Do gender-differences in access to urban landscapes lead to gender-inequalities in mental and physical health?

Research increasingly indicates that cities are built around the needs and habits of those with the greatest earning power, which has historically meant men, and the needs of other groups (e.g. women, elderly, children) have been somewhat discounted in urban planning. This is partly due to gaps in the data upon which plans are based. Gaps are caused by a lack of gender (and age) disaggregation of population-level data, along with a bias toward collecting data on the needs of the economically dominant labour force. Although the paid labour market comprises increasing numbers of women, they still conduct the majority of unpaid and/or paid part-time work. This means that many women have more complicated travel patterns than most men. Women's journeys typically involving multiple, short, sequential trips ('trip chaining') to locations in suburban neighbourhoods rather than central business districts. Reliance on public transport or active travel caused by reduced access to private vehicles comes with an increased time burden (e.g. circuitous routes, more changes), and potentially greater exposure to risky environments (e.g. pedestrian crossings), unhealthy commodities (e.g. advertising, fast-food, alcohol, tobacco) and crime/danger (e.g. sexual harassment/assault). Fear of crime may also impact on use of public spaces (e.g. bus stops, trains, sports facilities, parks), leading to inequality in access. This may not only impede access to work and leisure provisions for certain groups, but also have negative effects on their mental and physical health.

Through this Fellowship I will address the lack of knowledge on how individuals of different gender- and age-groups move through and use urban landscapes. Movement data, that has already been collected from GPS tracking studies on three age cohorts (children, teenagers, adults), will be used to determine whether gender differences in use of urban landscapes occur; what age gender differences become apparent; and what associations this has with individual-level health status. By using data collected at an individual-level we will gain detailed understanding of where people go during their daily activities, how they get there, and whether this is linked to measures of each individual's health. The movement datasets are vast, collected over different time periods and different geographic extents. Using mapped data sources, such location of parks, fast-food, and roads from Ordnance Survey, and data on greenspace and the built environment from satellite imagery, we will be able to describe the types of urban environment each particpant encounters and link this to their answers in health survey questionnaires.

The research findings will be used by other academics and health officials interested in linking health and place, but also Local Government Authorities, urban planners and civil engineers who are interested in making urban landscapes equally accessible for all.

Aims: The primary objective of this research is to fill data gaps between health geography and urban planning by quantifying gender- and age- disaggregated mobility and use of urban landscapes. Specifically, individual-level GPS-tracking and activity data will be used to determine if gender-differences in access health-promoting and health-constraining features in urban landscapes lead to gender-inequalities in mental and physical health.

Methods: Existing GPS and accelerometer datasets from previous physical-activity studies we be used to identify individual 'activity spaces' of participants, including 'trips' between destinations, mode of travel, and 'places of attraction'. Various methods (e.g. Latent class analysis, Random Forests) will be used to characterise urban environments based on a hyperdimensional mix of physical, social, and economic variables measured at different spatial scales.
Existing mapped datasets (e.g. Ordnance Survey, CORINE Land Cover) and new mapped data (e.g. NDVI from satellite imagery) will then be used to quantitatively-define urban environmental context (composition, configuration, density). A key strategy here is to use covariates common to other disciplines (e.g. urban planning) and that are quantitatively-defined, and therefore repeatable, to allow national and international comparison and application. Analysis of patterns will involve multi-level modelling with Bayesian inference to incorporate spatiotemporal autocorrelation among the data.

Impact: The proposed research seeks to determine how individual-level patterns of behaviour and mobility interact with the built environment to create inequalities in access to health-promoting and health-constraining features in the urban landscape. Findings will help identify interventions to remove barriers to healthy lifestyles.

This project aims to deepen our understanding of the interacting relationships between intersectional characteristics (gender and age), place, and critical mental and physical health outcomes. In doing so we aim to deliver clear impact goals. These are to:

1. Inform future urban planning and transport policy to ensure gender-equal cities;
2. Influence the political and public discourse regarding gendered right to urban environments.

Our research will be of interest and importance to a wide range of stakeholders, both nationally and internationally. The World Health Organisation recognises that gender (i.e. socially constructed characteristics determining norms, roles and relations) influences people's susceptibility to different health conditions; their enjoyment of good mental and physical health and wellbeing; their access to and uptake of health services; and on the health outcomes they experience throughout life. Despite shifts towards creating spaces that value diversity and inclusivity within the UK context, there is little reflection on how planning policy contributes to supporting inclusivity. One of the key objectives of this research is to contribute to growing conversations about gender outside of academia, within the public and mainstream media as well as political spheres.

To design interventions to make gender-equal access to resources, policy makers require robust evidence of any association between gendered differences in access to available resources and health outcomes. We aim to provide this evidence and support decision-making. We will seek out and work closely with project partners in achieving our impact strategy. These will include NHS Scotland, with whom we have good working ties, to develop health recommendations about ways to improve mental and physical health; non-government organisations involved with increasing active travel and sustainable transport (e.g. Paths For All, SUSTRANS); Community Councils and Local Authorities interested in making more liveable neighbourhoods and communities; and charities acting to reduce the harm caused by 'environmental bads', such as alcohol and tobacco (e.g. Alcohol Focus Scotland, and Action on Smoking and Health Scotland). Working with our partners we will ensure that they reach the most appropriate audiences, including the Scottish Parliament Information Centre (SPICe), NHS Health Scotland, and all planning authorities in Scotland. At first outreach and engagement will be focused at working within Scotland, where an established network of contacts already exsists. However, a key need from the project's inception will be to identify and engage with similar networks of individuals and organisations within the rest of the UK and within the European countries involved in the PASTA project on which aspects of the project will be based.

To support evidence-based policy and planning decision-making we will make our results publicly available via the SPHSU Neighbourhoods & Communities Programme blog and create research briefings, fact sheets and infographics. These resources will report our results and summarise the international evidence on gender, place, and health outcomes. We will deliver presentations to various audiences including public forums as well as industry workshops.