Bebbington, Andrew; Bajekal, Madhavi; (2003) Sub-national Variations in Health Expectancy. In: Robine, JM and Jagger, C and Mathers, CD and Crimmins, EM and Suzman, RM, (eds.) Determining Health Expectancies. (pp. 127-147). John Wiley & Sons: Chichester (West Sussex), UK.

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Abstract

Regional and local variations within countries are, along with social class, education, gender and ethnicity variations, an important aspect of equity which health expectancy1 measures have been used to examine. While location variations are perhaps less immediate to an individual’s personal circumstances than the other socio-demographic factors, there are three reasons why they are important. First, health services delivery is essentially geographically determined, and must be administered locally. In countries where the management of health care is centralised, identifying health variations as a basis for regional and local resource allocation is a major policy issue. Second, the collection of evidence about health, such as mortality statistics, is invariably organised locally, so figures for local variations are often more readily available, more reliable, and more detailed, than those based on, for example, social class. Third, some social characteristics which are relevant to equity issues are themselves closely linked to locality: such as comparisons between urban and rural dwellers, the needs of deprived neighbourhoods. This chapter reviews a number of studies that have been concerned with the sub-national dimension in health expectancy variations

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