Impact of the built environment on self-rated health and wellbeing and other health behaviours of people in social, intermediate, and market-rent accommodation: baseline characteristics of ENABLE London Study participants

Abstract

BackgroundEast Village (formerly the 2012 London Olympic Games Athletes' Village) was designed for healthy active living. The Examining Neighbourhood Activities in Built Living Environments in London (ENABLE London) study is a 2 year longitudinal study examining whether health behaviours show sustained change among individuals moving to East Village, compared with a control population living outside. We aimed to report baseline characteristics of participants in this study. MethodsAll adults seeking social, intermediate, or market-rent accommodation in East Village were recruited. Self-rated health, wellbeing, anxiety, depression, and perceptions of the local built environment were ascertained through questionnaires. Accelerometers were used to assess physical activity. Body-mass index (BMI) was calculated. FindingsThe baseline cohort, before any move to East Village, comprises 1278 adults. Social housing participants were older (n=520, median age 37 years [IQR 28–45]) than those from intermediate (524, 31 [27–36]) and market-rent sectors (234, 28 [25–33]), were mostly women (n=379, 73% vs 251, 48% vs 103, 44%), and non-white (424, 82% vs 166, 32% vs 71, 30%). Baseline findings show that those in social housing were least likely to agree with enjoying living in their area (n=275, 53%) and walking in their neighbourhood (256, 49%) compared with the intermediate (361, 69% vs 318, 61%) and market-rent sectors (167, 71% vs 142, 61%). A graded increase of very good or good health status was reported across housing sectors (social n=393, 76%; intermediate 463, 88%; market-rent 212, 90%), with a decrease in abnormal levels of anxiety (80, 15%; 57, 11%; 23, 10%) and depression (58, 11%; 21, 4%; 6, 3%). The social sector recorded fewer daily steps (n=509, mean number of steps 7750 [SD 3312]), compared with intermediate (504, 9699 [2916]) and market-rent sectors (221, 9361 [2992]). BMI was higher in social sector participants (n=515, 27·3 kg/m2 [SD 6·0]) than in those in intermediate (518, 24·8 [4·6]) and market-rent sectors (226, 24·2 [4·0]). To date, 324 (54%) of 605 participants have moved to East Village. InterpretationThe ENABLE London study offers a unique opportunity for a natural experiment. These baseline data provide strong evidence of marked differences in perceptions of the built environment, and health behaviours across housing sectors. 2 year follow-up of the cohort will measure change in these health outcomes, associated with moving to the same environment. FundingMedical Research Council National Prevention Research Initiative (grant MR/J000345/1) and National Institute for Health Research (grant 12/211/69).