People, places and policies - trying to account for health inequalities in impoverished neighbourhoods

Objective: We consider associations between individual, household and area-level characteristics and self-reported health. Method: Data is taken from baseline surveys undertaken in 13 socio-economically disadvantaged neighbourhoods in Victoria (n=3,944). The neighbourhoods are sites undergoing Neighbourhood Renewal (NR), a State government initiative redressing place-based disadvantage. Analysis: This focused on the relationship between area and compositional factors and self-reported health. Area was coded into three categories; LGA, NR residents living in public housing (NRPU) and NR residents who lived in private housing (NRPR). Compositional factors included age, gender, marital status, identifying as a person with a disability, level of education, unemployment and receipt of pensions/benefits. Results: There was a gradient in socioeconomic disadvantage on all measures. People living in NR public housing were more disadvantaged than people living in NR private housing who, in turn, were more disadvantaged than people in the same LGA. NR public housing residents reported the worst health status and LGA residents reported the best. Conclusions: Associations between compositional characteristics of disability, educational achievement and unemployment income and poorer self-reported health were shown. They suggested that area characteristics, with housing policies, may be contributing to differences in self-reported health at the neighbourhood level. Implications: The clustering of socioeconomic disadvantage and health outcomes requires the integration of health and social support interventions that address the circumstances of people and places.