Multiple Environmental Deprivation Multiple environmental deprivation in South Lanarkshire: Does it influence health? Dr Elizabeth Richardson Dr Jamie

Multiple Environmental Deprivation

Multiple environmental deprivation in South Lanarkshire:

Does it influence health?Dr Elizabeth Richardson

Dr Jamie PearceProf Richard Mitchell

Dr Niamh Shortt

SCHOOL OF GEOSCIENCES

Multiple Environmental Deprivation Outline

• Why South Lanarkshire?• What is “environmental deprivation”?• How can we measure it?• What can it tell us?

• Related to poor health?• Related to health inequalities?

• Wider utility of this approach


• Life expectancy among the worst in Scotland and the UK • Health gap between affluent and deprived communities

• A South Lanarkshire Community Plan (2008) objective: “improved environments and life circumstances to support healthier lives and address health inequalities”

• SL Council commissioned us to investigate the link between the environment and health, to help inform work towards this objective

Why South Lanarkshire?


• Some areas are healthier than others:

Health in South Lanarkshire

!

!

!

!

Hamilton

Cambuslang

Rutherglen

East Kilbride

0 2 41km!

!

!!

!

!!

Lanark

Biggar

Hamilton

CambuslangRutherglen

Strathaven

East Kilbride

0 10 205km

Standardised Mortality Ratio

(2004 - 2007)

12 - 50 (< 0.5 x average)

51 - 90 (< average)

91 - 110 (average)

111 - 150 (> average)

151 - 200 (1.5 to 2 x average)

201 - 322 (over 2 x average)

!

!

!!

!

!!

Lanark

Biggar

Hamilton


Strathaven

East Kilbride

0 10 205km

Standardised Mortality Ratio

(2004 - 2007)

12 - 50 (< 0.5 x average)

51 - 90 (< average)

91 - 110 (average)

111 - 150 (> average)

151 - 200 (1.5 to 2 x average)

201 - 322 (over 2 x average)

Mortality

!

!

!

!

Hamilton

Cambuslang

Rutherglen

East Kilbride

SIMD

Data source: 2004-2007 Standardised Mortality Ratios and 2009 SIMD from SNS

Multiple Environmental Deprivation “Environmental deprivation”

DEPRIVATION = unmet need caused by a lack of resources

Many resources can contribute to good health and well-being:• Individual: food, sleep, water, exercise…• Household: material resources, shelter, warmth, social contact…• Neighbourhood: clean air, clean water, safe streets, pleasant surroundings…

ENVIRONMENTAL DEPRIVATION (health-relevant) =Lack of neighbourhood environmental resources that can contribute to health and

well-being of a population• presence of environmental determinants of poor health (e.g., air pollutants)• absence of environmental determinants of good health (e.g., green space)

… but how can we measure it?


Measures of Multiple Socioeconomic Deprivation(e.g., Scottish Index of Multiple Deprivation)

Socioeconomic deprivation• Socioeconomic deprivation:

• Multi-dimensional, e.g.:


Measures of Multiple Environmental Deprivation?

Environmental deprivation • Physical environmental deprivation:

• Multi-dimensional, e.g.:

Multiple Environmental Deprivation Measuring environmental deprivationIndicators of health-relevant environmental deprivation selected for SL:

• Air pollution • Annual average PM10 conc. from SNS, population weighted (OS Address Point)

• Noise• ≈ proximity to major road and rail routes, population weighted

• Traffic environment • SG Transport Directorate: locations of road accidents by user type

• Undesirable land uses population weighted % data zone area within 100 m of:

• contaminated land• industrial facilities• derelict land• mining activities (all from SEPA or SL Council)

• Crime rates • SIMD 2009 crime domain : per capita rate of certain neighbourhood crimes (SNS)

South Lanarkshire Index of Multiple Environmental Deprivation (SLIMED)



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!

!!

!

!!

Lanark

Biggar

Hamilton


Strathaven

East Kilbride

SLIMED quintile

1 (least environmental deprivation)

2

3

4

5 (most environmental deprivation)0 10 205

km ¯

SLIMED quintile


2

3

4


km ¯


!(

!(

!(

!(

Hamilton

Cambuslang

Rutherglen

East Kilbride

SLIMED quintile


2

3

4


km ¯


SLIMED quintile


2

3

4


km ¯


Self-reported health = "not good"

1.001.02

1.07 1.071.09

0.90

1.00

1.10

1.20

1 (least) 2 3 4 5 (most)

SLIMED quintile

IRR

SLIMED and health

Increasing environmental deprivation

Hig

her r

isk

Lower risk

9%

Data sources: health and population composition from 2001 CensusSIMD and Urban-Rural classification from SNS


Respiratory disease hospital admissions

1.001.04

1.011.03

1.12

0.80

0.90

1.00

1.10

1.20

1.30

1 (least) 2 3 4 5 (most)

SLIMED quintile

IRR

SLIMED and health


Hig

her r

isk

Lower risk

12%

Data sources: 2007 hospital admissions from ISD Scotland, via SNSData zone age and sex composition, SIMD and Urban-Rural classification from SNS

Whole Scotland age- and sex-specific rates from ISD Scotland


0.5

1.0

1.5

2.02.5

3.0

3.5

4.0

1 (leastenvironmental

deprivation)

2 3 4 5 (mostenvironmental

deprivation)

1 (least deprived)

2

3

4

5 (most deprived)

SLIMED and health inequality

1.9 x higher

SIMD deprivation

3.3x higher

Data sources: health and population composition from 2001 CensusSIMD and Urban-Rural classification from SNS


Multiple Environmental Deprivation Implications

• Environmental deprivation is associated with poor health in South Lanarkshire

• Improving environmental quality could have benefits for health and reduced inequalities

• SLIMED identifies data zones where most work needed… and where health benefits could be greatest (cost efficiency)

Multiple Environmental Deprivation Wider utility of approach

• Identifying populations exposed to high environmental deprivation could help to target resources where most needed

• Progress towards addressing a number of SG National Outcomes:• We live longer, healthier lives• We have tackled the significant inequalities in Scottish society• Our children have the best start in life and are ready to succeed• We have improved the life chances for children, young people and

families at risk• We value and enjoy our built and natural environment and protect it

and enhance it for future generations

Documents

Multiple Environmental Deprivation Multiple environmental deprivation in South Lanarkshire: Does it influence health? Dr Elizabeth Richardson Dr Jamie