Abstract
It is increasingly understood that the physical environment remains an important determinant of area-level health and spatial and socioeconomic health inequalities. Existing research has largely focused on the health effects of differential access to green space, the proximity of waste facilities, or air pollution. The role of brownfield—or previously developed—land has been largely overlooked. This is the case even in studies that utilise multiple measures of environmental deprivation. This paper presents the results of the first national-scale empirical examination of the association between brownfield land and morbidity and mortality, using data from England. Census Area Statistical ward-level data on the relative proportion of brownfield land (calculated from the 2009 National Land Use Database), standardised morbidity (2001 Census measures of ‘not good’ general health and limiting long-term illness), and premature (aged under 75 years) all-cause mortality ratios from 1998/99 to 2002/03 were examined using linear mixed modelling (adjusting for potential environmental, socioeconomic, and demographic confounders). A significant and strong, adjusted, area-level association was found between brownfield land and morbidity: People living in wards with a high proportion of brownfield land are significantly more likely to suffer from poorer health than those living in wards with a small proportion of brownfield land. This suggests that brownfield land could potentially be an important and previously overlooked independent environmental determinant of population health in England. The remediation and redevelopment of brownfield land should therefore be considered as a public health policy issue.
Highlights
It is well established that the physical environment is an important—and socially produced— determinant of public health and health inequalities (World Health Organisation, 2008)
The remediation and redevelopment of brownfield land should be considered as a public health policy issue
The geographical distribution of brownfield land is presented in figure 1(a) alongside the standardised morbidity ratios (SMRs) for ‘not good health’, limiting long-term illness, and mortality in figures 1(b)–1(d)
Summary
It is well established that the physical environment is an important—and socially produced— determinant of public health and health inequalities (World Health Organisation, 2008). With the exception of work conducted at the city level in the USA by Litt et al (2002), such research has not examined the role of derelict, contaminated, vacant, or previously developed land (collectively referred to as ‘brownfield land’ in this paper). The term ‘brownfield land’ is often applied to such previously used sites and is defined as sites that ““have been affected by former uses of the site or surrounding land; are derelict or underused, are mainly in fully or partly developed urban areas; require intervention to bring them back to beneficial use; and may have real or perceived contamination problems” (Concerted Action on Brownfield and Economic Regeneration Network, 2012)
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