Healthy land? An examination of the area-level association between brownfield land and morbidity and mortality in England

Abstract

It is increasingly understood that the physical environment remains an important determinant of area-level health and spatial and socioeconomic health inequalities. Existing research has largely focused on the health effects of differential access to green space, the proximity of waste facilities, or air pollution. The role of brownfield—or previously developed—land has been largely overlooked. This is the case even in studies that utilise multiple measures of environmental deprivation. This paper presents the results of the first national-scale empirical examination of the association between brownfield land and morbidity and mortality, using data from England. Census Area Statistical ward-level data on the relative proportion of brownfield land (calculated from the 2009 National Land Use Database), standardised morbidity (2001 Census measures of ‘not good’ general health and limiting long-term illness), and premature (aged under 75 years) all-cause mortality ratios from 1998/99 to 2002/03 were examined using linear mixed modelling (adjusting for potential environmental, socioeconomic, and demographic confounders). A significant and strong, adjusted, area-level association was found between brownfield land and morbidity: people living in wards with a high proportion of brownfield land are significantly more likely to suffer from poorer health than those living in wards with a small proportion of brownfield land. This suggests that brownfield land could potentially be an important and previously overlooked independent environmental determinant of population health in England. The remediation and redevelopment of brownfield land should therefore be considered as a public health policy issue.