Small-Area Indices of Potential Environmental Health Risk: Construction and Application to Environmental Health Equity in England and Wales

This study developed small-area environmental indices and applied them in an investigation of environmental health equity. Publicly available, georeferenced environmental datasets were obtained, and GIS-based methods were used to construct indices of potential environmental health risk for standard small-area geographies of England and Wales. Associations between these indices, socio-economic and health outcome measures were assessed using both individual and aggregate data sources. Indicators of socio-economic status, such as deprivation indices and social class, were found to be strongly associated with several of the environmental indices. The environmental indices were also found to have measurable adverse effects on some health outcomes following adjustment for socio-economic status and may, to a small extent, explain gradients between area deprivation and morbidity/mortality. Small-area environmental indices, such as those constructed here, are proposed as a means by which the distribution of environmental health risk may be considered in the context of national and regional health, social and planning policy