Interregional variations inmeasures ofhealth from theHealth andLifestyle Surveyandtheir relation withindicators ofhealth care needinEngland

Studyobjective-The aimwastoassess theextenttowhicha rangeofroutinely available needindicators whichhavebeen suggested foruseinNHS spatial resource allocation formulaswere associated geographically in England with the different dimensions ofpopulation health statuscollected inthe1985/86 Healthand Lifestyle Survey(HLS). Design-Regional health authorities were rankedaccording toeachoftheHLShealth variables whichvaried significantly between authorities. TheHLS health variables were regressed ona selection fromtherangeof routinelyavailablemorbidityand socioeconomic indicators available fromthe 1981census. Thepotential needindicators werealsoregressed onthehealth variables. Setting-The analyses wereundertaken at individual leveland at regional health authority level inEngland. Subjects-The studycomprisedthe English componentoftheHLS random samplerepresentative ofthepopulation in private households inGreatBritain. Mainresults-The different HLS health variables didnotyield consistent regional healthauthority rankings. Among the variables, forced expiratory volumeinone second(FEVy) and selfassessed health appeared tobeassociated withmostofthe otherhealthand needvariables except longstanding illness. Longstanding illness wasnotstrongly associated withanyofthe otherHLShealth variables butappeared to show some association with three deprivation indices constructed fromthe 1981Census. Conclusions-There may bea casefor including ameasureofchronic ill health in thenewNHS systemofcapitated finance in addition to theallcausestandardised mortality ratio whichisusedcurrently asa measureofneedforhealth care.