Abstract
Objectives: To identify plausible mechanisms by which resilience (low mortality rates despite persistent economic adversity) was achieved in some areas in Britain between 1971 and 2001.
Methods: Mixed method observational study, combining quantitative analyses of cause- and age group-specific mortality rates, and area sociodemographic and environmental characteristics, with case studies of resilient areas which included in-depth interviews.
Results: The causes of death, and age groups, contributing most to resilience varied markedly between the 18 resilient areas; as disease aetiology varies, a range of protective processes must be in operation. Four area characteristics, which plausibly contributed to resilience, emerged from the in-depth interviews: population composition; retaining or attracting population; environment and housing; and social cohesion. Quantitative analyses demonstrated significant difference between resilient and non-resilient areas in retaining or attracting population only.
Conclusions: While we identified plausible area characteristics through which resilience was achieved, there does not appear to be a definitive set that reliably produces resilience, and resilient and non-resilient areas did not differ significantly in their possession of most of these characteristics. If such characteristics do have a role in creating resilience, but are present in both resilient and non-resilient areas, further work is needed to explore what makes them "successful'' in some areas, but not in others.
| Original language | English |
|---|---|
| Pages (from-to) | 18-23 |
| Number of pages | 6 |
| Journal | Journal of epidemiology and community health |
| Volume | 63 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 2009 |
Keywords
- SOCIOECONOMIC DETERMINANTS
- SHRINKING AREAS
- HEALTH
- MORTALITY
- ENGLAND
- WALES
- INEQUALITIES
- MIGRATION
- DEPRIVATION
- GREENSPACE