Objective: The ability to measure social health inequalities is a prerequisite to the implementation of local policies designed to reduce such inequalities. The absence of individual socioeconomic data in medical and administrative databases does not allow direct evaluation of those inequalities. The objective of this study is to propose a method of measurement of social health inequalities from national health insurance databases and a validated deprivation index.
Methods: 27 health care and prevention indicators were constructed to identify social health inequalities. Medical and administrative databases were cross-matched with the European Deprivation Index, completed by a potential spatial accessibility indicator in order to take into account the spatial distribution health care services.
Results: The study population comprised data devived from the three main health insurance schemes, and represents 89% of the population of the Midi-Pyrenees region. 98% were able to be geographically coded. The 27 indicators were therefore calculated on a total of 2,574,310 individuals, i.e. 87% of the regional population.
Conclusion: This study illustrates the value of using medical and administrative data to create databases allowing measurement of social health inequalities and their variations within a region. The proposed indicators could be used as decision-making tools for the selection of zones of intervention and to assess the impact of public policies designed to reduce social health inequalities.
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