Deprivation: Introduction

What is deprivation?

“Deprivation takes many different forms in every known society. People can be said to be deprived if they lack the types of diet, clothing, housing, household facilities and fuel and environmental, educational, working and social conditions, activities and facilities which are customary, or at least widely encouraged and approved, in the societies to which they belong.” (Townsend 1987: p.126)

Deprivation therefore has multiple dimensions – both material and social – and relates to individuals (not areas) and their position relative to others in the same society. ‘Deprivation’ is typically used as shorthand for ‘multiple deprivation’. It is a wider concept than ‘poverty’, which looks at income in isolation.  

Why is it important?

Deprivation increases the risk of early death and is associated with higher rates of illness from certain diseases. For example, in 2019-2021, healthy life expectancy for those living in the 10% most deprived areas was 26.0 years lower for males and 24.9 years lower for females compared to those living in the 10% least deprived areas (measured using the Scottish Index of Multiple Deprivation, or SIMD).

Health inequalities have been defined as the ‘systematic differences in the health of people occupying unequal positions in society’ (Graham, 2009). For more information on health inequalities and how the Scottish Government is tackling them, see the ScotPHO Health Inequalities pages.

How is it measured?

As an individual- or household-level concept, deprivation would ideally be measured at this scale. In practice, though, individual-level information on the multiple dimensions of deprivation is not usually available. For this reason, area-based measures have been developed.

All deprivation measures aim to adequately represent the socioeconomic status of the population of a small geographical area relative to all such areas. They do this by aggregating a range of variables – typically from the Census and other routine sources – into a summary score. 

The area's deprivation level is then used as the best available estimate of the deprivation level of individuals residing there. However, it is important to note that areas will still contain a mixture of individuals of differing deprivation levels: not all people experiencing deprivation live in deprived areas, and not everyone in a deprived area is experiencing deprivation.

Measures of deprivation are used to measure and monitor inequalities in health and healthcare provision and usage.

The Scottish Index of Multiple Deprivation

The Scottish Index of Multiple Deprivation (SIMD) is the Scottish Government’s standard approach for identifying small-area concentrations of multiple deprivation across Scotland. The SIMD provides a relative ranking of 6,976 small areas (datazones) across Scotland from the most deprived (ranked one) to the least deprived in Scotland (ranked 6,976).

The SIMD is derived from administrative data (routine data gathered through registration for, and use of, services such as health or education). As it is not reliant on Census data it can be updated on a more frequent basis. The SIMD was first published in 2004. Updates were released in 2006, 2009, 2012, 2016 and 2020.

A datazone’s overall SIMD score is a weighted average of the scores for a range of over-arching ‘domains’, each of which consists of several indicators. The SIMD 2020 included 34 indicators nested within seven domains. The domains and their weightings are as follows:

  • Income (28%)
  • Employment (28%)
  • Education (14%)
  • Health (14%)
  • Access to Services (9%)
  • Crime (5%)
  • Housing (2%)

The Scottish Government has published information about the SIMD 2020, including downloadable data and methodological information. Information about previous SIMD releases is also available. An interactive map of SIMD deprivation and its domains is available at simd.scot.

Public Health Scotland produces and uses a population-weighted version of the SIMD, rather than the unweighted version used by the Scottish Government and National Records of Scotland. Population-weighting ensures that groupings such as quintiles (fifths) and deciles (tenths) contain 20% and 10% of Scotland’s population, respectively, rather than 20% or 10% of its datazones. Lookup files are available from the Scottish Health and Social Care Open Data website. PHS has published guidance on the use of deprivation data for analysts.

Use of the SIMD

SIMD rankings can be used to compare overall deprivation and the individual deprivation domains between areas, although the size of any differences cannot be quantified (Scottish Government, 2020). In addition, rankings should not be compared over time, due to boundary changes (datazones are modified after each Census) and methodological/data changes.

The SIMD is widely used across local and national government for directing resources: e.g., it has been used to identify populations with higher risk and need, so that they can be prioritised for service delivery (e.g., ChildSmile dental services, the Mental Health and Learning Difficulties care programme). It is also used for setting targets (the National Performance Framework) and monitoring social and health inequalities (see for example the Scottish Government’s Long-Term Monitoring of Health Inequalities).

The Carstairs and Morris Index (or Carstairs Index)

To measure area deprivation prior to 1996, and to monitor long-term trends, Public Health Scotland recommend use of the Carstairs and Morris Index (Carstairs and Morris 1990): this has been produced for 1981, 1991, 2001 and 2011, using Census data. The index is derived from four Census indicators: low social class, lack of car ownership, overcrowding and male unemployment. It is a simple measure but is not a good measure of rural deprivation. The data can be downloaded as a lookup file by selecting SIMD version ‘All’ on this Public Health Scotland archived page.  See McLoone and Boddy (1994) for an analysis using the Carstairs and Morris Index.