Should uptake of state benefits be used as indicators of need and disadvantage?

Government requires indicators of disadvantage to guide programmes and allocate resources to those areas which are most in need. Proxy measures of relative disadvantage are often utilised for this task in the absence of ideal indicators of need. The recent availability of government administrative datasets, such as social security benefit uptake levels, are increasingly being used throughout the UK and have been hailed as a significant advance on previous measures of need. However, their suitability presupposes that the association between those in need of benefit and those actually in receipt of benefit is not confounded by non-needs-related factors. In the present study, the authors examine area-level factors associated with uptake of one health-related benefit and show that, while closely correlated with health status, it is also associated with factors which might be related to the propensity and ability to make a successful claim, as well as local adjudication practices. They conclude that, while the use of these government datasets has increased our ability to target resources, researchers and policy makers should be aware of these additional influences.