Faculty of Biology Medicine and Health, University of Manchester, Greater Manchester, UK.
NIHR School for Primary Care Research, University of Manchester, Greater Manchester, UK.
J Epidemiol Community Health. 2018 Jul;72(7):636-644. doi: 10.1136/jech-2017-209895. Epub 2018 Mar 19.
At a low geographical level, little is known about the associations between population characteristics and deprivation, and their trends, which would be directly affected by the house market, labour pressures and government policies. We describe temporal trends in health and overall deprivation in England by age, sex, urbanity and ethnicity.
Repeated cross-sectional whole population study for England, 2004-2015, at a low geographical level (average 1500 residents). We calculated weighted medians of the Index of Multiple Deprivation (IMD) for each subgroup of interest.
Over time, we observed increases in relative deprivation for people aged under 30, and aged 30-59, while median deprivation decreased for those aged 60 or over. Subgroup analyses indicated that relative overall deprivation was consistently higher for young adults (aged 20-29) and infants (aged 0-4), with increases in deprivation for the latter. Levels of overall deprivation in 2004 greatly varied by ethnicity, with the lowest levels observed for White British and the highest for Blacks. Over time, small reductions were observed in the deprivation gap between White British and all other ethnic groups. Findings were consistent across overall IMD and its health and disability subdomain, but large regional variability was also observed.
Government policies, the financial crisis of 2008, education funding and the increasing cost of houses relative to real wages are important parameters in interpreting our findings. Socioeconomic deprivation is an important determinant of health and the inequalities this work highlights may have significant implications for future fiscal and healthcare policy.
在较低的地理水平上,人们对人口特征与贫困之间的关联及其趋势知之甚少,而这些关联和趋势将直接受到房屋市场、劳动力压力和政府政策的影响。我们描述了英格兰按年龄、性别、城市性和种族划分的健康和总体贫困状况的时间趋势。
这是一项在英格兰进行的低地理水平(平均 1500 名居民)的重复横断面全人群研究。我们计算了每个感兴趣的亚组的多重剥夺指数(IMD)的加权中位数。
随着时间的推移,我们观察到 30 岁以下和 30-59 岁人群的相对贫困程度增加,而 60 岁或以上人群的贫困程度中位数下降。亚组分析表明,年轻成年人(20-29 岁)和婴儿(0-4 岁)的总体相对贫困程度一直较高,后者的贫困程度有所增加。2004 年,各种族的总体贫困水平差异很大,白种英国人的贫困水平最低,黑人的最高。随着时间的推移,白种英国人与所有其他种族群体之间的贫困差距略有缩小。这些发现与总体 IMD 及其健康和残疾子域一致,但也观察到了很大的区域差异。
政府政策、2008 年金融危机、教育资金以及房屋价格相对于实际工资的上涨,是解释我们研究结果的重要因素。社会经济贫困是健康的一个重要决定因素,这项工作所强调的不平等现象可能对未来的财政和医疗保健政策产生重大影响。