Developing openly accessible health indicators for small areas in Great Britain: an observational study. (November 2018)

• Record Type: Journal Article
• Authors: Green, Mark A; Daras, Konstantinos; Davies, Alec; Barr, Ben; Bayliss, David; Singleton, Alex
• Is Part Of: Lancet. Volume 392(2018)Supplement 2
• Page Start: S39
• Publication Date: 2018-11
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Medicine; Electronic journals; Periodicals; 610.5
• DOI: 10.1016/S0140-6736(18)32876-9
• Languages: English
• ISSNs: 0140-6736

Abstract

Abstract: Background: Public health has long been concerned with understanding how the accessibility of individuals to certain environmental features can influence health and wellbeing. Such insights are increasingly being adopted by policy makers for designing healthy neighbourhoods. We aimed to use small area national level data to support and inform decision making about effects of environmental features on health. Methods: Measures were selected by a scoping review of geographical determinants of health. Road network distance for every postcode centroid in Great Britain to its nearest outlet postcode centroid (for ten retail and health-related services) was calculated. These results were aggregated to lower super output areas. We also created measures of green space (amount of green space within a 900 m 2 buffer) and concentrations of air pollutants (nitrogen dioxide, sulphur dioxide, and particulate matter less than 10 μm in diameter). Data were validated through field observations. An index (Access to Healthy Assets and Hazards) was also developed to summarise all the indicators into an overall measure of how healthy neighbourhoods are. Outcomes were point estimates of distance to nearest service, or level of green space or air pollution, and an overall score summarising these values for the index. Findings: Individuals were located nearest to health services (eg, median distance to a general practice was 1·05 km, IQR 0·65–1·79), although they were just as near to many health negating outlets (eg, pubs 1·12, 0·64–1·99). Wide social inequalities were observed; for example, mean distance to a fast food outlet in the most deprived decile of areas in England was 1·17 km (95% CI 1·17–1·22) compared with 2·42 (2·35–2·49) in the least deprived decile. Access to Healthy Assets and Hazards identified suburban regions as the healthiest environments, and inner city and isolated rural areas as the least healthy. Interpretation: Our open source suite of measures offers a useful resource for understanding the accessibility of small areas to positive and negative features of environments. We extend previous approaches towards designing health-related indicators by creating a multidimensional index, which has been incorporated into Public Health England's FingerTips system. Funding: Economic and Social Research Council (grant no ES/L011840/1). The funder had no role in the research.