Inequalities in local government expenditure on environmental and regulatory services in England from 2009 to 2020: a longitudinal ecological study

Background Gastrointestinal (GI) infections affect one in five people in the UK and local authorities play a crucial role in controlling these infections. However, there have been substantial reductions in funding for environmental and regulatory (ER) services that enable GI infectious disease preve...

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Main Authors: Ben Barr, Mark Alan Green, Helen E Clough, Xingna Zhang, Katie Fahy, Iain Edward Buchan, Lauren Murrell, Roger Gibb, Marie Anne Chattaway
Format: Article
Language:English
Published: BMJ Publishing Group 2024-12-01
Series:BMJ Public Health
Online Access:https://bmjpublichealth.bmj.com/content/2/2/e001144.full
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author Ben Barr
Mark Alan Green
Helen E Clough
Xingna Zhang
Katie Fahy
Iain Edward Buchan
Lauren Murrell
Roger Gibb
Marie Anne Chattaway
author_facet Ben Barr
Mark Alan Green
Helen E Clough
Xingna Zhang
Katie Fahy
Iain Edward Buchan
Lauren Murrell
Roger Gibb
Marie Anne Chattaway
author_sort Ben Barr
collection DOAJ
description Background Gastrointestinal (GI) infections affect one in five people in the UK and local authorities play a crucial role in controlling these infections. However, there have been substantial reductions in funding for environmental and regulatory (ER) services that enable GI infectious disease prevention and control via food safety and infection control (FSIC) services. This study investigates how local funding cuts to these services have varied across England to understand the potential consequences of inequalities in GI infections.Methods We carried out a longitudinal observational ecological study, using a panel of annual data between 2009/2010 and 2020/2021. Analysis of ER service expenditure and FSIC service expenditure included 312 and 303 local authorities respectively. Generalised estimating equation models were used to estimate the annual per cent change of ER service expenditure between 2009/2010 and 2020/2021 in addition to FSIC expenditure change overall, and as a share of total ER expenditure. Models analysed trends by local authority structure, population density and deprivation level.Results ER services saw the largest cuts in unitary authorities, declining by 1.9%. London boroughs had the greatest reductions in FSIC expenditure, decreasing by 9.9%. Both ER and FSIC expenditure decreased with increasing population density. Areas of higher deprivation had the largest reduction in expenditure, with ER and FSIC cuts of 2.4% and 22.8%, respectively, compared with a 1.2% and 7.5% reduction in the least deprived areas. The share of ER expenditure spent on FSIC decreased by 13.4% in the most deprived authorities compared with 6.3% in the least deprived areas.Conclusion The unequal distribution of cuts shows the need for increased and equitable investment into these services to enable resilience to emerging infectious disease threats and to prevent the widening of health inequalities.
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spelling doaj-art-11ce5cd6204d480ea16976591865af292025-08-20T02:49:19ZengBMJ Publishing GroupBMJ Public Health2753-42942024-12-012210.1136/bmjph-2024-001144Inequalities in local government expenditure on environmental and regulatory services in England from 2009 to 2020: a longitudinal ecological studyBen Barr0Mark Alan Green1Helen E Clough2Xingna Zhang3Katie Fahy4Iain Edward Buchan5Lauren Murrell6Roger Gibb7Marie Anne Chattaway8senior clinical lecturer in applied public healthGeography & Planning, University of Liverpool, Liverpool, UKDepartment of Livestock and One Health, University of Liverpool Institute of Infection Veterinary and Ecological Sciences, Liverpool, UKDepartment of Public Health, Policy and Systems, University of Liverpool, Liverpool, UKDepartment of Public Health, Policy & Systems, University of Liverpool Institute of Population Health, Liverpool, UKPublic Health and Policy, University of Liverpool, Liverpool, UKNational Institute for Health and Care Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UKPublic Contributor, PPI Advisor to: Health Protection Research Unit Gastrointestinal Infection, University of Liverpool, Liverpool, UKNational Institute for Health and Care Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UKBackground Gastrointestinal (GI) infections affect one in five people in the UK and local authorities play a crucial role in controlling these infections. However, there have been substantial reductions in funding for environmental and regulatory (ER) services that enable GI infectious disease prevention and control via food safety and infection control (FSIC) services. This study investigates how local funding cuts to these services have varied across England to understand the potential consequences of inequalities in GI infections.Methods We carried out a longitudinal observational ecological study, using a panel of annual data between 2009/2010 and 2020/2021. Analysis of ER service expenditure and FSIC service expenditure included 312 and 303 local authorities respectively. Generalised estimating equation models were used to estimate the annual per cent change of ER service expenditure between 2009/2010 and 2020/2021 in addition to FSIC expenditure change overall, and as a share of total ER expenditure. Models analysed trends by local authority structure, population density and deprivation level.Results ER services saw the largest cuts in unitary authorities, declining by 1.9%. London boroughs had the greatest reductions in FSIC expenditure, decreasing by 9.9%. Both ER and FSIC expenditure decreased with increasing population density. Areas of higher deprivation had the largest reduction in expenditure, with ER and FSIC cuts of 2.4% and 22.8%, respectively, compared with a 1.2% and 7.5% reduction in the least deprived areas. The share of ER expenditure spent on FSIC decreased by 13.4% in the most deprived authorities compared with 6.3% in the least deprived areas.Conclusion The unequal distribution of cuts shows the need for increased and equitable investment into these services to enable resilience to emerging infectious disease threats and to prevent the widening of health inequalities.https://bmjpublichealth.bmj.com/content/2/2/e001144.full
spellingShingle Ben Barr
Mark Alan Green
Helen E Clough
Xingna Zhang
Katie Fahy
Iain Edward Buchan
Lauren Murrell
Roger Gibb
Marie Anne Chattaway
Inequalities in local government expenditure on environmental and regulatory services in England from 2009 to 2020: a longitudinal ecological study
BMJ Public Health
title Inequalities in local government expenditure on environmental and regulatory services in England from 2009 to 2020: a longitudinal ecological study
title_full Inequalities in local government expenditure on environmental and regulatory services in England from 2009 to 2020: a longitudinal ecological study
title_fullStr Inequalities in local government expenditure on environmental and regulatory services in England from 2009 to 2020: a longitudinal ecological study
title_full_unstemmed Inequalities in local government expenditure on environmental and regulatory services in England from 2009 to 2020: a longitudinal ecological study
title_short Inequalities in local government expenditure on environmental and regulatory services in England from 2009 to 2020: a longitudinal ecological study
title_sort inequalities in local government expenditure on environmental and regulatory services in england from 2009 to 2020 a longitudinal ecological study
url https://bmjpublichealth.bmj.com/content/2/2/e001144.full
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