As the next national census is not due until 2001, the Department of the Environment, Transport and the Regions commissioned Manchester University to update the 1991 Index of Local Conditions, taking into account changed local authority boundaries.2 It measured unemployment, low income, health, educational attainment, the environment, crime and housing conditions and has produced an updated single deprivation score for each local authority (see box 1).
Birmingham has the three most deprived wards in the UK, which is an indicator of severity or intensity of deprivation in the local authority. Using Jarman deprivation scores, Birmingham, Liverpool and Manchester also feature in the six most deprived health authorities in the UK.2,3
Age structure and ethnic composition of the population are two other predictors of psychiatric need and use. On these indicators, Birmingham has identical problems to London.