Eastern European Business and Economics Journal

Material and social deprivation in Italy: an analysis on a regional basis



Enrico Ivaldi


Ivaldi E. 2016. Material and social deprivation in Italy: an analysis on a regional basis. Eastern European Business and Economics Journal 2(3): 248-268.


Full text




Raimi LUKMAN, Yaba College of Technology, Nigeria;

Mohammad Mafizur RAHMAN, University of Southern Queensland, Australia;

Giuseppina TALAMO, Università Degli Studi Di Enna Kore, Italy.



The existence of an inverse association between socioeconomic status and the incidence of most diseases is well-established in literature: higher rates of morbidity and mortality have been reported among lower socioeconomic groups in many European countries. However, it’s an open question which component of socioeconomic status affects health most, and how that relationship should be measured. The relation between socioeconomic factors and health inequality may be proved at the individual level, or at the geographic-area level. In this paper we follow the second stream of literature, i.e studies on deprivation relating the state of disadvantage suffered by an individual, with the living conditions of the area where the individual resides. The aim of this study is to measure two different conceptions of deprivation, in order to develop two different indicators of deprivation: the first concerning material deprivation, through the study of direct variables, and the second related to social deprivation, calculated using indirect variables. The proposed indicators have been validated respectively with life expectancy at birth and a composite index of security, in order to determine which of the two indices affects more the living conditions. The final conclusion of this work leads to establishing the existence of two different deprivation indicators for 20 Italian regions, both validated and recommended as measures of the material and social disadvantage of one region compared to the other.



Italy, Material, Social, Deprivation


JEL classification:

A13, C43, C81







Atkinson, A.B., Cantillon, B., Marlier, E. & Nolan, B. (2001), Indicators for social inclusion in the European Union, report presented at conference on indicators for social inclusion: making common EU objectives work, Antwerp.

Barnett, R., Moon, G. & Kearns, R. (2004), Social inequality and ethnic differences in smoking in New Zealand. Social Science et Medicine, 59, 129-143.

Barnett, S., Roderick, P., Martin, D. & Diamond, I. (2001). A multilevel analysis of the effects of rurality and social deprivation on premature limiting long term illness. J. Epidemiology Community Health, 55, 44-51.

Bartley, M. & Blane, D., (1994). Commentary: Appropriateness of deprivation indices must be ensured. British Medical Journal, 309, 1479.

Benach, J. & Yasui, Y. (1999). Geographical patterns of excess mortality in Spain explained by two indices of deprivation. J. Epidemiology Community Health, 53, 423-431.

Biggeri, A., Benvenuti, A., Merler, E., Nardulli, M. & Olmastroni, L., (1998). La mortalità per condizione socioeconomica e professionale nello studio longitudinale toscano. Comuni di Livorno e Firenze.  Informazioni Statistiche, Settore Studi e Ricerche, n° 5, Maggio.

Boarini, R. & Mira d’Ercole M. (2006). Measures of Material Deprivation in OECD Countries. OECD Social Employment and Migration Working Papers, 37. 1/8/2006.

Boyle, P, Gatrell, A. & Duke-Williams, O. (1999). The effect on morbidity of variability in deprivation and population stability in England and Wales: an investigation at small-area level. Social Science & Medicine, 49, 791-799.

Brenna, E. (2007). La ponderazione della quota capitaria in base a fattori di deprivazione. Suggerimenti per l’Italia dall’esperienza scozzese. Politiche Sanitarie, 8(2), 65:76.

Buckingham, K., & Freeman, P. (1997). Sociodemographic and morbidity indicators of need in relation to the use of community health service: observational study. British Medical Journal, 315, 994-996.

Cadum, E., Costa, F., Biggeri, A., & Martuzzi M. (1999). Deprivazione e mortalità: un indice di deprivazione per l’analisi delle disuguaglianze su base geografica. Epidemiologia E Prevenzione, 23, 175-187.

Caranci, N., Biggeri, A., Grisotto, L., Pacelli, B., Spadea, T., & Costa,  G. (2010). The Italian deprivation index at census block level: definition, description and association with general mortality. Epidemiologia e Prevenzione, 34(4), 167:176.

Carr Hill, R., Jamison, J., O’reilly, D., Stevenson, M., & Reid, J. (2002). Risk adjustment for hospital use using social security data: Cross sectional small area analysis. British Medical Journal, 324, 390.

Carstairs, V., & Morris, R. (1991). Deprivation and health in Scotland. Aberdeen: Aberdeen University Press.

Costa, G., Cislaghi, C., & Caranci N. (2009). Le disuguaglianze sociali di salute. Problemi di definizione e di misura. Salute e Società, Franco Angeli, 1, 6. a. VIII n°1.

Costa, G., Spadea, T., & Cardano, M. (2004). Diseguaglianze di salute in Italia. Epidemiologia e Prevenzione, 28, 3-15.

Crampton, P., Salmond, C., & Sutton, F. (1997). Research Report No 5: NZDep91 Index of Deprivation, Wellington, Health Services Research Centre.

Crayford, T., Shanks, J., Bajekal, M., & Langford, S. (1995). Analysis from inner London of deprivation payments based on enumeration districts rather than wards. British Medical Journal, 311, 787-788.

Davey Smith, G., Whitley, E., Dorling, D., & Gunnel, D. (2001). Area based measures of social and economic circumstances: cause specific mortality patterns depend on the choice of index. Journal of Epidemiology and Community Health, 55, 149-150.

Department of environment, transport and the regions (DETR), (2000).  Indices of Deprivation 2000. Regeneration Research Summary, 31, 3-42.

Forrest, R., & Gordon, D., (1993). People and places: a 1991 census atlas of England, University of Bristol: Saus Publications.

Fuchs, V.R. (2004). Reflections on the socio-economic correlates of health. Journal of Health Economics, 23, 653-661.

Vercelli M, Lillini R, Capocaccia R, Micheli A, Coebergh JW, Quinn M, Martinez-Garcia C, Quaglia A; ELDCARE Working Group.(2006). Cancer survival in the elderly: Effects of socio-economic factors and health care system features. European Journal of Cancer, 42, 234-242.

Gordon, D. (1995). Census Based Deprivation Indices: Their Weighting and Validation. Journal of Epidemiology and Community Health, 49 (Suppl 2), S39-S44.

Gordon, D., & Pantazis, C. (1997). Breadline Britain in the 1990s. Aldershot: Ashgate Publishing Limited.

Hales, S., Black, W., Skelly, C., Salmond, C., & Weinstein, P. (2003).  Social deprivation and the public health risks of community drinking water supplies in New Zealand. Journal Epidemiology Community Health,  57, 581-583.

Istituto nazionale di statistica - Rapporto BES 2015 (2015). Il benessere equo e sostenibile in Italia. Istituto nazionale di statistica, ISBN 978-88-458-1876-9.

Ivaldi, E. (2006). Indicatori di deprivazione come misura di svantaggio sociale, il caso dell’area metropolitana genovese. Impressioni Grafiche, Acqui Terme.

Ivaldi, E., Bonatti, G., & Soliani, R. (2016) The construction of a synthetic index comparing multidimensional well-being in the European Union. Social Indicators Research, 125(2), 397-430.

Ivaldi, E., Clement, A., & Soliani, R. (2015). Social and material deprivation in French and Italian macroregions: a proposal of new indicators from eu-silc data. International Review of Social Sciences, 3(9), 405-419.  

Ivaldi, E., & Testi, A.  (2011). Genoa Index of Deprivation (GDI): An Index of Material Deprivation for Geographical Areas, in Baird, C.M. (eds.), Social Indicators: Statistics, Trends and Policy Development, Chapter 4, 75-98. New York: Nova Science Publishers.

Ivaldi, E., & Testi, A. (2012). Socio-Economic Conditions and Health in Europe: a Comparison among the 27 EU Countries, in Rowsen, J. D., & Eliot, A.P. (eds), Social Inequalities, chapter 5, 127-150. New York: Nova Science Publishers.

Jarman, B. (1983). Identification of underprivileged areas. British Medical Journal, 286, 1705-09.

Jarman, B. (1984). Underprivileged areas: validation and distribution of scores. British Medical Journal, 289, 1587-92.

Judge, K., & Mays, N. (1994a). Equity in the NHS allocating resources for health and social care in England. British Medical Journal, 308, 1363-1366.

Judge, K., & Mays, N. (1994b). Equity in health care. British Medical Journal, 309, 673.

Kawachia, I., Kennedy, B.P., & Wilkinson, R.G. (1999). Crime: social disorganization and relative deprivation. Social Science & Medicine 48(6), 719–731.

Kelleher, C., Timoney, A., Friel, S., & Mckeown, D. (2002). Indicators of deprivation, voting patterns and health status at area level in the Republic of Ireland. Journal Epidemiology Community Health, 5, 36-44.

Lancaster, G., & Green, M. (2002). Deprivation, ill-health and the ecological fallacy. Journal Royal Statistic Society A, 165(part 2), 263-278.

Macintyre, S., Ellaway, A., & Cummins, E. (2002). Place effects on health: how we can conceptualise, operationalise and measure them?. Social Science And Medicine, 55, 125-139.

Mackenbach, J. P, Bos, V., Andersen, O., Cardano, M., Costa, G., Harding, S., Reid, A., Hemström, O., Valkonen, T., & Kunst, A. E (2003). Widening socioeconomic inequalities in mortality in six Western European countries. International Journal of Epidemiology, 32(5), 830–837.

Michelozzi, P., Perucci, C., Forastiere, F., Fusco, D., Ancona, A., & Dell’Orco, V. (1999). Differenze sociali nella mortalità a Roma negli anni 1990-1995. Epidemiologia e Prevenzione, 23, 230-238.

Payne, G., Payne, J., & Hyde, M. (1996). Refuse of all classes? Social indicators and social deprivation. Sociological Research Online, 1(1). 29/3/96.

Quaglia, A., Lillini, R., Casella, C., Giachero, G., Izzotti, A., Vercelli, M., & Liguria Region Tumour Registry (2011). The combined effect of age and socio-economic status on breast cancer survival. Critical Reviews in Oncology Hematology, 2011, 77(3), 210-220.

Quaglia, A., Vercelli, M., Lillini, R., Mugno, E., Coebergh, J.W., Quinn, M., Martinez-Garcia, C., Capocaccia, R., Micheli, A., & the ELDCARE Working Group (2005). Socio-economic factors and health care system characteristics related to cancer survival in the elderly. A population-based analysis in sixteen European countries. Critical Reviews in Oncology Hematology, 54 (2), 117-128.

Rapiti, E., Perucci, C., Agabiti, N., Ancona, C., Arcà, M., Di Lallo, D., Forastiere, F., Miceli, M., & Porta, D. (1999). Disuguaglianze socioeconomiche nell’efficacia dei trattamenti sanitari. Tre esempi nel Lazio. Epidemiologia E Prevenzione, 23, 153-160.

Reijneveld, S., Verheij, R., & De Bakker, D. (2000). The impact of area deprivation on differences in health: does the choice of geographical classification matter?. Journal of Epidemiology & Community Health, 54 (4), 306-313.

Salmond, C., & Crampton, P. (2002). Heterogeneity of deprivation within very small areas. Journal of Epidemiology & Community Health, 56, 669-670.

Sen, A. (1987). On ethics and economics. Oxford: Basil Blackwell. 

Sheldon, T., & Carr-Hill, R., (1992). Resource Allocation by Regression in the National Health Service: a Critique of the Resource Allocation Working Party’s Review. Journal of the Royal Statistical Society, 155 (part 3), 403-420.

Sloggett, A, & Joshi, H. (1994). Higher mortality in deprived areas: community or personal disadvantage?. British Medical Journal, 309, 1470-1474.

Smits, J., Westert, G., & Van Den Bos, G. (2002). Socioeconomic status of very small areas and stroke incidence in the Netherlands. Journal of Epidemiology and Community Health, 56, 637-640.

Spandonaro, F., Mennini, F.S., & Atella, V. (2004). Criteri per l’allocazione regionale delle risorse per la sanità. Politiche Sanitarie, 5(1), 27-32.

Sutton, M., Gravelle, H., Morris, S., Leyland, A., Windmeijer, F., Dibben, C., & Muirhead, M., (2002). Allocation of Resources to English Areas (AREA). Individual and small area determinants of morbidity and use of healthcare resources. Report to the Department of Health. London 2002.

Testi, A., & Ivaldi, E. (2009). Material vs social deprivation and health: a Case Study of in an Urban Area. The European Journal of Health Economics, 10(3), 323 – 328.

Torsheim, T., Currie, C., Boyce, W., Kalnins, I., Overpeck, M., & Haughland, S. (2004). Material deprivation and self-rated health: a multilevel study of adolescents from 22 European and North American countries. Social Science et Medicine, 59, 1-12.

Townsend, P. (1987). Deprivation. Journal of Social Policy, 16(2), 125-146.

Townsend, P., Phillimore, P., & Beattie, A. (1988). Health and Deprivation: Inequality and the North. London: Croom Helm.

Valerio, M., & Vitullo, F. (2000). Sperimentazione di un indice di svantaggio sociale in Basilicata.Epidemiologia e Prevenzione, 24, 219-223.