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Rising levels of income inequality have been directly linked to rising levels of spatial segregation. In this paper, we explore whether rising segregation may in turn erode support for the redistributive policies of the welfare state, further increasing levels of inequality – a form of positive feedback. The role of the neighbourhood has been neglected in attitudes research but, building on both political geography and 'neighbourhood effects' literatures, we theorise that neighbourhood context may shape attitudes through the transmission of attitudes directly and through the accumulation of relevant knowledge. We test this through multilevel modelling of data from England on individual attitudes to redistribution in general and to welfare benefit recipients in particular. We show that the individual factors shaping these attitudes are quite different and that the influence of neighbourhood context also varies as a result. The findings support the idea that neighbourhood context shapes attitudes, with the knowledge accumulation mechanism likely to be the more important. Rising spatial segregation would appear to erode support for redistribution but to increase support for welfare recipients – at least in a context where the dominant media discourse presents such a stigmatising image of those on welfare benefits.

Background: Coronary heart disease (CHD) death rates have fallen across most of Europe in recent decades. However, substantial risk factor reductions have not been achieved across all Europe. Our aim was to quantify the potential impact of future policy scenarios on diet and lifestyle on CHD mortality in 9 European countries. Methods: We updated the previously validated IMPACT CHD models in 9 European countries and extended them to 2010–11 (the baseline year) to predict reductions in CHD mortality to 2020(ages 25–74 years). We compared three scenarios: conservative, intermediate and optimistic on smoking prevalence (absolute decreases of 5%, 10% and 15%); saturated fat intake (1%, 2% and 3% absolute decreases in % energy intake, replaced by unsaturated fats); salt (relative decreases of 10%, 20% and 30%), and physical inactivity (absolute decreases of 5%, 10% and 15%). Probabilistic sensitivity analyses were conducted. Results: Under the conservative, intermediate and optimistic scenarios, we estimated 10.8% (95% CI: 7.3–14.0), 20.7% (95% CI: 15.6–25.2) and 29.1% (95% CI: 22.6–35.0) fewer CHD deaths in 2020. For the optimistic scenario, 15% absolute reductions in smoking could decrease CHD deaths by 8.9%–11.6%, Salt intake relative reductions of 30% by approximately 5.9–8.9%; 3% reductions in saturated fat intake by 6.3–7.5%, and 15% absolute increases in physical activity by 3.7–5.3%. Conclusions: Modest and feasible policy-based reductions in cardiovascular risk factors (already been achieved in some other countries) could translate into substantial reductions in future CHD deaths across Europe. However, this would require the European Union to more effectively implement powerful evidence-based prevention policies.