Developing and Validating an Individual-Level Deprivation Index for Children's Health in France

• Published in: International journal of environmental research and public health Vol. 19; no. 24; p. 16949
• Main Authors: Laporte, Remi, Babe, Philippe, Jouve, Elisabeth, Daguzan, Alexandre, Mazoue, Franck, Minodier, Philippe, Noel, Guilhem, Urbina, Diego, Gentile, Stephanie
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 16-12-2022; MDPI
• Subjects: Child; Child Health; Children; Children & youth; Childrens health; Clinical medicine; Cross-Sectional Studies; Deprivation; Derivation; Discussion groups; Emergency medical care; Emergency services; Europe; France; Health care access; Health care policy; Health disparities; Health insurance; Humans; Indexes; Inequality; Literature reviews; Pediatrics; Phases; Professionals; Public health; Sensitivity; Social Factors; Social workers; Socioeconomic Factors; France; Europe; social support; deprivation; access to health care; health inequalities; screening; social determinants of health
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph192416949

Deprivation generates many health inequalities. This has to be taken in account to enhance appropriate access to care. This study aimed to develop and validate a pediatric individual-level index measuring deprivation, usable in clinical practice and in public health.
The French Individual Child Deprivation Index (FrenChILD-Index) was designed in four phases: item generation then reduction using the literature review and expert opinions, and index derivation then validation using a cross-sectional study in two emergency departments. During these last two phases, concordance with a blinded evaluation by an expert enabled us to determine thresholds for two levels of moderate and severe deprivation.
The generation and reduction phases retained 13 items. These were administered to 986 children for the derivation and validation phases. In the validation phase, the final 12 items of the FrenChILD-Index showed for moderate deprivation (requiring single specific care for deprived children) a sensitivity of 96.0% [92.6; 98.7] and specificity of 68.3% [65.2; 71.4]. For severe deprivation (requiring a multidisciplinary level of care), the sensitivity was 96.3% [92.7; 100] and specificity was 91.1% [89.2; 92.9].
The FrenChILD-Index is the first pediatric individual-level index of deprivation validated in Europe. It enables clinical practice to address the social determinants of health and meet public health goals.