The design of the built environment can be especially powerful in reducing health inequalities.  Unlike interventions that focus on improving the information available to people when making lifestyle ‘choices’ (such as what to eat or how much exercise to take), changing the default by adjusting the environment within which these ‘choices’ are made can have a powerful impact across all social groups. 4

Evidence shows that a disproportionate burden of ill-health associated with the built environment is borne by people living in more deprived areas. Hackney is one of the most deprived local authorities in the country and there are significant pockets of deprivation in the City of London.  For further information, see the ‘Living standards’ section of this JSNA chapter.  Box 5 provides a summary of ways in which people living in more deprived groups may be adversely impacted by a lower quality living environment.

Box 5: Deprivation and living environment 5

  • Poorer families have greater exposure to air and noise pollution and higher traffic levels (see the ‘Transport and travel’ section of this JSNA chapter), which cause respiratory disease, mental stress and road traffic injuries.
  • Features of a lower quality urban environment such as dilapidation, vandalism, graffiti and litter are disproportionately found in disadvantaged areas. These aspects can lead to a sense of insecurity on streets and in parks and play areas, meaning that the more vulnerable in particular use them less, leading to reduced physical activity and social interaction and exacerbating health problems such as obesity and isolation.
  • Open spaces – in particular green spaces – have many benefits for physical and mental health and populations that are exposed to the greenest environments also have the lowest levels of health inequality related to income deprivation. However, poorer neighbourhoods often lack green space or have poorly maintained or vandalised green areas.
  • Climate change will also impact significantly on the urban environment and disproportionately on the disadvantaged, particularly through increasing temperatures and flooding. For further information, see the Health and environment section of this JSNA chapter.

Figure 1 shows the geographical distribution across Hackney of one measure of living environment deprivation, based on the 2015 Index of Multiple Deprivation (IMD2015).C (See the ‘Living Standards’ section of this JSNA chapter). This living environment ‘domain’ covers the quality of housing (indoor living environment), as well as air quality and road traffic accidents (outdoor living environment). The data show that living environment deprivation is high across most areas – though within Hackney a few localities score lower than average (i.e. less deprived) on this measure – for example to the east around Hackney Wick and King’s Park.

Figure 1: Living Environment Deprivation in Hackney (IMD 2015), by neighbourhood (ward and LSOA, 2015)

Figure 1: Living Environment Deprivation in Hackney (IMD 2015), by neighbourhood (ward and LSOA, 2015)

Source: Indices of Deprivation, Department of Communities and Local Government, Crown Copyright, 2015

In general, the City of London is much less deprived than other areas (see the ‘Living standards’ of this JSNA chapter), but scores relatively poorly on the living environment IMD2015 domain. Four of the six lower-layer-super output areas (LSOAs)D in the City are within the 20% most deprived in England in terms of living environment. This is perhaps not surprising given its inner city location, where air quality and road traffic accidents might be expected to be relatively high. 6

 

 

Notes

  1. This covers seven domains: Income Deprivation; Employment Deprivation; Health Deprivation and Disability; Education, Skills and Training Deprivation; Crime; Barriers to Housing and Services; and Living Environment Deprivation.
  2. The IMD2015 is a summary measure calculated at neighbourhood level – specifically Lower Layer Super Output Areas (LSOAs), which contain an average population of 1,500 people.
  3. This covers seven domains: Income Deprivation; Employment Deprivation; Health Deprivation and Disability; Education, Skills and Training Deprivation; Crime; Barriers to Housing and Services; and Living Environment Deprivation.
  4. The IMD2015 is a summary measure calculated at neighbourhood level – specifically Lower Layer Super Output Areas (LSOAs), which contain an average population of 1,500 people.

References

  1. S. Macintyre, “Inequalities in health in Scotland: what are they and what can we do about them? Occasional Paper No 17,” Medical Research Council Social & Public Health Sciences Unit, 2007
  2. M. Grant, C. Bird and P. Marno, “Health inequalities ann determinants in the physical urban environment: Evidence briefing,” University of the West of England, 2012
  3. Department of the Built Environment, City of London Corporation, “City of London Resident Population – Deprivation Index 2015,” 2016
  4. S. Macintyre, “Inequalities in health in Scotland: what are they and what can we do about them? Occasional Paper No 17,” Medical Research Council Social & Public Health Sciences Unit, 2007
  5. M. Grant, C. Bird and P. Marno, “Health inequalities ann determinants in the physical urban environment: Evidence briefing,” University of the West of England, 2012
  6. Department of the Built Environment, City of London Corporation, “City of London Resident Population – Deprivation Index 2015,” 2016