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地方政府在文化、环境和规划服务方面支出的不平等:英格兰、苏格兰和威尔士的时间趋势分析。

Inequalities in local government spending on cultural, environmental and planning services: a time-trend analysis in England, Scotland, and Wales.

机构信息

Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, L69 3GB, UK.

Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.

出版信息

BMC Public Health. 2023 Feb 28;23(1):408. doi: 10.1186/s12889-023-15179-9.

Abstract

BACKGROUND

Local government provides Cultural, Environmental, and Planning (CEP) services, such as parks, libraries, and waste collection, that are vital for promoting health and wellbeing. There have been significant changes to the funding of these services over the past decade, most notably due to the UK government's austerity programme. These changes have not affected all places equally. To understand potential impacts on health inequalities, we investigated geographical patterning of recent CEP spending trends.

METHODS

We conducted a time trend analysis using routinely available data on local government expenditure. We used generalised estimating equations to determine how expenditure trends varied across 378 local authorities (LAs) in Great Britain between 2009/10 and 2018/19 on the basis of country, deprivation, rurality, and local government structure. We investigated the gross expenditure per capita on CEP services, and the CEP expenditure as a proportion of total local authority budgets. We present the estimated annual percentage change in these spend measures.

RESULTS

Expenditure per capita for CEP services reduced by 36% between 2009/10 and 2018/19. In England, the reduction in per capita spending was steepest in the most deprived quintile of areas, falling by 7.5% [95% CI: 6.0, 8.9] per year, compared to 4.5% [95% CI: 3.3, 5.6] per year in the least deprived quintile. Budget cuts in Scotland and Wales have been more equitable, with similar trends in the most and least deprived areas. Welsh LAs have reduced the proportion of total LA budget spent on CEP services the most (-4.0% per year, 95% CI: -5.0 to -2.9), followed by Scotland (-3.0% per year, 95% CI: -4.2 to -1.7) then England (-1.4% per year, 95% CI: -2.2 to -0.6). In England, rural and unitary LAs reduced their share of spending allocated to CEP more than urban and two-tier structured LAs, respectively.

CONCLUSION

Funding for cultural, environmental and planning services provided by local government in the UK has been cut dramatically over the last decade, with clear geographical inequalities. Local areas worst affected have been those with a higher baseline level of deprivation, those with a single-tier local government structure, and English rural local authorities. The inequalities in cuts to these services risk widening geographical inequalities in health and wellbeing.

摘要

背景

地方政府提供文化、环境和规划(CEP)服务,例如公园、图书馆和废物收集,这些服务对于促进健康和幸福感至关重要。在过去十年中,这些服务的资金发生了重大变化,最显著的是由于英国政府的紧缩计划。这些变化并非对所有地方都产生了同样的影响。为了了解对健康不平等的潜在影响,我们调查了最近 CEP 支出趋势的地理模式。

方法

我们使用常规可用的地方政府支出数据进行了时间趋势分析。我们使用广义估计方程来确定 2009/10 年至 2018/19 年期间,英国 378 个地方当局(LA)之间 CEP 支出趋势的差异,这些差异基于国家、贫困程度、农村地区和地方政府结构。我们调查了人均 CEP 服务支出以及 CEP 支出占地方政府总预算的比例。我们展示了这些支出措施的估计年百分比变化。

结果

2009/10 年至 2018/19 年期间,人均 CEP 服务支出减少了 36%。在英格兰,最贫困五分之一地区的人均支出减少幅度最大,每年下降 7.5%[95%置信区间:6.0,8.9],而最富裕五分之一地区的支出每年减少 4.5%[95%置信区间:3.3,5.6]。苏格兰和威尔士的预算削减更为公平,最贫困和最富裕地区的趋势相似。威尔士地方当局减少了用于 CEP 服务的地方政府总预算的比例最大(每年减少 4.0%,95%置信区间:5.0 至 2.9),其次是苏格兰(每年减少 3.0%,95%置信区间:4.2 至 1.7),然后是英格兰(每年减少 1.4%,95%置信区间:2.2 至 0.6)。在英格兰,农村和单一制地方当局比城市和两级结构的地方当局减少了分配给 CEP 的支出份额。

结论

在过去十年中,英国地方政府提供的文化、环境和规划服务的资金大幅削减,存在明显的地域不平等。受影响最严重的地区是那些贫困程度较高、地方政府结构为单一层次以及英格兰农村地方当局的地区。削减这些服务的不平等可能会扩大健康和幸福感方面的地域不平等。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2db/9976516/bbd21b95bece/12889_2023_15179_Fig1_HTML.jpg

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