New Deal for Communities

Health Inequalities Study

Project Summary

'Evaluating the impact of New Deal for Communities on Health Inequalities'

This 3 year study is funded by the Department of Health Policy Research programme and began in January 2010.

Background

Although health and life expectancy have been increasing for many years, socially disadvantaged groups and communities continue to have poorer health than advantaged ones.

The government funded New Deal for Communities (NDC) programme was launched in 1998 and aimed to improve the physical environment (including housing), education and health as well as reduce crime and unemployment in 39 disadvantaged neighbourhoods. Each neighbourhood was funded for 10 years and received on average £50 million from government. New Deal for Communities had the potential to reduce health inequalities because it focused on key determinants of inequalities such as unemployment, crime, education and the physical environment.

In 2005 we completed a scoping study, commissioned by the Department of Health, to assess the feasibility of evaluating the impact on health inequalities of the NDC initiative. This included an assessment of the availability and coverage of relevant data sources and a preliminary data analysis. Based on this, we concluded that a full evaluation of the impact of the NDC initiative on health inequalities was both feasible and desirable and this research builds on that work.

Aims

The aims are to investigate the medium term impacts of the NDC initiative on health inequalities and to establish a data legacy to allow longer term follow up. The main research questions are:

1. What happens to initial improvements in health and social determinants of health over time in NDC areas?
2. Do any differences emerge between social groups within NDC areas and between NDC populations and populations in comparison areas over time?
3. How has the health gap between NDC areas and the England average changed over time?
4. Does the impact of the NDC initiative on health inequalities and social determinants vary across types of NDC areas and approaches?
5. What are the lessons for future initiatives aiming to reduce health inequalities?

Plan of investigation

The evaluation involves three linked strands of work:

• Development of typologies of local NDC programmes according to (1) contextual characteristics; socio-economic trajectories and (2) NDC approaches to social/economic regeneration.
• Linking NDC typologies to health and social outcomes in two data sources based on residents in intervention areas and in matched comparator areas: Ipsos MORI survey data and administrative databases. This data is being used to explore outcomes for different socio-economic groups in NDC areas compared with the NDC comparator areas and outcomes across NDC areas of different types compared with similar types of comparator areas. In addition, data from the Health Survey for England, which is nationally representative, are being used to compare outcomes for NDC areas with areas from across the socio-economic spectrum.
• The construction and preliminary analysis of a data legacy: a resource that can be updated and analysed over time to test for longer term health impacts on the NDC populations