(L19) The influence of neighbourhoods on population health

NZ Index of Multiple Deprivation (IMD) Variables

• Employment

• Income

• Crime

• Housing

• Health

• Education

• Access

IMD allows one to…

Look at disadvantages in overall terms, as well as in terms of seven domains of deprivation

The seven domains are weighted to reflect the relative importance of each domain in representing the key determinants of socioeconomic deprivation, the adequacy of their indicators and their indicators and the robustness of the data that they use

Appropriate uses of NZDep2018

• Planning and resource allocation

• Research

• Advocacy

Appropriate interpretation of NZDep2018

“People living in the most deprived neighbourhoods…”

NOT

“The most deprived people…”

Ecological fallacy

The error that arises when information about groups of people is used to make inferences about individuals

Upstream interventions tend to belong on the…

outermost arch on the Dahlgren and Whitehead model

However interventions can still target individual, family + community, environment

What is a healthy environment?

The physical, social or political setting(s) that prevent disease while enhancing human health and well-being

Chronic diseases such as CVD and obesity are associated with environments that favour more sedentary lifestyles and/or poor nutrition

Elements of a healthy environment

• Clean air and water

• Appropriate housing

• Access to wholesome food

• Safe community spaces

• Access to transport

• Opportunities to incorporate exercise as part of daily life

The built environment

‘all the buildings, spaces and products that area created, ot at least significantly modified by people.’

e.g homes, schools, parks, roads, waste disposal, motorways

How are built environments measured?

• Context specific - depends on research question

• Urban density - population or employment

• Land-use mix - residential, industrial, waste land, commercial

• Street connectivity - lollipop vs well connected

• Community resources - access to recreational facilities, healthy foods

Street connectivity

Reduces distance between destination, encouraging the use of ‘active transport’

Traffic calming and other street design features

Facilities that encourage walking and cycling and discourage driving

Mix of residential, commercial and business uses

Increases opportunities for active transport

Public open spaces & physical activity spaces

Increase opportunities for physical activity