1. Multiple Environmental Deprivation Multiple environmental deprivation in South Lanarkshire: Does it influence health? Dr Elizabeth Richardson Dr Jamie Pearce Prof Richard Mitchell Dr Niamh Shortt SCHOOL OF GEOSCIENCES

2. Multiple Environmental Deprivation Outline Why South Lanarkshire? What is “environmental deprivation”? How can we measure it? What can it tell us? Related to poor health? Related to health inequalities? Wider utility of this approach

3. Multiple Environmental Deprivation Life expectancy among the worst in Scotland and the UK Health gap between affluent and deprived communities A South Lanarkshire Community Plan (2008) objective: “improved environments and life circumstances to support healthier lives and address health inequalities” SL Council commissioned us to investigate the link between the environment and health, to help inform work towards this objective Why South Lanarkshire?

4. Multiple Environmental Deprivation Some areas are healthier than others: Health in South Lanarkshire Mortality SIMD Data source: 2004-2007 Standardised Mortality Ratios and 2009 SIMD from SNS

5. Multiple Environmental Deprivation “Environmental deprivation” DEPRIVATION = unmet need caused by a lack of resources Many resources can contribute to good health and well-being: Individual: food, sleep, water, exercise… Household: material resources, shelter, warmth, social contact… Neighbourhood: clean air, clean water, safe streets, pleasant surroundings… ENVIRONMENTAL DEPRIVATION (health-relevant) = Lack of neighbourhood environmental resources that can contribute to health and well-being of a population presence of environmental determinants of poor health (e.g., air pollutants) absence of environmental determinants of good health (e.g., green space) … but how can we measure it?

6. Multiple Environmental Deprivation Measures of Multiple Socioeconomic Deprivation (e.g., Scottish Index of Multiple Deprivation) Socioeconomic deprivation Socioeconomic deprivation: Multi-dimensional, e.g.:

7. Multiple Environmental Deprivation Measures of Multiple Environmental Deprivation? Environmental deprivation Physical environmental deprivation: Multi-dimensional, e.g.:

8. Multiple Environmental Deprivation Measuring environmental deprivation Indicators of health-relevant environmental deprivation selected for SL: Air pollution Annual average PM 10 conc. from SNS, population weighted (OS Address Point) Noise ≈ proximity to major road and rail routes, population weighted Traffic environment SG Transport Directorate: locations of road accidents by user type Undesirable land uses population weighted % data zone area within 100 m of: contaminated land industrial facilities derelict land mining activities (all from SEPA or SL Council) Crime rates SIMD 2009 crime domain : per capita rate of certain neighbourhood crimes (SNS) South Lanarkshire Index of Multiple Environmental Deprivation (SLIMED)

9. Multiple Environmental Deprivation South Lanarkshire Index of Multiple Environmental Deprivation (SLIMED)

10. Multiple Environmental Deprivation South Lanarkshire Index of Multiple Environmental Deprivation (SLIMED)

11. Multiple Environmental Deprivation SLIMED and health Increasing environmental deprivation Higher risk Lower risk 9% Data sources: health and population composition from 2001 Census SIMD and Urban-Rural classification from SNS

12. Multiple Environmental Deprivation SLIMED and health Increasing environmental deprivation Higher risk Lower risk 12% Data sources: 2007 hospital admissions from ISD Scotland, via SNS Data zone age and sex composition, SIMD and Urban-Rural classification from SNS Whole Scotland age- and sex-specific rates from ISD Scotland

13. Multiple Environmental Deprivation SLIMED and health inequality 1.9 x higher SIMD deprivation 3.3x higher Data sources: health and population composition from 2001 Census SIMD and Urban-Rural classification from SNS Increasing environmental deprivation

14. Multiple Environmental Deprivation Implications Environmental deprivation is associated with poor health in South Lanarkshire Improving environmental quality could have benefits for health and reduced inequalities SLIMED identifies data zones where most work needed… and where health benefits could be greatest (cost efficiency)

15. Multiple Environmental Deprivation Wider utility of approach Identifying populations exposed to high environmental deprivation could help to target resources where most needed Progress towards addressing a number of SG National Outcomes: We live longer, healthier lives We have tackled the significant inequalities in Scottish society Our children have the best start in life and are ready to succeed We have improved the life chances for children, young people and families at risk We value and enjoy our built and natural environment and protect it and enhance it for future generations