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Evaluating the effect of change in the built environment on mental health and subjective well-being: a natural experiment
  1. Bina Ram1,
  2. Elizabeth S Limb1,
  3. Aparna Shankar1,
  4. Claire M Nightingale1,
  5. Alicja R Rudnicka1,
  6. Steven Cummins2,
  7. Christelle Clary2,
  8. Daniel Lewis2,
  9. Ashley R Cooper3,4,
  10. Angie S Page4,
  11. Anne Ellaway5,
  12. Billie Giles-Corti6,
  13. Peter H Whincup1,
  14. Derek G Cook1,
  15. Christopher G Owen1
  1. 1 Population Health Research Institute, St George’s, University of London, London, UK
  2. 2 Department of Public Health, Environments & Society, London School of Hygiene and Tropical Medicine, London, UK
  3. 3 National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
  4. 4 Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK
  5. 5 MRC/SCO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
  6. 6 NHMRC Centre of Research Excellence in Healthy Liveable Communities, RMIT University, Melbourne, Victoria, Australia
  1. Correspondence to Dr Bina Ram, Population Health Research Institute, St George’s, University of London, London SW17 0RE, UK; bram{at}sgul.ac.uk and Professor Christopher G Owen; cowen{at}sgul.ac.uk

Abstract

Background Neighbourhood characteristics may affect mental health and well-being, but longitudinal evidence is limited. We examined the effect of relocating to East Village (the former London 2012 Olympic Athletes’ Village), repurposed to encourage healthy active living, on mental health and well-being.

Methods 1278 adults seeking different housing tenures in East village were recruited and examined during 2013–2015. 877 (69%) were followed-up after 2  years; 50% had moved to East Village. Analysis examined change in objective measures of the built environment, neighbourhood perceptions (scored from low to high; quality −12 to 12, safety −10 to 10 units), self-reported mental health (depression and anxiety) and well-being (life satisfaction, life being worthwhile and happiness) among East Village participants compared with controls who did not move to East Village. Follow-up measures were regressed on baseline for each outcome with group status as a binary variable, adjusted for age, sex, ethnicity, housing tenure and household clustering (random effect).

Results Participants who moved to East Village lived closer to their nearest park (528 m, 95% CI 482 to 575 m), in more walkable areas, and had better access to public transport, compared with controls. Living in East Village was associated with marked improvements in neighbourhood perceptions (quality 5.0, 95% CI 4.5 to 5.4 units; safety 3.4, 95% CI 2.9 to 3.9 units), but there was no overall effect on mental health and well-being outcomes.

Conclusion Despite large improvements in the built environment, there was no evidence that moving to East Village improved mental health and well-being. Changes in the built environment alone are insufficient to improve mental health and well-being.

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This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors CGO, PHW, BG-C, DGC, ARR, DL, SC, ARC, ASP and AE designed the study and raised funding. BR, ARR and CGO enrolled participants. BR, CC, ARR and CGO collected data for the study; BR, ESL, CMN, CC, DP, ARR and CGO managed the data; and BR and ESL analysed the data. BR wrote the first draft of the paper to which all authors contributed. CGO is responsible for data integrity and affirms that the manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted and that any discrepancies from the study as originally planned (and, if relevant, registered) have been explained.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Data sharing statement Further details of the ENABLE London Study are available from the study website. Proposals for collaborative projects are welcome. For general data sharing inquiries, contact Professor Christopher Owen.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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