International Journal of Epidemiology 2003;32:357-366
© International Epidemiological Association 2003
Special Theme: Socio-economic position |
Neighbourhood deprivation and health: does it affect us all equally?
International Centre for Health and Society, Department of Epidemiology and Public Health, University College London Medical School, London WC1E 6BT, UK.
Correspondence:
Ms Mai Stafford, Department of Epidemiology and Public Health, University College London Medical School, 1–19 Torrington Place, London WC1E 6BT, UK. E-mail:
mai{at}public-health.ucl.ac.uk
Background Neighbourhood socioeconomic status (SES) may affect rich and poor residents differentially. Two models are proposed. Model 1: living in a non-deprived neighbourhood is better for health because better collective material and social resources are available. Model 2: being poor (rich) relative to the neighbourhood average is associated with worse (better) health because of the discrepancy between an individual’s situation and those around them.
Methods Individual data from the Whitehall II study covering health, SES, and perceived status were linked to census data on neighbourhood deprivation.
Results Both individual and neighbourhood deprivation increased the risk of poor general and mental health. There was a suggestion that the effect of living in a deprived area was more marked for poorer individuals, although interactions were not statistically significant. Poor people in poor neighbourhoods reported more financial and neighbourhood problems and rated themselves lowest on the ladder of society.
Conclusions We found no evidence that personal poverty combined with affluent neighbourhood had negative health consequences. Rather, living in a deprived neighbourhood may have the most negative health effects on poorer individuals, possibly because they are more dependent on collective resources in the neighbourhood.
Keywords Context, neighbourhood, area deprivation, relative deprivation, multilevel
Accepted 21 November 2002
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