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Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Research article

Social deprivation and exposure to health promotion. A study of the distribution of health promotion resources to schools in England

Authors: Corina M Chivu, Daniel D Reidpath

Published in: BMC Public Health | Issue 1/2010

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Abstract

Background

Area deprivation is a known determinant of health. It is also known that area deprivation is associated with lower impact health promotion. It is less well known, however, whether deprived areas are less responsive to health promotion, or whether they are less exposed. Using data from a national, school-based campaign to promote vaccination against the human papilloma virus (HPV), the relationship between area deprivation and exposure was examined.

Methods

Taking advantage of a health promotion campaign to provide information to schools about HPV vaccination, a cross sectional study was conducted to examine the relationship between area level, social deprivation, and take-up of (i.e., exposure to) available health promotion material. The sample was 4,750 schools across England, including government maintained and independent schools. The relationship between area deprivation and exposure was examined using bi- and multivariate logistic regression.

Results

It was found that schools in the least deprived quintile had 1.32 times the odds of requesting health promotion materials than schools in the most deprived areas (p = .01). This effect was independent of the school size, the type of school, and the geographic region.

Conclusion

The relationship between area deprivation and the impact of health promotion may be due, at least in part, to differential levels of exposure. The study was limited in scope, pointing to the need for more research, but also points to potentially important policy implications.
Literature
1.
go back to reference Marmot M, Wilkinson RG: Social Determinants of Health. 2005, USA: Oxford University Press, 2CrossRef Marmot M, Wilkinson RG: Social Determinants of Health. 2005, USA: Oxford University Press, 2CrossRef
2.
go back to reference Siegrist J, Marmot M: Social Inequalities in Health: New Evidence and Policy Implications. 2006, USA: Oxford University Press, 1CrossRef Siegrist J, Marmot M: Social Inequalities in Health: New Evidence and Policy Implications. 2006, USA: Oxford University Press, 1CrossRef
3.
go back to reference Romeri E, Baker A, Griffiths C: Mortality by deprivation and cause of death in England and Wales, 1999-2003. Health Statistics Quarterly/Office for National Statistics. 2006, 32: 19-34.PubMed Romeri E, Baker A, Griffiths C: Mortality by deprivation and cause of death in England and Wales, 1999-2003. Health Statistics Quarterly/Office for National Statistics. 2006, 32: 19-34.PubMed
4.
go back to reference Fukuda Y, Nakamura K, Takano T: Higher mortality in areas of lower socioeconomic position measured by a single index of deprivation in Japan. Public Health. 2007, 121 (3): 163-173. 10.1016/j.puhe.2006.10.015.CrossRefPubMed Fukuda Y, Nakamura K, Takano T: Higher mortality in areas of lower socioeconomic position measured by a single index of deprivation in Japan. Public Health. 2007, 121 (3): 163-173. 10.1016/j.puhe.2006.10.015.CrossRefPubMed
5.
go back to reference Graham DJ, Stephens DA: Decomposing the impact of deprivation on child pedestrian casualties in England. Accident; Analysis and Prevention. 2008, 40 (4): 1351-1364. 10.1016/j.aap.2008.02.006.CrossRefPubMed Graham DJ, Stephens DA: Decomposing the impact of deprivation on child pedestrian casualties in England. Accident; Analysis and Prevention. 2008, 40 (4): 1351-1364. 10.1016/j.aap.2008.02.006.CrossRefPubMed
6.
go back to reference Daponte-Codina A, Bolivar-Munoz J, Toro-Cardenas S, Ocana-Riola R, Benach-Rovira J, Navarro-Lopez V: Area deprivation and trends in inequalities in self-rated health in Spain, 1987--2001. Scandinavian Journal of Public Health. 2008, 36 (5): 504-515. 10.1177/1403494807088454.CrossRefPubMed Daponte-Codina A, Bolivar-Munoz J, Toro-Cardenas S, Ocana-Riola R, Benach-Rovira J, Navarro-Lopez V: Area deprivation and trends in inequalities in self-rated health in Spain, 1987--2001. Scandinavian Journal of Public Health. 2008, 36 (5): 504-515. 10.1177/1403494807088454.CrossRefPubMed
7.
go back to reference Scanlon PH, Carter SC, Foy C, Husband RFA, Abbas J, Bachmann MO: Diabetic retinopathy and socioeconomic deprivation in Gloucestershire. Journal of Medical Screening. 2008, 15 (3): 118-121. 10.1258/jms.2008.008013.CrossRefPubMed Scanlon PH, Carter SC, Foy C, Husband RFA, Abbas J, Bachmann MO: Diabetic retinopathy and socioeconomic deprivation in Gloucestershire. Journal of Medical Screening. 2008, 15 (3): 118-121. 10.1258/jms.2008.008013.CrossRefPubMed
8.
go back to reference Testi A, Ivaldi E: Material versus social deprivation and health: a case study of an urban area. The European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care. 2009, 10 (3): 323-328.CrossRefPubMed Testi A, Ivaldi E: Material versus social deprivation and health: a case study of an urban area. The European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care. 2009, 10 (3): 323-328.CrossRefPubMed
9.
go back to reference Adams RJ, Howard N, Tucker G, Appleton S, Taylor AW, Chittleborough C, et al: Effects of area deprivation on health risks and outcomes: a multilevel, cross-sectional, Australian population study. International Journal of Public Health. 2009, 54 (3): 183-192. 10.1007/s00038-009-7113-x.CrossRefPubMed Adams RJ, Howard N, Tucker G, Appleton S, Taylor AW, Chittleborough C, et al: Effects of area deprivation on health risks and outcomes: a multilevel, cross-sectional, Australian population study. International Journal of Public Health. 2009, 54 (3): 183-192. 10.1007/s00038-009-7113-x.CrossRefPubMed
10.
go back to reference Ocaña-Riola R, Saurina C, Fernández-Ajuria A, Lertxundi A, Sánchez-Cantalejo C, Saez M, et al: Area deprivation and mortality in the provincial capital cities of Andalusia and Catalonia (Spain). Journal of Epidemiology and Community Health. 2008, 62 (2): 147-152. 10.1136/jech.2006.053280.CrossRefPubMed Ocaña-Riola R, Saurina C, Fernández-Ajuria A, Lertxundi A, Sánchez-Cantalejo C, Saez M, et al: Area deprivation and mortality in the provincial capital cities of Andalusia and Catalonia (Spain). Journal of Epidemiology and Community Health. 2008, 62 (2): 147-152. 10.1136/jech.2006.053280.CrossRefPubMed
11.
go back to reference Amuzu A, Carsona C, Watt HC, Lawlor DA, Ebrahim S: Influence of area and individual lifecourse deprivation on health behaviours: findings from the British Women's Heart and Health Study. European Journal of Cardiovascular Prevention and Rehabilitation. 2009, 16 (2): 169-173. 10.1097/HJR.0b013e328325d64d.CrossRefPubMed Amuzu A, Carsona C, Watt HC, Lawlor DA, Ebrahim S: Influence of area and individual lifecourse deprivation on health behaviours: findings from the British Women's Heart and Health Study. European Journal of Cardiovascular Prevention and Rehabilitation. 2009, 16 (2): 169-173. 10.1097/HJR.0b013e328325d64d.CrossRefPubMed
12.
go back to reference Gray L, Leyland AH: A multilevel analysis of diet and socio-economic status in Scotland: investigating the 'Glasgow effect'. Public Health Nutrition. 2009, 12 (9): 1351-8. 10.1017/S1368980008004047.CrossRefPubMed Gray L, Leyland AH: A multilevel analysis of diet and socio-economic status in Scotland: investigating the 'Glasgow effect'. Public Health Nutrition. 2009, 12 (9): 1351-8. 10.1017/S1368980008004047.CrossRefPubMed
13.
go back to reference Giskes K, van Lenthe FJ, Turrell G, Brug J, Mackenbach JP: Smokers living in deprived areas are less likely to quit: a longitudinal follow-up. Tobacco Control. 2006, 15 (6): 485-488. 10.1136/tc.2006.015750.CrossRefPubMedPubMedCentral Giskes K, van Lenthe FJ, Turrell G, Brug J, Mackenbach JP: Smokers living in deprived areas are less likely to quit: a longitudinal follow-up. Tobacco Control. 2006, 15 (6): 485-488. 10.1136/tc.2006.015750.CrossRefPubMedPubMedCentral
14.
go back to reference Stimpson JP, Nash AC, Ju H, Eschbach K: Neighborhood Deprivation is associated with lower levels of serum carotenoids among adults participating in the Third National Health and Nutrition Examination Survey. Journal of the American Dietetic Association. 2007, 107 (11): 1895-1902. 10.1016/j.jada.2007.08.016.CrossRefPubMed Stimpson JP, Nash AC, Ju H, Eschbach K: Neighborhood Deprivation is associated with lower levels of serum carotenoids among adults participating in the Third National Health and Nutrition Examination Survey. Journal of the American Dietetic Association. 2007, 107 (11): 1895-1902. 10.1016/j.jada.2007.08.016.CrossRefPubMed
15.
go back to reference Utter J, Scragg R, Mhurchu CN, Schaaf D: At-home breakfast consumption among New Zealand children: associations with body mass index and related nutrition behaviors. Journal of the American Dietetic Association. 2007, 107 (4): 570-576. 10.1016/j.jada.2007.01.010.CrossRefPubMed Utter J, Scragg R, Mhurchu CN, Schaaf D: At-home breakfast consumption among New Zealand children: associations with body mass index and related nutrition behaviors. Journal of the American Dietetic Association. 2007, 107 (4): 570-576. 10.1016/j.jada.2007.01.010.CrossRefPubMed
16.
go back to reference Ecob R, Macintyre S: Small area variations in health related behaviours; do these depend on the behaviour itself, its measurement, or on personal characteristics?. Health & Place. 2000, 6 (4): 261-274.CrossRef Ecob R, Macintyre S: Small area variations in health related behaviours; do these depend on the behaviour itself, its measurement, or on personal characteristics?. Health & Place. 2000, 6 (4): 261-274.CrossRef
17.
go back to reference Middleton E: Comparison of social distribution of immunisation with measles, mumps, and rubella vaccine, England, 1991-2001. BMJ. 2003, 326 (7394): 854-854. 10.1136/bmj.326.7394.854.CrossRefPubMedPubMedCentral Middleton E: Comparison of social distribution of immunisation with measles, mumps, and rubella vaccine, England, 1991-2001. BMJ. 2003, 326 (7394): 854-854. 10.1136/bmj.326.7394.854.CrossRefPubMedPubMedCentral
18.
go back to reference Maheswaran R, Pearson T, Jordan H, Black D: Socioeconomic deprivation, travel distance, location of service, and uptake of breast cancer screening in North Derbyshire, UK. Journal of Epidemiology and Community Health. 2006, 60 (3): 208-212. 10.1136/jech.200X.038398.CrossRefPubMedPubMedCentral Maheswaran R, Pearson T, Jordan H, Black D: Socioeconomic deprivation, travel distance, location of service, and uptake of breast cancer screening in North Derbyshire, UK. Journal of Epidemiology and Community Health. 2006, 60 (3): 208-212. 10.1136/jech.200X.038398.CrossRefPubMedPubMedCentral
19.
go back to reference Lynch JW, Kaplan GA, Salonen JT: Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse. Social Science & Medicine. 1997, 44 (6): 809-819.CrossRef Lynch JW, Kaplan GA, Salonen JT: Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse. Social Science & Medicine. 1997, 44 (6): 809-819.CrossRef
21.
go back to reference Castellsagué X: Natural history and epidemiology of HPV infection and cervical cancer. Gynecologic Oncology. 2008, 110 (3 Suppl 2): S4-7. 10.1016/j.ygyno.2008.07.045.CrossRefPubMed Castellsagué X: Natural history and epidemiology of HPV infection and cervical cancer. Gynecologic Oncology. 2008, 110 (3 Suppl 2): S4-7. 10.1016/j.ygyno.2008.07.045.CrossRefPubMed
24.
go back to reference Shack L, Jordan C, Thomson CS, Mak V, Møller H: Variation in incidence of breast, lung and cervical cancer and malignant melanoma of skin by socioeconomic group in England. BMC Cancer. 2008, 8: 271-10.1186/1471-2407-8-271.CrossRefPubMedPubMedCentral Shack L, Jordan C, Thomson CS, Mak V, Møller H: Variation in incidence of breast, lung and cervical cancer and malignant melanoma of skin by socioeconomic group in England. BMC Cancer. 2008, 8: 271-10.1186/1471-2407-8-271.CrossRefPubMedPubMedCentral
25.
go back to reference Noble M, McLennan D, Wilkinson K, Whitworth A, Barnes H: The English Indices of Deprivation 2007. 2007, London Noble M, McLennan D, Wilkinson K, Whitworth A, Barnes H: The English Indices of Deprivation 2007. 2007, London
26.
go back to reference Chin RFM, Neville BGR, Peckham C, Wade A, Bedford H, Scott RC: Socioeconomic deprivation independent of ethnicity increases status epilepticus risk. Epilepsia. 2009, 50 (5): 1022-1029. 10.1111/j.1528-1167.2008.01796.x.CrossRefPubMed Chin RFM, Neville BGR, Peckham C, Wade A, Bedford H, Scott RC: Socioeconomic deprivation independent of ethnicity increases status epilepticus risk. Epilepsia. 2009, 50 (5): 1022-1029. 10.1111/j.1528-1167.2008.01796.x.CrossRefPubMed
28.
go back to reference Selvin S: Statistical Analysis of Epidemiologic Data. 1996, USA: Oxford University Press, 2 Selvin S: Statistical Analysis of Epidemiologic Data. 1996, USA: Oxford University Press, 2
29.
go back to reference World Health Organization: Ottawa Charter for Health Promotion. 1986, WHO, Geneva World Health Organization: Ottawa Charter for Health Promotion. 1986, WHO, Geneva
30.
go back to reference Department of Health (UK): Choosing Health: Making healthy choices easier. 2004, DOH, London Department of Health (UK): Choosing Health: Making healthy choices easier. 2004, DOH, London
31.
go back to reference Aurélio Peres M, Simara Fernandes L, Glazer Peres K: Inequality of water fluoridation in Southern Brazil - the inverse equity hypothesis revisited. Social Science & Medicine. 2004, 58 (6): 1181-1189.CrossRef Aurélio Peres M, Simara Fernandes L, Glazer Peres K: Inequality of water fluoridation in Southern Brazil - the inverse equity hypothesis revisited. Social Science & Medicine. 2004, 58 (6): 1181-1189.CrossRef
32.
go back to reference Victora CG, Vaughan JP, Barros FC, Silva AC, Tomasi E: Explaining trends in inequities: evidence from Brazilian child health studies. Lancet. 2000, 356 (9235): 1093-1098. 10.1016/S0140-6736(00)02741-0.CrossRefPubMed Victora CG, Vaughan JP, Barros FC, Silva AC, Tomasi E: Explaining trends in inequities: evidence from Brazilian child health studies. Lancet. 2000, 356 (9235): 1093-1098. 10.1016/S0140-6736(00)02741-0.CrossRefPubMed
34.
go back to reference Buston K, Wight D, Hart G, Scott S: Implementation of a teacher-delivered sex education programme: obstacles and facilitating factors. Health Education Research. 2002, 17 (1): 59-72. 10.1093/her/17.1.59.CrossRefPubMed Buston K, Wight D, Hart G, Scott S: Implementation of a teacher-delivered sex education programme: obstacles and facilitating factors. Health Education Research. 2002, 17 (1): 59-72. 10.1093/her/17.1.59.CrossRefPubMed
35.
go back to reference Schaalma HP, Abraham C, Rogers Gillmore M, Kok G: Sex Education as Health Promotion: What Does It Take?. Archives of Sexual Behavior. 2004, 33 (3): 259-269. 10.1023/B:ASEB.0000026625.65171.1d.CrossRefPubMed Schaalma HP, Abraham C, Rogers Gillmore M, Kok G: Sex Education as Health Promotion: What Does It Take?. Archives of Sexual Behavior. 2004, 33 (3): 259-269. 10.1023/B:ASEB.0000026625.65171.1d.CrossRefPubMed
36.
go back to reference Reidpath D, Diamond MR, Hartel G, Glasziou P: Improving interpretability: γ As an alternative to R2 as a measure of effect size. Statistics in Medicine. 2000, 19 (10): 1295-1302. 10.1002/(SICI)1097-0258(20000530)19:10<1295::AID-SIM493>3.0.CO;2-Z.CrossRefPubMed Reidpath D, Diamond MR, Hartel G, Glasziou P: Improving interpretability: γ As an alternative to R2 as a measure of effect size. Statistics in Medicine. 2000, 19 (10): 1295-1302. 10.1002/(SICI)1097-0258(20000530)19:10<1295::AID-SIM493>3.0.CO;2-Z.CrossRefPubMed
Metadata
Title
Social deprivation and exposure to health promotion. A study of the distribution of health promotion resources to schools in England
Authors
Corina M Chivu
Daniel D Reidpath
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-473

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