City Know-hows

Developing a socio-environmental deprivation index for monitoring intra-urban health inequalities

Spatial distribution of the Socio-environmental Deprivation Index within the Human Development Units of the Municipality of São Paulo, Brazil.

Monitoring slum health through ecological deprivation indexes is a useful strategy to understand and reduce health inequalities within a city. We developed a robust socioenvironmental index capable of explaining health outcomes in small intraurban areas and differentiating areas with the presence of different slum typologies and non-slum spaces.

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Target audience

Urban planners and public health practitioners.

The problem

Ecological multidimensional deprivation indexes help to identify the underlying mechanisms of health inequalities. Unfortunately, most approaches in health research use a single geographic variable as a proxy for deprivation or socioeconomic status (e.g., median household income) and the environmental context has been commonly neglected. Furthermore, there is a lack of data for small areas that delays the understanding of the relationship between health and deprivation of vulnerable communities within a city.

What we did and why

Guided by theoretical references on health, we developed the robust Socio-environmental Deprivation Index (SeDI) for the Municipality of São Paulo, Brazil. SeDI was developed through Principal Component Analysis. By using spatial regression models, with the SeDI as the predictor, we explained around 60% or more of the ageing rate in small areas of the city. Additionally, we found significant statistical differences between the index scores of different municipal slum typologies and non-slum areas.

Our study’s contribution

Our approach brings many advantages for health studies, such as:

  • Developing of a deprivation index, which can be subdivided into two robust subindexes of the socioeconomic and environmental contexts.
  • Enabling the identification of health inequalities within neighbourhoods.
  • Utilising spatial units of great internal homogeneity of socioeconomic characteristics.

Besides the often employed area-level socioeconomic measures, we found that variables of the surrounding environment greatly contributed to explaining health outcomes.

Impacts for city policy and practice

Our Socio-environmental Deprivation Index (SeDI) approach can help to leverage social mobility and improve health in deprived urban settlements. It can be a useful tool for developing multiscale studies, which commonly lack data for small areas. Our methodology can be easily replicated for other Brazilian metropolitan areas and other countries with comparable situations. It can guide the development of indexes for health studies in small areas of megacities with high levels of inequality. Lastly, our Socio-environmental Deprivation Index’s dimensions can help to compare different aspects of deprivation worldwide.

Further information

Full research article:

A Socioenvironmental Deprivation Index for slum health research in the municipality of São Paulo, Brazil by Mirela Barros Serafim, Paula Santana, Alessandra Cristina Corsi & Ligia Vizeu Barrozo.

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