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The Environment and Health Atlas for England and Wales

The Small Area Health Statistics Unit published an environment and health atlas for England and Wales on 24 April 2014. The atlas maps the spatial variation between areas for both long-term risks of 14 health conditions and levels of five environmental agents at a very high spatial resolution. Simply comparing the health and environment maps will not enable people to conclude there is a causal link between a specific environmental agent and a health condition, but it can assist in the development of hypotheses about the role of environmental factors in chronic disease and to inform public health research and action. The Atlas has been developed so that it is accessible to a range of audiences, including researchers and health professionals, policy makers and the public.

Contents of the Environment and Health Atlas:

The Atlas provides readers with a detailed set of maps highlighting spatial patterns relevant to potential exposure. Currently, the following five environmental factors in England and Wales have been mapped. The choice of the environmental exposures is in part related to availability of data, as high resolution information for many environmental exposures is not available at national scale.

  • Pesticide usage on agricultural land
  • Air pollution (NO2, PM10) levels
  • Chlorination disinfection by-products in drinking water
  • Radon exposure risk
  • Sunshine duration

The spatial variation in long-term (25 years: 1985 -2009) risk for fourteen health outcomes in England and Wales has been mapped at ward level:

  • Lung Cancer
  • Breast Cancer
  • Prostate Cancer
  • Leukaemia
  • Malignant Melanoma
  • Bladder Cancer
  • Mesothelioma
  • Liver Cancer
  • Brain Cancer
  • Ischaemic Heart Disease Mortality
  • Obstructive Lung Disease Mortality (COPD & Asthma)
  • Kidney Disease Mortality
  • Reproductive Outcomes
  • Stillbirths
  • Low birth weight

Health maps are presented separately for males and females (except breast cancer – females only; prostate cancer – males only).

Each set of maps are presented with a short explanatory text to aid interpretation. Comparison of patterns seen in the environmental exposure and health outcome maps can suggest hypotheses about possible associations, but cannot prove or disprove causation, which needs information from external studies.  The text highlights authoritative reviews and relevant major studies to help interpret any patterns seen in the maps.

The print version of the atlas was published by Oxford University Press on April 2014 and can be purchased here:

SAHSU have also created on-line version of the Atlas. This is complementary to the print edition. Via this interface, users are able to input a postcode and toggle between maps for environmental agents and health conditions and to compare this with other areas in England and Wales. The free interactive version of the Environment and Health Atlas can be found at:


Working with Sense About Science

In order to ensure that the Atlas would be readily accessible to each of members of the public, policy makers and academics, SAHSU  spent two years working with the charity ‘Sense About Science’ ( who promote the public understanding of science.

As part of this process, advisory group meetings were held with 30 individuals of the anticipated target audience who recommended improvements to the atlas format, wording and design to improve readability and interpretation. Attendees ranged in their experience from academics within the field (i.e. epidemiologists, health geographers, and statisticians), academics from alternate disciplines, medical doctors, journalists and science communicators, representatives from government organisations, local government and interested public.