Effects of area deprivation on health risks and outcomes: a multilevel, cross-sectional, Australian population study.
OBJECTIVE
Our aim was to examine the effect of local area socio-economic disadvantage after accounting for individual socio-economic status (SES), and to determine if these differ between various health and risk factor variables.


METHODS
The North West Adelaide Health Study (NWAHS) is a biomedical representative population study of adults. The Index of Relative Socio-Economic Disadvantage (IRSD), produced from the Australian Bureau of Statistics (ABS) Census data at the level of Collector Districts (200 dwellings) was used as an indicator of local area disadvantage. Multi-level modeling techniques examined the effects of IRSD level on a variety of health outcomes and risk factors, after accounting for individual socio-economic factors.


RESULTS
Significant, independent associations were seen between IRSD and obesity, smoking, and health-related quality of life, with 5 % to 7.2 % of the variance located at the neighborhood level. No independent associations were seen between IRSD and estimated cardiovascular disease risk, diabetes, physical activity, or at-risk alcohol use.


CONCLUSIONS
Aggregated area-level characteristics make modest, but significant independent contributions to smoking, obesity and quality of life, but not for other health outcomes.
Adams
Robert J
RJ
Discipline of Medicine, The Health Observatory, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, SA, 5011, Australia. robert.adams@adelaide.edu.au
Howard
Natasha
N
Tucker
Graeme
G
Appleton
Sarah
S
Taylor
Anne W
AW
Chittleborough
Catherine
C
Gill
Tiffany
T
Ruffin
Richard E
RE
Wilson
David H
DH
D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D054624:Health Status Disparities; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D011610:Psychosocial Deprivation; D011788:Quality of Life; D012111:Residence Characteristics; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D013021:South Australia