Tailoring health services to the needs of individual communities

Abstract

In order to assess the need for community health services in different neighbourhoods within Greater Glasgow, it was decided to present a wide variety of health information for each community as a set of summary profiles. These profiles clearly demonstrate that the same areas have the highest standardised mortality ratios, the least favourable socioeconomic circumstances, the highest hospital admission rates, and the poorest child health characteristics. The greatest benefit in overall health be achieved by targetting community resources on these disadvantaged communities. Adoption of this policy should reduce existing inequalities in health, and we argue that such 'positive discrimination' is implied in the formulae used in Great Britain for allocation of revenue expenditure for community services. The health profiles that we describe provide the baseline information necessary to target community services to particular communities according to objective measures, and to evaluate the effectiveness of new and existing methods of health promotion.