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Background: Evidence is mounting that area-level socioeconomic indicators are important tools for predicting health outcomes. However, few studies have examined these alongside individual-level education. This nested cohort study within the control arm of the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) assesses the association of mutually adjusted individual (education) and area-level (Index of Multiple Deprivation-IMD 2007) socioeconomic status indicators and all-cause female mortality. Methods: Participants resident in England who had completed both baseline (Wave 1) and follow up (Wave 2) questionnaires were included. Follow-up was through the Health and Social Care Information Centre with deaths censored on 31st December 2012. IMD, education and a range of covariates were explored. Cox regression models adjusted for all covariates were used. Sensitivity analysis using imputation was performed (1) including those with missing data and (2) on the entire cohort who had completed the baseline questionnaire. Results: Of the 54,539 women resident in England who completed both Wave 1 and Wave 2 questionnaires, 4,510 had missing data. The remaining 50,029 women were included in the primary analysis. Area-level IMD was positively associated with all-cause mortality for the most deprived group compared to the least deprived (HR=1.42, CI=1.14-1.78) after adjusting for all potential confounders. Sensitivity analyses showed similar results with stronger associations in the entire cohort (HR=1.90, CI=1.68-2.16). The less educated an individual, the higher the mortality risk (test for trend p=<0.001). However, the crude effect on mortality of having no formal education compared to college/university education disappeared when adjusted for IMD rank (HR=1.08, CI=0.93-1.26). Conclusion: Women living in more deprived areas continue to have higher mortality even in this less deprived cohort and after adjustment for a range of potential confounders. [ABSTRACT FROM AUTHOR]

Recent investigations indicate that personality traits are unevenly distributed geographically, with some traits being more prevalent in certain places than in others. The geographical distributions of personality traits are associated with a range of important political, economic, social, and health outcomes. The majority of research on this subject has focused on the geographical distributions and macro-level correlates of personality across nations or regions of the United States. The aim of the present investigation was to replicate and extend that past work by examining regional personality differences in Great Britain. Using a sample of nearly 400,000 British residents, we mapped the geographical distributions of the Big Five Personality traits across 380 Local Authority Districts and examined the associations with important political, economic, social, and health outcomes. The results revealed distinct geographical clusters, with neighboring regions displaying similar personality characteristics, and robust associations with the macro-level outcome variables. Overall, the patterns of results were similar to findings from past research. [ABSTRACT FROM AUTHOR]

Abstract: This paper estimates the pattern of private and public physician visits and hospitalisation by socioeconomic position in two countries in which private healthcare expenditure constitutes a different proportion of the total amount spent on health care: Britain and Spain. Private physician visits and private hospitalisations were quantitatively more important in Spain than in Britain. In both countries, the use of private services showed a direct socioeconomic gradient. In Spain, the use of public GPs and public specialists tends to favour the worst-off, but no significant differences were observed in public hospitalisation. In Britain, with some exceptions, no significant socioeconomic differences were observed in the use of public health care services. The different pattern observed in the use of public specialist services may be due to the high frequency of visits to private specialists in Spain. [Copyright &y& Elsevier]

Abstract: The current study draws on data from the 2007 and 2009 Citizenship Survey collected in England (n=17,572) to explore the role of social capital in building community resilience and health, using the bonding, bridging, and linking social capital framework of . The results show that the indicators of the different types of social capital are only weakly interrelated, suggesting that they capture different aspects of the social environment. In line with the expectations, most indicators of bonding, bridging, and linking social capital were significantly associated with neighbourhood deprivation and self-reported health. In particular bonding and bridging social cohesion, civic participation, heterogeneous socio-economic relationships, and political efficacy and trust appeared important for community health after controlling for neighbourhood deprivation. However, no support was found for the hypothesis that the different aspects help buffer against the detrimental influences of neighbourhood deprivation. [Copyright &y& Elsevier]

Drugs and alcohol misuse in young people is a major public health problem with substantial levels of morbidity and mortality. Social, economic and cultural factors play a major part in the initiation and maintenance of substance misuse in young people. Many young people who misuse drugs have multiple antecedent and co-occurring mental health problems, unrecognized learning difficulties, family difficulties and deeply entrenched social problems. Given the heterogeneity of the patterns of substance misuse in these young people, and the potential for persistence of serious problems into their adult lives, a range of interventions should be developed to address the risk factors across biological, psychological and social domains. Family/systemic interventions provide the best outcomes for young people with substance misuse, though even the most intensive forms of systemic therapies may fall short of producing enduring changes, especially for marginalized young people and communities. Appreciative inquiry (AI) is one of the most significant innovations in action research in the past decade and a method of producing long-lasting changes to the larger social system. AI is an attempt to generate a collective image of a new and better future by exploring the best of what is and has been. We describe an anecdotal experience of using AI in producing long-lasting changes in a group of marginalized young people in South Africa, who were engaged in drug and alcohol misuse and antisocial behaviour. The principles and practice of AI are described in detail, followed by a discussion of the implications of these findings for a UK population. [ABSTRACT FROM AUTHOR]

Background: Advertising in magazines contributes to nutritional knowledge and social norms and may play a role in food choice and adiposity. In contrast to food advertising on television, that in magazines has received little research attention. We describe the type and nutritional content of foods advertised in popular UK weekly magazines and explore variations in these according to the socio-economic and gender profile of readers. Method: Four consecutive issues of 30 popular UK weekly magazines were obtained. Food advertisements were categorized into one of eight food groups. Manufacturer's data on the nutritional content of advertised foods was used to determine the nutritional content of advertised foods. Socio-economic and gender profile of magazines was determined from national readership statistics. Results: Four hundred forty three advertisements for food products were identified. The most common categories of foods advertised were meals, combination foods, soups and sauces (26%) and foods containing fat/sugar (23%). Advertised foods had a lower percentage of energy from carbohydrate (43%), lower fibre density (2 g/MJ), but higher percentage of energy from sugars (24%) and higher sodium density (0.5 g/MJ) than a diet recommended to avoid diet-related disease. There were variations in the type of foods advertised according to the socio-economic profile of readers and in the nutritional content of advertised foods according to the socio-economic and gender profile of readers. Conclusions: Food advertising reflects, and may reinforce, socio-economic and gender variations in food choice and adiposity. Producers of more healthy food may need help from policy makers and health promoters to effectively market their products. [ABSTRACT FROM AUTHOR]

The Economic and Social Research Council, the body which funds much social science in the UK, recently imposed on UK social science a system of research ethics governance already well established in other areas of research and in much of the rest of the developed world. This system requires that research involving human subjects receive prior ethical approval from a committee made up of, typically, multidisciplinary researchers and lay people. Our aim in this paper is to prompt debate about the purpose and practice of such an anticipatory ethical review. We begin by describing the rich and varied ethical and political debates ongoing in human geography. We argue that these are, at best, ignored and, at worst, threatened by this system of ethical review by committee. We describe the emergence of these formal mechanisms of research governance and important differences between the ethical contexts, history, and demands of research in the medical and social sciences. The paper draws on empirical research investigating National Health Service (NHS) research ethics committees to propose three salutary lessons geographers would do well to consider from experience elsewhere with ethical review. We argue that in review by committee deliberations extend beyond the ethical to include the methodological, that the system is a self-perpetuating and increasingly rule-bound mechanism, and that despite a rhetoric of accountability it is a system as obscure to outsiders as professional ethics. [ABSTRACT FROM AUTHOR]

The article explores the progress that has been made on achieving health care equality in the United Kingdom. The country's Labour government has attested its commitment to health care equality by reviewing the National Health Service's foundations. Issues such as specialist service referrals, geographical location of services, and clinical decision-making processes have all appeared as potential equality obstacles. The article comments on how people from lower socio-economic backgrounds are less likely to be referred for further treatments. It concludes that certain medical policies could undermine the foundations placed to promote equal health care for all citizens.

There are substantial inequities within the current National Health Service (NHS), with people in lower socioeconomic groups (SEGs) using a wide range of services less relative to their needs than people in higher SEGs. These inequities are likely to arise due to factors on both the demand and the supply side of the system. On the demand side, they could arise from differences in patients' beliefs, knowledge, costs, resources and capabilities. On the supply side, professional beliefs and attitudes, and risk selection or cream-skimming by providers may result in inequities. This paper discusses whether these factors are at play within the English NHS and analyses whether current policy to extend patient choice of provider is likely to reduce or increase these inequities. It shows that extending patient choice may leave unchanged inequity due to differences in health beliefs (because choice does not affect these directly), increase inequity due to unequal resources (because patients may have to travel further), and decrease inequity due to unequal capabilities (because the poor will have access to a new and, for them a more effective, source of leverage over health service professionals). On the supply side, there will be little change. The paper then discusses policy options for dealing with factors that contribute to greater inequity on the demand side. It proposes a package of supported choice whereby individuals from lower SEGs would receive assistance in making choices, including an identified key worker to act as patient care adviser and help with transport costs. The paper concludes that policies for extending patient choice can enhance equity – so long as they are properly designed. [ABSTRACT FROM AUTHOR]

Objectives: To synthesise data on the impact on health and key socioeconomic determinants of health and health inequalities reported in evaluations of national UK regeneration programmes. Data Sources: Eight electronic databases were searched from 1980 to 2004 (IBSS, COPAC, HMIC, IDOX, INSIDE, Medline, Urbadisc/Accompline, Web of Knowledge). Bibliographies of located documents and relevant web sites were searched. Experts and government departmental libraries were also contacted. Review methods: Evaluations that reported achievements drawing on data from at least two target areas of a national urban regeneration programme in the UK were included. Process evaluations and evaluations reporting only business outcomes were excluded. All methods of evaluation were included. Impact data on direct health outcomes and direct measures of socioeconomic determinants of health were narratively synthesised. Results: 19 evaluations reported impacts on health or socioeconomic determinants of health; data from 10 evaluations were synthesised. Three evaluations reported health impacts; in one evaluation three of four measures of self reported health deteriorated, typically by around 4%. Two other evaluations reported overall reductions in mortality rates. Most socioeconomic outcomes assessed showed an overall improvement after regeneration investment; however, the effect size was often similar to national trends. In addition, some evaluations reported adverse impacts. Conclusion: There is little evidence of the impact of national urban regeneration investment on socioeconomic or health outcomes. Where impacts have been assessed, these are often small and positive but adverse impacts hove also occurred. Impact data from future evaluations are required to inform healthy public policy; in the meantime work to exploit and synthesise ‘best available’ data is required. [ABSTRACT FROM AUTHOR]

Urban populations around the world face increasingly common health problems. This is partly because of common spatial and socio-economic factors that result in substantial inequalities in health among urban populations. Spatial methods can now map out dimensions of urban living, such as the segregation of poor communities as a result of population concentration of poverty in deprived neighbourhoods. Even in rich countries such as the UK, separate from the health disadvantages of living in a poor neighbourhood, if you live in a neighbourhood that is surrounded by deprivation, you have a higher risk of mortality. However, neighbourhood deprivation is not synonymous with poor social capital. Some communities can be resilient to the health-damaging aspects of living in a poor neighbourhood if they have access to social support and other social ties. [ABSTRACT FROM AUTHOR]

Focuses on the increasing socioeconomic inequalities on public health in Great Britain. Link between social position and health; Differences in mortality between the deprived and affluent people; Consequences of changes on the differences in health.