Geographical inequalities in health in a time of austerity: Baseline findings from the Stockton-on-Tees cohort study

Abstract

Stockton-on-Tees has the highest geographical inequalities in health in England with the life expectancy at birth gap between the most and deprived neighbourhoods standing at over 17 years for men and 11 years for women. In this study, we provide the first detailed empirical examination of this geographical health divide by: estimating the gap in physical and general health (as measured by EQ. 5D, EQ. 5D-VAS and SF8PCS) between the most and least deprived areas; using a novel statistical technique to examining the causal role of compositional and contextual factors and their interaction; and doing so in a time of economic recession and austerity. Using a stratified random sampling technique, individual-level survey data was combined with secondary data sources and analysed using multi-level models with 95% confidence intervals obtained from nonparametric bootstrapping. The main findings indicate that there is a significant gap in health between the two areas, and that compositional level material factors, contextual factors and their interaction appear to be the major explanations of this gap. Contrary to the dominant policy discourse in this area, individual behavioural and psychosocial factors did not make a significant contribution towards explaining health inequalities in the study area. The findings are discussed in relation to geographical theories of health inequalities and the context of austerity.

Inequalities in mental health and well-being in a time of austerity: Follow-up findings from the Stockton-on-Tees cohort study

“…The survey participants are older than the general population and there is a higher representation of women ( Bhandari, Kasim, Warren, Akhter, & Bambra, 2017 ; Mattheys et al, 2016 ). There is also considerable attrition over the four waves.…”

“…The baseline sample size was moderate (although within power calculations) and the response rate was low with only c36% of contacted households (and only c10% of all of our 8000 sampling frame) participating in the survey. The survey also experienced high attrition with only 37% in the final wave ( Bhandari et al, 2017 ). This may undermine the representativeness of the cohort sample and indeed, older people and women were over represented compared to the general population.…”

Prevalence of Childhood Overweight and Obesity in Liverpool between 2006 and 2012: Evidence of Widening Socioeconomic Inequalities

“…At the individual level, children from deprived neighbourhoods often live in low-income family households that may struggle to afford providing children a balanced diet [11] and active lifestyle [12]. These individual and area level factors act individually and collectively [13] and place children living in deprived neighbourhoods at greater risk of developing obesity compared with their more affluent peers [14,15].…”

A death in the family: Citizens' experiences of changing healthcare commissioning practices in South East England

“…The metaphor of death so frequently recalled in the data reflects a tangible, observable degradation of citizens' own health and the health of their families. Austerity measures in place in the United Kingdom have been shown to significantly erode citizens' mental health, life expectancy and growing inequalities (Barr, Kinderman, & Whitehead, 2015; Bhandari, Kasim, Warren, Akhter, & Bambra, 2017; Buck & Maguire, 2015; Maynard, 2017). Citizens' perceived relationships to their localities, including their capacity to exercise collective action locally, can have important implications for well‐being (Carbone, 2019).…”