Do attitude and area influence health? A multilevel approach to health inequalities

This paper demonstrates an area effect on health and suggests improvements in research practice for work in this field. We use an area classification which can be related clearly to factors that influence the health of indivi duals and take account of people's differing propensities to draw influence from their area. Multilevel analysis demonstrates that the degree of deind ustrialisation which an area experienced in Britain, in the 1980s, has an i ndependent association with the health of resident individuals. A significa nt relationship between a person's attitude to their community and their he alth is shown to be independent of individual and area characteristics. We conclude that both individual and area characteristics influence health. (C ) 2000 Elsevier Science Ltd. All rights reserved.