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Title: The changing geography of health inequalities : a spatial exploration of area deprivation and Limiting Long-Term Illness across Britain
Author: Dearden, E. K.
ISNI:       0000 0004 8505 9713
Awarding Body: University of Liverpool
Current Institution: University of Liverpool
Date of Award: 2019
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Socioeconomic gradients in health which manifest geographically are well documented in Britain but remain poorly understood. Although the study of variations in health has a long history, exploring the changing spatial structure of health in Britain has previously been limited by inconsistent spatial data which do not permit comparability over time. To date, most geographically-focused health inequalities research has relied on conventional non-spatial methodologies and there are very few studies of how geographical circumstances throughout time influence health outcomes. The value of this thesis derives from its exploitation of consistent geographical zones which permit comparisons across space and over time. Through documenting the long-term unevenness of characteristics and the resulting inequalities in health between localities, this thesis offers a new level of insight into changing population health and geographic inequalities for the whole of Britain which has not previously been available. This thesis utilises consistent 1km2 spatial units to examine the changing spatial structure of self-reported health in Britain, 1991 to 2011, against a backdrop of 1971 to 2011 area deprivation and social indicators. It applies an explicitly spatial approach to identify how the long-term geography of socioeconomic inequality is associated with changing health variation in Britain. Through accounting for spatial structure the analysis provides a detailed representation of the influence of deprivation for understanding health inequalities across Britain. Results demonstrate the extent to which the socioeconomic history of local areas matter for health, highlighting that long-term economic inequalities play a significant role in the divergent health profiles of different places. The impact of deprivation for health is not evenly spread across Britain, but is instead revealed to be spatially concentrated. The substantive issue of whether Britain has become more segregated by health status through time is also addressed with findings demonstrating that inequalities in health have grown across spatial dimensions over time. An understanding of the changing spatial structure of health in Britain, the association between deprivation and spatial inequalities in health, the drivers of these associations, and the importance of historical factors in shaping contemporary patterning of health inequalities is demonstrated through the findings presented in this thesis. Such knowledge can help to inform targeted policies aimed at reducing health inequalities, offering potential for improving health outcomes across the social gradient, but particularly amongst the most disadvantaged groups.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral