Broader Well-being Research Articles

Systems Change, Mental Health, and the Coming Paradigm Shift in Higher Education

ABSTRACT The field of college mental health is changing dramatically, and we are approaching a necessary paradigm shift in how “mental health” is defined and addressed. This paper will outline two primary forces impacting how we think about mental health and how a systems change perspective might help us understand what comes next. We will conclude with opportunities to integrate ways of thinking about mental health into the broader well-being and systems change work that higher education institutions have embarked on in recent years. The conclusion will include an overview of a project at the authors’ home institution that is aligned with this worldview and holds the promise of a healthier, more sustainable path forward in college mental health.

Experiences of integrating social prescribing link workers into primary care in England: Bolting on, fitting in or belonging.

Following the 2019 NHS Long-Term Plan, link workers (LWs) have been employed across primary care in England to deliver social prescribing (SP). To understand and explain how the LW role is being implemented in primary care in England. Realist evaluation undertaken in England. Focused ethnographies around seven LWs from different parts of England. As part of this, we interviewed 61 patients and 93 professionals from healthcare and the voluntary, community and social enterprise (VCSE) sector. We reinterviewed 41 patients, seven LWs and a LW manager 9-12 months after their first interview. We developed four concepts around how LWs are integrated (or not) within primary care: Centralising or diffusing power; Forging an identity in general practice; Demonstrating effect; Building a facilitative infrastructure. These concepts informed the development of a programme theory around a continuum of integration of LWs into primary care - from being 'bolted on' to existing provision, without much consideration, to 'fitting in', shaping what is delivered to be accommodating, through to 'belonging', whereby they are accepted as a legitimate source of support, making a valued contribution to patients' broader well-being. SP was introduced into primary care to promote greater attention to the full range of factors affecting patients' health and well-being, beyond biomedicine. For that to happen, our analysis highlights the need for a whole system approach to defining, delivering and maintaining this new part of practice.

Investigation of Factors for Adopting Mobile Commerce in a Developing Country

The growth of mobile phones and the internet technologies have greatly improved access to information and encompassed the social and business world. From the Information and Communication Technology for Development (ICTD) perspective, researchers are interested in whether mobiles promote or enable economic growth or broader well-being. In developing countries, a successful model in one country cannot easily be replicated in another country. This study investigates the factors that may lead to adopting mobile commerce in a developing country in South Asia.

The Cantril Ladder elicits thoughts about power and wealth

The Cantril Ladder is among the most widely administered subjective well-being measures; every year, it is collected in 140+ countries in the Gallup World Poll and reported in the World Happiness Report. The measure asks respondents to evaluate their lives on a ladder from worst (bottom) to best (top). Prior work found Cantril Ladder scores sensitive to social comparison and to reflect one’s relative position in the income distribution. To understand this, we explored how respondents interpret the Cantril Ladder. We analyzed word responses from 1581 UK adults and tested the impact of the (a) ladder imagery, (b) scale anchors of worst to best possible life, and c) bottom to top. Using three language analysis techniques (dictionary, topic, and word embeddings), we found that the Cantril Ladder framing emphasizes power and wealth over broader well-being and relationship concepts in comparison to the other study conditions. Further, altering the framings increased preferred scale levels from 8.4 to 8.9 (Cohen’s d = 0.36). Introducing harmony as an anchor yielded the strongest divergence from the Cantril Ladder, reducing mentions of power and wealth topics the most (Cohen’s d = −0.76). Our findings refine the understanding of historical Cantril Ladder data and may help guide the future evolution of well-being metrics and guidelines.

Life Satisfaction Among Chinese Aged Workers: Interplay of Organizational Justice, Workplace Emotions, and Subjective Age Perception.

Organizational justice, as a multifaceted construct, plays an essential role in shaping organizational behaviors vital for boosting productivity. Previous research has underlined its influential role in both task performance and organizational citizenship behaviors. Importantly, positive emotions stemming from perceptions of both distributive and procedural justice have been associated with heightened levels of life satisfaction. This study aimed to elucidate the mediating role of these emotions in the connection between organizational justice perceptions and life satisfaction. Participants (N= 588) in two waves of multisource data from fifteen private firms in China, have been aged workers from 40 to 60 years old. The findings revealed a significant mediation effect of positive emotions linking employees' perceptions of justice and their overall life satisfaction. In alignment with the Spill-over hypothesis, our findings underscore the importance of cultivating an equitable work environment. Such an environment does not only drive job-specific outcomes but also deeply influences employees' broader well-being and happiness. By grasping the intricacies of organizational justice and its myriad effects on employee satisfaction, organizations can devise precise interventions, thereby elevating both employee well-being and overall productivity.

Do all job changes increase wellbeing?

AbstractWe provide a comprehensive framework, based on person–environment fit, for evaluating the relationship between types of job change and wellbeing, and estimate it using fixed‐effects methods applied to UK longitudinal data. Changing job is associated with large swings in job satisfaction, but not all job changes are equal. Changes in workplace are associated with increased job satisfaction only when they are associated with a change in job role. The largest associations are for changing employers. These associations extend beyond job satisfaction to mental health and, to a lesser extent, life satisfaction. Changes in broader wellbeing are especially pronounced for women.

The online language of work-personal conflict

With the blurring of boundaries in this digital age, there is increasing concern around work-personal conflict. Assessing and tracking work-personal conflict is critical as it not only affects individual workers but is also a vital measure among broader well-being and economic indices. This inductive study examines the extent to which work-personal conflict corresponds to individuals’ language use on social media. We apply an open-vocabulary analysis to the posts of 2810 Facebook users who also completed a survey for an established work-personal conflict scale. It was found that the language-based model can predict personal-to-work conflict (r = 0.23) and work-to-personal conflict (r = 0.15) and provide important insights into such conflicts. Specifically, we found that high personal-to-work conflict was associated with netspeak and swearing, while low personal-to-work conflict was associated with language about work and positivity. We found that high work-to-personal conflict was associated with negative emotion and negative tone, while low work-to-personal conflict was associated with positive emotion and language about birthdays.

From Slavery to Servitude: Transformations and Continuities in Hacienda Labor, Well-Being, and Foodways in Eighteenth- and Nineteenth-Century Nasca

Abstract The nineteenth century was a dynamic period for hacienda workers on the south coast of Peru. Former Jesuit vineyards with two of the largest enslaved African-descended populations in rural coastal Peru—the haciendas of San Joseph (San José) and San Francisco Xavier (San Javier)—and their annexes in Nasca's Ingenio Valley underwent dramatic transformations with the replacement of their grapevines with cotton and the introduction of new types of workers. Cantonese indentured workers were contracted beginning in the 1830s, and the majority-enslaved workforce was legally emancipated in 1854. Seasonally, highland Andean workers joined the demographically shifting permanent hacienda population. We use evidence from excavated midden contexts at San Joseph, San Xavier, and San Joseph's annex of Hacienda La Ventilla to explore these changing agroindustrial dynamics and worker well-being in the eighteenth and nineteenth centuries. Despite the transformations at the estates, we find that culinary practices developed by enslaved Africans and their descendants during the Jesuit administration, such as the preparation of one-pot meals and stews, continued into the republican era among Cantonese indentured laborers and wage workers of Indigenous, mestizo, and Cantonese origins. We argue that such strategies centered on foodways were a crucial aspect of worker self-care regimes and broader well-being.

How well can U.S. military veterans' suicidal ideation be predicted from static and change-based indicators of their psychosocial well-being as they adapt to civilian life?

Identifying predictors of suicidal ideation (SI) is important to inform suicide prevention efforts, particularly among high-risk populations like military veterans. Although many studies have examined the contribution of psychopathology to veterans' SI, fewer studies have examined whether experiencing good psychosocial well-being with regard to multiple aspects of life can protect veterans from SI or evaluated whether SI risk prediction can be enhanced by considering change in life circumstances along with static factors. The study drew from a longitudinal population-based sample of 7141 U.S. veterans assessed throughout the first three years after leaving military service. Machine learning methods (cross-validated random forests) were applied to examine the predictive utility of static and change-based well-being indicators to veterans' SI, as compared to psychopathology predictors. Although psychopathology models performed better, the full set of well-being predictors demonstrated acceptable discrimination in predicting new-onset SI and accounted for approximately two-thirds of cases of SI in the top strata (quintile) of predicted risk. Greater engagement in health promoting behavior and social well-being were most important in predicting reduced SI risk, with several change-based predictors of SI identified but stronger associations observed for static as compared to change-based indicator sets as a whole. Findings support the value of considering veterans' broader well-being in identifying individuals at risk for suicidal ideation and suggest the possibility that well-being promotion efforts may be useful in reducing suicide risk. Findings also highlight the need for additional attention to change-based predictors to better understand their potential value in identifying individuals at risk for SI.

Latent profiles of childhood psychological maltreatment and their links to adult mental health in China and the UK

BackgroundThough links between childhood maltreatment and mental health have been established, little known about how specific types of childhood maltreatment tend to cluster and how the resulting patterns of exposure impact mental health outcomes.MethodThe current study used latent profile analyses in Chinese (N = 544) and UK (N = 589) samples to identify childhood psychological maltreatment profiles (i.e., profiles of psychological abuse, psychological neglect, and psychological non-support) in different country contexts, and their associations with a range of mental health (i.e., depression, anxiety, anger, physical aggression, verbal aggression, and hostility), and broader well-being (i.e., self-esteem) outcomes. Unadjusted as well as analyses adjusted for adverse childhood experiences (ACEs) were conducted.ResultsFour profiles were identified in both samples, but their nature differed between the Chinese sample (“Psychological Non-support”, “Low-Maltreated”, “High-Maltreated”, and “Severe-Maltreated”) and the UK sample (“Low-Maltreated”, “Moderate-Maltreated”, “High-Maltreated”, and “Severe-Maltreated”). Individuals in the “Psychological Non-support” in China and “Low-Maltreated” class in the UK displayed better mental health outcomes–lower levels of depression, anxiety, and aggression, and higher self-esteem. In contrast, individuals in the “Severe-Maltreated” profiles in both the Chinese and UK samples displayed poorer mental health outcomes–higher depression, anxiety, and aggression, and lower self-esteem. Interventions and prevention efforts are needed for individuals categorized in profiles affected by psychological maltreatment.ConclusionThis study highlights the importance of using targeted intervention or prevention to prevent psychological maltreatment, as well as improve mental health outcomes in individuals who have experienced psychological maltreatment.

Review of the Impact of Housing Quality on Inequalities in Health and Well-Being.

Housing quality is essential for population health and broader well-being. The World Health Organization Housing and health guidelines highlight interventions that protect occupants from cold and hot temperatures, injuries, and other hazards. The COVID-19 pandemic has emphasized the importance of ventilation standards. Housing standards are unevenly developed, implemented, and monitored globally, despite robust research demonstrating that retrofitting existing houses and constructing high-quality new ones can reduce respiratory, cardiovascular, and infectious diseases. Indigenous peoples, ethnic minorities, and people with low incomes face cumulative disadvantages that are exacerbated by poor-quality housing. These can be partially ameliorated by community-based programs to improve housing quality, particularly for children and older people, who are hospitalized more often for housing-related illnesses. There is renewed interest among policy makers and researchers in the health and well-being of people in public and subsidized housing, who are disproportionately disadvantaged by avoidable housing-related diseases and injuries. Improving the overall quality of new and existing housing and neighborhoods has multiple cobenefits, including reducing carbon emissions.

Burden of illness in people with medically refractory epilepsy who suffer from daily to weekly seizures: 12-month follow-up of participants in the EPISODE study.

A small group of people with epilepsy suffers from frequent seizures despite the available pharmacological and non-pharmacological interventions. The impact of epilepsy on these people extends beyond health-related quality of life (HRQoL), impacting a person's broader well-being and ability to participate in society. This study describes the burden of medically refractory epilepsy in people who suffer from daily to weekly seizures, in terms of HRQoL, well-being, and societal costs. Data from the EPISODE study on (cost-) effectiveness of seizure dogs for adults with severe medically refractory epilepsy were used, collected in 25 patients during the first 12 months before they were partnered with a certified seizure dog. Data comprised seizure diaries covering 365 days and five three-monthly surveys, including the EQ-5D-5L, QOLIE-31-P, and ICECAP-A to measure HRQoL and well-being. A societal perspective was applied to estimate costs using the iMCQ and iPCQ questionnaires about healthcare use, informal care, and productivity losses. Daily seizure frequency and survey data were collected in 25 patients. A minimum of 114 observations was available for each instrument included in the survey. A total of 80% of participants experienced seizures on three or more days per week, with a median ranging from 1 to 17 seizures per seizure day. The mean EQ-5D-5L utility score was 0.682 (SD 0.235), which is considerably lower than the age-adjusted general population average. The mean QOLIE-31-P and ICECAP-A scores were 55.8 (SD 14.0) and 0.746 (SD 0.172), respectively. The average annual total cost amounted to €39,956 (range €3,804-€132,64). Informal care accounted for the largest share of costs (50%); those who received informal care reported, on average, 26 h per week (SD 30). Severe medically refractory epilepsy is associated with a considerable burden of illness at the patient and societal level. People with this condition have significantly reduced HRQoL and well-being and are limited in their ability to work while having substantial medical costs and a strong dependency on informal care.

Development of a refugee health assessment toolkit for specific populations to support primary care

Abstract Issue/problem The United Kingdom (UK) hosts c.136,000 refugees and last year received the most asylum applications in two decades. Despite this, expertise in migrant health is not widespread in general practice, with few comprehensive toolkits available to support crucial initial health assessments of new arrivals. Description of the problem A large influx of Afghan refugees entered the UK in autumn 2021. In London, primary care practitioners quickly identified a lack of readily accessible, comprehensive guidance to support them in conducting health assessments for arrivals with a complex range of needs. This was compounded by many in primary care having little or no experience of migrant health. Results To address this gap in advice on conducting initial health assessments, a bespoke toolkit was created. The toolkit consolidated advice from a range of partners and resources: the UK Afghan migrant health guide, clinicians with humanitarian experience, front-line practitioners, Doctors of the World, and those leading on the health and public health response. The toolkit ensured greater consistency in the nature and content of assessments, considered not only primary needs but also broader wellbeing, and was responsive to both anticipated and known health priorities. Lessons The initial health assessment toolkit for Afghan migrants was well received by frontline staff and has implications for international practice in other areas providing similar health support. The toolkit and associated supporting information has formed a template that can be rapidly adapted to suit emerging needs, as has been done for new arrivals from Ukraine. This work has fed into best practice by the UK National Asylum Steering Group and is to be a case study for a WHO project on country-specific health assessments. Key messages • The toolkit is a proof of concept for partnership working towards holistic initial health assessments of new migrants in primary care, bringing together best evidence and pragmatic practice. • This work has implications for other countries experiencing similar trends in migration and providing health support to an increasing number of new refugees.

The Impact of the COVID-19 Pandemic on Trajectories of Well-Being of Middle-Aged and older Adults: A Multidimensional and Multidirectional Perspective

The COVID-19 pandemic has resulted in profound changes of individuals’ everyday lives. Restrictions in social contacts and in leisure activities and the threatening situation of a spreading virus might have resulted in compromised well-being. At the same time, the pandemic could have promoted specific aspects of psychosocial well-being, e.g., due to intensified relationships with close persons during lockdown periods. We investigated this potentially multidimensional and multi-directional pattern of pandemic-specific change in well-being by analyzing changes over up to 8 years (2012-2020) in two broad well-being domains, hedonic well-being (life satisfaction) and eudaimonic well-being (one overarching eudaimonic well-being indicator as well as environmental mastery, personal growth, positive relations with others, and self-acceptance), among 423 adults who were aged 40-98 years in 2012. By modelling longitudinal multilevel regression models and allowing for a measurement-specific intra-individual deviation component from the general slope in 2020, i.e. after the pandemic outbreak, we analyzed potential normative history-graded changes due to the pandemic. All mean-level history-graded changes were nonsignificant, but most revealed substantial interindividual variability, indicating that individuals’ pandemic-related well-being changes were remarkably heterogeneous. Only for personal growth and self-acceptance, adding a pandemic-related change component (and interindividual variability thereof) did not result in a better model fit. Individuals with poorer self-rated health at baseline in 2012 revealed a pandemic-related change toward lower life satisfaction. Our findings suggest that not all well-being domains - and not all individuals - are equally prone to “COVID-19 effects”, and even pandemic-associated gains were observed for some individuals in certain well-being domains.

Strengths and vulnerabilities: Comparing post-9/11 U.S. veterans’ and non-veterans’ perceptions of health and broader well-being

BackgroundPrior research has examined how the post-military health and well-being of both the larger veteran population and earlier veteran cohorts differs from non-veterans. However, no study has yet to provide a holistic examination of how the health, vocational, financial, and social well-being of the newest generation of post-9/11 U.S. military veterans compares with their non-veteran peers. This is a significant oversight, as accurate knowledge of the strengths and vulnerabilities of post-9/11 veterans is required to ensure that the needs of this population are adequately addressed, as well as to counter inaccurate veteran stereotypes. MethodsPost-9/11 U.S. veterans’ (N = 15,160) and non-veterans’ (N = 4,533) reported on their health and broader well-being as part of a confidential web-based survey in 2018. Participants were drawn from probability-based sampling frames, and sex-stratified weighted logistic regressions were conducted to examine differences in veterans’ and non-veterans’ reports of health, vocational, financial, and social outcomes. ResultsAlthough both men and women post-9/11 veterans endorsed poorer health status than non-veterans, they reported greater engagement in a number of positive health behaviors (healthy eating and exercise) and were more likely to indicate having access to health care. Veterans also endorsed greater social well-being than non-veterans on several outcomes, whereas few differences were observed in vocational and financial well-being. ConclusionDespite their greater vulnerability to experiencing health conditions, the newest generation of post-9/11 U.S. veterans report experiencing similar or better outcomes than non-veterans in many aspects of their lives. Findings underscore the value of examining a wider range of health and well-being outcomes in veteran research and highlight a number of important directions for intervention, public health education, policy, and research related to the reintegration of military veterans within broader civilian society.

Adolescent experience of radically open dialectical behaviour therapy: a qualitative study

BackgroundRadically Open Dialectical Behaviour Therapy (RO DBT) is a novel transdiagnostic treatment that targets ‘maladaptive overcontrol’; a transdiagnostic cluster of traits associated with excessive emotional and behavioural inhibitory control. Outcomes are promising for adults with a range of psychiatric disorders. No study to date has explored the adolescent experience of RO DBT.MethodsOf the 25 eligible adolescents who received RO DBT between March 2015 and April 2017, 15 (14–17 years) consented and completed a semi-structured interview about their experience of treatment within 1 month of discharge. Interviews were recorded and then transcribed manually. Free text responses were analysed using reflexive thematic analysis.ResultsThe majority (n = 13) had a primary diagnosis of anorexia nervosa, although comorbidity was the norm, with 80.0% having two or more predicted comorbid psychiatric diagnoses. All had received some prior psychological treatment. Four themes were identified from analysis of transcripts: 1) Broadening Horizons, 2) Building Connections, 3) Flexibility, 4) Information Overload. Generally, RO DBT was perceived as helpful in both content and process. The focus on social and broader well-being, rather than specific mental health symptoms, was considered beneficial by many. Adolescents appreciated the group-based format of skills classes and reported benefiting from learning and practicing skills each week. The fourth theme, Information Overload, highlighted that for some, the amount of content felt overwhelming and that it was hard to remember and digest all the information, suggesting that adaptations, or simplifications, may be required to ensure accessibility for adolescents.ConclusionsRO DBT is perceived as a relevant and beneficial new treatment for adolescents with maladaptive overcontrol. The broad treatment focus is perceived as unique and of particular benefit. It is reported to help with general and social functioning and foster cognitive and behavioural flexibility. Nevertheless, the amount and complexity of material was felt to be very large by some and may suggest the need for modified adolescent-specific materials.

Psychological safety in elite sport settings: a psychometric study of the Sport Psychological Safety Inventory.

ObjectivesEffectively supporting the mental health of elite athletes and coaches requires validated tools that assess not only individual-level factors but organisational-level influences. The aim of this study was to develop a bespoke scale assessing perceived psychological safety within high-performance environments.Methods337 elite athletes (M=24.12 years) and 238 elite-level coaches and high-performance support staff (HPSS; M=41.9 years) identified via the Australian Institute of Sport provided data across a range of mental health and well-being domains. Exploratory factor analysis (EFA; n=169 athletes) with parallel analysis identified the Sport Psychological Safety Inventory (SPSI) factor structure. Confirmatory factor analysis (CFA) validated the identified structure in separate validation subsamples of athletes (n=168) and coaches/HPSS (n=238).ResultsEFA identified the 11-item, 3-factor SPSI. Factors assessed domains of the Mentally Healthy Environment, Mental Health Literacy and Low Self-Stigma. All scale items loaded strongly on their specific domain. CFA model fit indices validated scale structure for athletes and coaches/HPSS. Internal consistency and convergent and divergent validity were evident. Logistic regression indicated that incrementally higher Mentally Healthy Environment scores reduced the likelihood of athletes scoring in the ‘moderate’ range of general and athlete-specific distress, with a stronger endorsement of the Low Self-Stigma subscale reducing the likelihood of being identified for athlete-specific distress.ConclusionPsychometric properties of the SPSI support scale utility among athletes and coaches/HPSS in elite sports settings, though further psychometric efforts are needed. This brief measure may support benchmarking efforts across elite sporting contexts to improve mental health culture and broader well-being among athletes and coaches/HPSS.

Meta-analysis of early adolescent self-regulation interventions: Moderation by intervention and outcome type.

Self-regulation has been identified as a highly promising target for interventions promoting broad wellbeing across development; however, there appear to be notable limitations in efficacy for early adolescents in particular. One possible reason is that the emotion regulation needs of youth have not been intentionally targeted in many interventions for this age group. The aim of this study is to advance understanding of how different intervention approaches defined from a clear theoretical model may impact different types of outcomes and with regard to different types of measures. We conducted a systematic literature review of four databases using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and identified 33 studies of early adolescents (aged 10-15) using five different intervention approaches that were methodologically rigorous (e.g., randomized controlled trial design with low risk of bias). Studies were conducted predominantly in North America (58%), and Western Europe (30%). A two-level mixed-effects meta-analysis indicated a small but significant overall intervention effect (Hedges g = 0.12). When examined by intervention type, effects were significant only for approaches focusing predominantly on emotion regulation (g = 0.20), which significantly improved behavioral outcomes as well as emotional outcomes. Approaches examining cognitive regulation, parent training, physical activity, and working memory did not differ significantly from zero. Across intervention types, outcomes demonstrated the largest effects for youth report of emotional distress. Overall, results suggest that emotion regulation may be a critically important self-regulation mechanism during early adolescence and demonstrates value in the use of applied theoretical frameworks to operationalize intervention approaches and outcomes.

Black and Latino Adolescents’ Self-Regulation: Placing College Preparedness in Context

Students from minoritized backgrounds, who disproportionately face higher poverty rates, are more likely to encounter risk factors, which tend to undermine individuals’ broader well-being by compromising self-regulatory processes. Yet, sociocultural theory highlights the presence of minoritized families’ cultural wealth. Consistent with a focus on assets, it is notable that college enrollment rates have increased among Black and Latino students in the U.S. Using a mixed methods approach, the current study integrated asset and risk frameworks, in order to advance knowledge on the context of minoritized teens’ college preparedness, defined here as making decisions and taking action steps toward college. Participants included low-income, predominantly Black and Latino families with adolescents ( n = 344). First, drawing from the voices of families, we examined responses to open-ended questions about aspirations, supports, and challenges. Salient themes included social-emotional and social-cultural factors. Indicators of cumulative contextual risk and cumulative individual risk were based on the qualitative data. Second, we tested whether the linkage from cumulative risk indices to teens’ college preparedness occurred via various dimensions of self-regulation (i.e., lower impulsivity, more cognitive control, and better organization skills), net of background characteristics. Adolescents’ organization skills were a significant mediator. Possible next steps for research are discussed.

“Two quid, chicken and chips, done”: understanding what makes for young people’s sense of living well in the city through the lens of fast food consumption

ABSTRACT Fast food seems unequivocally at odds with any moves towards more sustainable food consumption. It is identified as a major contributor to obesity, health inequalities, and to environmental impacts through its production and distribution. However, this problematisation of fast food ignores its contribution to understandings of “living well”, particularly for young people. This paper draws on data from an international project which explores how young people understand what makes for living well in cities. We focus on research with young people in Lambeth, London, exploring the role of food – specifically fast food practices – in their constructions of living well. Drawing on focus group interviews and photo diaries with young people aged 12–24, we highlight the enthusiasm inherent in discussions of fast food whereby it is constructed as easily accessible, inexpensive and attractive, whilst affording young people a degree of autonomy and agency. Fast food outlets are regarded as friendly, convenient, and safe social spaces, in a context where austerity cuts have reduced access to spaces specifically for young people. Further, consumption of fast food facilitates and legitimises young people’s use of local streets and green spaces. Thus practices of fast food consumption might be understood to contribute to the ability to “live well” from the perspective of young residents. Making fast food less accessible to young people may be part of obesity and sustainable food strategies, but a broader wellbeing strategy is needed which is informed by understanding the valued social practices fast food currently affords young people.