A Socio-Spatial Analysis of Perinatal Mortality in Greater Leicester

This thesis examines the social and spatial distribution of perinatal mortality in Greater Leicester. The study area comprises the city of Leicester and the surrounding contiguous built up area. Following a discussion of the current status of relevant research in medical geography and perinatal epidemiology the three major data sources used here are described, these being the 1981 Population Census, the Leicestershire Perinatal Mortality Survey to 1982 and the Leicestershire Births records for 1980. The analysis commences with a classification of census enumeration districts into nine socio-economic 'clusters', reflecting demographic, economic and social differences within the study area. The new small areas created by this classification are then used as a basis for mapping census variables and describing the geography of Greater Leicester. In a detailed analysis of the perinatal and births data some 21 variables are found to be associated with adverse perinatal outcome. These describe physical, obstetric, socio-economic and health care characteristics of both mother and infant. Both statistical and cartographical methods are used to examine these in a spatial dimension. It is concluded that neither perinatal mortality nor the risk factors associated with it are uniformly distributed with respect to the 'at risk' population. Further data analysis shows how perinatal, births and census data may usefully be combined. Poisson probability maps are used to show the relative likelihood of perinatal death in different parts of the study area. The thesis concludes with a summary of the main results and some suggestions regarding directions for future research.