Structures of Geographical and Social Space and Their Consequences for Human Health

There is a growing body of evidence, involving both international comparisons and national studies, which suggests that inequality is bad for human health, even when absolute levels of income, or material deprivation, are controlled for. Yet much of the literature exploring links between health outcomes and either absolute or relative deprivation has failed to consider sufficiently fully a spatial perspective. This paper attempts to redress this balance, drawing upon empirical work first for England and Wales as a whole and, in more detail, for a health authority in north-west England. Evidence is presented that a measure of relative deprivation that takes account of the locations of small areas in relation to each other performs well as a correlate of morbidity and mortality. Some theoretical arguments are advanced to support the relationships between health outcome and relative deprivation, and especially the role of location in geographical and social space in mediating this relationship.