Regional Inequalities in Health in the UK: the contribution of individual-level characteristics and the role of the small area environment.

Ilori, Godsfavour (2025) Regional Inequalities in Health in the UK: the contribution of individual-level characteristics and the role of the small area environment. Doctoral thesis, University of East Anglia.

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Abstract

Background: Regional health inequalities in the UK pose a significant public health challenge, marked by considerable disparities in health outcomes across different geographical areas. Understanding these geographic differences is complex, influenced by various lifestyle factors and health indicators at both individual and environmental levels, with limited information available to guide intervention development.

Objective: This study investigates the underlying sources of regional disparities in chronic kidney disease (CKD) and hypertension in the UK and examines the contribution of neighbourhood environments to these disparities.

Methods: Using a nationally representative dataset from the Understanding Society data, individual-level biomarker data was linked to neighbourhood-level data from the English Indices of Deprivation at the Lower Layer Super Output Area (LSOA) level. The London region served as a reference group due to its generally better health outcomes. Initially, ordinary least squares regression and Oaxaca-Blinder decomposition were employed, later supplemented by unconditional quantile regression analysis to assess regional differentials in the biomarkers and quantify contribution of neighbourhood characteristics.

Results: Significant regional disparities were found across the UK, primarily driven by differences in observed regional characteristics. Education appeared as a crucial factor in health disparities. Concentration was given to the lower tail (25th quantile) of estimated glomerular filtration rates and the upper tail (90th quantile) of systolic blood pressure, indicating higher risks for CKD and hypertension respectively. Neighbourhood-level characteristics were significant drivers of these regional inequalities. Socioeconomic status and demographics are associated with coastal disparities in the East of England region.

Conclusion: The findings suggest that individual-level characteristics and neighbourhood environments contribute to regional health disparities in the UK. Addressing CKD and hypertension requires integrated approaches that combine individual interventions with a focus on the neighbourhood context. However, methods used in this study only show associations and do not establish causality, limiting specific intervention recommendations for local authorities.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Kitty Laine
Date Deposited:	21 May 2025 08:54
Last Modified:	21 May 2025 08:54
URI:	https://ueaeprints.uea.ac.uk/id/eprint/99317
DOI:

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