Is Living in a High-Rise Building Bad for Your Self-Rated Health?

Abstract

While the construction of high-rise buildings is a popular policy strategy for accommodating population growth in cities, there is still much debate about the health consequences of living in high flats. This study examines the relationship between living in high-rise buildings and self-rated health in Belgium. We use data from the Belgian Census of 2001, merged with the National Register of Belgium (N = 6,102,820). Results from multilevel, binary logistic regression analyses show that residents living in high-rise buildings have considerable lower odds to have a good or very good self-rated health in comparison with residents in low-rise buildings (OR 0.67; 95 % CI 0.67-0.68). However, this negative relationship disappears completely after adjusting for socioeconomic and demographic variables (OR 1.04; 95 % CI 1.03-1.05), which suggests that residents' worse self-rated health in high-rise buildings can be explained by the strong demographic and socioeconomic segregation between high- and low-rise buildings in Belgium. In addition, there is a weak, but robust curvilinear relationship between floor level and self-rated health within high-rise buildings. Self-rated health increases until the sixth floor (OR 1.19; 95 % CI 1.15-1.24) and remains stable from the seventh floor and upwards. These findings refute one of the central ideas in architectural sciences that living in high buildings is bad for one's health.

Social consequences and mental health outcomes of living in high-rise residential buildings and the influence of planning, urban design and architectural decisions: A systematic review

“…We note first, that the majority of papers included in this review report results of research carried out in North America and Europe, where a large number of high-rise residential buildings were developed by the public sector after the Second World War in deprived areas (Verhaeghe et al, 2016). Secondly, from the 1970s, high-rise residential buildings in these continents became associated with a negative image (Pereira, 2017).…”

High-Rise Apartments and Urban Mental Health—Historical and Contemporary Views

“…It may be argued that this was because of easy access to a place of great height but those people living above the eighth floor may have been socially isolated which contributed to their mental health issues. From the fifth floor and upwards residents become disconnected with what is going on in the world around them as they cannot see what is happening on the ground [22,28,44].…”

“…Social wellbeing Social isolation/less social interaction >social isolation Fanning [41] <social support and involvement Wilcox and Holahan [48] <social interaction Zalot and Webber [49] <social networks McCarthy and Saegert [50] <social support Churchman and Ginsberg [51] <social contact Levi, et al [52] >poor social outcomes Kearns, et al [18] >social isolation Chile, et al [40] Social wellbeing Alienation >feelings of alienation Amick and Kviz [53] Psychological health Nervous disorders >neurotic scores Bagley [54] Psychological health Psychological problems i.e., depression >depression Moore [55] >depression Richman [56] >emotional strain Gillis [43] >psychological distress McCarthy and Saegert [50] <depression after moving out Littlewood and Tinker [13] >psychological distress McCarthy, et al [37] >psychological distress Husaini, et al [57] < stress coping skills Dasgupta, et al [58] >mental symptoms Hannay [42] >worse psychosocial outcomes Kearns, et al [18] Psychological health Suicide >suicide by jumping on higher floors Panczak, et al [28] Psychological health Self-rated health <self-rated health Verhaeghe, et al [44] Psychiatric health Psychiatric problems >neurotic personalities likely to experience psychiatric illness Moore [45] Edwards, et al [59] Sense of place Perceptions of neighbourhood factors that influence health >perceived negative influence Warr, et al [47] Sense of control Sense of efficacy (control) >sense of efficacy after moving out Rosenbaum, et al [60] The studies in Table 1 clearly show an exacerbation of mental health problems in high-rise buildings in comparison to low-rise or detached houses. Psychological problems (58%) and social isolation (35%) featured prominently in the literature as areas of difficulty for apartment dwellers, and contributing to this are socio-economic factors and building design.…”

“…For green space interventions, carefully controlled comparative studies would need to take into account the likelihood that wealthier high-rise dwellers may be more able to access help for mental health issues, and have access to private transport to visit green spaces and other community facilities. With cross-sectional designs, because of the 'moment in time' aspect of these type of studies there is the classical debate that residents who have poor mental health may choose to live in high-rise apartments and upper floors due to the causality of associations [11,12,44], however this debate may have unfounded claims. Gifford [1] ascertains that no causal conclusions between high-rise apartment living and mental health can be drawn because of the uncertainty over whether any study of high rise apartments meets standard criteria for scientific hypothesis testing, which is often because researchers have been forced to use research designs that are sub-optimal.…”

“…The majority of studies used self-reported surveys that are still being used in valid research today. Verhaeghe et al [44] state that most architectural studies claiming that 'high buildings make people crazy' are old and do not take into account socioeconomic position however most high-rise buildings of the post-war construction boom were built in more deprived areas and therefore comparative socioeconomic studies were not considered. Although observational or longitudinal design would be beneficial, the weight of replication of the cross-sectional studies with similar conclusions means that those results should still be taken into account, particularly when informing socioeconomic policy.…”