Public Health Monitoring of Privilege and Deprivation With the Index of Concentration at the Extremes

Overview

Journal Am J Public Health

Specialty Public Health

Date 2015 Dec 23

PMID 26691119

Citations 179

Authors

Nancy Krieger

Pamela D Waterman

Jasmina Spasojevic

Wenhui Li

Gil Maduro

Gretchen Van Wye

Affiliations

Soon will be listed here.

Abstract

Objectives: We evaluated use of the Index of Concentration at the Extremes (ICE) for public health monitoring.

Methods: We used New York City data centered around 2010 to assess cross-sectional associations at the census tract and community district levels, for (1) diverse ICE measures plus the US poverty rate, with (2) infant mortality, premature mortality (before age 65 years), and diabetes mortality.

Results: Point estimates for rate ratios were consistently greatest for the novel ICE that jointly measured extreme concentrations of income and race/ethnicity. For example, the census tract-level rate ratio for infant mortality comparing the bottom versus top quintile for an ICE contrasting low-income Black versus high-income White equaled 2.93 (95% confidence interval [CI] = 2.11, 4.09), but was 2.19 (95% CI = 1.59, 3.02) for low versus high income, 2.77 (95% CI = 2.02, 3.81) for Black versus White, and 1.56 (95% CI = 1.19, 2.04) for census tracts with greater than or equal to 30% versus less than 10% below poverty.

Conclusions: The ICE may be a useful metric for public health monitoring, as it simultaneously captures extremes of privilege and deprivation and can jointly measure economic and racial/ethnic segregation.

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