Does car ownership reflect socio-economic disadvantage in rural areas? A cross-sectional geographical study in Wales, UK
Introduction
A recent discussion paper1 has highlighted the urgent need for evidence to inform the derivation of robust and sensitive indicators of rural deprivation. Despite the widely held belief that existing deprivation indicators are inappropriate for use in rural areas,1., 2. the Townsend index3 and the Carstairs index4 are commonly used across rural and urban areas for investigation of health need and targeting of resources.1 These indices, which include the car ownership census variable, may be poor indicators of deprivation in rural areas since levels of car ownership in households with similar income have been shown to be higher in rural areas.5 The aim of this study is therefore, to assess whether the relation between lack of car ownership and socio-economic deprivation varies between urban and rural enumeration districts in Wales, UK, and whether excluding car ownership from the Townsend index substantively affects the deprivation ranking of enumeration districts.
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Methods
We used the Office for National Statistics' urban/rural classification of enumeration districts.6 Using a geographical information system (MapInfo Professional Version 6.5), we stratified enumeration districts in Wales (population 2.9 million) into deciles of population density within the urban and rural groups, based on equal population size within each decile.
From the 1991 Census of Population Small Area Statistics, we extracted the enumeration district level proportions of: households with
Results
Of the 6376 enumeration districts classified, 4740 (74%) were urban and 1636 (26%) were rural. The proportion of households with no car was lower in rural areas (17%) than in urban areas (35%). Table 1 shows that for the seven census variables correlated with the car ownership variable, the correlation coefficients were greater in urban than in rural areas. The pattern of correlations varied by population density within urban and rural areas. Within urban enumeration districts, all correlations
Discussion
Although car ownership is related to household income,5., 7. our results suggest that car ownership is a poor proxy for social disadvantage in the most sparsely populated rural areas of Wales. In these deep rural areas, the level of car ownership is higher than would be expected from the level of the other proxy variables for deprivation. Exclusion of the car ownership variable from the Townsend index had a substantive effect on the rankings of rural enumeration districts, re-categorizing them
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