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Open Access Research article

Geographic correlation between deprivation and risk of meningococcal disease: an ecological study

Christopher J Williams1*, Lorna J Willocks2, Iain R Lake3 and Paul R Hunter4

Author Affiliations

1 East & North Hertfordshire Health Protection Unit, Welwyn Garden City, Hertfordshire AL8 6JL, United Kingdom

2 Health Protection Agency East of England, Cambridge CB2 2SR, United Kingdom

3 School of Environmental Sciences, University of East Anglia, Norwich, United Kingdom

4 School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, United Kingdom

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BMC Public Health 2004, 4:30  doi:10.1186/1471-2458-4-30

Published: 26 July 2004



Meningitis caused by Neisseria meningitidis is a serious infection which is most common in young children and adolescents. This study investigated the relationships between the incidence and age distribution of meningococcal disease, and socioeconomic environment.


An ecological design was used, including mapping using a Geographical Information System (GIS) at census ward level.


Incidence of meningococcal disease was highest in the most deprived wards, with a relative risk of 1.97 (1.55 – 2.51). Mapping revealed geographical coincidence of deprivation and meningococcal disease, particularly in urban areas. Two-thirds of the increased incidence was due to cases in the under fives.


The results suggest that area deprivation is a risk factor for meningococcal disease, and that its effects are seen most in young children.

Meningitis; meningococcal; Meningococcal infections; Communicable disease; Geography; Maps; Socioeconomic factors.