Places, people, and their physical and mental functional health

Study objective: To investigate the impact of area of residence on functional health as represented by medical outcomes study SF-36 physical and mental component summary scores. Design: Multilevel analysis of cross sectional data from the European Prospective Investigation into Cancer and Nutrition in Norfolk, UK (EPIC-Norfolk). Participants: A community dwelling cohort of 18 399 men and women, aged 41 to 80 and resident in 162 electoral wards in Norfolk, UK. Main results: Significant residual variation in physical functional health was observed at the area level after controlling for important individual level socioeconomic factors (p < 0.001). However, the extent of this variation was modest when compared with that at the individual level (representing 0.6% of the total). About half of this variation could be explained by area deprivation. Area deprivation was associated with impaired mental functional health but residual variation at the area level (adjusted for individual level factors) was observed only for men (0.5% of total, p = 0.02). Conclusions: Area of residence was associated with physical functional health, albeit with modest effect size. Evidence for an association between area of residence and mental functional health was weak.