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  • Geographical epidemiology of health and overall deprivation in England, its changes and persistence from 2004 to 2015: a longitudinal spatial population study

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Research report
Geographical epidemiology of health and overall deprivation in England, its changes and persistence from 2004 to 2015: a longitudinal spatial population study
  1. Evangelos Kontopantelis1,2,
  2. Mamas A Mamas3,
  3. Harm van Marwijk1,2,
  4. Andrew M Ryan4,
  5. Iain E Buchan1,5,
  6. Darren M Ashcroft6,
  7. Tim Doran7
  1. 1 Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
  2. 2 NIHR School for Primary Care Research, University of Manchester, Manchester, UK
  3. 3 Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Keele, UK
  4. 4 School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
  5. 5 Microsoft Research, American College of Medical Informatics, Cambridge, UK
  6. 6 Division of Pharmacy and Optometry, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
  7. 7 Department of Health Sciences, University of York, Yorkshire, UK
  1. Correspondence to Dr Evangelos Kontopantelis, Faculty of Biology Medicine and Health, University of Manchester, Manchester, M13 9PL, UK; e.kontopantelis{at}manchester.ac.uk

Abstract

Background Socioeconomic deprivation is a key determinant for health. In England, the Index of Multiple Deprivation (IMD) is a widely used composite measure of deprivation. However, little is known about its spatial clustering or persistence across time.

Methods Data for overall IMD and its health domain were analysed for 2004–2015 at a low geographical area (average of 1500 people). Levels and temporal changes were spatially visualised for the whole of England and its 10 administrative regions. Spatial clustering was quantified using Moran’s I, correlations over time were quantified using Pearson’s r.

Results Between 2004 and 2015 we observed a strong persistence for both overall (r=0.94) and health-related deprivation (r=0.92). At the regional level, small changes were observed over time, but with areas slowly regressing towards the mean. However, for the North East, North West and Yorkshire, where health-related deprivation was the highest, the decreasing trend in health-related deprivation reversed and we noticed increases in 2015. Results did not support our hypothesis of increasing spatial clustering over time. However, marked regional variability was observed in both aggregate deprivation outcomes. The lowest autocorrelation was seen in the North East and changed very little over time, while the South East had the highest autocorrelation at all time points.

Conclusions Overall and health-related deprivation patterns persisted in England, with large and unchanging health inequalities between the North and the South. The spatial aspect of deprivation can inform the targeting of health and social care interventions, particularly in areas with high levels of deprivation clustering.

  • deprivation
  • clusters
  • spatial analysis
  • epidemiology
  • health inequalities

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/jech-2017-209999

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    Footnotes

    • Contributors EK designed the study, extracted the data from all sources, performed the analyses and drafted the manuscript. MAM, HvM, AMR, DMA, IEB and TD critically edited the manuscript. EK is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

    • Funding MRC Health eResearch Centre Grant (MR/K006665/1) supported the time and facilities of EK and IEB.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The data used in this study are freely available and the authors are willing to share in an organised and cleaned final data set.