The physical environment is likely to have an important influence on health differences between neighbourhoods (in addition to the influences we know more about: e.g., population characteristics and neighbourhood wealth). We are interested in exploring whether levels of ‘environmental deprivation’ help to explain health differences.
‘Deprivation’ refers to unmet need due to a lack of resources, so when referring to ‘environmental deprivation’ we mean the absence of physical environmental conditions that can contribute to good health and well being (e.g., clean air and water, and safe neighbourhood streets and parks). Measuring levels of environmental deprivation between different neighbourhoods was our first challenge, because we know that each of the important environmental factors varies independently of the others. So far we have successfully developed measures of environmental deprivation for a range of different contexts: the UK, New Zealand and South Lanarkshire (a local authority in Scotland).
Our second challenge has been to explore whether environmental deprivation has an independent relationship with health outcomes and health inequalities. Environmental inequality (i.e., poor neighbourhoods being more likely to suffer environmental deprivation than affluent areas) complicates this work, because we need to ensure that any health relationships we find are not simply due to neighbourhood differences in wealth. We find that environmental deprivation is significantly related to self-reported poor health, and certain causes of hospital admissions and death, even after affluence is accounted for. Nonetheless, we also find that the poor health of the least affluent is more strongly a function of their social and economic situation than of their physical environment.
To date this work has been supported by the Joint Environment & Human Health Programme (NERC, EA, Defra, MOD, MRC, The Wellcome Trust, ESRC, BBSRC, EPSRC and HPA) and by South Lanarkshire Council.