Abstract
Using Census-derived data for consistent spatial units, this paper explores how the population of Britain in 1991, 2001 and 2011 was spatially structured by self-reported health including exploring the trajectories of change. This paper uses consistent small area units to examine the changing spatial structure of census-derived Limiting, Long-Term Illness (LLTI) in Britain over the twenty year period and utilises the 2011 Office for National Statistics Output Area Classification (OAC) as a geodemographic indicator. The results allow the geography of change to be captured, highlighting how health is inextricably linked to geography, demonstrating quantitatively a complex, yet distinctive, spatial organisation of health inequalities within Britain. Overall decreasing unevenness values, coupled with increased positive spatial association suggests that neighbouring areas have become more similar over time – the distinction between areas characterised by poor health or by good health is decreasing.
Highlights
Social and spatial inequalities in health across Britain are well documented, with differences in health found between constituent countries (Young et al, 2010), regions (ONS, 2013; Whitehead, 2014), urban and rural communities (Allan et al, 2017), and deprived and more affluent areas (Benzeval et al, 2014; Livingston and Lee, 2014)
This paper explores the spatial structure of health inequalities in Britain over the twenty year period 1991–2011, examining the trajectories of change in LLTI of small areas with differing demographic and socioeconomic characteristics depicted using an area classification framework
Before the processes which contribute to spatial health inequalities can be explored comprehensively it was first important to gain a detailed understanding of how health inequalities have been spatially structured over time
Summary
Social and spatial inequalities in health across Britain are well documented, with differences in health found between constituent countries (Young et al, 2010), regions (ONS, 2013; Whitehead, 2014), urban and rural communities (Allan et al, 2017), and deprived and more affluent areas (Benzeval et al, 2014; Livingston and Lee, 2014). Chronic limiting illness and disability require intensive health and social care resources, and, coupled with increasing life expectancy, have become pertinent global health concerns (Manor et al, 2001; Moon et al, 2018). Many countries routinely record Limiting Long Term Ilnness [LLTI] information which provides considerable scope for analysis including international comparisons of morbidity prevalence and monitoring health trends over time (Manor et al, 2001). This paper explores the spatial structure of health inequalities in Britain over the twenty year period 1991–2011, examining the trajectories of change in LLTI of small areas with differing demographic and socioeconomic characteristics depicted using an area classification framework
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