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Issue 6, July 2000, pp.5.

Reports from the Programme conference:
Who you are or where you live, which matters more for your health?
Heather Joshi

There are wide disparities in health across the UK. These regional and local differences can happen because unhealthy people congregate in particular places and also because some places are less 'healthy' in themselves. It is often not possible to distinguish such effects of composition and context because data on health are provided by areas, but not for individuals within them.

Our project used evidence on the health of individuals within areas to assess the relative importance of personal and geographical factors in explaining health variations. A major source of evidence is the Office for National Statistics Longitudinal Study of England and Wales, (ONS-LS) where we looked at long-standing illness among men and women in terms of their own characteristics, those of the electoral ward in which they live and the district to which it belongs. We also analysed sample survey data from the Health and Lifestyle Survey and the National Child Development Study. In all these exercises, personal characteristics - including occupational background and employment history - were found to be major predictors of poor health, but where you live also makes a difference.

Our project has confirmed that the reasons for this lie in many factors: among them climate, economic structure and the strength of the local community.

Associated references:
Wiggins, R. D., Bartley, M., Gleave, S., Joshi, H., Lynch, K. and Mitchell, R. (1998) 'Limiting long-term illness: a question of where you live or who you are? A multilevel analysis of the 1971-1991 ONS Longitudinal Study' Risk, Decision and Policy 3, 181-198.
Gleave, S., Wiggins, R. D., Joshi, H. and Lynch, K. (2000) 'Identifying area effects: a comparison of single and multilevel models' (LS Working Paper 79), London : Institute of Education. Also forthcoming in P. Boyle, S. Curtis, A. Gatrell, E. Graham and E. Moore (eds.) The Geography of Health Inequalities in the Developed World, Aldershot : Ashgate.
Mitchell, R., Gleave, S., Bartley, M. and Wiggins, R. D. (2000) 'Do attitude and area influence health?' Health and Place, 6 67-79.