Abstract
Background
Area-based index of multiple deprivation (IMD) indicators of financial hardship lack individual specificity and sensitivity. This study compared self-reports of hardship with area measures in relation to health status.
Methods
Interviews in one London Borough, reported financial hardship and health status. Associations of health status with most and least deprived quintiles of the IMD 2015 were compared with self-reported hardship; always or sometimes ‘having difficulty making ends meet at the end of the month’ in relation to never.
Results
1024 interviews reported hardship status in 1001 (98%). 392 people (39%) reported they ‘always’ or ‘sometimes’ had hardship. In multivariate analysis, self-reported hardship was more strongly associated with smoking; odds ratio = 5.4 (95% CI: 2.8–10.4) compared with IMD, odds ratio = 1.9 (95% CI: 1.2–3.2). Health impairment was also more likely with self-reported hardship, odds ratio = 11.1 (95% CI: 4.9–25.4) compared with IMD; odds ratio = 2.7 (95% CI: 1.4–5.3). Depression was similarly related; odds ratio = 2.4 (95% CI: 1.0–5.6) and 2.7 (95% CI: 1.2–6.6), respectively.
Conclusions
Self-reported hardship was more strongly related to health status than area-based indicators. Validity and implementation in routine health care settings remains to be established.
Area-based index of multiple deprivation (IMD) indicators of financial hardship lack individual specificity and sensitivity. This study compared self-reports of hardship with area measures in relation to health status.
Methods
Interviews in one London Borough, reported financial hardship and health status. Associations of health status with most and least deprived quintiles of the IMD 2015 were compared with self-reported hardship; always or sometimes ‘having difficulty making ends meet at the end of the month’ in relation to never.
Results
1024 interviews reported hardship status in 1001 (98%). 392 people (39%) reported they ‘always’ or ‘sometimes’ had hardship. In multivariate analysis, self-reported hardship was more strongly associated with smoking; odds ratio = 5.4 (95% CI: 2.8–10.4) compared with IMD, odds ratio = 1.9 (95% CI: 1.2–3.2). Health impairment was also more likely with self-reported hardship, odds ratio = 11.1 (95% CI: 4.9–25.4) compared with IMD; odds ratio = 2.7 (95% CI: 1.4–5.3). Depression was similarly related; odds ratio = 2.4 (95% CI: 1.0–5.6) and 2.7 (95% CI: 1.2–6.6), respectively.
Conclusions
Self-reported hardship was more strongly related to health status than area-based indicators. Validity and implementation in routine health care settings remains to be established.
Original language | English |
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Article number | fdad161 |
Number of pages | 6 |
Journal | Journal of public health |
DOIs | |
Publication status | Published - 24 Aug 2023 |
Bibliographical note
© The Author(s) 2023Keywords
- FINANCE
- Public health
- social determinants