title: Evaluating the health inequalities impact of area-based initiatives across the socioeconomic spectrum: a controlled intervention study of the New Deal for Communities, 2002-2008.
abstract: BACKGROUND
  Previous evaluations of area-based initiatives have not compared intervention areas with the full range of areas from top to bottom of the social spectrum to evaluate their health inequalities impact.
  
  
  METHODS
  Deprived areas subject to the New Deal for Communities (NDC) intervention, local deprivation-matched comparator areas, and areas drawn from across the socioeconomic spectrum (representing high, medium and low deprivation) in England between 2002 and 2008.
  
  
  METHODS
  Secondary analysis of biannual repeat cross-sectional surveys collected for the NDC National Evaluation Team and the Health Survey for England (HSE).
  
  
  METHODS
  Following data harmonisation, baseline and time trends in six health and social determinants of health outcomes were compared. Individual-level data were modelled using regression to adjust for age, sex, ethnic and socioeconomic differences among respondents.
  
  
  RESULTS
  Compared with respondents in HSE low deprivation areas, those in NDC intervention areas experienced a significantly steeper improvement in education, a trend towards a steeper improvement in self-rated health, and a significantly less steep reduction in smoking between 2002 and 2008. In HSE high deprivation areas, significantly less steep improvements in five out of six outcomes were seen compared with HSE low deprivation areas.
  
  
  CONCLUSIONS
  Although unable to consider prior trends and previous initiatives, our findings provide cautious optimism that well-resourced and constructed area-based initiatives can reduce, or at least prevent the widening of, social inequalities for selected outcomes between the most and least deprived groups of areas.
authors.affiliation: Reader in Social Epidemiology, MRC Unit for Lifelong Health and Ageing at UCL, London, UK.
authors.forename: Mai
authors.initials: M
authors.lastname: Stafford
authors.affiliation: Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Hannah
authors.initials: H
authors.lastname: Badland
authors.affiliation: Cathie Marsh Centre for Census and Survey Research, University of Manchester, Manchester, UK.
authors.forename: James
authors.initials: J
authors.lastname: Nazroo
authors.affiliation: Division of Health Research, University of Lancaster, Lancaster, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Halliday
authors.affiliation: Cathie Marsh Centre for Census and Survey Research, University of Manchester, Manchester, UK.
authors.forename: Pierre
authors.initials: P
authors.lastname: Walthery
authors.affiliation: Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.
authors.forename: Sue
authors.initials: S
authors.lastname: Povall
authors.affiliation: School of GeoSciences, University of Edinburgh, Edinburgh, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Dibben
authors.affiliation: Department of Public Health, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.
authors.forename: Margaret
authors.initials: M
authors.lastname: Whitehead
authors.affiliation: Division of Health Research, Department of Sociology and Public Health, University of Lancaster, Lancaster, UK.
authors.forename: Jennie
authors.initials: J
authors.lastname: Popay
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004739:England; D005260:Female; D006291:Health Policy; D006293:Health Promotion / Q000379:methods / Q000458:organization & administration* / Q000592:standards; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000592:standards; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D011204:Poverty Areas; D015397:Program Evaluation; D064890:Social Determinants of Health
keywords: DEPRIVATION; INEQUALITIES; POLICY; SOCIO-ECONOMIC