Background: The role of housing as a social determinant of health is well-established, but the causal pathways are poorly understood beyond the direct effects of physical housing defects. For low-income, vulnerable households there are particular challenges in creating a sense of home in a new tenancy which may have substantial effects on health and wellbeing. This study examines the role of these less tangible aspects of the housing experience for tenants in the social and private rented sectors in west central Scotland. Methods: The paper analyses quantitative data from a mixed methods, longitudinal study of tenants from three housing organisations, collected across the first year of their tenancy. The paper postulates causal hypotheses on the basis of staff interviews and then uses a Realist Research approach to test and refine these into a theoretical framework for the connections between tenants' broader experience of housing and their health and wellbeing. Results: Housing service provision, tenants' experience of property quality and aspects of neighbourhood are all demonstrated to be significantly correlated with measures of of health and wellbeing. Analysis of contextual factors provides additional detail within the theoretical framework, offering a basis for further empirical work. Conclusions: The findings provide an empirically-informed realist theoretical framework for causal pathways connecting less tangible aspects of the housing experience to health and wellbeing. Applying this within housing policy and practice would facilitate a focus on housing as a public health intervention, with potential for significant impacts on the lives of low-income and vulnerable tenants. The framework also offers a basis for further research to refine our understanding of housing as a social determinant of health.
Purpose-Previous research emphasises the need for preventative interventions to reduce mental health problems among disadvantaged children and adolescents. There is however little consensus concerning the delivery and impacts of such interventions particularly non-clinical, arts-based models delivered within community settings. The purpose of this paper is to begin to address this deficit through a qualitative assessment of the short-to medium-term impacts to participants' mental and emotional wellbeing within Sistema Scotland's Big Noise orchestral programme. Design/methodology/approach-Semi-structured interviews, observation, participant drawing exercise, participatory filmmaking, focus group and analysis of programme engagement were undertaken to examine the mental and emotional wellbeing impacts of the programme which are observable at this early stage of programme delivery and participants' lives. Findings-The qualitative findings indicate that participation in the Big Noise programme enhances participant mental and emotional wellbeing in three ways; first, the happiness and enjoyment of taking part in the programme and orchestra, particularly from music making; second, the security, belonging and relationships fostered through participation; the quality of musician/participant relationship is important here as is programme design which enables support, routine and structure; and third, increased pride, confidence and self-esteem, as a result of acquiring difficult musical skills, receiving regular praise and having frequent opportunities to demonstrate these acquired skills through regular orchestral performances. Originality/value-There is little evidence or understanding of community-based, preventative, arts interventions like Big Noise: their delivery, their life-course impacts and their potential contribution to mental health and to addressing social and health inequalities. The causal pathways in the field are under-theorised. These early findings are important as they serve as an important basis from which to consider the programme's wider and longer term impacts, which will be assessed through an ongoing longitudinal, mixed method summative evaluation.
This article will explore the utility of Swidler's concepts of cultured capacities and strategies of action in mapping the pathways through which area-based, multiple deprivation and inequality impact upon resources for health, health outcomes and health inequalities. It will be argued that these concepts have the potential to bring the collective and aggregated impacts of resource distribution to the fore in unpicking the processes through which area-based inequalities become manifest in health outcomes. This has the potential to illuminate the some of the economic, social and political processes though which neoliberalism has generated widening health inequalities in the United Kingdom. To that end, these concepts will be employed in a case study of the postindustrial town of Clydebank. It will consider the implications for population health of changes in: the amount and quality of employment on offer; the quality and affordability housing; and the accessibility of social and political resources for those who live in more deprived areas. Swidler's concepts will be used to theoretically map the relationships between the growing wealth inequalities, widening place-based inequalities and increasing health inequalities observed over the past few decades in the United Kingdom.
Poverty, poor housing and poor health are complexly interconnected in a cycle that has proven resistant to intervention by housing providers or policy makers. Research often focuses on the impacts of the physical housing defects, particularly upon rates of (physical) illness and disease. There has been comparatively little research into the ways in which housing services can underpin the generation of positive health and, especially, wellbeing. Drawing on qualitative data from 75 tenants in the social and private rented sectors, this paper describes the findings of a research project that tracked tenants’ experiences across their first year in a new tenancy in Greater Glasgow, Scotland. The project collected data on tenants’ perceptions of housing and housing service quality, financial coping and health and wellbeing, which was analysed using the principles of Realist Evaluation to elucidate impacts and causal pathways. Being able to establish a sense of home was key to tenants’ wellbeing. The home provided many tenants with a recuperative space in which to shelter from daily stressors and was a source of autonomy and social status. A sense of home was underpinned by aspects of the housing service, property quality and affordability which are potentially amenable to intervention by housing providers. These findings raise questions about the extent to which social housing providers and the private rental market in the UK are able to meet the needs of vulnerable tenants. They suggest that approaches to housing provision that go beyond providing a basic dwelling are needed to successfully intervene in the cycle of poverty, poor housing and poor health.
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