A standardisation approach tothecontrol of socioeconomic confounding insmall area studies ofenvironment andhealth

Objective - To assesshow effectively a routine adjustment canbemadeforsocioeconomicconfounding insmallareastudiesof environmentand healthusing indirect standardisation andsmallarea deprivation indices, including analysis of theappropriate sizeofpopulation uniton whichtobasethedeprivation indexand theimportance ofregion andurban/rural status asaxesofstratification. Method- Standardised morbidity ratios werecalculated forcancers inGreatBritainfor1981andstandardised mortality ratios forallcausemortality inGreatBritainbetweeen1982and1985.Deprivation indices werecalculated forenumeration districts andwardsfrom1981smallarea censusstatistics. Cancersanddeaths were allocated toenumeration districts viatheir postcode. Standardised morbidity and mortality ratios werecalculated byquintileofenumeration district according tothe deprivation index. Standardised mortality ratioswere furtheranalysed by deprivation ofward,region, andurban/rural