Rich land, poor land

A chara, – I agree that a more detailed understanding of spatial distributions of affluence and deprivation, including indicators…

A chara, – I agree that a more detailed understanding of spatial distributions of affluence and deprivation, including indicators related to personal and community health, are an essential tool to inform progressive public policy (Carl O’Brien, News Features, January 5th).

In this regard, while working at the department of community health at Trinity College Dublin in 2002, I helped to produce a similar index as part of a research initiative funded by the Combat Poverty Agency. This approach, as well as utilising census data, included additional information from local authorities.

One of the key findings of this work was the extent to which the inclusion of such additional datasets related to deprivation, as well as being more up-to-date, can significantly change the results of the analysis. I would therefore suggest that the results presented in O’Brien’s article be interpreted with caution.

Perhaps more importantly, the risk of stigmatisation of specific regions, towns, and villages identified as “deprived” as a result of such analyses continues to be a distinct source of concern, and raises a number of ethical questions around the advisability of the promotion and circulation of these results in the media.

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Finally, may I suggest that, as with so many other indicator-based assessments, the risk of falling into the “McNamara Fallacy” (if you can’t measure it, it doesn’t exist) remains a threat and helps to explain why so many areas highlighted as “deprived” are in fact very attractive places for other, unmeasurable reasons. – Yours, etc,

SEBASTIAN KEVANY,

University of California,

San Francisco Institute for Health Policy Studies,

California Street,

San Francisco,

California, US.