4.0 Disparity

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4.0 Disparity

4.1 Disparity Rate Ratio

Definition
Ratio of the rate of a health indicator for the least affluent neighbourhood income quintile to the rate for the most affluent neighbourhood income quintile.

Method of Calculation
Indicator rate for the least affluent neighbourhood income quintile / indicator rate for the most affluent neighbourhood income quintile

Interpretation
This indicator reflects the rate for the least affluent socio-economic group compared to the most affluent. It provides a summary measure of the magnitude of the socio-economic disparity for a health indicator in a jurisdiction. It should be evaluated together with other measures, such as the indicator rate for each socio-economic group as well as potential rate reduction.

Standards/Benchmarks
A rate ratio of 1 indicates no disparity between the least affluent and the most affluent groups.

Data Sources
2006 Census, Statistics Canada;
Discharge Abstract Database, Canadian Institute for Health Information;
National Ambulatory Care Reporting System, Canadian Institute for Health Information;
Alberta Ambulatory Care Database, Alberta Health and Wellness;
Fichier des hospitalisations MED-ÉCHO, ministère de la Santé et des Services sociaux.

Reference Period
April 1, 2008 -  March 31, 2009

Comprehensiveness
Available for all provinces. Not available for the territories due to the small population in each quintile.

References
Kunst, A. E. and J. P. Mackenbach. Measuring Socio-Economic Inequalities in Health. Copenhagen, Denmark: World Health Organization, 1994.

Keppel, K. et al. “Methodological Issues in Measuring Health Disparities.” Vital and Health Statistics, Series 2 141. Washington, D.C.: National Center for Health Statistics, 2005.

Comments
Socio-economic status was measured using neighbourhood income quintile. In the absence of personal socio-economic characteristics (that is, individual-level data) in the administrative health databases, small geographic area characteristics based on census data were used to derive neighbourhood income quintile. The methodology for defining neighbourhood income quintile is provided on page 3.

4.2 Potential Rate Reduction (PRR)

Definition
Potential reduction in a health indicator rate that would occur in the hypothetical scenario that each socio-economic group in the jurisdiction experienced the rate of the most affluent socio-economic group.

Method of Calculation

Where  and  are the age-standardized rate and the proportion of population in each of the five income quintiles, respectively.

Interpretation
This indicator is based on the concept of population-attributable risk and provides a summary measure of the overall effect of socio-economic disparity on a health indicator in a jurisdiction.
This indicator is relevant when disparity has been identified by other measures such as the indicator rates for each socio-economic group as well as the disparity rate ratio.

Standards/Benchmarks
Benchmarks are not available for this measure. 

Data Sources
2006 Census, Statistics Canada;
Discharge Abstract Database, Canadian Institute for Health Information;
National Ambulatory Care Reporting System, Canadian Institute for Health Information;
Alberta Ambulatory Care Database, Alberta Health and Wellness;
Fichier des hospitalisations MED-ÉCHO, ministère de la Santé et des Services sociaux.

Reference Period
April 1, 2008 -  March 31, 2009

Comprehensiveness
Available for all provinces. Not available for the territories due to the small population in each quintile.

References
Kunst, A. E. and J. P. Mackenbach. Measuring Socio-Economic Inequalities in Health. Copenhagen, Denmark: World Health Organization, 1994.

Keppel, K. et al. “Methodological Issues in Measuring Health Disparities.” Vital and Health Statistics, Series 2 141. Washington, D.C.: National Center for Health Statistics, 2005.

Comments
Socio-economic status was measured using neighbourhood income quintile. In the absence of personal socio-economic characteristics (that is, individual-level data) in the administrative health databases, small geographic area characteristics based on census data were used to derive neighbourhood income quintile. The methodology for defining neighbourhood income quintile is provided on page 3.