Neighborhoods
Between different neighborhoods in North London there is a 10-year variation in life expectancy for men (79.6 years in Belsize Park, 69.7 in Kilburn).
Our research shows that for people of equivalent social status, it is the area that matters. More deprivation in an area means worse health. Lower social position means worse health.
In London people classified as unskilled manual have about twice the mortality rate of top professionals. In the north-east of England, the difference in mortality is sixfold.
Our own studies confirm that poor people living in poor neighborhoods have worse health than if they lived in richer ones.
We gave respondents in a study of civil servants a drawing of a ladder representing the social hierarchy and asked them to place a cross on the rung that marked their place. As expected, the lower the grade of employment, the lower people were likely to place themselves. For people of low employment grade, the more deprived the area, the lower they ranked themselves on the social ladder. For those of low status at work, their perception of social position was enhanced by living in a more affluent area, and further diminished by living in a poor one.
In our studies, we characterised neighborhoods according to responses to a simple survey. We found that trust, tolerance and sense of attachment to the neighbourhood were strongly related to health. These links were independent of the physical infrastructure.
The links of social cohesion to health were stronger among women than men.
Ichiro Kawachi, using responses to a simple social survey, showed that the higher the income inequality of a state, the lower was the level of trust, perceived fairness, perceived helpfulness or civic engagement. He concluded that low social capital provides the mechanism that links income inequality to mortality.