable researchers to identify communities that go against expectation.

“If we’re all speaking the same language, we can identify the outliers,” Liaw said. “We can look at the communities that have better or worse outcomes than expected, despite their level of deprivation. We can start to identify and learn from them and figure out what characteristics make them more resilient or more fragile than expected.”

The Robert Graham Center Social Deprivation Index – the most recent tool – is based on indices used in New Zealand and the United Kingdom. Both countries use data that identify communities that lack good access to housing, employment, income, transportation and access to health facilities. The countries’ policymakers then allocate health, social, housing and other resources to communities based on their level of social deprivation.

Regardless of the index chosen to measure social deprivation, its components should be weighted for accurate measurement and the index should be validated by comparing it to outcomes, according to Liaw.

“The index should have these two elements so we can see if the areas with worse deprivation have worse outcomes,” he said. 


About the Robert Graham Center

The Robert Graham Center for Policy Studies in Family Medicine and Primary Care works to improve individual and population health by enhancing the delivery of primary care. The Center staff generates and analyzes evidence that brings a family medicine and primary care perspective to health policy deliberations at local, state, and national levels.

Founded in 1999, the Robert Graham Center is an independent research unit affiliated with the American Academy of Family Physicians (AAFP). The information and opinions contained in research from the Center do not necessarily reflect the views or policy of the AAFP.