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Area deprivation, individual factors and low birth weight in England: is there evidence of an “area effect”?
  1. Chris Dibben1,
  2. Maria Sigala2,
  3. Alison Macfarlane3
  1. 1School of Geography and Geosciences, University of St Andrews, St Andrews, UK
  2. 2Department of Social Policy and Social Work, University of Oxford, Oxford, UK
  3. 3Department of Midwifery, City University, London, UK
  1. Correspondence to:
 C Dibben
 School of Geography and Geosciences, University of St Andrews, Irving Building, North Street, St Andrews KY16 9AL, Fife, UK; cjld{at}


Objective: To explore the relationship between low and very low birth weights, mother’s age, individual socioeconomic status and area deprivation.

Design: Analysis of the incidence of low and very low birth weights by area deprivation, maternal age, social class of household and estimated income.

Setting: England 1996–2000.

Subjects: 2 894 440 singleton live births and the 10% sample of these births for which parents’ individual-level socioeconomic measures were coded.

Results: Social class, estimated household income, lone-parenthood and mother’s age were all associated with the risk of low and very low birth weight. Even when controlling for these individual level factors, area income deprivation was significantly associated with low and very low birth weight (p<0.00). For low birth weight there was a significant interaction between area income deprivation and mother’s age. For very young mothers, the area effect was non-significant (p<0.37). For older mothers, particularly those aged 30–34 years, it was stronger (p<0.00). As a result, mothers aged <18 years, although at relatively high risk of low birth weight irrespective of area income deprivation, were actually at slightly lower risk than mothers aged >40 years in the most deprived areas.

Conclusions: For all but very young mothers, there seems to be a negative effect on birth weight from living in areas of income deprivation, whatever their individual circumstances.

  • AID, area income deprivation
  • ONS, Office for National Statistics
  • SOA, super output areas

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  • Competing interests: None.

  • This study formed part of a larger project on inequalities in the outcome of pregnancy, funded by the Department of Health for England by a contract to Alison Macfarlane of City University. The other members of the project team were Nirupa Dattani, Joanne Maher and Aleks Collingwood Bakeo, Office for National Statistics, Chris Dibben, formerly of the University of Oxford, Sam Pattenden, London School of Hygiene and Tropical Medicine, Seeromanie Harding, University of Glasgow, and Helen Dolk, University of Ulster.

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