Category Archives: Built Environment

New ESRC funded study on Tobacco and Alcohol

We are delighted to announce that we have been awarded funding from the ESRC for a project exploring tobacco and alcohol environments in Scotland. The project ‘Change in alcohol and tobacco availability, population health and the lived experience’ will be funded for 3 years, beginning December 2019 for a total of £761, 470. The project will be led by Professor Niamh Shortt with co-investigators from the University of Edinburgh (Professor Jamie Pearceand Dr Tom Clemens), Glasgow Caledonian University (Professor Carol Emslie) and the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow (Professor Richard Mitchell).

This research will measure change in the availability of alcohol and tobacco in Scottish neighbourhoods over time and explore how this change relates to health outcomes and how residents experience the availability of alcohol and tobacco in their neighbourhoods. The findings will be important because smoking and alcohol consumption are leading causes of illness and death. In Scotland smoking causes one in every 5 deaths and one in 20 deaths is related to alcohol. This harm is not equally shared; those on the lowest incomes suffer the greatest harm. These illnesses and deaths are preventable. The World Health Organisation recommends that nations prioritise interventions that reduce the supply of alcohol and tobacco.

Why might neighbourhood supply of alcohol and tobacco matter? Research suggests that when there are a lot of outlets in a neighbourhood this impacts upon consumption in three ways. 1. The outlets may be more competitive and drive prices down to attract customers. 2. Oversupply may normalise the products when they are sold alongside everyday commodities, such as bread and milk. 3. Tobacco and alcohol may simply be easier to buy in areas where there are more outlets.

In order to explore the relationship between supply, behaviour and harm we need data on the location of every outlet in Scotland selling tobacco and/or alcohol. Ideally, to be able to say something about whether the relationship may be causal, we need this data over time. We have already collected data on the specific location of every outlet selling tobacco and licensed to sell alcohol over multiple time periods (2012 and 2016 (nationwide alcohol and tobacco – see paper here) and 2008 (alcohol in four cities – see paper here)). As part of this project we will collect updated data for 2019/20. This will allow us to measure this change over time. Using an approach called trajectory modelling we will group neighbourhoods that have had a similar degree of change; some neighbourhoods may have lost, or gained, local shops or pubs, whereas some may not have changed at all. We will then identify features of these neighbourhoods that may be driving this change, for example the age profile of the population or poverty levels. This will help policy makers understand the drivers of change in our neighbourhoods.

To measure the relationship between changing supply and harm we will link these trajectories, and our measures of availability at each time point, to alcohol and tobacco health outcomes (behaviour, illness and death). We will use statistical models to see whether areas experiencing an increase or decrease in outlets have seen a corresponding increase or decrease in these outcomes. This will allow us to get a better understanding of whether an over supply of alcohol and tobacco is related to smoking and alcohol consumption and harm. These findings will provide important evidence related to the provision of such commodities in our neighbourhoods.

Although these statistics are important to report we also need to understand why an oversupply of alcohol and tobacco may influence behaviour and harm. Whilst the literature suggests the pathways listed above, we know little about the experiences of individuals living in neighbourhoods with contrasting availability. We don’t understand the individual experience of any of these pathways. Professor Carol Emslie will lead a qualitative work package and researchrs will meet with groups of individuals, in neighbourhoods of contrasting trajectories, to talk to them about the supply of alcohol and tobacco. We will explore their experiences of neighbourhood and assess how their perceived notions of their neighbourhood availability contrast with our statistical measures. Finally, we will meet with residents, retailers and policy stake-holders to explore potential interventions related to supply. Policies at this level require public, retailer and political support. We will discuss the priorities held by various groups, present our quantitative results and gauge attitudes towards potential interventions.

Throughout the project will be committed to knowledge exchange, public events and speaking with non academic partners. If you wish to know more about this research, or would like one of the researchers to come to your organisation to provide you initial findings (once the project is under way) then contact the Principal Investigator here: niamh.shortt@ed.ac.uk

An atlas of change in Scotland’s built environment 2016-17

By Laura Macdonald from the MRC/CSO  Social and Public Health Sciences Unit, University of Glasgow @theSPHSU

Our neighbourhood environments change and evolve often; some changes are minor, while others involve major transformation. Change can take various forms; green space created or removed, existing housing or amenities demolished, new housing estates built, new motorways created, or existing transport infrastructure modified or extended. Change may affect neighbourhood residents’ physical or mental health, or health-related behaviours, to their benefit or to their detriment. To study how change in our neighbourhoods might affect our health we need robust information but data showing how our neighbourhoods are changing, at a fine geographic scale, for the whole of Scotland, did not exist – until now! This is why we created an atlas showing what’s changed, and an interactive mapping application which allows you to explore the data yourself. Continue reading An atlas of change in Scotland’s built environment 2016-17

Children in deprived areas encounter shops selling tobacco six times more frequently than those in well-off areas

By Dr Fiona Caryl.

Our new study  looking at exposure of children to tobacco retailing, recently published in the journal Tobacco Control, shows that an average 10-to-11-year-old child in Scotland comes within 10m of a shop selling tobacco 43 times a week. This rises to 149 times a week for children living in the poorest areas—six times more than the 23 encounters a week experienced by children living in affluent areas. This demonstrates an unexpectedly large inequality in the amount of times children are exposed to tobacco sales. Unexpected because in the same study we showed that tobacco outlets are 2.6 times more common around the homes of children living in the most deprived areas than the least. Yet we found a six-fold difference in exposure because we used GPS trackers (fully consented and ethics-approved, of course) to follow exactly where children moved through their environments. We found that most exposure came from convenience stores (41%) and newsagents (15%) on school days, with peaks before and after school hours. At weekends, we found most exposure came from supermarkets (14%), with a peak around midday.

Why does this matter? This may not sound like a lot of exposure, and we might ask if a child is really exposed to tobacco just by being in or near a shop selling tobacco, especially after the ban on point-of-sale (POS) tobacco displays. But then we don’t actually know how many micro-exposures it takes to make a child think that smoking is a normal, acceptable and widespread behaviour rather than a major cause of premature death. Research into advertising suggests that the mere-exposure to indirect and incidental stimuli can influence attitudesnon-consciously when they’re repeatedly presented. The ban on POS tobacco displays has reduced children’s susceptibility to smoking, but children still notice tobacco on sale. In fact, recent research shows that the conspicuousness and prominence of tobacco in shops varies considerably between areas of high and low deprivation. And the difference in prominence has been increasing since the POS ban.

The difference in the number of times children in poor areas are in or near to places selling tobacco is most concerning when you consider the pathways leading people to start smoking. Most adult smokers start when they are teenagers, and the availability of tobacco products is a key factor in in why people start to smoke and why they find it hard to give-up. Our findings raise important questions about when and where tobacco products are sold and the messaging this is sending to children.

What is ‘on the ground’ in a city linked to levels of inequality in life satisfaction

In a European-wide study of 63,554 people from 66 cities in 28 countries, we found links between urban design and levels of inequality in life satisfaction. This is the first study to theorise and examine how the entire urban landscape may affect levels of and inequalities in wellbeing in a large international sample.

Cities with an even distribution of facilities, housing and green space were linked with lower levels of inequality between residents’ life satisfaction levels, suggesting that more equal access to a range of facilities and types of land may help reduce the gap in life satisfaction between the most economically-deprived and most affluent residents of a city.

There was a strong link between higher life satisfaction and living in cities with homes surrounded by natural, green space. However, lower life satisfaction was linked to living in cities that had more wasteland, more space dedicated to housing, and more space in which all the land is concrete or tarmacked.

Implications for policy and planning.

The findings of our study suggest that urban planning has a role to play in addressing inequalities in cities. Our finding that more equal distribution of land cover/use is associated with lower levels of socio-economic inequality in life satisfaction supports the idea that city environments could be equigenic – that is, could create equality.

What people want or need from their city varies moment to moment, day to day, life stage to life stage. If a city is varied enough to offer people what they need, when they need it, it is likely to support a higher quality of life.

Three Generation Out Walking

Why understanding city design is important for population health and well-being?

With the United Nations reporting that more than half the world’s population residing in urban areas and this proportion rising, it is important to understand how well-planned urban environment might improve, and reduce inequalities in, quality of life. Therefore, understanding the influence urban environments can have on all aspects of health and wellbeing is increasingly important. Cities are continuously evolving and there is ample opportunity to ensure these are healthier and happier place to live.

What we did:

We applied theory and methods from landscape ecology to explore associations between cities’ land cover/use, residents’ reported life satisfaction and within-city socio-economic inequalities in life satisfaction. We joined individual-level responses to the European Urban Audit (EUA) Perception Surveys (2012 and 2015) with city-level data from the European Urban Atlas classifying land cover/use into 26 different classes. Our sample included 63,554 people from 66 cities in 28 countries.

The study, ‘Are urban landscapes associated with reported life satisfaction and inequalities in life satisfaction at the city level? A cross-sectional study of 66 European Cities’ is published in Social Science & Medicine (Open Access). The work was funded by The Medical Research Council (MRC) and Scottish Government Chief Scientist Office.

By Rich Mitchell, Natalie Nicholls & Jon Olsen , Neighbourhoods and Communities programme, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow.

Do people actually use the facilities in their home neighbourhood?

This blog explores a key question in neighbourhood and health research: if there is a facility or amenity close to someone’s home, is it OK to assume they use it? Surprisingly, this assumption is at the heart of a lot of health and environment research.

We often have data which tells us where facilities and amenities are, and we tend to make the assumption that proximity means use. So, for example, if we see that some neighbourhoods have more parks or more leisure facilities, we expect the people who live in that neighbourhood use them more. Understanding local amenity and facility use is important because we want to know whether / how these things affect health.

With technological advances in recent years, studies have started to collect precise data which tell us exactly where people go using global position system (GPS) devices. We no longer have to assume, for example, that if there’s a park close to a child’s home, they will visit it. The GPS tracks we collect will tell us if they did or not. That presents an opportunity to test our assumptions.

Do children use facilities they have access to in their home neighbourhood?

Our team is interested in children’s use of facilities in and around their homes and to test whether we need GPS to research this we conducted an analysis of facility availability and facility use for 30 10-year-old children living in Glasgow. We used data from GPS devices worn by the children for eight days. These children were part of our ‘Studying Physical Activity in Children’s Environments across Scotland’ Study (SPACES).

The diagram below shows what we did. Our key finding was that facility availability in the home neighbourhood is not a good indicator of facility use; the children used facilities from across a much wider area in the city, even if they had a facility close to their home.  For example, 18 of the 30 children (60%) had a leisure centre within their ‘neighbourhood’ (which we defined as 800m around their home). Only 3 of the 18 actually visited that facility (as identified by their GPS tracks). Of those 18 children, 8 actually visited a leisure centre outside of their ‘neighbourhood’. We saw the same kind of pattern when exploring availability and visits to playing fields, public parks and libraries

Blog graphic

Are our results similar to other research?

Yes, other studies that used GPS devices have found that children do spend time outside of their immediate home area for specific purposes. For example, a 2017 study by Chambers and colleagues in Wellington, New Zealand analysed leisure time GPS data (before and after school) in 114 children aged 11 to 13 years from 16 schools, and found that 38% of their leisure time was spent outside of the home neighbourhood (using a 750m buffer around the home). Time outside of the home neighbourhood was mostly spent visiting their school, other residential locations, and fast food outlets.

These results, and those from similar studies, show that it is important not to treat what’s in someone’s immediate home neighbourhood as a good measure of what they do, or in epidemiological language ‘what they are exposed to’. We must challenge the idea that residential neighbourhood is an adequate way to capture the socio-environmental factors which contribute to health. Many people, including children, can and do access environments well beyond their immediate home neighbourhood. We think that a much wider geographic area should be considered when we’re asking questions about how environment affects health and we call this the city-wide landscape.

What does this mean for future research?

It’s clear that the ‘traditional’ approach which uses someone’s neighbourhood (often defined by a distance around their home, or an administrative area in which their home sits) to assess their access to facilities or exposure to environments is seriously flawed.

  • Other methodological approaches are required to measure ‘exposure’ to environment;
  • We must move beyond traditional fixed neighbourhood-health relationships (although we can’t ignore them);
  • We should embrace and integrate innovative technology to explore mobility (e.g. GPS and accelerometer).

Of course, even when we’re able to see exactly where people go and what they do, we still need to understand the decisions people make about whether or not to visit or spend time at different places.

By Jon Olsen, Research Associate with the Neighbourhoods and Communities programme, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow.

Urban health and neighbourhood effects: PhD studentships at Glasgow Uni

CRESH’s Rich Mitchell is part of the GCRF Funded Centre for Sustainable, Healthy and Learning Cities and Neighbourhoods (SHLC) at the University of Glasgow. The centre is offering 3 new PhD studentships which include a focus on neighbourhood and city effects on health. More details and how to apply can be found below and via the University’s Website: http://bit.ly/SHLCPhD

Closing Date: 17 June 2018

Research Topic

Candidates are required to provide an outline proposal of no more than 1000 words. We are particularly interested in proposals that encompass any of the following topics:

a) The development and operationalisation of indicators/classification/measures of spatial differentiation (including its temporal evolution) of neighbourhoods within SHLC case study cities, and the implications of spatial differentiation for access to public services;

b) The development and operationalisation of indicators/classification/measures for lifelong learning in cities and neighbourhoods in the global south, including links to a range of life wide literacies;

c) Qualitative/ethnographic studies of neighbourhoods in SHLC case study cities paying particular attention to the interaction between urban, health and education challenges

d) Investigations of the impact of informality on social sustainability in neighbourhoods within SHLC case study cities, paying particular attention to the interaction between urban, health and education challenges

e) Understanding the relationships between neighbourhood-level and city-level influences on residents’ health, paying particular attention to variations by health outcome, person and/or SHLC case study city/country.

The award
Both Home/EU and International applicants are eligible to apply. The scholarship is open to +3 (3 years PhD only) commencing in October 2018 and will provide: a stipend at the ESRC rate, 100% tuition fee waiver, and access to the Research Training Support Grant.

How to Apply

All applicants should complete and collate the following documentation then attach to a single email and send to socsci-scholarships@glasgow.ac.uk with the subject line ‘GCRF SHLC Scholarship application‘ by 17 June 2018

  1. Academic Transcript(s) and Degree Certificate(s)

Final or current degree transcripts including grades and degree certificates (and official translations, if needed) – scanned copy in colour of the original documents.

  1. References

2 references on headed paper (academic and/or professional).

At least one reference must be academic, the other can be academic or professional. Your references should be on official headed paper. These should also be signed by the referee.

If your referees would prefer to provide confidential references direct to the University then we can also accept the reference by email, from the referee’s official university or business email account to socsci-scholarships@glasgow.ac.uk clearly labelling the reference e.g. “<applicant name> CoSS Scholarship Reference”

  1. Copy of CV
  2. Research Proposal 

Applicants are required to provide research proposal of not more than 1000 words. It should include:

  • a straightforward, descriptive, and informative title
  • the question that your research will address
  • a justification of why this question is important and worth investigating
  • an assessment of how your own research will engage with recent research on the subject
  • a brief account of the methodology and data sources you will use
  • References to sources cited in the proposal and an indicative wider bibliography (The references and bibliography are in addition to the 1000 words).

For more information please visit the University’s website (http://bit.ly/SHLCPhD) or contact SHLC’s Senior Business Manager Gail Wilson gail.wilson@glasgow.ac.uk

Changing places and mental health: do changes in perceptions of neighbourhood influence anxiety and depression in adults?

Written by Dr Jon Olsen, Research Associate with the Neighbourhoods and Communities programme, MRC/CSO Social and Public Health Sciences Unit. This blog is mirrored on the SPHSU website.

Mental health problems are a global issue. In 2013 over 615 million individuals suffered from anxiety and/or depression across the world, a rise of 50% since 1990. How people experience their local environment can impact on mental health. Living in areas that are perceived to have higher levels of neighbourhood problems such as poor housing quality, limited amounts of greenspace, industrial activity, and high traffic volume, has been linked to poorer mental health by some research studies. But, few studies have explored how change in what people think about their neighbourhood is linked to change in their mental health. It would be useful to know this as improving the neighbourhood environment could strengthen mental health.

In our recently published study, we wanted to see how changes in what people thought about their neighbourhood impacted on residents’ mental health over time. We looked at two mental health outcomes: anxiety and depression. Adults who lived in West Central Scotland, an area including Glasgow and eight neighbouring local authorities, were asked to complete the same questionnaire in 1997 and 2010.

Glasgow, United Kingdom – October 20, 2013: People come to walk around and shop at the historic Barras Market Place flea market.

What did we find?

Overall, anxiety and depression in the people we spoke to reduced between 1997 and 2010. However, those who experienced worsening neighbourhood perceptions from 1997 to 2010 also had increased anxiety and depression scores.

Why this matters

Our study showed that worsening neighbourhood perceptions were linked with small increases in anxiety and depression scores. People living in areas where perceptions of the neighbourhood got worse, did not benefit from the general improvements in anxiety and depression scores enjoyed by the population as a whole; this could widen health inequalities.

Wheelie bins (blue for recycling, green for general refuse) lined up for collection in a Glasgow alley.

 

The take home message from this study

There is a clear need for national and local policy to target areas where neighbourhood conditions are substantially deteriorating to ensure people’s mental health does not suffer.

Further information about the study

We used data from the Transport, Housing and Well-being study; a postal survey of adults in eight local authority areas in the west of Scotland in 1997 and 2010. More information and a link to the full questionnaire can be found here: http://thaw.sphsu.mrc.ac.uk/.

Anxiety and depression was measured using the Hospital Anxiety and Depression Scale (HADS), a common measure of psychological distress that has been in use for over 30 years.

The full paper was published in the International Journal of Environmental Research and Public Health and is freely available here.

Disclaimer: The views expressed in this blog are those of the author.

The MRC/CSO Social and Public Health Sciences Unit is funded by the Medical Research Council and the Scottish Government Chief Scientist Office. The views expressed are not necessarily those of the Medical Research Council or the Scottish Government.