The fundamental causes of health inequality affect the places and communities in which we live.
Where we live and where we spend our time has an important influence on our health and wellbeing.
Whether somewhere nurtures good health or contributes to poor health depends on how a variety of factors come together to affect the people and communities within it. These factors relate to
- place - the buildings, streets, public spaces and natural spaces that make up the physical environment of neighbourhoods
- communities - the relationships, social contact and support networks that make up the social environment of neighbourhoods.
How places are designed, how they evolve and how they are maintained is therefore vital to the health of the people and communities within them. Those communities should have a central role in decisions about place.
To assist in this, we partnered with the Scottish Government and Architecture & Design Scotland to create the Place Standard for Scotland. This innovative tool is designed for use in communities to increase the potential of physical and social environments to support health and wellbeing and tackle inequalities.
Place and health
Positive aspects of place that can nurture health and wellbeing include
- contact with nature in everyday life
- having a warm, dry, affordable house
- the availability of services and amenities
- well maintained streets and public spaces
- having good quality greenspace within walking distance
- the ability to move around places easily and safely on foot or by bike.
Other positive aspects are
- feelings of safety
- street and urban design
- effective public transport
- having places to meet people
- a sense of belonging and a sense of control
- having a good mix of different housing types and tenures
- thriving communities with an abundance of local businesses and good access to job opportunities.
Negative aspects of place can include
- feeling unsafe
- high traffic volumes
- poor air and noise quality
- lack of public transport links
- lack of contact with other people
- poor access to services and shops
- poorly maintained streets and public spaces
- being near to derelict land and sites of pollution.
Place is particularly important in ensuring that children have access to a wide range of spaces and opportunities to play. The value of creating good places for children to grow up in has been highlighted through work by the Good Places, Better Health initiative (external website), launched in 2008 as the Scottish Government’s environment and health strategy.
Inequality in place
The health protecting and health harming factors of place are not equally distributed. Those living in deprived areas are likely to experience fewer of the positive benefits that place can offer. They are also more likely to suffer the consequences of poor physical environments.
Housing and health
Housing has the potential to reduce or reinforce health inequalities. It can have a substantial influence on health and wellbeing through
- the affordability of homes
- the quality of homes
- the role of the home as a platform for inclusion in community life.
The Scottish Public Health Network (ScotPHN) has recently published a Health Impact Assessment of the Scottish Government’s commitment to build 50,000 new affordable homes over the life of the current parliament. It was written by the Scottish Health and Inequalities Impact Assessment Network (SHIIAN). You can read this report on the ScotPHN website (external).
In Scotland, many people do not live in a house that is warm, dry and affordable, with people on low incomes being disproportionately affected. You can find out more in our Housing and Health inequalities briefing.