Research note: Health and material deprivation in Plymouth: an interim replication.

Abstract

The research in Britain in the 1970s which led up to the publication of the Black Report (1980) broke new ground in applying essentially epidemiological methods to the study of social as well as health ineqxialities. It had a significant impact on both politicians and the medical and medical-sociology disciplines, demonstrating as it did the apparent failure of post-war social welfare and economic policy to make any significant impact on the divide between the more affluent and the more impoverished in our society. A number of studies followed which applied similar methods to more limited areas studied in greater detail. A relationship between health status and class, poverty or material deprivation has been demonstrated, for example, for parts of Scotland (Carstairs and Morris 1991), Sheffield (Thunhurst 1986), Bristol (Townsend et al 1985), London (Townsend et al 1986a) and the Northem Regional Health Area (Townsend et al 1986b). In 1988 we published a 'mini Black Report' which examined the relationship between material deprivation and health status in the Plymouth Health District (Abbott, 1988 summarised in Abbott et al, 1992). The analysis was based on data from the 1981 Census plus mortality statistics for the years 1982-1986 from the Office of Population Censuses and Surveys (OPCS). The decennial Census, the most reliable count of population, provided figures on size, gender and age of population, the number of people who declared themselves to be permanently sick or disabled, and characteristics of households which might be taken as indicators of material deprivation/poverty in the absence of direct measures of income or wealth. Figures are available for quite small geographical areas local govemment wards (of which there are twenty in the City of Plymouth alone) or even enumeration districts (the smaller areas covered by a single data-gatherer when Census data are collected). We chose to work at the level of wards. These are not necessarily homogeneous in social terms there may be pockets of gentrification in deprived areas or islands of poverty in middle-class areas but they are small enough to be describable in terms of averages without grossly distorting the range of