Built environment, health & inequalities · 2017-11-01 · Built environment, health & inequalities Jamie Pearce Professor of Health Geography School of GeoSciences University of

Built environment, health & inequalities

Jamie PearceProfessor of Health Geography

School of GeoSciences

University of Edinburgh

[email protected]

@jamie0pearce

@CRESHnews

Predicted mean mental wellbeing by perceived financial strain and ease of access to recreational / green areas.

Are neighbourhood characteristics associated with narrower socio-economic inequalities in mental wellbeing?

• 21,294 urban residents, 34 European nations• 2012 European Quality of Life Survey• Associations: mental wellbeing & financial strain • 5 neighbourhood characteristics (including

reported access to green areas)

American Journal of Preventive Medicine 2015, 49 80–84.

American Journal of Preventive Medicine 2015, 49 80–84.

Can the characteristics of the places we live:• Enhance health and well-being?• Narrow socio-economic inequalities in health & well-being?

Children in Scotland: 2 (1.5) examples• Developmental outcomes & mental health• Tobacco & alcohol environments

Child spaces, health & inequalities in Scotland

The role of public & private natural space in children’s social, emotional & behavioural

development in Scotland: a longitudinal study

Jamie PearceElizabeth A. Richardson, Niamh Shortt, Richard Mitchell

Example 1

Children’s social, emotional and behavioural development

• Recent (substantial) rise childhood social, emotional & behavioural problems

• Poor mental health in childhood:• implications for health & wellbeing later in life

• considerable burden for families & societies

• ‘Alienation from nature’ may be a root cause• today’s children spend less time outdoors in

nature, are less physically active & more obese

Research aims

1. Are social, emotional & behavioural development for pre-schoolers better for those with more natural space around their homes?

2. Are different types of natural space (park space & private garden) more important?

3. Are relationships different between:

• boys & girls?

• household educational status?

• Data from the GUS survey• nationally-representative birth cohort• selected in 2005/2006 (n=5,217) from families with babies• followed up annually

• Outcome measures: • Social, emotional & behavioural difficulties assessed (25-

item Strengths & Difficulties Questionnaire): SDQ

• Green spaces: • public parks

• total natural space around each child’s home

• access to private garden

How did we do this?

What did we find? Key messages

1. A social patterning in green space availability • e.g. garden access was significantly more common for least deprived neighbourhoods

& most educated households

2. Neither parks nor total natural space associated with the SDQ outcomes

3. Access to a garden substantially more important than local natural space: • significantly higher scores for Hyperactivity Problems, Peer Problems, Conduct

Problems, & Total Difficulties

4. Significant differences between boys & girls• e.g. boys sensitive to park access, girls not

5. Children from low-education households may benefit from:• natural space (some outcomes)• particularly garden access

Age… 70 in 2006

…and 73 in 2009

…and 76 in 2012

…and 79 in 2015Age 11 in 1947

Lothian Birth Cohort 1936N = 1091

Deary et al. (2007) BMC Geriatrics, 7, 28.Deary et al. (2012) International Journal of Epidemiology, 41, 1576-1584.

Lifetime green space exposure

Green space & mental health

Total HADS score

• influence limited to most socially disadvantaged neighbourhoods

• green space during childhood (10% increase in green space, 14%

reduction in HADS total score)

Anxiety outcome

• most socially disadvantaged neighbourhoods

• accumulated green space exposure important

• particularly green space during childhood

Green space & cognitive ageing

Positive association with change cognitive test score 70-76• Childhood a particularly sensitive period: affecting

cognitive function trajectory in later life • enhanced by green space in adulthood

• Strongest amongst women, & low SES

Tobacco & alcohol environment: smoking & drinking during adolescence

Jamie PearceNiamh Shortt, Catherine Tisch, Richard Mitchell

Example 2

Can we achieve the tobacco ‘end game’?

• How do we achieve the ‘end game’ in Scotland?• target=2034

• equity focused

• Requires wide-ranging & inter-sectoral plans• almost certainly include reducing supply &

availability of tobacco

• tobacco outlet availability & density

• Young people particularly vulnerable to environmental context

Key Findings• Adolescents in areas of high tobacco outlet density more

likely - ever smoked & current smoking.• BUT adolescents attending schools in areas of highest

density less likely - ever smoked & current smoking• Results NOT support retailer reduction solely in ‘child spaces’• Rather should regulate density of outlets across all

neighbourhoods to reduce the likelihood of smoking and smoking initiation in adolescents

Acknowledgements

• We are grateful to:• ScotCen for access to the Growing Up in

Scotland data • Ordnance Survey and Greenspace Scotland for

access to the natural space data (© Crown Copyright and Database Right 2015. Ordnance Survey (Digimap Licence)).

• The work was supported by:• European Research Council [ERC-2010-StG

Grant 263501]• EPSRC [EP/K037404/1]• Scottish Collaboration for Public Health

Research and Policy (SCPHRP)

Further details:

[email protected]@CRESHnews@jamie0pearce

www.cresh.org.uk