Week 10-Creating places of wellbeing

Question 1

What does feeling good and functioning well depend on?

Answer 1

Depends on having access to the things that make life worthwhile (needs and wants).

Question 2

What is the Hedonic approach to wellbeing?

Answer 2

Well-being comes from striving for maximum pleasure and minimum pain or displeasure (hedonic pleasures include eating something nice as an example) A dominant but short-term wellbeing strategy (difficult to sustain) – it is resource-depleting (e.g., being drunk then hungover).

Question 3

What is the Eudaimonic approach to wellbeing?

Answer 3

(ancient Greek good ‘eu’ and spirit ‘daimon’) Well-being comes from the pursuit of meaningful goals; ‘transcending oneself’ for the sake of the greater good (e.g., education, exercise). A longer-term wellbeing strategy - it is resource-sustaining (i.e., the things we can keep up and maintain in our lives).

Question 4

Measuring Wellbeing: Give an example of the ONS4 Questionnaire

Answer 4

ONS4 (0 is “not at all” and 10 is “completely”):

Overall, how satisfied are you with your life nowadays?
Overall, to what extent do you feel the things you do in your life are
worthwhile?
Overall, how happy did you feel yesterday?
Overall, how anxious did you feel yesterday?

Attempts to cover the hedonic (pleasure) and eudaimonic (satisfaction) aspects

Question 5

Measuring Wellbeing: Give an example of the Short Warwick -Edinburgh Mental Well-being Scale (SWEMWBS; Stewart -Brown, 2002)

Answer 5

Short Warwick -Edinburgh Mental Well-being Scale (SWEMWBS ;
Stewart -Brown, 2002; 1=none of the time; 2=rarely; 3= some of the time; 4=often; 5=all of the time):

I’ve been feeling optimistic about the future
I’ve been feeling useful
I’ve been feeling relaxed
I’ve been dealing with problems well
I’ve been thinking clearly
I’ve been feeling close to other people
I’ve been able to make up my own mind about things

Blends both hedonia and eudaimonia

Question 6

Measuring Wellbeing: Give an example of the Ryff scales of Psychological Wellbeing (Ryff, 1989)

Answer 6

6 Subscales of self-actualisation/eudiamonia:

1. Autonomy: Self-determination & independence
2. Environmental mastery: extent to which you manage the context you live/work within to meet your needs
3. Personal growth: sense of one’s continual development/ improvement
4. Positive relations with others: having good relations and being empathic
5. Purpose in life: sense of goals and direction; sense of meaning to one’s past, present and future
6. Self-acceptance: generally positive attitude towards self–accepting of ‘bad’ traits and ‘good’

-Each has 20 item, 14 item, 9 item or 3 item versions (reliability decreases as number of item falls).

Question 7

How is Wellbeing a Place Variable? (ONS, 2015)

Answer 7

-It’s dependent on where we live

-2014/2015 regions in England and the change over time

-There are regional differences in factors such as life satisfaction, worthwhile, happiness and anxiety (e.g., northwest high in worthwhile but lower in happiness), which may differ if you break this into towns

-These findings doesn’t seem to change over time suggesting there is something inherent about the location (shows inequitable wellbeing across the country i.e., not everyone is experiencing the same wellbeing).

Question 8

What is Individual wellbeing?

Answer 8

Spatially distributed i.e., you can map it out and see the differences across regions

Question 9

What is Community wellbeing?

Answer 9

• Feeling good and functioning well together
• More than the sum of individual wellbeing
• We-ness (how WE cope with things together)
• Wider determinants – social, environmental & economic
• ‘Community wellbeing is the combination of social, economic, environmental, cultural, and political conditions identified by individuals and their communities as essential for them to flourish and fulfil their potential.’ [Wiseman and Brasher, 2008: 358]

Question 10

What is the professional view on community wellbeing?

Answer 10

 317 professionals/practitioners working in the field of wellbeing
surveyed.

 What is meant by the term community wellbeing?

 62%: ” strong networks of relationships and support between people in a community, both in close relationships and friendships, and between neighbours and acquaintances”. (relationships really embedded in this definition).

 35%: “people feeling able to take action to improve things in, and influence decisions about, their community”. (i.e., empowerment and the sense that your voice matters).

 30 %: “people’s feelings of trust in, belonging to and safety in
their community”.

-People also talked about minimising exclusion, the total sum of wellbeing of all individuals living in the community, and its what emerges from the physical surroundings enabling people to flourish (i.e., it’s complex!)

Question 11

What did Benjamin Disraeli say about cities?

Answer 11

“In great cities men are brought together by the desire of gain. They are not in a state of co-operation, but of isolation, as to the making of fortunes; and for all the rest they are careless of neighbours. Christianity teaches us to love our neighbour as ourselves; modern society acknowledges no neighbour.” (called the urbanicity effect/penalty which is the tendency for cities to be bad for our health and wellbeing compared to rural areas).

Question 12

How do urban vs rural views on neighbourhood differs? (Understandng society survey)

Answer 12

-78% trust people in their neighbourhood in rural areas whereas it’s 61% in urban areas

-81% are willing to help people in their neighbourhood in rural areas whereas it’s 67% in urban areas

-82% feel safe walking alone in the dark in rural areas whereas it’s 71% in urban areas.

-72% feel a sense of belonging in their neighbourhood in rural areas whereas it’s 61% in urban areas

-Whilst this is from a while ago, it hasn’t changed much!

Question 13

How does Coastal distress differ?

Answer 13

-IoD 2019 looked at anxiety and mood disorders across the UK

-The browner the area the higher prevalence as determined by GPS

-Found clusters around the coast (they’re languishing)

-The urbanicity effect is not just about cities but small towns

Question 14

What is a timeline of the Urbanicity effect?

Answer 14

 1938 - Wirth: Depression higher in urban compared to rural settings.

 1939 - Faris & Dunham: “Mental disorders in urban areas”: Schizophrenia was much more common in deprived inner-city Chicago than its affluent suburbs.

 2001 Pedersen & Mortensen: A dose-response relationship between time spent in urban environments in childhood and risk (more deprived area=more likely to develop psychosis in later life).

 2003/2009 - Evans and Ellaway et al: The relationship between the urbanicity effect and perceived quality is associated with perceived quality of place.

 2004 - Sundquist et al: Sweden - 4.4 million adults. Those living in the most densely populated areas (i.e., urban) had 68–77% more risk of developing psychosis and 12 –20% higher risk of developing depression than the reference group.

 2010 - Peen, Schoevers, Beeckman & Dekker: Meta-analysis of urban-rural differences of mood and anxiety disorder.

 2012 - Vassos et al: Meta-analysis of urbanicity in schizophrenia.

Question 15

What are some Urban Adversities?

Answer 15

• Victimisation and discrimination contribute to paranoia and depression (Schreier et al., 2009) and these experiences may be more likely in urban areas.
• Powerlessness in urban areas increases risk of depression
  and paranoia (Mirowsky & Ross, 1983).

Question 16

What’s the link between Walkability and mixed use? (How do we reduce urbanicity?)

Answer 16

• Social capital: “networks together with shared norms, values and understandings that facilitate co-operation within or among groups” (co-operating where we will be heard and supported)
• Leyden (2003) found that the walkability (nicer walking place and quietness) of a neighbourhood predicted neighbourliness, trust (bumping into neighbours more) and civic (engaging in politics more) and social engagement, i.e. higher levels of reported social capital.
• Mixed use (residential, cultural, occupational etc.,) neighbourhoods = more social capital
• Designing places to encourage regular contact with others will, in turn, help to build trust.

Question 17

What is the impact of perceived quality?

Answer 17

• Those living in resource-depleted, noticeably deprived urban areas are exposed to increased risk of depression, anxiety and paranoia.
• Housing type and quality impact on psychological wellbeing and influence perceived control, social support, risk of victimisation of crime and sense of belonging.

(Evans, 2003; Sundquist et al., 2004; Stafford, Chandola & Marmot, 2007; Romans, Cohen & Forte, 2011).

Question 18

How are we not doing so well currently in the UK?

Answer 18

Data on mental health hotspots in the UK:
-Liverpool one of the highest areas for mental distress (measured by GP’s prescriptions and reports)
-Also seen in London

Question 19

What was found in the NIHR CLAHRC NWC Household Health Survey (2015)?

Answer 19

Wellbeing & Deprivation in Wards:
-Well-being scores is lower in the more disadvantaged neighbourhoods compared to the relatively well of neighbourhoods

Question 20

What is meant by levelling up white paper?

Answer 20

• Levelling up the 25% people at the bottom of places languishing
• Increasing wellbeing in UK = over-arching mission of levelling up with improvement achieved through contribution of all 12 missions.
• Mission 8 – by 2030 wellbeing will have improved and that the gap between areas representing wellbeing inequalities will have
  reduced.
• Up to £92 billion could be generated from annual increase in ‘life satisfaction in the bottom 25% of places.

Question 21

What was found in the NIHR CLAHRC NWC
Place Characteristics related to MH&W?

Answer 21

Sense of belonging:
-depression=YES
-anxiety=YES
-paranoia=NO
-wellbeing=YES

Use of Open Space:
-depression=NO
-anxiety=NO
-paranoia=NO
-wellbeing=YES

Level of reported incivilities (the visible cues to impoverishment, threat and poor place stewardship i.e., unsociable behaviour):
-depression=YES
-anxiety=YES
-paranoia=YES
-wellbeing=YES

YES=there was a relationship to these variables

Level of Community Trust:
-depression=MARGINAL
-anxiety=NO
-paranoia=NO
-wellbeing=NO

Question 22

Urbanity or ‘Quality’? (Corcoran et al., 2017)

Answer 22

 Photo contemplation studies (thinking of questions whilst looking e.g., does it look a nice place to live?) show that urban vs rural residential photos matched for perceived quality do not differ in how they change psychological responses e.g., optimism towards future and anticipating threat

 While residential photos that differ in perceived quality (matched for greenness) do alter responses differently (perceiving the quality of an area especially the one we live in, impacts our MH).

Described salient features. Nicer neighbourhoods:
“Sense of calm”
“Upper-class commercial”
“Houses-seems like a pleasant place
to live”
“Vibrant and colourful”
“Busy roads”

‘Worse neighbourhoods’:
“Weed smell”
“Run down buildings”
“Not cared for-rubbish everywhere”

Question 23

What was found in The South Liverpool Walking Study? (Corcoran et al., 2017)

Answer 23

 Picton Ward. Almost 40% of the residents here are working class or not working. 76.4% of neighbourhoods in this ward fall within the most deprived 5% nationally.

 Princes Park Ward. Very similar to Picton, but with higher rates of child poverty, but reduced reported crime and higher house
values.

 Greenbank Ward. Whilst the statistics are generally less severe than Picton and Princes Park, the neighbourhoods they walk
passes through is indistinguishable from them.

 St Michael’s Ward. Over 70% of residents are middle and upper middle class. 22.1% of the area is in the 10% most deprived
(notably flanking the walk), far less than the Liverpool average 49.6%.

Question 24

How do Places Change Beliefs? (Corcoran et al., 2017)

Answer 24

Sentiment Analysis:
-Expression of sentiment within salient feature descriptors correlates with on-the-spot sense of: threat = -0.45 (negative emotions): trust =0.63; wealth/resource = 0.65: community spirit= 0.58

-Clear differentiation of Emotional reaction between groups in low IMD/ low resource Environments.

Question 25

What was found in the Statistical network analysis: MH & neighbourhood social environment (McElroy et al., 2018)

Answer 25

-Paranoia has bridging role to neighbourhood social environment - 2 positive links with social disorder and 4 negative links with social cohesion

-Anxiety also negatively linked with social cohesion

-More significant bridges between MH & neighbourhood social environment in disadvantaged areas

Question 26

What was found in the Statistical network analysis: well-being & place variables (McElroy et al., 2021)

Answer 26

-Neighbourhood variables- overall well-being was positively associated with local green/open space usage, civic agency (involved and engaged in the neighbourhoods), and neighbourhood cohesion (the togetherness of the community) and negatively associated with housing disrepair.

Links between place variables and individual well-being questions:
1. Neighbourhood cohesion was positively associated with “I’ve been feeling close to other people.”

2. Civic agency (i.e., people feeling that they could influence local decisions) was positively associated with “I’ve been feeling optimistic about the future.”
3. Green space usage was positively associated with both of the above.

Question 27

Systematic Reviews: How does Place Infrastructure impact Wellbeing? (Bagnall et al., 2017)

Answer 27

-Place Infrastructure affects Community Well-being

-Public realm design (the way spaces between buildings are designed) affects several outcomes e.g., relationships BUT does not affect things like heritage culture and networks

-Community hubs are very good at increasing skills and knowledge base of the community

Question 28

Developing Measures: What is the Wellbeing in Place Perception Scale (Corcoran et al., 2022)

Answer 28

Factor Analysis:
-2 subscales in determinants of wellbeing in place section 1 – People (perceptions of residents’ health & wellbeing; perceptions of social capital) and Place (perceived economic success; living environmental quality).

-1 subscale of community wellbeing in section 2

-Creates a scale that is meaningful and cohesive to Community Well-being

Question 29

Theory and Model Development: What is the public health approach?

Answer 29

It’s not the individual but rather the society that’s creating the context in which the individual has to develop

Question 30

Theory & Model Development: What is meant by Lived Experience?

Answer 30

Places of Paradoxical Pride & Shame – an Ambivalent Attachment to Place?

-Hayden (2013): “…place comes to define people and how they, in turn, define their community as in need of defence and not easily understandable to strangers.”

-Stafford et al. (2008): Strong attachment to a deprived neighbourhood increases the risk of depression.

-Participant: “…because I feel ashamed being associated with part of that area when deep down people would come to the area and say ‘oh my god look, looks rough round here’. But the people are lovely. I’m not ashamed to be associated… I’m ashamed of people that have got no shame in themselves and they just throw litter. Maybe I’ve used the wrong word of saying I feel ashamed because I’m not ashamed of coming from where I’ve come from because I’ve come from there all me life, and it’s better for me because I’m not a posh nob or I don’t try and be what I’m not.

Question 31

Developing Policy: What is Well-Design? (Corcoran & Marshall, 2016)

Answer 31

Can the ‘Five Ways to Wellbeing’ deliver place-making principles?

1. Connect
   Well-Design should prioritise and facilitate legible connections to and between potential hubs and gathering places, and remove barriers to everyday interactions.
2. Give
   Well-design should include flexible places and environments that prioritise, accommodate and give explicit consent to cooperative community activity.
3. Take Notice
   Well-design should promote people’s conscious awareness of place, of each other and our relationships.
4. Keep Learning
   Well-design should embrace ‘co-production’ to enable individuals to
   learn about and so develop an allocentric response to and sense of
   place.
5. Be Active
   Well-design should promote active movement to and between potential hubs and gathering places to facilitate the pursuit of everyday physical activity.

-Well-design should encourage, facilitate and enable people to volunteer their time as a form of ‘stewardship’ in the pursuit of good places to live.

Question 32

Evidence-based Practice: What is Relational Design? (Blauvelt, 2012)

Answer 32

-“Whilst most 20th century design is autonomous, independent, isolated and closed, relational design is synonymous with interdependence, connectedness and openness.”

Relational design is:
-“preoccupied not just with the design’s form or meaning, but with its effects; not with isolated objects, but rather with situations embedded in everyday life.”

-Involving end-users in a process of ‘designerly thinking’

Question 33

Relational Design: What are Co-design Outputs? (Bagnall et al., 2017; Corcoran et al., 2017; Pennington et al., 2018)

Answer 33

No evidence top-down regeneration improves well-being (when you DON’T involve the community):
-Systematic review showed meaningful joint-decision making has wellbeing benefits for those involved and the wider community

-Tokenistic involvement can have negative impacts

-Co-Design itself has well-being benefits

Question 34

What are the Relational Design Principles? (Corcoran et al., 2021)

Answer 34

Relational Well-being, Relational Spaces, Relational Design:
-Understands the human need to be social and to form trusting relationship

-Is non-hierarchical-levelling-up power imbalances

-Is context specific - standardised solutions cannot simply be imposed

-Is agile, flexible, dynamic and evolving: relational design does not stop with an output and relational wellbeing is an emergent property of interactions across time and space

-Is open to, respectful and tolerant of difference - understanding the need for difference before consensus

-Is open to experiences and the wide views coming from diversity

-Is always encouraging - establishing trust

-Is willing to take risks because sometimes ideas will fail and we can always learn

Question 35

Impact of relational design: What is the Halton NHS Healthy New Town?

Answer 35

 July 2017 3 x full day workshops with 73 young local people (ages 10 -18) from local schools.

 August 2017 2 x ½ day workshops with 50 adult residents (20 male, 30 female; 98% white British) of Halton.

 Sept 2017 Halton Lea NHS Healthy New Town Stakeholder summit

 Information gathering followed by place design

 Total thoughts, consideration and ideas = 884 (398 adult + 486 young people

Question 36

Data reduction –thematic analysis
Community Insights Report: Themes 1 Making a Healthy Halton Lea for Young People

Answer 36

What do you understand by health and wellbeing?
 Health & wellbeing = positive mind-set and happiness

 “Happiness”
” | “Mind set”

 People and relationships regarded as the single most important factor for H&W with hobbies, physical activities and R&R also important.

 Barriers to heath and wellbeing included lack of cleanliness, safety, money, jobs and lack of opportunities, place stigma, feeling judged and social class.