Deprivation indices, population health and geography: an evaluation of the spatial effectiveness of indices at multiple scales.

Area-based deprivation indices (ABDIs) have become a common tool with which to investigate the patterns and magnitude of socioeconomic inequalities in health. ABDIs are also used as a proxy for individual socioeconomic status. Despite their widespread use, comparably less attention has been focused on their geographic variability and practical concerns surrounding the Modifiable Area Unit Problem (MAUP) than on the individual attributes that make up the indices. Although scale is increasingly recognized as an important factor in interpreting mapped results among population health researchers, less attention has been paid specifically to ABDI and scale. In this paper, we highlight the effect of scale on indices by mapping ABDIs at multiple census scales in an urban area. In addition, we compare self-rated health data from the Canadian Community Health Survey with ABDIs at two census scales. The results of our analysis confirm the influence of spatial extent and scale on mapping population health-with potential implications for health policy implementation and resource distribution.