Exploratory award: Multiple environmental classification of areas for researching spatial health inequalities

There are big differences between places in the UK in terms of how healthy people are. People live much longer in some places than others and people are much more likely to die of certain things like heart disease or cancer in some places, than in others. This is both unfair (why should you be at greater risk just because of where you live?), and also a problem for the NHS because it makes doctors and hospitals in some areas much busier than in others. Scientists know quite a lot about what causes these differences in health and one important reason is that generally, richer people tend to be healthier and live longer than poorer people. Richer and poorer people tend to live in different places to each other and that's partly why some areas seem to be healthier than others. Doctors often measure how wealthy a place is using information such as how many people who live there are in work, how many have big houses and how many have cars. They join these items of information together and use them to summarise the neighbourhood with a label, or classification, called a 'deprivation category'. This classification, or label, is so useful that doctors can use it to make pretty good estimates at how healthy a place is. However, the health in an area is not just about how wealthy the residents are. We know that our physical environment, things like the air we breathe, the water we drink, the land we walk on and the climate we experience can all have an impact on our health as well. Air pollution, for example, can cause breathing problems. These aspects of physical environment vary from place to place in the UK, just as wealth does. In fact, it is generally true that poorer areas in the UK tend also to have a worse physical environment. There is often more pollution and less woodland and park land in poorer neighbourhoods than in richer neighbourhoods for example. Doctors and other scientists want to find out how much our physical environment is responsible for differences in people's health so they can try to fix environmental problems and also plan what kinds of health care the residents of the area might need. But, to find out how much our physical environment matters for our health in the UK, they need a way to summarise and describe what kind of physical environment each neighbourhood has. They need something like the 'deprivation category', but for environment, rather than wealth. This is a difficult task because there are lots of different aspects to physical environment; from the air we breathe to the parks and woods we do, or do not, have access to. This project is a first attempt to produce a classification of the environment in different places in the UK. First, we are going to look at existing research to find out which aspects of environment are most likely to be influencing the population's health. Then we will gather together information on how these aspects of environment vary from place to place. Next we will try to use this information to give each neighbourhood in the UK a label, or classification, which describes what kind of physical environment it has. When we have that classification, we will work out whether it tells us something about the health of the residents more than we could estimate from knowing their wealth. We will look at different kinds of health, from heart disease to specific cancers. We will also make a comparison between a classification for the UK and for New Zealand. This will help us work out whether the role environment plays in determining our health here in the UK is similar or different to that in other developed countries. In the future such knowledge may help us to identify the best kinds of environmental and health policies from around the world so that the UK can improve its own policies. Finally, if the classification is useful, we will make sure that other doctors and scientists in the UK and around the world can use it.