Neighbourhoods and Health

A growing number of studies have shown that where people live is important for their health, even after individual socio-economic circumstances (such as income and employment status) are taken into account. However, less is known about what aspects of the local social and physical environment matter most for health and the ability to lead a healthy life, when these factors might matter (e.g. neighbourhood conditions in childhood or at older ages), and for whom (e.g. women, unemployed people, people living in more rural areas). Policies which focus solely on changing individual health behaviours (e.g. diet and physical activity) have had limited impact, in some cases further widening the health gap between rich and poor, whereas those which have focussed solely on environmental improvements, such as housing, without a corresponding change to individual financial resources, educational or employment opportunities, may have limited impact. Our programme of research offers the opportunity to shed light on how neighbourhood ‘gets under the skin’ and inform policy and the design of interventions.

Interest in the role of neighbourhood in influencing health has burgeoned since the early 1990s, with research showing that although ‘who you are’ explains a lot of geographical variation in health outcomes, there is also an effect of ‘where you are’. Less is known however about which features of the residential neighbourhood influence health, the plausible timing of exposures (time lags and different stages of the lifecourse), differential exposures and vulnerability (e.g. age, social position, gender and rurality) and the meaning and use of local amenities and facilities. The aim of this programme is to further our understanding of the ways in which aspects of the local social and physical environment interact to influence health and the ability to lead a healthy life. In this programme we focus on three main influences of the local neighbourhood: (i) what’s in a place (facilities, amenities and people), (ii) what a place is like to live in (perceptions and use of area) and (iii) how people interact with each other. Through these three themes we will explore pathways between these influences and health and health behaviours and the extent to which the social and the physical interact. Our strategy for the next five years is to build on existing strengths and, in the main, to capitalise on existing or already funded data sets, concentrate on health outcomes and behaviours which are major public health burdens (e.g. mental health, obesity, smoking, physical activity, diet) and those aspects of the social and physical environment which are amenable to policy intervention (e.g. housing, transport, retail, land use, air pollution).