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Institute of Epidemiology & Health Care

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Neighbourhood change and health

Helena Tunstall, Jamie Pearce, Niamh Shortt, Liz Richardson and Catherine Tisch, University of Edinburgh, Richard Mitchell, University of Glasgow and Claire Niedzwiedz, Mental Health Foundation in Scotland

(Project no. 1000282)

The purpose of this project is to understand better the relationship between change in neighbourhood socio-demographic and housing characteristics, migration and individual and area general health in England and Wales. The research would link ONS LS and neighbourhood data to complete longitudinal analysis of interactions between individual and area variables.

Research programme

This planned research is part of a larger European Research Council Starting Grant project, entitled 'Physical Built Environments and Health Inequalities', led by Primary Investigator Prof Jamie Pearce with Co-Investigators Dr Niamh Shortt and Prof Richard Mitchell of the Universities of Edinburgh and Glasgow. This five year project was funded from 1 October 2011 until 30 Sept 2016. This project is comprised of a programme of research which aims to understand the role of environment in explaining changing spatial inequalities in health in recent decades in UK and Europe. The key themes of this health geography research programme include health and selective migration, neighbourhood environments and the life course. This proposed project draws upon these themes focussing upon the relationship between neighbourhood change, migration and individual and area health over time in England and Wales.

Research context and objectives

The aim of this study is to understand better the relationship between neighbourhood change, migration and individual and area general health in England and Wales. A large number of research studies have assessed 'neighbourhood effects' upon health. These studies have sought to identify how the social and physical environment affect the health of individuals resident in areas. This research has however largely been cross-sectional in approach and has rarely assessed neighbourhood change and migration. Studies which have assessed the impacts of selective migration upon neighbourhood health outcomes have generally focussed on describing broad patterns of spatial inequality and have rarely focussed upon neighbourhoods experiencing significant change.

This proposed project would centre upon developing understanding of interactions between individual and area health over time in changing neighbourhoods. It would consider both how individual's residential mobility changes population health in neighbourhoods and how neighbourhood change influences the health of individuals resident in changing areas, and effects residents displaced by these changes. It would aim to assess what kind of neighbourhood 'improvement' benefits health.

This research would focus upon socio-economically deprived neighbourhoods that have experienced changes in their socio-economic status. It would assess what types of neighbourhood change are beneficial to the health of low socio-economic status populations in these deprived neighbourhoods.

The research would consider both socio-demographic change and changes to housing environments in neighbourhoods experiencing gentrification, expanding high socio-economic status populations, increasing house prices, substantial new-build housing and destruction of housing stock, changes in housing tenure, studentification, changes in levels of unemployment and population turnover, growth and loss. The planned research would assess how relationships between these socio-demographic and housing changes in deprived neighbourhoods and health vary between population groups with different socio-economic status, ages and between housing tenure.

This research plans to address four main research questions regarding health and neighbourhood change:

1. How does selective migration influence population health in changing neighbourhoods?

2. What are the impacts of neighbourhood change upon the health of individuals resident in changing areas?

3. What is the effect of relocation upon the health of individuals 'displaced' from changing areas?

4. Do these relationships vary with individual age, socio-economic status and housing tenure?

Analysis strategy

The planned analysis would link ONS Longitudinal Study data from 1991, 2001 and 2011 to Lower Super Output level data describing a typology of neighbourhood change 1991-2011. The analysis would assess the health of those moving between and living in these neighbourhoods over two decades.

The typology of neighbourhoods would categorise LSOA into groups based upon the types of socio-demographic and housing change they had experienced 1991-2011. These typologies will be defined using socio-demographic data from the Census, 1991-2011, and housing data from the Land Registry, 1995-2011. The main health outcomes assessed in this analysis would be based upon ONS Longitudinal Study describing individual's limiting long term illness (1991-2011) and general health (2001-2011).

ONS LS data would be used to describe the health characteristics of migrants moving in and out of the neighbourhood types and assess the impacts of their migration upon rates of poor health in the neighbourhoods. The contextual effects of neighbourhood change upon the health of long-term residents in the changing areas would then be considered through regression analysis.

ONS LS data would support the stratification of the analysis by decade, age group, education level, socio-economic class and housing tenure and between regions in England and Wales. Variables describing sex, ethnic group and immigrant status, which are closely related to health and patterns of mobility, would be used as control variables in the analysis.

Purposes for which the micro-data are requested

ONS Longitudinal Study micro data are essential for our proposed analysis as they will allow us to link individuals (and their health outcomes and socio-demographic characteristics) with the neighbourhoods in which they live and move between. The key purpose for which ONS Longitudinal Study micro-data is requested is to trace the relationship between individual's place of residence, movements in and out of the neighbourhood areas and changing personal characteristics over two decades.

This proposed project assessing the relationship between neighbourhood change and health addresses some similar themes to the ONS Longitudinal Study project led by Ian Gordon and Andy Pratt, entitled 'Exploration of the relationship between gentrification and resident health' in London (Project number 30059). While both proposed project would assess gentrification our project plans to assess other types of neighbourhood change. It would analyse neighbourhood changes driven by changes in housing, in particular new build, as well as socio-demographic characteristics of neighbourhood populations. It will consider not only the contextual effects of neighbourhood change upon individual health but also how migration associated with neighbourhood change