Changing places. Do changes in the relative deprivation of areas influence limiting long-term illness and mortality among non-migrant people living in non-deprived households?

Numerous studies have investigated the relative importance of contextual (place) and compositional (person) factors in explaining health and mortality variations. Commonly, these studies control for a range of individual characteristics before testing whether one or more contextual variables have a significant impact on the health or mortality outcome. The findings have been inconsistent, although the growing consensus is, first, that contextual effects are significant but are less important than compositional factors and, second, that contextual effects have a stronger impact in studies of morbidity than in studies of mortality. Here we use longitudinal data to examine a related, but rather different, question. Extracting a select group of people from the ONS Longitudinal Study for England and Wales who had not moved house between 1971 and 1991 and who were living in non-deprived households throughout the 20-year period, we tested whether a change in the relative deprivation of the area in which they were living influenced their health and mortality status. The results demonstrate that changes in the relative deprivation of areas are related to health and mortality outcomes in a consistent way for both outcomes, although the results were more significant for morbidity. These findings suggest that neighbourhood-based public health and regeneration programmes may have demonstrable effects on the health of the residents who live there. (C) 2003 Elsevier Ltd. All rights reserved.