Defying deprivation: A cross-sectional analysis of area level health resilience in England

Abstract

Previous research has found evidence that some economically deprived areas in England exhibit ‘health resilience’ in terms of lower than expected mortality rates. Consistent with earlier research we analysed area ‘resilience’ for parliamentary constituencies and our work extends previous research by including measures of morbidity. Standardised Morbidity Ratios (SMRs) of self-reported general health, limiting long-term illness, emergency hospital admissions, and CHD hospital admissions were derived from the 2001 UK Census and 2001 Hospital Episodes Statistics, and combined into a Composite Morbidity Index (CMI). Area variation in the CMI was compared with previous findings about mortality rates. Multiple Correspondence Analysis (MCA) was used to test the associations between area level ‘health resilience’ and ethnic composition, residential mobility, employment type, housing tenure, and an indicator of social cohesion. Nine areas were ‘resilient’ in terms of morbidity. Only four areas of England exhibited ‘health resilience’ in terms of both mortality and morbidity. MCA revealed that there may be several factors associated with greater ‘health resilience’.