Personal perspectives on urban health and wellbeing
They’re changing all the time. They are densely populated (twice the average in the capital) and have a high level of population churn. There is also a complex ethnic and social mix, including large black and LGBT communities and over 300 different languages spoken. Like many London boroughs, affluence and poverty exist side by side.
The health challenges facing the boroughs are complex and significant, and mirror many of the same challenges facing cities across the UK and around the world.
We wanted to explore how the characteristics of urban environment, diverse population and high levels of deprivation influence these health outcomes. As these characteristics are not unique to these boroughs, insight could be drawn from other cities and learning shared with those facing similar challenges. Uscreates, a human-centred design and innovation agency, was commissioned to combine quantitative and qualitative data to create a rich picture of the lived experience of health.
Uscreates began by looking broadly at the variance between Lambeth and Southwark and a selection of urban, diverse and deprived statistical neighbours: Haringey, Nottingham and Leicester. This was followed by a literature review and a wide range of interviews with local health experts and social influencers to build up a picture of what was known about health and urban areas, health and diversity and health and deprivation. Finally, Uscreates interviewed a cross section of local residents to understand their perceptions, motivations and behaviour in relation to their health.
This research builds on a large body of work studying the impact of urban, diverse and deprived characteristics on people’s health, and confirms much of what the health sector already understands to be the best way to create place-based health strategies.
What is different about it is that it:
This research suggests that the assets and risk factors of urban environment, diverse communities and deprived areas interact with each other in complex ways. The impact varies from individual to individual, in some cases amplifying or compounding each other, in others cancelling each other out.
The research identified a set of themes which add valuable context and insight into the lived experience of health through an urban, diverse and deprived lens.
The ability to navigate the city has a strong payoff for health
High quality green space can improve people’s health and build community
The fast pace, transient nature and density of the urban environment can negatively impact on physical and mental health
Diversity influences health seeking behaviours and how people access health services
Complex diversity within cities means many different cultural assumptions and attitudes to health exist in a relatively small geographical area
Language barriers limit people’s understanding of what is available and dialogue about health with health professionals and employers
There is often a reliance on ‘outside the system’ networks to support health
Whilst social networks, individual resilience and mental wellbeing play a part in protecting health, living in a deprived area can still be detrimental to health
The city is expensive and pressure to survive can be a strain on people’s health when managing on a small income
If you are struggling to make ends meet on a low income, there isn’t the headspace or time available to consider exercise and diet
This work has started to uncover the interplay between the assets and risks of urban, diverse and deprived areas, and the resulting impact on people’s health. It also highlights the different ways people demonstrate resilience that enables them to respond and adapt to them.
It reinforces the need for a sophisticated, multi-layered and in many ways, community led approach to improve health outcomes. One that can connect health with non-health partners, formal and informal sectors, and help this combined effort reach into and out from communities.
But it also highlights how much more work is needed to fully understand how to maximise the opportunities for health in the modern city environment. Work we are keen to progress with others.