IJE Advance Access originally published online on December 20, 2006
International Journal of Epidemiology 2007 36(2):348-355; doi:10.1093/ije/dyl267
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Are socially disadvantaged neighbourhoods deprived of health-related community resources?
1GeoHealth Laboratory, Department of Geography, University of Canterbury, New Zealand.
2Centre for Social and Health Outcomes Research and Evaluation, Massey University, New Zealand.
3Wellington School of Medicine and Health Sciences, University of Otago, New Zealand.
* Corresponding author. GeoHealth Laboratory, Department of Geography, University of Canterbury, Private Bag 4800, Christchurch 8020, New Zealand. E-mail: jamie.pearce{at}canterbury.ac.nz
| Abstract |
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Background Recent work in a number of countries has identified growing geographical inequalities in health between deprived and non-deprived neighbourhoods. The health gaps observed cannot be entirely explained by differences in the characteristics of individuals living in those neighbourhoods, which has led to a concerted international public health research effort to determine what contextual features of neighbourhoods matter. This article reports on access to potentially health-promoting community resources across all neighbourhoods in New Zealand. Prevailing international opinion is that access to community resources is worse in deprived neighbourhoods.
Methods Geographical Information Systems were used to calculate geographical access to 16 types of community resources (including recreational amenities, and shopping, educational and health facilities) in 38 350 small census areas across the country. The distribution of these access measures by neighbourhood socioeconomic deprivation was determined.
Results For 15 out of 16 measures of community resources, access was clearly better in more deprived neighbourhoods. For example, the travel time to large supermarkets was
80% greater in the least deprived quintile of neighbourhoods compared with the most deprived quintile.
Conclusions These results challenge the widely held, but largely untested, view that areas of high social disadvantage have poorer access to community resources. Poor locational access to community resources among deprived neighbourhoods in New Zealand does not appear to be an explanation of poorer health in these neighbourhoods. If anything, a pro-equity distribution of community resources may be preventing even wider disparities in neighbourhood inequalities in health.
Keywords Health inequality, neighbourhoods, context, community resources, New Zealand
Accepted 30 October 2006
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