Household Deprivation Research Articles

Time and place: putting individual health into context. A multilevel analysis of the British household panel survey, 1991–2001

Examination of the extent to which time and place affect people's health has been constrained by the resources available to answer this question. A British longitudinal, nationally representative survey of 8301 adults aged 16 years and older living in private households was used to consider the influence of household membership, area of residence and time using multilevel logistic regression. Self-rated health was assessed by general health and limiting illness during periods characterized by economic decline (1992), economic improvement (1996) and prosperity (2000). There was modest evidence of clustering of poor general health within areas and stronger support for within household similarities in general health which increased over time. Individual, household and area level deprivation accounted for almost all the area-level variability but had little effect on household variance. There was greater evidence of clustering of limiting illness within areas: deprivation did not account for this to any great extent. Area differences in general health reduced as the economy improved but time trends in differences in limiting illness lagged behind the timing of economic recovery. Both time and place are shown to affect self-rated health although the processes may differ depending on the health outcome.

Individual, household and neighborhood socioeconomic status and mortality: a study of absolute and relative deprivation

Our objectives were twofold (1) to examine the effects of neighborhood socioeconomic status (SES) on mortality by gender and age and (2) to assess the impact of individual's household SES relative to one's neighborhood on mortality. Data were taken from the Israel Longitudinal Mortality Study, which linked a 20% sample of the 1983 census to mortality records through 1992. Multilevel modeling was performed on 131,156 men and women aged 45–89 years living in approximately 880 neighborhoods. Overall, 27,334 deaths were reported during the 9.5 year study period. Independent of individual characteristics, mortality risks increased 1–2% (p<0.05) per unit increase in area deprivation. Results did not vary by age or gender. Household deprivation relative to that of one's neighborhood and adjusted for absolute SES affected mortality in men only. Specifically, men living in relative disadvantage to their neighbors had lower risks of mortality than those living in concordance with their area (OR 0.86, 95% CI 0.80–0.92).

The West London Schools Study: the effects of chronic aircraft noise exposure on child health.

Previous field studies have indicated that children's cognitive performance is impaired by chronic aircraft noise exposure. However, these studies have not been of sufficient size to account adequately for the role of confounding factors. The objective of this study was to test whether cognitive impairments and stress responses (catecholamines, cortisol and perceived stress) are attributable to aircraft noise exposure after adjustment for school and individual level confounding factors and to examine whether children exposed to high levels of social disadvantage are at greater risk of noise effects. The cognitive performance and health of 451 children aged 8-11 years, attending 10 schools in high aircraft noise areas (16 h outdoor Leq > 63 dBA) was compared with children attending 10 matched control schools exposed to lower levels of aircraft noise (16 h outdoor Leq < 57 dBA). Noise exposure was associated with impaired reading on difficult items and raised annoyance, after adjustment for age, main language spoken and household deprivation. There was no variation in the size of the noise effects in vulnerable subgroups of children. High levels of noise exposure were not associated with impairments in mean reading score, memory and attention or stress responses. Aircraft noise was weakly associated with hyperactivity and psychological morbidity. Chronic noise exposure is associated with raised noise annoyance in children. The cognitive results indicate that chronic aircraft noise exposure does not always lead to generalized cognitive effects but, rather, more selective cognitive impairments on difficult cognitive tests in children.

Ward-Level Deprivation and Individual Social and Economic Outcomes in the British Household Panel Study

This paper is an investigation of the association between the level of social deprivation in electoral wards and various aspects of individuals' lives using data from the British Household Panel Study 1991 to 1998 and the 1991 Census. The main finding is to establish that ecological associations of various indicators of individual adversity with a census-based indicator of area deprivation are largely, if not entirely, accounted for by individual and household characteristics. For some outcomes there is evidence that social and economic inequalities between more and less disadvantaged individuals are especially marked in more affluent areas, rather than in more deprived areas. This emerges in the form of significant interactions between residence in social housing and ward deprivation in models allowing such interdependence. At the same time, there is evidence of variation in the experience of adverse life events between wards not accounted for by individual and household factors and area deprivation. It is concluded that, although individual characteristics are very important for the differences in social and economic outcomes observed between people, their geographical setting also has some significance. The results have implications for policies aiming to reduce social and economic inequalities

Small area variations in health related behaviours; do these depend on the behaviour itself, its measurement, or on personal characteristics?

In this paper we examine the patterning, by small areas, of four health related behaviours (smoking, alcohol consumption, diet, and exercise) in the West of Scotland, after controlling for a range of individual/household characteristics, using multilevel models. Smoking and drinking were measured both as binary and as continuous variables, and diet and exercise were each measured in two ways: ‘good’ (health promoting) and ‘bad’ (health damaging). ‘Area effects’ (unattributed variation by post code sector) were found for ‘bad’ diet only. ‘Good’ and ‘bad’ diet, ‘bad’ exercise patterns and current smoking were associated with postcode sector deprivation. For ‘bad’ diet this effect was found only for individuals in more affluent households, and for ‘good’ exercise and current smoking the association with area deprivation differed between adolescents and adults. We conclude that the influence of area on health related behaviours varies according to the behaviour and the way it is measured, and that the influence of area deprivation and/or of area can vary by age and household deprivation.

Educational attainment, deprivation-affluence and self reported health in Britain: a cross sectional study.

STUDY OBJECTIVE: The level of material deprivation or affluence is strongly and independently correlated with all cause mortality at an area level, but educational attainment, after controlling for deprivation-affluence, remains...