Lifecourse of Place: how environments throughout life can support healthy ageing

Lead Research Organisation: University of Edinburgh
Department Name: Sch of Geosciences

Abstract

Providing new insights into the how the places we live and grow older can be best designed to support healthy ageing has emerged as an important research and policy priority. Many studies have looked to identify the barriers to health and effective functioning for older people, and into producing environments experienced in older age that support people to age well. However, we know much less about the aspects of environments experienced throughout life that might support the maintenance of healthy functioning in later life. Therefore, this interdisciplinary proposal draws together expertise from geography, psychology and landscape architecture to utilise novel longitudinal datasets to examine how place-based circumstances from childhood through the rest of life can enhance healthy ageing.

The study draws on a new framework labelled the "life course of place" which helps us to examine how places evolve over time and matter at different points in the lifecourse in predicting later life health outcomes. We will utilise two longitudinal datasets - the Lothian Birth Cohort 1936 (LBC1936) alongside a suite of small area historical environmental measures - which were collated as part of an earlier study. The combined datasets provide detailed information on a cohort of people born in 1936 (LBC1936) as well as the environmental circumstances in which the participants lived at various points during their lives. These data collection efforts resulted in a unique dataset that captured the lifetime environmental circumstances (including green space, air pollution and area-level deprivation) of a cohort of older people alongside detailed individual-level information, including high quality indicators of healthy ageing. A key novelty of our work will be to examine full lifetime exposures. The study utilises a set of robust indicators of healthy ageing available for LBC1936 participants, collected through brain imaging, cognitive testing and biomarkers of biological ageing (telomere length and epigenetic clock). These outcomes are rarely utilised in social scientific research.

The overarching research question therefore is to examine whether lifetime exposure to green space, air pollution and area-level deprivation affect indicators of healthy ageing (measures of cognitive ageing, brain health and biological ageing). In particular, we will examine whether there are (a) critical periods (childhood, early adulthood, adulthood and later adulthood) in which the three area-level characteristics are particularly important in explaining the later life outcomes, and/or (b) whether the environmental factors accumulate over the lifecourse to affect healthy ageing. Our analyses will consider whether the relationships differ by sex and socioeconomic circumstances.

By examining relationships over the full lifecourse, the research findings have the potential to make a significant contribution to our understanding of the dynamics of places and the implications for health trajectories in later life. The UK Government has identified meeting the needs of an ageing society as one of its 'Grand Challenges' and has committed to identifying innovative ways to ensure older citizens can continue to contribute to society through leading independent and fulfilled lives. One of the defined missions in the strategy is to "ensure that people can enjoy at least 5 extra healthy, independent years of life by 2035, while narrowing the gap between the experience of the richest and poorest." Our research will improve our understanding of the role of place throughout life in supporting healthy ageing, and identify critical periods in which key environmental factors affect subsequent health trajectories and inequalities. Therefore, by identifying actionable, long-term and sustainable policy opportunities, and working with our key project partners, the proposed research has the potential to make significant contributions to meeting the needs of an ageing society.

Planned Impact

We aim to increase recognition of the role of the environment across the life course in affecting cognitive and brain ageing, and evidence policy opportunities for enhancing the beneficial influences of the places in which we age. The impact goals of this study are to: (i) inform the development of future healthy ageing policies, particularly relating to environmental planning and management; (ii) influence the political and public discourse, reframing debates regarding place-based factors affecting healthy ageing; and (iii) build capacity in undertaking the complex analyses needed to fully understand the influence of environments over the life course on health.

The key, long-term beneficiaries of our research will be older people, their families and carers. We have identified three sets of stakeholders with whom we will work with closely to accelerate the impact of our research: (i) older people's advocacy organisations; (ii) policymakers working to enable older people to live healthy, active and independent lives; and (iii) wider public including older people. Our proposal has been developed in collaboration with key partners representing the key stakeholder groups: Age UK (advocacy), NHS Health Scotland (policy), and the Place Standard Team at Scottish Government (policy). These ambitions will be supported by a series of activities working with each of the three sets of stakeholders. The nature of the activities will reflect the needs and interests of the target audiences and utilise seminars, workshops, debates, interactive websites, and conference presentations as appropriate.

First, our key partner advocating for older people's concerns will be Age UK. We have costed for a series of events that build on our well-established track record of collaboration between the research team and Age UK. The key outcomes will be: a co-produced workshop with older people, older people's organisations, social care, and healthcare practitioners; a plain language research summary targeting a general audience of typically older people and their families; other co-produced research summaries (e.g. for The Geographer, a Royal Scottish Geographical Society publication with an international readership of >12,000); and supplementing online resource currently being developed for older people which summarises the relevant scientific evidence.

Second, our key partners working in the policy arena will be NHS Health Scotland and the Scottish Government. In particular, we will work with the Place Standard team led by NHS Health Scotland (see: www.placestandard.scot/) to develop: a workshop for practitioners in environmental planning, design and management, and in service delivery who use (or wish to use) the tool; a policy brief, specifically targeted at policy makers; and a senior-level invitation only KE workshop to engage policymakers with our study, as the findings emerge, and consider their implications for policy development. We will also continue our ongoing engagement with Cross-Party Groups, public committees, networking events and consultations (e.g. offering contributions to the meetings of the Scottish Parliament's Cross Party Groups on Health Inequalities and/or Older People and Ageing).
Finally, we will engage with a broad public audience through online content. This will include the policy paper and summaries prepared for expert and lay audiences and through publishing on our research group webpages which are important vehicles for disseminating research findings (e.g. blog posts and our social media channels). We will support public participation in local decision by making our results and data publically available via our mapping and data sharing web tool https://creshmap.com We will organise a dedicated events such as the 2021 Edinburgh International Science Festival and take advantage of the regular end-of-wave LBC1936 Reunion Event organised for all study participants to discuss new findings from the proposed research.
 
Description Government Office for Science/ESRC high-level working group on Covid-19 Areas of Research Interest: Working group 6. Land Use
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
URL https://www.gov.uk/government/collections/rebuilding-a-resilient-britain
 
Description Public Health Scotland 'Social & Systems Recovery: Environment & Spaces Group' - Evidence & Data Sub-group
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
URL https://www.greenspacescotland.org.uk/news/how-have-covid-19-restrictions-changed-our-use-of-greensp...
 
Description Workshop - Development of an Open Space and Health Outcome Framework
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
Impact The Frameowrk to inform Government is still being drafted so it has yet to influence policy and practice
 
Description Artificial Intelligence and Multimorbidity: Clustering in Individuals, Space and Clinical Context (AIM-CISC)
Amount £3,919,510 (GBP)
Funding ID NIHR202639 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 07/2021 
End 08/2024
 
Description GroundsWell: Community-engaged and Data-informed Systems Transformation of Urban Green and Blue Space for Population Health
Amount £7,116,894 (GBP)
Funding ID MR/V049704/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 08/2021 
End 09/2026
 
Description The Advanced Care Research Centre
Amount £9,581,537 (GBP)
Funding ID 9862317 
Organisation Legal and General Group 
Sector Private
Country United Kingdom
Start 03/2020 
End 03/2027
 
Description The health and equity impacts of climate change mitigation measures on indoor and outdoor air pollution exposure (HEICCAM)
Amount £507,898 (GBP)
Funding ID NE/V002090/1 
Organisation Natural Environment Research Council 
Sector Public
Country United Kingdom
Start 08/2020 
End 08/2023
 
Description British Academy/Wellcome health policy workshop 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact This contribution to a workshop on post Covid recovery asked 'How can real or virtual spaces promote good mental health?' leading to questions and discussion afterwards, and follow up enquiries subsequently
Year(s) Of Engagement Activity 2021
 
Description Environmental Protection Scotland Seminar 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact 'Evidence on access to and use of green space: Healthy and Inclusive Landscapes': Invited presentation to 'Green & Natural Spaces for the Triple-Win' Environmental Protection Scotland seminar, delivered online 25th Feb 2021. Audience consisted of policymakers and practitioners, principally from local authority councils, and discussion focused on future actions and research opportunities.
Year(s) Of Engagement Activity 2021
URL https://www.ep-scotland.org.uk/news/green-natural-spaces-for-the-triple-win/
 
Description How Do We Design Places to Promote Wellbeing? 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact 85 members of the public attended this event which formed part of the programme of the Royal Society of Edinburgh annual 'Curious' summer festival. Audience members asked a number of questions and there was a wide-ranging debate, with very positive audience evaluation of the event.
Year(s) Of Engagement Activity 2020
URL https://www.rse-curious.com/how-do-we-design-places-to-promote-wellbeing/
 
Description Life course neighbourhood deprivation and frailty in older adults 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact 20 researchers (including PGR students) attended the talk at the annual meeting of the Society for Social Medicine and Population Health. The talk which sparked questions and discussion afterwards.
Year(s) Of Engagement Activity 2021
 
Description Life course neighbourhood social deprivation and frailty in the Lothian Birth Cohort of 1936 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Talk was given at the annual conference of the Society of Longitudinal and Lifecourse Studies
Year(s) Of Engagement Activity 2021
 
Description Lifecourse of Place: how environments throughout life can support healthy ageing 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Other audiences
Results and Impact 20 non university researchers attended a seminar on the research leading to questions and discussion aftrwards
Year(s) Of Engagement Activity 2021
 
Description Lifecourse of Place: how environments throughout life can support healthy ageing 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Around 30 researchers and postgraduate students attended this invited seminar, which sparked questions and discussion afterwards, and led to future research collaborations.
Year(s) Of Engagement Activity 2021
 
Description Lifecourse of place 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact A public facing seminar attending by 80 members of the public, third sector organisations and policymakers led to questions and discussion afterwards on the role of place in supporting healthy ageing.
Year(s) Of Engagement Activity 2021
 
Description Lifecourse of place: a longitudinal approach to understanding health, place & inequalities 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact Around 30 people attended a seminar on the new research which sparked questions and discussion afterwards
Year(s) Of Engagement Activity 2021
 
Description Plenary conference presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Around 200 researchers and postgraduate students attended this invited plenary, which sparked questions and discussion afterwards, and led to future research collaborations.
Year(s) Of Engagement Activity 2022
URL https://iussp.org/en/4th-conference-european-society-historical-demography