Deprivation amplification revisited; or, is it always true that poorer places have poorer access to resources for health
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BioMed Central
Open Access
Debate
Deprivation amplification revisited; or, is it always true that poorer places have poorer access to resources for healthy diets and physical activity? Sally Macintyre Address: MRC Social and Public Health Sciences Unit, Glasgow, G12 8RZ, UK Email: Sally Macintyre - [email protected]
Published: 7 August 2007 International Journal of Behavioral Nutrition and Physical Activity 2007, 4:32 5868-4-32
doi:10.1186/1479-
Received: 26 July 2007 Accepted: 7 August 2007
This article is available from: http://www.ijbnpa.org/content/4/1/32 © 2007 Macintyre; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: It has commonly been suggested (including by this author) that individual or household deprivation (for example, low income) is amplified by area level deprivation (for example, lack of affordable nutritious food or facilities for physical activity in the neighbourhood). Discussion: The idea of deprivation amplification has some intuitive attractiveness and helps divert attention away from purely individual determinants of diet and physical activity, and towards health promoting or health damaging features of the physical and social environment. Such environmental features may be modifiable, and environmental changes may help promote healthier behaviors. However, recent empirical examination of the distribution of facilities and resources shows that location does not always disadvantage poorer neighbourhoods. This suggests that we need: a) to ensure that theories and policies are based on up-to-date empirical evidence on the socioeconomic distribution of neighbourhood resources, and b) to engage in further research on the relative importance of, and interactions between, individual and environmental factors in shaping behavior. Summary: In this debate paper I suggest that it may not always be true that poorer neighbourhoods are more likely to lack health promoting resources, and to be exposed to more health damaging resources. The spatial distribution of environmental resources by area socioeconomic status may vary between types of resource, countries, and time periods. It may also be that the presence or absence of resources is less important than their quality, their social meaning, or local perceptions of their accessibility and relevance.
Background Since the mid 1990s there has been considerable interest in the relative importance of individual and environmental characteristics in influencing health and health related behaviors. An extensive literature on area variations in health has reviewed the traditional distinction between compositional and contextual explanations (the former
referring to the nature of the residents of an area, the latter to the nature of the area) [1-5]. Most empirical studies have c
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