Deprived Inner-city Area Research Articles

Maker-centricity and ‘edge-places of creativity’: CARE-full making in a CARE-less world

Susan Luckman, citing Katherine Gibson’s call for a return to ‘the grass-roots work of engaging the community and being open to developing new economies’, advocates a vision of creative industries that builds the affordances of ‘edge-places of creativity’. Luckman’s focus is non-urban localities. Her proposal, nevertheless, could equally apply to the amateur craft groups, community organisations and independent businesspeople that the Arts and Humanities Research Council–funded projects Co-Producing CARE: Community Asset-based Research and Enterprise, and Maker-Centric: Building Place-based, Co-making Communities worked with in deprived inner-city areas in the British Midlands. Both projects were undertaken with Craftspace and other stakeholder organisations, worked collaboratively with community groups, employed co-production processes and combined hand-making with digital fabrication. The aim of each project was to prototype a method with communities that builds agencies (cultural, social, economic, skills-based) through making and could be applied by other groups. While the CARE method was concerned with the affordances of collaborative making, Maker-Centric looked at these through a heritage and placed-based lens. This article examines the potential for local, collaborative, purposeful, social making as an ‘edge-place’ activity for creative enterprise that is inclusive and supportive.

Exploring the obesity concerns of British Pakistani women living in deprived inner-city areas: A qualitative study.

IntroductionBritish South Asians have a higher prevalence of overweight and obesity than the wider population. Bradford (UK), with its high Pakistani presence and levels of economic deprivation, has exceptionally high instances, especially in deprived areas where many Pakistanis reside. British Pakistani women in Bradford are more likely to be overweight and obese. There is uncertainty on how these women can be aided to manage their weight. Therefore, the objective of this study was to explore the obesity concerns of Pakistani women living in deprived inner‐city areas of Bradford.MethodsThree focus groups interviews were carried out with 23 Pakistani women living in deprived areas of Bradford. Data were analysed thematically.ResultsThis exploratory study identified a wide range of concerns that women had around managing their weight. Participants disclosed distrust in information given around medication, conflicting dietary information and reported low levels of trust in women‐only organized physical activities. Cultural barriers were identified, which included the gender role of the woman, the lack of culturally appropriate dietary advice, cultural misunderstandings of what constitutes a healthy diet and healthy weight, the lack of culturally suitable exercise facilities and conforming to family and community expectations. Other concerns were language barriers around a lack of understanding, the inability to read Urdu and reliance on others to translate information.ConclusionThese findings have implications for researchers, local authorities, policy makers and others with an interest in reducing the rates of obesity in this population. Recommendations include training health practitioners to be culturally aware of the diet and eating practices of this community, exploring different ways to support socially isolated women to be more physically active at home, addressing physical activity and diet misconceptions and designing obesity management information materials appropriate for a range of literacy levels.Patient or Public ContributionPublic contributors were involved in the development of the interview guide and design of the research. A pilot focus group with participants not included in the present paper was used to help test and refine the focus group questions. Interview transcripts were member checked by participants, and participants assisted with data analysis.

Accessibility Inequality and Income Disparity in Urban China: A Case Study of Guangzhou

Unlike in Western cities, where the poor population tends to be concentrated in the deprived inner-city areas and experiences low accessibility, the geographic distribution of the low-income population in Chinese cities might be relatively dispersed across accessibility-rich and accessibility-poor areas. This study aims to examine the relationships between income disparity and accessibility inequality in Chinese cities, as well as to identify the particular group of low-income residents who are at risk of inaccessibility. We conducted an empirical study in the city of Guangzhou, China, based on the population census, points of interest, and road network data and measured accessibility based on the three-step floating catchment area (3SFCA) method. Results reveal that although the essential services are significantly concentrated in the central-city areas, the geographic distribution of the low-income population is considerably dispersed across the central-city and suburban areas, thereby indicating the possibility of considerable intragroup inequality of accessibility among the low-income group. The findings from the regression analyses suggest that although urban development in Chinese cities has not resulted in the distinct residential segregation observed in Western cities, the low-income population might still face a dilemma between small floor area and low service accessibility. The study also reveals that nonlocal residents as well as nonurban hukou holders among the low-income population living in suburban areas also experience low service accessibility, which highlights the importance of incorporating hukou as an explanatory variable in analyzing accessibility inequality issues in the Chinese context. Key Words: 3SFCA, inequality, service accessibility, suburbanization, urban China.不同于西方城市贫穷人口倾向集中于衰败的市中心地区，并经验较低的可及性，中国城市低收入人口的地理分佈，相对而言较为分散，并遍佈可及性高与可及性低的地区。本研究旨在检视中国城市的所得差异与可及性不均之间的关系，并指认面临可及性风险的低所得居民之特定群体。我们根据人口统计、兴趣点与道路网络数据，在中国广州的城市中进行经验研究，并根据三阶段流动搜寻法 (3SFCA) 测量可及性。研究结果显示，尽管基本生活服务显着地集中在城市中心地区，但低收入人口的地理分佈大幅分散在市中心与郊区，因而指出出低收入群体中巨大的群体内部可及性不均的可能性。迴归分析的研究结果显示，尽管中国城市发展尚未导致在西方城市所观察到的显着居住隔离，但低收入人口却仍可能面临小楼地板面积抑或低落的服务可及性之困境。本研究同时揭露，居住于郊区的低收入人口中，非在地居民与非城市户口所有者，同时经历了低落的服务可及性，凸显出分析中国脉络下的可及性不均议题时，纳入户口作为解释变因的重要性。关键词： 3SFCA，不均，服务可及性，郊区化，中国城市。A diferencia de lo que ocurre en las ciudades occidentales, donde la población pobre tiende a concentrarse en las áreas urbanas más deprimidas y a experimentar mala accesibilidad, la distribución geográfica de la población de bajos ingresos en las ciudades chinas podría darse de manera relativamente dispersa a través de áreas de accesibilidad tanto muy buenas como malas. Este estudio apunta a examinar las relaciones entre disparidad del ingreso y desigualdad de accesibilidad en ciudades chinas, lo mismo que a identificar el grupo particular de residentes de bajos ingresos que se encuentran en riesgo de inaccesibilidad. Llevamos a cabo un estudio experimental en la ciudad china de Guangzhou, apoyado en el censo de población, puntos de interés y datos sobre la red de carreteras y la medida de accesibilidad, con base en el método de área de cuenca flotante de tres etapas (3SFCA). Los resultados revelan que, aunque los servicios esenciales están significativamente concentrados en las áreas de la ciudad central, la distribución geográfica de la población de bajos ingresos es considerablemente dispersa a través de la ciudad central y las áreas suburbanas, indicando así la posibilidad de mucha desigualdad en la accesibilidad a nivel de grupo entre la gente de bajos ingresos. Los hallazgos de los análisis de regresión sugieren que, aunque el desarrollo urbano de las ciudades chinas no ha resultado en la clara segregación residencial que se observa en las ciudades occidentales, la población de bajos ingresos podría enfrentar todavía un dilema entre área de planta muy reducida y bajo servicio de accesibilidad. También revela el estudio que los residentes no locales, lo mismo que los propietarios dentro del sistema hukou no urbano, parte de la población de bajos ingresos que viven en áreas suburbanas, también experimentan baja accesibilidad a los servicios, lo cual destaca la importancia de incorporar el hukou como una variable explicativa para analizar problemas de desigualdad por accesibilidad en el contexto chino. Palabras clave: 3SFCA, accesibilidad a los servicios, China urbana, desigualdad, suburbanización.

Five years’ experience with a primary care electronic patient record in a community sexual and reproductive health service

Lewisham Sexual and Reproductive Health (SRH) service is one of the largest in the UK with approximately 60 000 attendances a year. It works from four centres spread across a...

Experiences of neighbourhood exclusion and inclusion among older people living in deprived inner-city areas in Belgium and England

ABSTRACTThis article explores conceptual and empirical aspects of the social exclusion/inclusion debate in later life, with a particular focus on issues of place and space in urban settings. Exploratory findings are reported from two empirical studies in Belgium and England, which sought to examine experiences of social exclusion and inclusion among people aged 60 and over living in deprived inner-city neighbourhoods. Semi-structured interviews were conducted with an ethnically diverse sample of 102 older people in Belgium and 124 in England. Thematic analysis of interview data identifies four issues in relation to the neighbourhood dimension of social exclusion/inclusion in later life: experiences of community change; feelings of security and safety; the management of urban space; and strategies of control. The results suggest that neighbourhoods have a significant influence on shaping the experience of exclusion and inclusion in later life, with a number of similarities identified across the different study areas. The article concludes by discussing conceptual and policy issues raised by the research.

‘It all boils down to respect doesn't it?’: Enacting a sense of community in a deprived inner‐city area

AbstractAudio recordings of meetings of two community groups in a deprived inner‐city area were analysed, using discursive psychological and conversation analytic techniques to explore situated enactments of ‘community’. Participants situated themselves as members of a geographical community, of an ‘imagined’ community and of other constitutive communities. A sense of community was enacted through five interactional strategies: Affirming moral codes, ‘defending’ other members, distinguishing insiders from outsiders, enacting empowerment and challenging institutions. Participants regularly employed emotional displays and affirmed moral positions, both to constitute ‘community’ and to take action in it. In so doing they worked up social capital and positioned community concerns in ways more reflective of their own situated values than of criminal law or government policy. Copyright © 2011 John Wiley & Sons, Ltd.

The Role of Independent Fast-Food Outlets in Obesogenic Environments: A Case Study of East London in the UK

In the battle to curb rising levels of obesity the focus has moved from individual interventions towards addressing factors within the ‘obesogenic environment’. Fast-food outlets are argued to be an increasingly important aspect of this environment and recent UK government policy has suggested that local authorities should use their planning powers to restrict the opening of new fast-food outlets in local neighbourhoods. This policy has a particular impact on the growing number of independent fast-food outlets which characterise deprived inner-city areas. Focusing on a case study of the London Borough of Tower Hamlets and its independent fast-food sector, this paper explores the range of local variables, and in particular the crucial mix of socioeconomic and cultural factors, which have influenced its development. The role played by fast-food outlets in providing local employment and a culturally acceptable social space for the local Muslim community, through the provision of halal food in an alcohol-free environment, is particularly highlighted. In uncovering these particular local sensitivities, the paper aims to contribute to debates regarding the nature of ‘obesogenic environments’ and demonstrate that local level research is essential for enabling better understanding for developing policy interventions.

Comparing the residential origins of homeless families and homeless individuals in Miami-Dade County, Florida

This study identifies and compares the residential origins of homeless families and homeless individuals. The study also analyses the spatial distribution of residential origins of homeless families and homeless individuals with the factors associated with the risk of homelessness. Data were obtained through the 2005 homelessness survey in Miami-Dade County,Florida.The analyses reveal the statistically significant differences in the spatial distribution of the residential origins of homeless families and homeless individuals. The results clearly suggest that homeless individuals are more highly concentrated in neighbourhoods of high poverty than homeless families. The study suggests the possibility that drift effects drive more homeless individuals but fewer homeless families to move to deprived inner-city areas. The study also suggests that the spatial analysis of prior addresses of homeless families and individuals in this study can provide some ideas for other major cities or regions to better formulate homelessness prevention and outreach programmes.

Social communication deficits in disruptive primary-school children

Parent and teacher data, from questionnaire surveys, suggest that school-identified disruptive children often have pragmatic language deficits of an autistic type. This replication study aimed to confirm earlier findings, using individual clinical assessment to investigate traits of autism-spectrum disorder in disruptive children. Persistently disruptive children (n = 26) and a comparison group (n = 22) were recruited from primary schools in a deprived inner-city area. Measures included standardised autism diagnostic interviews (with parents) and tests of IQ, social cognition, theory of mind and attention (with children). The disruptive children possessed poorer pragmatic language skills (P<0.0001) and mentalising abilities (P<0.05) than comparisons. Nine disruptive children (35%) met ICD-10 criteria for atypical autism or Asperger syndrome. Many persistently disruptive children have undetected disorders of social communication, which are of potential aetiological significance.

‘At the moment it is just a couple of eccentrics doing it’: concordance in day-to-day practice

Abstract Objectives To assess the feasibility and acceptability of concordance in pharmacy practice through examination of communication between customers and pharmacists in two community pharmacies in consultations for over-the-counter medicines. Method A qualitative pilot study involving data drawn from six sources: audiotaped training session with all the pharmacists involved, observational field work in the pharmacies, audiotaped consultations with pharmacists and customers, debriefing interviews with pharmacists after the consultation, and semi-structured interviews with customers a few days after their consultation. Setting Two community pharmacies that concentrate their services on medicine advice and dispensing, one in a deprived inner-city area, the other in a more affluent suburban area of London. Key findings The pharmacists developed a personal understanding of concordance which informed their practice. Customers reported a high level of satisfaction with services they received from the respective pharmacists. Their accounts of the consultations verified the pharmacists' patient-centredness in their day-to-day practice. Conclusion The implementation of a concordance model was possible through the development of a personalised, patient-centred model which drew on the model of concordance but was adapted in accordance with both structural constraints as well as the personal style of the pharmacists involved.

Community-Acquired Needle-Stick Injuries: Rapid and Safe Retrieval of Discarded Needles Is Essential

To the Editor .— The frequency of community-acquired needle-stick injuries (CA-NSIs) increases in line with the rise in intravenous drug abuse. Although previously limited to deprived inner-city areas, few communities are now spared. Papenburg et al1 confirmed the low incidence of seroconversion after pediatric CA-NSI. Although no seroconversions were noted, the costs of clinical care and the inherent risks of precautionary postexposure therapies, where indicated, together with often-severe anxiety affecting patient, family, and community at large cannot be overlooked. The prompt and safe retrieval of discarded needles is a key step in prevention of CA-NSI. In most jurisdictions, city …

Design of a pragmatic cluster randomised controlled trial: Ecological approach to increasing physical activity in an urban community

This study was set up to test an ecological intervention using a pragmatic cluster randomised controlled design (RCT) aimed at increasing physical activity (PA) within the community in a deprived inner-city area in the UK. The research will provide a detailed mapping (using Graphical Information Systems GIS) of the environment at lower super output area (SOA) level in Stoke-on-Trent (SoT) and will evaluate the relationship between the environment, PA behaviour, health and healthcare utilisation. The environmental mapping will aggregate data from a wide range of available databases, augmented by local data gathering and validation, to produce a comprehensive geo-coded map of 10 SOAs (covering a population ~15,000). GIS will be used to derive indices through which to evaluate the relationship between environmental characteristics and levels of physical activity and health, using Hierarchical Linear Modelling (HLM). Environmental indices used will include: proximity of PA spaces and facilities, street connectivity, land use mix, population density, mass transport provision, traffic, safety, crime, proximity of food outlets and shops, “Walkability Index”, weather and indices of multiple deprivation (IMD). The areas for mapping, baseline assessment and intervention will be considered in two parts, a) community-based and b) schools-based. The effectiveness of the community-based intervention will be assessed by an independent panel survey conducted at baseline and at 2 years follow-up, with an expected 10% increase in the proportion of the population more active in the intervention arm. Effectiveness of the schools-based intervention will be designed to detect an increase of ~15 min/day in school children's moderate to vigorous PA (MVPA). Resource use, cost, willingness to pay and incidental consequences data will be collected alongside the community-based intervention to enable economic modelling from health and social care, societal, other public service and participant perspectives. Findings from the project will inform public policy for increasing population PA and improving neighbourhoods and urban design.

Increasing uptake of physical activity: a social ecological approach

Increasing population physical activity (PA) is a public health priority. An approach to increasing PA in an urban community, based on the social ecology model, is presented and evaluated. A quasi-experimental (non-equivalent control group) design was chosen to test whether this approach can increase, significantly, the population proportion that is physically active. Two deprived inner-city electoral ward areas of Sheffield, UK, with similar socio-demographic and health profiles were selected. Implementation was carried out in five phases over 21 months: preparation and piloting, initial survey estimates, community awareness campaign, PA intervention and evaluation. Impact was evaluated by recording uptake and attendance at all sessions, and using a post-intervention postal survey. At follow-up, questionnaires were sent to 2500 randomly selected addresses in both areas, which assessed changes in PA, health and PA participation over the last year. A pilot baseline survey confirmed similar proportions taking some form of PA on most days: intervention 36% (25-47), control 33% (21-45). At follow-up, 38 different activity groups were in place and 1275 individuals had attended at least one activity. Satisfactorily completed responses were received from 1532 (31%), 55% (846) intervention, 45% (686) control. Relative to the control, the intervention sample demonstrated trends towards: being more physically active compared with one year ago, greater readiness to take up PA, better general health and improved health compared with one year ago (p < or = 0.001). Further, 30.6% (intervention) vs 18.3% (control) reported an increase in PA compared with one year ago, while 13.7% (intervention) vs 24.5% (control) reported no intention to exercise. These differences in proportions translated to an overall effect size estimate of 0.23 for the intervention. Relative to those whose PA had remained the same, intervention area residents were more likely to report being more active (odds ratio (95% confidence interval) = 1.79 (1.38-2.32), p < 60; 0.001). These results suggest that, even within one of the most deprived inner-city areas in the UK, a community-based social ecological approach can positively change PA behaviour and attitudes.

Mental health of the ageing immigrant population

About 6% of older people in the UK are immigrants. Concentrated in deprived inner-city areas, their numbers are rising rapidly, with the ageing of those arriving after the Second World War. Cultural, language and educational differences cause problems in studying this group's mental health. Idioms of distress may affect presentation, help-seeking behaviour and acceptability of treatment. Ethnic elders may be considered vulnerable to depression because of socio-economic deprivation, immigrant status and old age but studies are contradictory and may use inappropriate screening instruments. Relatively few consider immigrant status and dementia. Uncontrolled hypertension could relate to higher dementia rates in Black immigrants which are not reflected in the country of origin. No genetic risk has been found. There is potential for prevention in this population.

Life at the margin: education of young people, social policy and the meanings of social exclusion

This paper explores the term ‘social exclusion’ in the context of new social and education policies being constructed in the UK. It examines the links with terms such as ‘poverty’, ‘deprivation’ and ‘equality’ and the implications of policy developments for those identified as socially excluded. Tensions and contradictions appear to be emerging between the UK government's stated policy intentions to address social exclusion, and local knowledge and experience. Issues of power, market power, participation and inclusiveness are explored specifically in the context of education. The paper draws on research being undertaken in a deprived inner-city area with voluntary sector organizations that provide education for marginalized young people.

Evaluating the use of a psychiatric intensive care unit: is ethnicity a risk factor for admission?

This paper presents a descriptive study, undertaken in 1993, of a Psychiatric Intensive Care Unit (PICU) serving a deprived inner-city area, investigating the role of ethnicity as a risk factor for admission to the unit. Clinical and demographic data were collected on consecutive admissions to a PICU. Global Assessment of Function Scale scores were rated on admission and at discharge from the unit. The majority of patients were male (63%) and the commonest DSM-IV diagnoses were schizophrenia (42%) and bipolar affective disorder (24%). Average length of stay was 13 days with patients making significant improvement in functioning during their stay. Fifty-five percent of PICU admissions came from ethnic minorities (compared with 25.6% of total hospital admissions and 20.9% of the local catchment area population aged between 16 and 65 years). There was no evidence that ethnic minority patients were being inappropriately admitted to the PICU. It is likely that a variety of factors contributed to the high rate of PICU admission amongst ethnic minority patients, including an increased prevalence of major mental illness and more frequent cannabis abuse.

Attachment representations and representations of the self in relation to others: a study of preschool children in inner-city London.

The study examined the relationship between attachment representations and representations of the self in relation to others in a sample of 42 children aged between 4 and 5.9 years. The relationship between children's attachment representations and parents' style of regulating negative affect was also explored. The families were using local authority day-care facilities in a deprived inner-city area of London. The quality of attachment representations was assessed using a modified version of the Separation Anxiety Test. Assessments of the representation of the self in relation to others consisted of (a) assessment of the child's view of self within the relationship with the attachment figure, using an incomplete doll story procedure; and (b) assessment of the child's perceptions of the way others view them using a puppet interview. Significant connections between attachment representations, representations of self in relation to others, and parents' negative affect regulation were found. Children with secure attachment representations had a significantly more positive view of the self in the relationship with the attachment figure than children with disorganized attachment representations, and a significantly more positive perception of the way others view them than children with avoidant attachment representations. Children with secure attachment representations had parents with more adaptive ways of regulating their own negative affect than children with ambivalent or disorganized attachment representations.

Expletives of lower working-class women

ABSTRACTFor many decades, women's speech has been seen as being very different from that used by men. Stereotyped as swearing less, using less slang, and as aiming for more standard speech style, women were judged according to their sex rather than other aspects of their lives, such as class and economic situation. With many critics now challenging these ideas, this article sets out to look at the reality of the swearing used by a group of women from a deprived inner-city area. Their constant use of strong expletives flies in the face of the theories proffered of the “correctness” of the language of women. (Expletives, taboo words, working-class women, female speech, female group, social networks, sociolinguistics, inner-city England)

Behavioral Style in Failure-To-Thrive Infants: A Preliminary Communication

In a pilot inner-city survey, nine 1-year-old infants with nonorganic failure to thrive (NOFT) and pairwise matched controls from the same deprived inner-city area were studied at home. A multimethod approach to the study of infant behavioral style was adopted. A consistent pattern of NOFT infants' behaviors in mothers' descriptions, in observation of play behavior, and in interaction with the examiner during standard testing emerged. NOFT infants were found to be more fussy, demanding, and unsociable. They were also less task-oriented and persistent, and their mothers expressed more negative emotions during play interaction. Mental development was significantly delayed in NOFT infants. The findings emphasize the importance of behavioral contributions from both infant and mother to the relationship problems characteristic of NOFT.

Action research in day nurseries: evaluating programmes through staff perceptions and attitudes.

Day nurseries in deprived inner-city areas have to cope with a wide range of problems which are presented by the young children and their families. Many of the children can be delayed in some area of their development or have emotional problems which require sensitive handling. These challenges are in addition to the expected difficulties of helping young children to adjust to a new situation and the presence of unfamiliar adults and children. The staff of day nurseries tend to be young and the 2-year training has a great deal to cover on normal development. The consequence is that staff in their late teens and early twenties have to face the demands of children whose development is often far from 'normal' in terms of the average range. It was a concern about this situation in a very disadvantaged area of London and the fact that nurseries have traditionally been fairly isolated institutions that led to the planning of a 2-year exploratory project with the objective of introducing new ideas and approaches to nursery staff which would help them provide a better quality of care to socially disadvantaged under-5s.