How do we create interventions that can encourage all members of society to be more physically active and eat better diets? It’s a knotty question with many different factors to be considered. One basic element is where the interventions are. We’re pretty sure that good neighborhood design, with well-located resources, can reduce health disparities associated with poverty. However, an intervention is less likely to improve minority health if it’s not accessible to those most in need. I investigated this using the English ‘Healthy Towns’ communities, a group of ethnically diverse towns and cities, including neighborhoods in London, experiencing poverty and ill health. The government had funded health promoting infrastructure in these places. I tested a
technique for spatial equity analysis to help us understand what infrastructure was put where, for whom and why.
This technique can be used to identify resource gaps and suggest locations where interventions should be located to address health disparities. The process is relatively straightforward, but you need to be thorough when collecting your evidence. It’s not just a case of drawing, say, a one mile circle around existing play parks and claiming that children living in these areas are well-provided for and those outside aren’t. For example, some locations have more children living there, therefore a higher demand. Or, parks may be plentiful but underused because of their poor quality or poor access. These considerations are crucial for directing infrastructure and other interventions to where they’re needed most.
Overall, this work indicated that spatial equity analysis can be useful as the first step in future evaluations for health interventions, especially when it’s too early to measure direct health impacts. In the case of the ‘Healthy Towns’ program, we found that interventions were generally well-located in areas of highest population need, as determined by program managers. This is a good start, but we’ll need to wait to see if the aims – to make people more active and healthier eaters – will be met.
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is a Senior Research Associate with the
University of East Anglia
(Norwich, UK). She uses GIS and GPS to understand
the health implications of human interactions with natural and built environments.
She works with researchers at the UKCRC Centre for Diet and Activity Research (CEDAR) .