Abstract
BackgroundIt has commonly been suggested (including by this author) that individual or household deprivation (for example, low income) is amplified by area level deprivation (for example, lack of affordable nutritious food or facilities for physical activity in the neighbourhood).DiscussionThe idea of deprivation amplification has some intuitive attractiveness and helps divert attention away from purely individual determinants of diet and physical activity, and towards health promoting or health damaging features of the physical and social environment. Such environmental features may be modifiable, and environmental changes may help promote healthier behaviors. However, recent empirical examination of the distribution of facilities and resources shows that location does not always disadvantage poorer neighbourhoods. This suggests that we need: a) to ensure that theories and policies are based on up-to-date empirical evidence on the socio-economic distribution of neighbourhood resources, and b) to engage in further research on the relative importance of, and interactions between, individual and environmental factors in shaping behavior.SummaryIn this debate paper I suggest that it may not always be true that poorer neighbourhoods are more likely to lack health promoting resources, and to be exposed to more health damaging resources. The spatial distribution of environmental resources by area socioeconomic status may vary between types of resource, countries, and time periods. It may also be that the presence or absence of resources is less important than their quality, their social meaning, or local perceptions of their accessibility and relevance.
Highlights
It has commonly been suggested that individual or household deprivation is amplified by area level deprivation
We have previously described this as 'deprivation amplification', a process, applying across the whole range of environmental influences on health, by which disadvantages arising from poorer quality environments amplify individual disadvantages in ways which are detrimental to health [16,17]
In Glasgow we found that large multiple supermarkets were more likely to be located in deprived neighbourhoods, and that when there were differences in the pricing of foodstuffs, these tended to be slightly cheaper in poorer areas [38,39]
Summary
Theoretical and policy utility of the concept of deprivation amplification The concept of deprivation amplification is important both for theorising about the influences of personal and environmental attributes (and interactions between them), and for policy. This, combined with our earlier findings about food retail outlets, suggests that in Glasgow, poorer areas are not necessarily deficient in access to affordable food meeting current nutritional guidelines (for example, fresh fruit and vegetables which are usually cheaper and of better quality in supermarkets), nor are they exposed to fast food outlets selling high-fat, high salt, energy dense food at low prices. It is possible that people are influenced in their behaviors by the availability of resources in locations other than their immediate residential environment (for example, shopping in supermarkets, or using a park, near to their place of work or child's school) Another issue is whether the location of facilities such as supermarkets in poorer areas is designed to meet, or meets, demand in the immediate area; such facilities may be patronised by customers from richer areas, and not be seen by locals as being appropriate to them. There http://www.ijbnpa.org/content/4/1/32 is the important issue of whether it is the actual, objectively measured, presence or absence of facilities that is most likely to influence behavior, or the perceived or symbolic presence or absence of facilities
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