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Objective: To examine the spatial clustering of obesity and dental caries in young children in Plymouth, United Kingdom, to evaluate the association between these conditions and deprivation, and explore the impact of neighbourhood-level characteristics on their distribution. Basic research design: Cross-sectional study analysing data from the National Child Measurement Programme (N=2427) and the Local Dental Health Survey (N=1425). The association of deprivation with weight status and caries was determined at individual and area level, using ANOVA and Poisson models. The overall spatial clustering was assessed using a modified version of the Global Moran's I, while clusters were located through Local Indicators of Spatial Association. Spatial autocorrelation was assessed using the variograms of the raw values. Log-linear Poisson models were fitted to assess the significance of neighbourhood characteristics on overweight/obesity and caries distribution. Results: At an individual level, deprivation was not associated with BMI z-scores but was a significant predictor of caries (p<0.05). However, at area level, deprivation related to the rates of both conditions. A significant positive autocorrelation was observed across neighbourhoods for caries. The variograms suggested spatial autocorrelations up to 2.5 km and 3 km for overweight/obesity and caries, respectively. Among several neighbourhood characteristics, the proportion of people on benefits was found to be a significant predictor of caries rates. Conclusions: Our results underline the importance of considering geographic location and characteristics of the broader environment when developing strategies to target obesity and caries. [ABSTRACT FROM AUTHOR]

Robust intelligence about the health of children and their families is required locally to ensure that commissioning of health visiting services reflects the needs of the populations they serve. In Plymouth, this information has been collected via a routine survey of health visitor caseloads for 12 years. This article aims to: share current practice; outline uses of the survey from a partnership perspective; highlight limitations and learning; and discuss future developments. It highlights that the survey is a useful method for collecting needs-based data about the family and living environment of children aged 0–5 years. The advantages of conducting the survey far outweigh the resource-intensity of the process and any other limitations.

Background— Among primary coronary heart disease (CHD) risk factors, certain socioeconomic characteristics of individuals and living environments appear to play a central role. The objective of this study was to assess the burden of neighbourhood deprivation-associated excess in mortality and hospital admission from CHD in Plymouth.Methods— A small area ecological study using indices of neighbourhood deprivation and coronary heart disease mortality and hospital admission data aggregated for 1991-2003 for CHD mortality and for 1997-2004 for CHD hospital admission. Locally defined community areas (n = 43) were classified according to the Townsend index, measuring material deprivation.Results— CHD mortality and hospital admission increased with Townsend deprivation score in all ages and gender groups.The age-adjusted deprivation-associated excess CHD hospital admission was 15.4% in men and 27.9% in women higher for most compared to the least deprived group.The age-adjusted deprivation-associated excess CHD mortality was 31.5% and 18.9% for men and women, respectively. Excess mortality in the 13-year period studied accounted for more than 1380 and 670 deaths for men and women. Excess hospital admissions in the 7-year period studied accounted for more than 966 and 769 hospital admissions for men and women. A larger proportion of excess CHD deaths were found among men while excess CHD hospital admissions were found among women. The most deprived areas showed the highest mortality and hospital admission risk.Conclusion— Despite the existence of a system of universal health care, inequalities in CHD mortality and hospital admission persist and need to be taken into account when implementing intervention programmes.

Several letters to the editor are presented in response to articles in previous issues including "We're Not Going to Live in Shame: The Legacy of Jim Deva," "Study Finds More Gay Men Now Die of Suicide than HIV," and "Minorities Should Be Protected, Says TWU Grad Denied Job."