Curtis S E
Department of Geography, Queen Mary and Westfield College, London University.
J Epidemiol Community Health. 1990 Mar;44(1):62-8. doi: 10.1136/jech.44.1.62.
The aim of the study was to examine the relationship between sociogeographic factors and health, using a particular social indicator of neighbourhood deprivation.
The study analysed the relationship between health problems (reported by randomly selected respondents to a household survey) and an area social indicator for the neighbourhoods where the respondents lived (based on census data). The area social indicator tested was the underprivileged areas indicator developed by the St Mary's Hospital Department of General Practice, London. Generalised linear interactive modelling with a logistic model was used to test the strength of the relationship between social indicators and morbidity, and to calculate the probability of reporting illness or consultations for survey respondents living in different types of area.
The study population was derived from three London health districts and their corresponding census enumeration districts.
Responses were obtained from 738 households drawn from the local taxation evaluation list (66% of those sampled), and 1384 persons over 16 participated in the survey (94% of eligible adults in households surveyed). Of these, 1221 provided complete data on health problems. The survey population was considered representative of the general population in the areas studied since its characteristics were similar to those reported for the population as a whole in the 1981 census.
Within different age and sex groups, those living in very deprived areas, with high underprivileged area scores, were more likely to consult their doctor and to report various indicators of poor health than those living in privileged areas, with low underprivileged area scores.
The underprivileged areas index may provide a useful surrogate indicator to estimate morbidity and use of general practitioner services in small areas. It is likely to be most effective in areas where sociodemographic profiles of the local population are highly contrasting.
本研究旨在利用邻里贫困的一项特定社会指标，探讨社会地理因素与健康之间的关系。
本研究分析了健康问题（通过对家庭调查中随机抽取的受访者报告）与受访者居住社区的区域社会指标（基于人口普查数据）之间的关系。所测试的区域社会指标是伦敦圣玛丽医院全科医学部制定的贫困地区指标。使用逻辑模型的广义线性交互模型来检验社会指标与发病率之间关系的强度，并计算居住在不同类型区域的调查受访者报告疾病或就诊的概率。
研究人群来自伦敦的三个健康区及其相应的人口普查枚举区。
从地方税收评估清单中抽取的738户家庭获得了回复（占抽样家庭的66%），1384名16岁以上的人参与了调查（占接受调查家庭中符合条件成年人的94%）。其中，1221人提供了关于健康问题的完整数据。由于该调查人群的特征与1981年人口普查中报告的总体人群特征相似，因此被认为代表了所研究地区的一般人群。
在不同年龄和性别组中，与居住在贫困地区得分较低的特权地区的人相比，居住在贫困地区得分较高的非常贫困地区的人更有可能去看医生，并报告各种健康状况不佳的指标。
贫困地区指数可能为估计小区域的发病率和全科医生服务利用情况提供一个有用的替代指标。在当地人口的社会人口概况差异很大的地区，它可能最有效。
