Science and Technology CommitteeSupplementary written evidence submitted by the Royal Geographical Society (with The Institute of British Geographers) (Census 33a)

EMAIL TO THE COMMITTEE FROM PROFESSOR PHIL REES, ROYAL GEOGRAPHICAL SOCIETY, 15 DECEMBER 2011

Oral Evidence 14 December 2011

I make a couple of observations on a remark made and a question asked by The Right Honourable Graham Stringer, Labour MP for Blackley and Broughton.

The role of an information infrastructure in building the welfare state

Mr. Stringer made the point that the reforms of the Labour Government of 1945–51 which established the foundations of Britain’s welfare state were uniformed by a census because in 1941 the exigencies of the Second World War meant that such an enumeration was not possible. However, I would point out that crucial to the war effort and the foundation of the National Health Service was the second National Register, 1939 to 1952. Conscription, labour direction, rationing and patient lists were founded on the National Register. I would argue that if you do not have a census after 2011, then such a register is absolutely necessary, where set up, as I argued for, as a full Population Register or constructed virtually by matching records across existing national administrative registers, including the NHS Register.

Do poor people report less or more illness than richer people?

Mr. Stringer stated that he was puzzled by higher rates of illness (Limiting Long Term Illness) revealed in the Census for Buckinghamshire than inner London or Manchester and suggested that the question on LLTI might achieve different responses from richer than poorer people. I don’t think this observation is correct. The maps of LLTI from the 2001 Census (eg Daniel Dorling and Bethan Thomas (2004. People and Places: A 2001 Census Atlas of the UK. The Policy Press, Bristol) show clearly that Buckinghamshire has lower LLTI rates than inner London or Manchester. A map from their atlas showing LLTI for persons age 16+ (adults) by local authority is available online at:

http://www.sasi.group.shef.ac.uk/publications/pandpexamples.htm#illness

However, I would observe that this map underestimates the inequalities because before you can compare illness rates in different areas, you must standardize for the effects of age structure. When you do that the gaps between poorer inner city and affluent suburb are even greater. Studies of the variation of standardized LLTI across local areas in the UK suggest that about 70% of the variation is associated with deprivation and a part of the 30% with urban living (linked to pollution, for example). There is a concern that the question about self-reported health or illness may elicit perceptual rather than real differences. However, a large number of prospective studies that link the answers to a health or illness question to subsequent presented illness or death confirm that people are telling the truth. That is why we have a health service that enables people to report their symptoms to their doctor.

Professor Phil Rees
Royal Geographical Society

December 2011