A County-Level Deprivation Index for China in 2020 and Its Association With Life Expectancy and Infant Mortality

OBJECTIVES: Following a decade of economic growth averaging 7% a year, China’s existing county-level deprivation index based on the 2010 census is out-of-date. This study aimed to develop an up-to-date version of this index and to investigate associations with life expectancy and infant mortality.

METHODS: Based on the China 2020 census, 15 indicators for 2844 counties were selected across six domains including income, employment, house facility, education, ethnic minority, and urban-rural difference. The index was created using principal component analysis with oblique rotation, and associations between deprivation quintile groups and life expectancy and infant mortality were examined, with extensive sensitivity analyses around alternative indicators and weighting methods.

RESULTS: The new deprivation index had four components – socioeconomic, house facility, occupation, and minority deprivation – and explained 78% of the variation in the 15 indicators. As expected, counties in the eastern region tended to be the least deprived, while counties in the southwestern region tended to be the most deprived. Average life expectancy was 3.95 years longer (4.24 years longer for men and 3.47 for women) for counties in the least deprived quintile than those in the most deprived quintile. Average infant mortality in the most deprived quintile group was 2.954‰ compared to 1.255‰ in the least deprived. The basic pattern of findings was robust to different weighting methods and indicators.

CONCLUSIONS: The 2020 county-level deprivation index for China has face validity and reveals a clear social gradient in life expectancy and infant mortality across deprivation quintile groups.