Wednesday, 15 July 2015

Mapped: where are people most likely to take anti-depressants?

This is a map I made today as part of some analysis of a new parliamentary research paper looking at different prescription rates around the country in 2014.

I chose to focus on anti-depressants, and specifically look at those areas where prescribing rates were significantly higher than the national average.

Prescribing rates are expressed as prescription items (the thing you get when you hand in your prescription - a box or course of anti-depressants, say) per 1,000 patients registered with a GP.

The average prescription rate for anti-depressants is about 1,000 per 1,000 across the year. Or, to put it another way, one boxful of anti-depressants for every many, woman and child in the country.

Certain places, though, have much higher rates. Here's the map; figures are only available for England, so ignore Wales and Scotland. Grey places have above-average prescription rates for anti-depressants, The darker the grey, the higher the rate. You can click on an area for precise figures; the number is the percentage by which anti-depressant prescriptions are higher than the national average:


Straight away, you can see some sort of visual pattern. There is definitely more grey in the north than the south. There is more grey on the coast than inland. There is no grey at all in or around London.

The areas with the highest rates of anti-depressant prescriptions are in County Durham, Blackpool, the Lincolnshire coast, and Norfolk. There are also clusters in Cornwall, Merseyside, Cumbria and the Yorkshire coast.

Now I haven't done detailed correlation work, and I am not in a position to draw any firm conclusions on the reasons for these patterns.

You could argue it has something to do with poverty; something to do with unemployment. I'm pretty sure the darker grey areas will have above-average deprivation. I'm less sure the correlation will be particularly precise. There is an awful lot of deprivation in London, for example, and in Manchester. Yet these areas are not top of the 'depression' list. London, in fact, is right at the bottom.

At the very least, therefore, there must be other factors in play. One might be age: some areas are younger than others, and younger people might be less likely to be on anti-depressants. I don't know; it's certainly possible.

Another factor might be GP access. Being registered with a GP doesn't necessarily make it is easy to see a GP. A lower level of anti-depressant prescriptions might not mean a lower level of depression; it might just mean people who need tablets aren't getting them.

Other demographic factors might be relevant, too. It's notable to me that the most culturally and ethnically mixed communities in England seem to have relatively low rates of anti-depressant prescriptions. I'm thinking of London and Birmingham, in particular. Could it be that white Britons are more likely to get depressed? Or rather, more likely to seek and obtain medication for it?

The most interesting theory put to me on Twitter today was none of these. Rather, a correspondent  pointed out that all the areas with the most grey seemed to be the most physically isolated. And there does seem something in that. I don't know how good the public transport links are in County Durham, Cornwall, Norfolk or West Cumbria. But I wouldn't be surprised to hear they weren't great.

I wonder if as sociable creatures it isn't important to our well-being to feel plugged in to a wider community. I also wonder if we don't need to feel free, not trapped, and moving forward, not standing still.

The original data was lodged in the House of Commons library as a research paper this week. I'd be interested to hear if anyone come up with some precise correlations, or even just wacky theories.

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