Tackling inequalities in health: evaluating the New Deal for Communities initiative

Objective: To assess health improvement and differential changes in health across various sociodemographic groups in neighbourhood renewal areas. Design and setting: A longitudinal survey of 10 390 residents in New Deal for Communities (NDC) areas and 977 residents in comparator areas in England. Measures and methods: Changes on several outcomes across five domains (health, unemployment, education, crime and the physical environment) were assessed by sex, age, educational and ethnic group. Results: Small overall improvements were seen on all domains in NDC areas but similar improvements were also seen in comparator areas. In NDC areas, higher educational groups were more likely to stop smoking, less likely to develop a limiting long-term illness, more likely to find employment and more likely to participate in education or training (p for trend <0.05). Older people and women were less likely to find employment and experienced smaller increases in income. These patterns were generally mirrored in comparator areas, although the education gradient in participation in education or training was less steep in NDC areas. Conclusions: Evidence from two-year follow-up does not support an NDC effect, either overall or for particular population groups. Residents with lower education experienced the least favourable health profiles at baseline and the smallest improvements. Programme leaders should consider how to encourage participation among those with the lowest education. A shallower social gradient in participation in education and training in NDC areas and a lack of gradient in income, crime and environmental outcomes indicate that some aspects of the programme may be reaching all sections of the community.