Socio-economic deprivation is associated with increased proximity to general practices in England: an ecological analysis

Background As health status is consistently negatively correlated with socio-economic deprivation, the need for health services is generally assumed to be greater in more deprived communities. The Inverse Care Law predicts that access to good quality primary care services in more deprived wards will be less than that in affluent wards. However, the relationship between deprivation and geographical proximity to health services has received little attention. Methods We investigated the relationship between geographical proximity to general practices and a number of markers of socio-economic deprivation at the electoral ward level in the North East of England using various domains of the Index of Multiple Deprivation 2000 (IMD2000). Results More deprived wards, as measured by the employment, education and income domains of the IMD2000, had greater proximity to general practices, as measured by the access domain of the IMD2000, than affluent wards. This results held in both urban and rural wards. Conclusions Contrary to our expectations and the predictions of the Inverse Care Law, geographical proximity to general practices was greater in more deprived, compared to more affluent wards. However, geographical proximity to services does not necessarily ensure that services will be accessed or that they are of good quality.