Evidence
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Someone’s wellbeing is influenced by their health, finances and other individual factors. But research shows that it also depends on aspects of the environment in which they live. Well-managed open spaces (parks or fields), and having a sense of belonging within their community, improve people’s wellbeing.

Wellbeing is about feeling good and functioning well. It includes happiness, purpose and control over your life choices. Policy and research to date have tended to emphasise the individual and what each person can do for themselves.

This study explored factors relating to people's environment (place), using information collected as part of a larger project. The research showed that while individual factors were more strongly linked to wellbeing, place factors also had a large part to play.

Local authorities and town planners influence place factors. To improve wellbeing, they need to consider access to open spaces, and community cohesion, the research concludes. Communities need to be involved in decisions about their surroundings.

The researchers hope their work will lead to open lines of communication between public health experts and town planners.

Further information about wellbeing can be found on the NHS website.

What’s the issue?

Wellbeing is a complex, subjective measure of how someone is feeling in their everyday lives. It includes happiness, satisfaction with life, a sense of purpose and sense of control. It overlaps with good mental health but is not the same. It means more than a lack of distress.

Most research into wellbeing has looked at what people can do for themselves to improve their wellbeing. It has stressed individual factors such as health and finances, which are important influences on health and wellbeing.

However, previous research has suggested that wellbeing is likely to result from complex relationships between an individual, their community and where they live. Social support, and a sense of belonging to a community (through being involved in decisions about the community, for example) could have an impact. Access to well-managed open spaces and the neighbourhood environment could be important.

Community wellbeing is now included in international policies, such as the Well-being of Future Generations (Wales) Act 2015 . The UK Government’s Levelling Up policy is designed to improve living standards and wellbeing for everyone in the UK.

Identifying the characteristics of places that influence wellbeing could inform the planning of towns and neighbourhoods. The researchers therefore wanted to explore the interactions between individual and place factors to see how they contribute to wellbeing.

What’s new?

The researchers looked at data previously collected in the Household Health Survey in the North West Coast region of England. The survey, in 2015 – 2016, explored health inequalities in 20 areas of high deprivation and 8 of less deprivation. The 4319 adults who took part had an average age of 49 years, and most (89%) were White British.

Participants completed a short wellbeing survey exploring 7 items. They reported on: their optimism about the future, how useful, relaxed, and close to other people they felt, how well they dealt with problems, could think clearly, and could make up their own mind.

In the same survey, participants provided information on individual factors (such as their health, finances and marital status); and place factors (such as housing conditions, access to open space and feeling involved in decisions about the community). The researchers looked at how these factors related to wellbeing.

Overall wellbeing was most strongly linked to two individual factors: self-reported health and financial difficulty.

However, a complex network of relationships existed. Wellbeing was associated directly and indirectly with all of the individual, community and place characteristics considered. Of the community and place characteristics, wellbeing was most strongly linked with access to open space, involvement in decisions about community (civic agency) and neighbourhood cohesion. Housing disrepair reduced wellbeing.

Certain elements of wellbeing were linked with individual or place characteristics.

  • Financial difficulties were strongly linked to feeling less relaxed; this was the strongest negative link.
  • Social support and neighbourhood cohesion were linked to feeling close to other people.
  • Involvement in community decisions was linked with optimism about the future.
  • Using open space was linked both with feeling close to other people and feeling optimistic about the future.

Why is this important?

This is the first study to explore relationships between individual and place factors in the context of wellbeing. The results back previous findings that individual factors are the strongest predictors of self-reported wellbeing. However, they also show that wellbeing is strongly linked with people’s living environments.

The analysis allowed the researchers to show how different factors interact. Poor wellbeing was linked to place factors beyond the individual’s control. It is most likely among people who lack access to open space, involvement in community decisions, neighbourhood cohesion or who have housing disrepair. Policies should therefore have more emphasis on place factors in order to increase wellbeing.

Previous work has shown that all aspects of wellbeing improve when the community is involved in decisions about their area. Community involvement is essential.

Use of open space was strongly linked with wellbeing. Planning of towns and neighbourhoods needs to include usable green spaces, to improve wellbeing and to encourage physical activity to improve health. More open and frequent dialogue between public health professionals and town planners is needed.

In England, just over 1 in 4 people live close to a park (within 5 minutes' walk). Previous research has shown that people in the most deprived areas are more likely to live close to a park than elsewhere. But if a park is unsafe or in disrepair, people will not use it. This research showed that using the space is more important than how near it is. The next steps include looking after open spaces and exploring how best to encourage their use, the researchers say.

What’s next?

Participants in this study were mostly White British, in line with the population in the North West Coast region. The wellbeing of people from other ethnic groups may be influenced by different factors. The strong positive link between wellbeing and open space, for example, might not hold true for some groups.

This research was carried out in relatively disadvantaged areas. Other regions may show different trends. Qualitative studies are needed to explore the nuances of wellbeing in different areas.

The researchers hope their work will prompt discussions between public health and town planners – and include local communities. Members of the team have delivered sessions to the Royal Institute of British Architects (RIBA) about their findings, and they hope that RIBA will take action.

You may be interested to read

This NIHR Alert is based on: McElroy E, and others. The individual, place, and wellbeing – a network analysis. BMC Public Health 2021;21:1621

A multi-disciplinary review exploring how to define wellbeing: Dodge R, and others. The challenge of defining wellbeing. Journal of Wellbeing 2012;2:3

A briefing from What Works Centre for Wellbeing, the UK’s independent body for wellbeing evidence, policy and practice: Can we improve social wellbeing relations and community wellbeing through better community infrastructure?


Funding: This study was supported by the NIHR Collaboration for Leadership in Applied Health Research and Care North West Coast, now recommissioned as the NIHR Applied Research Collaboration North West Coast. Funding for the data analysis was supported by a grant from the Economic and Social Research Council.

Conflicts of Interest: None declared.

Disclaimer: NIHR Alerts are not a substitute for professional medical advice. They provide information about research which is funded or supported by the NIHR. Please note that views expressed in NIHR Alerts are those of the author(s) and reviewer(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.


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Commentaries

Study author

Policy makers need to hear the messages about how to improve wellbeing. Originally, town planning emerged from public health concerns. Now public health and the built environment sectors operate quite separately. They work in silos, and don’t typically talk to one another. We need to encourage discussion across sectors and disciplines. We are starting to see a mindset shift in terms of wellbeing, and we hope our work will encourage this to continue.

Rhiannon Corcoran, Professor of Psychology and Public Mental Health, University of Liverpool & Research Director, Prosocial Place

Researcher

The paper is relevant in reinforcing research around the social determinants of health. It helps to build the evidence base that where people live and spend time has an important positive or negative impact on them. For public health professionals and local and national policy makers, this justifies investment in place. It is worthwhile and can have a real impact.

Stephanie Chambers, Researcher, Lecturer in Sociology of Health and Wellbeing, University of Glasgow

Member of the public

Individual regions are acknowledging the multiple determinants of deprivation, and working to address them. Unfortunately, this is patchy across the country, and the pace sluggish at times. This research underlines the crucial need for a national, bottom-up, overall strategy. It should involve co-design and co-production at all levels, with professionals and members of the public working together, and reaching out to include disadvantaged citizens who are too often overlooked.

As a patient, citizen and community leader, I am actively involved in and committed to “inverting the pyramid” in health and social care. We need to place people at the top and systems at the bottom of the process. The holistic approach used in this research, with networks and nodes, is long overdue.

It begs the question of why those in authority have not yet woken up to the evidence presented here. Received during the early part of the COVID-19 pandemic, the research underlines the crucial role of place and neighbourhood in individual wellbeing during the pandemic. The pandemic itself served to highlight the regional, local and individual differences in wellbeing. Everyone, whoever and wherever they are, has a right to wellbeing.

Ann Whitfield, East Midlands Patient Leaders, and Public Contributor, Nottinghamshire

Researcher

I engage in wellbeing research and practice. These findings reinforce patterns within the literature; community psychology has been making this case for some years. This paper has the potential to reinforce a holistic approach to understanding wellbeing, by including psychological, financial, and community (place-related) factors.

Andrew Clements, Researcher, Aston University, Birmingham

Clinician

The findings align with known evidence and use an innovative approach (network analysis) which gives greater plausibility. The paper provides additional evidence to support interventions for improving the built environment. National and local policies should require health and wellbeing impact assessments. Public health should influence built environment departments, transport planning and housing policy.

Samuel Hayward, Consultant in Public Health, North Somerset Council 

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