Evaluating the impact of a locality based social policy intervention on mental health: conceptual and methodological issues

'Lonesome Town'? Is Loneliness Associated with the Residential Environment, including Housing and Neighbourhood Factors?

This article considers whether feelings of loneliness are associated with aspects of the home and neighbourhood of residence. Multinominal logistic regression models were used to explore associations between residential environment and loneliness in 4,000 residents across deprived areas of Glasgow. People who rated their neighbourhood environment of higher quality, and who used more local amenities, were less likely to report loneliness. Respondents who knew more people within the local area were less likely to report loneliness. Those who reported more antisocial behaviour problems, who had a weak perception of collective efficacy, and who felt unsafe walking alone at night-time were more likely to report loneliness. Length of residence and dwelling type were not associated with reported loneliness. The findings indicate the potential importance of several dimensions of the neighbourhood physical, service and social environment, including aspects of both quality and trust, in protecting against or reducing loneliness in deprived areas.

From sociocultural disintegration to community connectedness dimensions of local community concepts and their effects on psychological health of its residents

In a series of community mental health promotion studies in Lofoten, Norway, the concept of sociocultural integration is used to describe properties of a local community that are related to people's psychological health. Starting with Durkheim's description of a cohesive society, we compare different concepts that are related to sociocultural integration, for example, sense of community, social capital, and social cohesion. We then examine the relationship of various individual oriented social psychological concepts to sociocultural integration. These concepts often share theoretical and operational definitions. The concept of sociocultural integration in the Lofoten studies was proved to be very valuable in understanding how the properties of a community can affect people's mental health and their social psychological properties. It has also shown its value in the planning of mental health services and demonstrating its success in concrete community-based mental health promotion projects. Thus they could make important contributions to further studies and actions in local communities where the intersection between the individual, their social network, and their local community occurs.

Housing improvement and self-reported mental distress among council estate residents

This paper is concerned with how housing improvements instigated either publicly or privately influence the degree of psychological stress reported by council estate residents in South Manchester. Stress is measured on the GHQ12 scale containing standard symptomatic items. Potential sources of variation in this indicator are analysed within a geographical setting where repeated samples of residents were drawn from two adjacent suburban council housing estates before and after the implementation of a single regeneration budget (SRB) housing initiative in late 1999. The residents of one of these estates (Wythenshawe) were targeted by this funding while those in the other (Mersey Bank) were not. The latter, therefore, serve as a control for the effects of the enhanced incidence of housing improvement activity promoted by this SRB. Regression analyses revealed that stress was raised significantly among the SRB residents perhaps on account of the additional environmental nuisance they encountered. The experience of stress among all residents, however, was dominated by measures of personal psychosocial risk and it is argued that future regeneration initiatives should address the manifestation of these risks in the effort to achieve better mental health.

State-event relations among indicators of susceptibility to mental distress in Wythenshawe in the UK

This paper explores the utility of concepts drawn from psychosocial theory as predictors of the proneness to mental distress among the residential population of a large suburban council estate (Wythenshawe, South Manchester). In this respect, items are selected and tested to form composite variables measuring individual ratings with regard to notions of structural risk, personal vulnerability, goal-setting behaviour, quality of life, and the frequency of life events and restricted opportunities. Mental distress is enumerated on the standard GHQ12-point scale. The design makes the distinction between composite variables that record persistent states and those which count events and aspirations immediate to the individual's present experience. To examine the consequences of this difference between indicators of prevalence and incidence, our analysis adopts a two-stage multiple regression format. The first examines these state-event interactions among the composite variables, while the second tests the separate significance of these types as predictors of GHQ12. The findings reveal significant proportions of the variation in GHQ12 are be explained either by associations with the ageing process or by those linked to subjective indicators of the quality of life. In contrast, structural deprivation correlates less significantly with the reporting of psychiatric distress in this socially homogeneous population. The discussion considers the methodological implications of these relationships for understanding common mental health problems together with their connotations for health policy.

Is Urban Regeneration Good for Health? Perceptions and Theories of the Health Impacts of Urban Change

An important issue for the geography of health in urban areas concerns how urban change arising from renewal of inner-city areas relates to health of urban populations. In this paper we examine ways in which urban regeneration schemes in Britain are attempting to incorporate consideration of health impact into their planning and development. It concentrates especially on diverse ways that different stakeholders perceive the outcomes of these schemes and the significance for health. The paper is based on two case studies of urban development projects, focusing on housing improvement and training for unemployed people, in a London borough where levels of deprivation are high and various forms of social exclusion affect large numbers of people. The methods used aimed to represent the views of different types of stakeholders, by means of interviews and focus groups with a range of stakeholders in these schemes. Health impact assessment needs to be evidence based. We discuss the evidence for potential health impact of regeneration projects through effects on housing and employment as determinants of health. We focus especially on the ways in which this evidence can be viewed and used by different stakeholders, and how far their perceptions seemed to match with research findings from public health. We consider the potential and the limitations for health improvement associated with urban regeneration in view of the case studies presented here.