The Vancouver Area Neighbourhood Deprivation Index (VANDIX): a census-based tool for assessing small-area variations in health status.

OBJECTIVE: The Vancouver Area Neighbourhood Deprivation Index (VANDIX) is a census-based measure of socio-economic status (SES). It was designed to serve as an accessible and representative proxy marker of population health status without requiring more extensive health data. This paper describes the structure and previous applications of the VANDIX for measuring relative variations in health outcomes in British Columbia, Canada. METHODS: The VANDIX was constructed from a 2005 survey of provincial medical health officers asking them to comment on the best census markers of health status in British Columbia. The VANDIX is based on the weighted summation of seven socio-economic variables from the census, including in order of weighted importance: proportion without high school completion; proportion without university completion; unemployment rate; proportion of lone-parent families; average income; proportion of home owners; and employment ratio. RESULTS: The VANDIX has been applied in numerous research and policy settings across the province against several distributions of health status, including self-rated health, injury and access to health care services. In each assessment, the VANDIX has shown that socio-economic inequities parallel health inequities. CONCLUSION: SES is one of the most influential factors that shape population patterns of health outcomes. Census-based indicators of SES such as the VANDIX can serve as easily accessible and representative markers of population health status, and have application for policy, research and public health promotion.