There are stark geographical difference in health between countries, regions and even neighbourhoods within a city. Health outcomes tend to be substantially worse in areas characterised by high levels of social disadvantage, compared to areas characterised by social and economic advantage. We find that that this gradient is apparent for most measures of death and illness, as well as for many health-related behaviours such as smoking and nutrition. Importantly, in most high income countries these geographical divisions are widening.
Health inequalities are not only unjust and unfair, but, importantly, are ameliorable and ultimately avoidable. To date, the paucity of research considering the role of the environment in shaping health inequalities has prevented the establishment of a knowledge base on which public policy decisions might be made. Our research seeks to identify environmental factors that may have a critical role in shaping inequalities in health outcomes. Our current and future research includes studies of the effect of physical environment (e.g. green spaces, multiple environmental deprivation, air pollution), social environment (e.g. community networks, residential segregation, health care) and the built environment (e.g. access to resources such as shops and schools, the number of destinations and the walkability of neighbourhoods). We seek to understand the susceptibility or resilience of different populations to environmental effects. We also examine the process that lead to disadvantaged groups suffering the unequal burden of poor quality environments.
In addition, we have considerable experience of monitoring health inequalities over time, an important first step in developing a robust argument for policy interventions. For example, we have completed research that has found increased geographical difference in health between regions of the UK and New Zealand.