Background Halton, in the North West of England provides a useful natural experiment to investigate the links between levels of industrial pollution and levels of deprivation. This is largely because of the creation of a new town in Runcorn in the 1960s, which is situated further away from polluting industry than other, more affluent areas of the town. This profile may provide a clearer picture of how pollution and fear of pollution may impact upon well-being and health outcomes.

Methods Pollution in different localities within Halton was assessed using modelling methods, and deprivation determined using results from routine small area measures. A questionnaire survey was used to assess residents’ perceptions of health, lifestyles and social capital, as well as biographical details such as length of residence in Halton and health status. The questionnaires measured characteristics, opinions and attitudes that would provide information that was explored in greater detail during face-to-face interviews. These took a life history approach to examine perceptions and experiences of health over time, and how lifestyle choices and perceptions of the local community were constructed.

Results The findings from this study indicate that socioeconomic advantage may confer a perceived immunity to the negative effects of pollution on health, and that this is re-enforced by the actual experience of relatively good health. Conversely, fears about pollution may be present in an area with a low modelled pollution load that experiences higher levels of socioeconomic deprivation, and this is similarly re-enforced by observations and experiences of poor health in the locale.

A strong sense of community was evident in these areas, but this appeared to have little bearing on either fears about pollution or the health status of the local population. Although poor health was attributed in part to local environmental pollution by lay knowledge, official knowledge appeared to place a greater emphasis on health choices rather than environmental factors as a prime cause of ill health.

Conclusion It is suggested that the possible effects of pollution are assessed primarily through socioeconomic positioning, and also that it is this positioning rather than environmental factors which, on the whole, may determine health status at a community, if not individual, level. Perceptions of pollution also appear to be an expression of position in society, and this could be argued to be equally true about the discounting of fears about pollution by official knowledge.