Abstract
BackgroundFeatures of the urban neighbourhood influence the physical, social and mental wellbeing of residents and communities. We explored the longitudinal association between change to the neighbourhood built environment and the wellbeing of local residents in deprived areas of Glasgow, Scotland.MethodsA cohort of residents (n = 365; mean age 50 years; 44% male; 4.1% of the 9000 mailed surveys at baseline) responded to a postal survey in 2005 and 2013. Wellbeing was assessed with the mental (MCS-8) and physical (PCS-8) components of the SF-8 scale. We developed software to aid identification of visible changes in satellite imagery occurring over time. We then used a Geographical Information System to calculate the percentage change in the built environment occurring within an 800 m buffer of each participant’s home.ResultsThe median change in the neighbourhood built environment was 3% (interquartile range 6%). In the whole sample, physical wellbeing declined by 1.5 units on average, and mental wellbeing increased by 0.9 units, over time. In multivariable linear regression analyses, participants living in neighbourhoods with a greater amount of change in the built environment (unit change = 1%) experienced significantly reduced physical (PCS-8: -0.13, 95% CI -0.26 to 0.00) and mental (MCS-8: -0.16, 95% CI -0.31 to − 0.02) wellbeing over time compared to those living in neighbourhoods with less change. For mental wellbeing, a significant interaction by baseline perception of financial strain indicated a larger reduction in those experiencing greater financial strain (MCS-8: -0.22, 95% CI -0.39 to − 0.06). However, this relationship was reversed in those experiencing lower financial strain, whereby living in neighbourhoods with a greater amount of change was associated with significantly improved mental wellbeing over time (MCS-8: 0.38, 95% CI 0.04 to 0.72).ConclusionsOverall, we found some evidence that living in neighbourhoods experiencing higher levels of physical change worsened wellbeing in local residents. However, we found a stronger negative relationship in those with lower financial security and a positive relationship in those with higher financial security. This is one of few studies exploring the longitudinal relationship between the environment and health.
Highlights
Features of the urban neighbourhood influence the physical, social and mental wellbeing of residents and communities
Stratified analysis indicated that in participants experiencing greater financial strain, those living in neighbourhoods with a greater amount of change in the built environment experienced significantly reduced mental wellbeing over time compared to those living in neighbourhoods with less change (MCS-8: -0.22, 95% Confidence interval (CI) -0.39 to − 0.06), a slightly larger coefficient than that found in the main analysis
In participants experiencing less financial strain, those living in neighbourhoods with a greater amount of change in the built environment experienced significantly improved mental wellbeing over time compared to those living in neighbourhoods with less change (MCS-8: 0.38, 95% CI 0.04 to 0.72), a reversal of the relationship found in the main analysis (Fig. 6)
Summary
Features of the urban neighbourhood influence the physical, social and mental wellbeing of residents and communities. An accumulating body of work indicates that the urban neighbourhood can influence the physical, social and mental wellbeing of residents and communities [2]. Together, this suggests that urban design has a key role to play in supporting population health in the future [3]. It has been proposed that in deprived neighbourhoods, multiple features of the physical environment [4] (for example, pollution, lack of access to transport, shops or health care, as well as incivilities such as litter and poorly maintained pavements) could compound to exacerbate health inequalities – a concept termed ‘deprivation amplification’ [5]. Efforts to tease out the relative contributions of area- and individual-level socioeconomic circumstances on heath suggest that low socio-economic status individuals living in deprived areas tend to have the worst health outcomes [7, 8], whereas higher socio-economic status can buffer individuals from the negative effects of living in deprived areas [8]
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