Local Inequalities in Health Behaviours: Longitudinal Findings from the Stockton-On-Tees Cohort Study

Nasima Akhter, Ross Stewart Fairbairn, Mark Pearce, Jon Warren, Adetayo Kasim and Clare Bambra
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Nasima Akhter: Department of Anthropology, Durham University, Dawson Building, Stockton Road, Durham DH1 3LE, UK
Ross Stewart Fairbairn: Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
Mark Pearce: Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
Jon Warren: St. Cuthberts Society, Durham University, Durham DH1 3LE, UK
Adetayo Kasim: Department of Anthropology, Durham University, Dawson Building, Stockton Road, Durham DH1 3LE, UK
Clare Bambra: Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK

IJERPH, 2021, vol. 18, issue 21, 1-15

Abstract: This paper provides a longitudinal examination of local inequalities in health behaviours during a period of austerity, exploring the role of ‘place’ in explaining these inequalities. Data from the Stockton-on-Tees prospective cohort study of 836 individuals were analysed and followed over 18 months (37% follow-up). Generalised estimating equation models estimated the deprivation gap in health behaviours (smoking status, alcohol use, fruit and vegetable consumption and physical activity practices) between the 20% most- and least-deprived neighborhoods (LSOAs), explored any temporal changes during austerity, and examined the underpinning role of compositional and contextual determinants. All health behaviours, except for frequent physical activity, varied significantly by deprivation ( p ? 0.001). Smoking was lower in the least-deprived areas (OR 0.21, CI 0.14 to 0.30), while alcohol use (OR 2.75, CI 1.98 to 3.82) and fruit and vegetable consumption (OR 2.55, CI 1.80 to 3.62) were higher in the least-deprived areas. The inequalities were relatively stable throughout the study period. Material factors (such as employment, education and housing tenure) were the most-important and environmental factors the least-important explanatory factors. This study suggests that material factors are the most important ‘place’ determinants of health behaviours. Health promotion activities should better reflect these drivers.

Keywords: social determinants; health behaviours; health inequalities; austerity; welfare; social inequality; cohort; survey (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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