An ecological analysis of child medical emergency admissions to hospitals in West Glamorgan

Despite the operation of the National Health Service in the United Kingdom for nearly 30 years, the poorer standards of health traditionally associated with the older industrial regions of the northe and west, the relatively inaccessible rural areas, the industrial environment of inner cities, and the lower status groups throughout the country, remain to a significant degree. Much of the investigation of this problem has concentrated on the national and regional scales of analysis. This study aims to determine whether such imbalances occur at a more local scale and, if they do, to determine whether they are associated with any particular characteristics of the housing or social environment. Attention was focused specifically on incidence rates of children admitted to hospitals as emergency medical cases in the West Glamorgan Health Authority area for a six month period in 1976. The analysis was undertaken at the scale of the 72 urban wards and rural parishes. Significant imbalances were noted and a human ecological investigations using principal component analysis was undertaken to identify meaningful patterns of association. Two distinct dimensions of disadvantage were suggested. High hospital admission rates were associated with concentrations of local authority housing estates and the explanatory significance of the social life style associated with this type of residential area was suggested. In addition, low status residential areas with concentrations of substandard terraced housing were similarly distinguished and the primary significance of the character of the built environment was suggested.