Objective To determine the incidence of epilepsy in a general practice population and its variation with socioeconomic deprivation. Design Prospective surveillance for new cases over an 18 or 24 month period. Participants All patients on practice registers categorised for deprivation with the Carstairs score of their postcode. Setting 20 general practices in London and south east England. Main outcome measure Confirmed diagnosis of epilepsy.Results 190 new cases of epilepsy were identified during 369 283 person years of observation (crude incidence 51.5 (95% confidence interval 44.4 to 59.3) per 100 000 per year). The incidence was 190 (138 to 262) per 100 000 in children aged 0-4 years, 30.8 (21.3 to 44.6) in those aged 45-64 years, and 58.7 (42.5 to 81.0) in those aged >65 years. There was no apparent difference in incidence between males and females. The incidence showed a strong association with socioeconomic deprivation, the age and sex adjusted incidence in the most deprived fifth of the study population being 2.33 (1.46 to 3.72) times that in the least deprived fifth (P=0.001 for trend across fifths). Adjustment for area (London v outside London) weakened the association with deprivation (rate ratio 1.62 (0.91 to 2.88), P=0.12 for trend). Conclusions The incidence of epilepsy seems to increase with socioeconomic deprivation, though the association may be confounded by other factors.
Objective: To develop and map indices to illustrate variation in the cost and availability of healthy food. Design: Two contiguous wards in London were selected by virtue of their high Carstairs deprivation scores. A 2-km area was defined around a randomly chosen central point. All retail outlets selling food within the area were visited and their location recorded. A list of foods, acceptable to the local ethnically diverse population, which met current dietary guidelines, was devised. Data on the availability and price of 71 food items were collected. Indices were developed using SPSS and mapped using Geographic Information System (GIS) software. Results: Information on availability and prices were collected from 199 outlets. The mean price index shows how expensive a shop is relative to other shops in the area. The least cost index shows the relative expense of a shop using the cheapest ways of buying their range of foods. Shorthand indices were tested, using data on 19 of the 71 prices. Availability indices are also discussed, including a green availability index and a fresh green availability index. Illustrative maps of the shop locations and the mean price index and fresh green availability index are shown. Conclusions: Data can be collected and indices developed which indicate geographic variation in shop 'expensiveness', and in the price and availability of healthy food. GIS software can be used to map these indices, to identify areas with high food prices or low availability.
Access to food is currently on the political agenda. This paper presents a quantitative method for local level use to help identify the geographic location of areas with inadequate access to food. A census of retail outlets selling food of any kind was carried out in a deprived area within a 2km radius from a central point between two estates. Information on the price and availability of “healthy” food lists, acceptable to each of the four major ethnic groups in the area, was collected. The food lists were not mutually exclusive. Food shops were mapped in terms of food availability and price indices using Geographical Information System (GIS) software. Maps show, progressively: roads within/outside 500m of a postcode with any outlet selling food; any outlet selling more than 50 per cent of the food list, below the area mean price, acceptable to a Gujarati Hindu; the latter in relation to population density. Within the area analysed there appears to be reasonable walking access to the more reasonably priced shops within the area, however the cost of a healthy diet would still require more than 50 per cent of the income of someone in receipt of income support.
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