Call for evidence: Community infrastructure (places and spaces) impact on social relations & community wellbeing evaluations

What’s happening?

We are carrying out a systematic review to find out whether interventions designed to improve community places and spaces are effective in improving social relationships and community wellbeing. We are particularly interested in any effects (positive or negative) on inequalities, and any differences in effects across different settings and population groups.

The review team will be doing a careful search for published material, but would also like to include ‘grey’ literature – such as evaluations that have yet to be published, or reports and evaluations produced by charities, government departments, or community groups.

How can you get involved?

If you are aware of an evaluation of an intervention designed to improve community places and spaces, with the aim of improving social relations or wellbeing, you can submit it to our systematic review and help us build an evidence base for community infrastructure interventions.

We are particularly seeking evidence that meets the following criteria:

  1. Evaluation studies with assessments of social relations or wellbeing taken before and after the intervention – this is to allow us to determine whether the intervention was associated with any changes in wellbeing.
  2. Evidence that includes comparison groups that were not exposed to the intervention is particularly welcome.
  3. Evaluations of interventions designed for populations at risk of inequalities
  4. Qualitative (e.g. interviews) and quantitative (i.e. figures-based) evidence is welcome.

All examples must be written in English and include an author and date. We can only include evidence which can be made publicly available. If the work was done outside the UK, it would be helpful if you could tell us something about how relevant you think the findings are likely to be to the UK setting.

Please send your submissions electronically to us at evidence@whatworkswellbeing.org with the subject line ‘Evidence: Wellbeing and Community Infrastructure”

Submission deadline: 9 August 2017.

The protocol is on PROSPERO

Election 2017: can wellbeing data help unpack what matters?

Uncertainty appears to be the new normal when it comes to politics. The traditional lenses we use to examine public attitudes and behaviour, like income and GDP or healthy life expectancy, are still part of the mix. But it is wellbeing concepts that give us a really useful vocabulary to talk about the incredible changes we’re seeing in attitudes at a local and national level.

The most important early observations from a wellbeing perspective are:

1. Governance, specifically trust in the delivery of public services, matters. This is something that’s relevant all the time, not just at elections. Governance is often overlooked when it comes to it’s effect on our wellbeing, compared to other things like health, personal finance or relationships. However, it’s now coming to the forefront as we try to better understand what voting behaviour is telling us about people’s lived experiences.

Using the World Bank indicators, analysis shows that what ranks highest in importance for people are ‘effectiveness of government services and efficiency of government and policy delivery’. This is particularly important at lower GDP levels, but still holds true in richer countries.

The European Social Survey suggests that once a country reaches a good level of GDP, other governance factors become important, particularly ‘voice and accountability’, ‘political stability and absence of violence and terrorism’.

The evidence shows that when people are satisfied with the way they are governed, wellbeing is higher and more equal. Political stability bucks this trend, presumably because the longer a government remains in power, the more people feel that their interests and opinions are not being taken into account.

In the UK we have seen a decline in views of  government effectiveness since 2004. There have also been sharp changes in voice, accountability and political stability between 2002 and 2006.

fig5The last factor cited in the survey – ‘absence of violence and terrorism’ – has taken on new relevance following the three terrorist attacks that happened in Manchester and London during the election campaign. Hopefully more analysis will be carried out to fully understand its exact impact, but it certainly created an unprecedented context in which people cast their votes.

2. Being seen and heard matters. The European Social Survey suggests that two conditions affect our perceived satisfaction with society: unemployment levels and ‘perceived quality of society and societal wellbeing’, which includes things like quality of public services and feeling listened to.

We’ve seen high employment in the UK, and arguably this has cushioned the UK from the wellbeing impacts of the financial crisis. But  many clearly “feel more acutely that their interests and opinion are not being taken into account.” We can see that the financial crisis recovery didn’t reach everyone.

Additionally, the strength of our social fabric gives countries resilience and there are additional wellbeing benefits when a country’s strong social relations can help them weather crises. An interesting example is Iceland.

3. Wellbeing, and wellbeing inequality, can tell us more of the real story than income and political voting records alone when it comes to the mood of the country, or any given area. It was the an important indicator, for example, of how different regions voted in the EU Referendum.

It would be interesting to see more analysis at a constituency level before drawing too many specific conclusions. However, it’s an exciting time to be in the midst of a new way of measuring and understanding what really matters to people – which is all wellbeing really is about.

We already know, from research carried out by our evidence team at the London School of Economics, that when average wellbeing drops, an incumbent government is more likely to be booted out. When it rises, this has little effect on voting patterns. We can see that average national wellbeing rose between 2011 and 2015, and then levelled off in 2016, and we’re left with tantalising questions about its relationship to our current hung parliament.The election raises important issues for our Centre. The changing world of work, how people view their public services, social trust are just some of the elements that are shifting the balance of politics as usual. We need to keep working to understand what it means to be human and what matters to us most.

We must focus our collective efforts on creating the conditions to improve our wellbeing. This means:  

  • policy that values what matters to people including dignity, control, trust and place
  • a focus on societal advancement with human beings at the centre and the purpose of the wellbeing of future generations.  

These problems can’t be solved by government, business or charities alone. New types of collaboration are needed. This is what we aim to achieve as a collaborating centre at the What Works Centre for Wellbeing. And we’re looking forward to sharing new evidence over the coming months that will help policymakers and practitioners make better decisions to improve people’s lives.

Five ways to Wellbeing in the UK

5The Five Ways to Wellbeing are a set of evidence-based actions which promote people’s wellbeing. Whilst not claiming to be the biggest determinants of wellbeing, it’s a set of simple things individuals can do in their everyday lives. They were developed by the New Economics Foundation and based on the findings of the 2008 Government Office for Science Foresight report on Mental Capital and Wellbeing that aimed to develop a long term vision for maximising wellbeing in the UK.

They are

  1. Connect
  2. Be Active
  3. Take Notice
  4. Keep Learning
  5. Give

The 5 ways to wellbeing are integral to many activities that we care about and enjoy. Since their publication, the five ways have had an enormous reach, being used as evaluation frameworks, in school curriculums and by local authorities . They have formed the basis to specific interventions to improve wellbeing that we will be reviewing as part of our community wellbeing programme. 

In 2012, the European Social Survey was the first major survey to include questions directly on the five ways to wellbeing, allowing exploration of patterns of five ways behaviours across Europe for the first time.

fig19The Making Wellbeing Count for Policy research by Cambridge University, City University and the New Economics Foundation looked at this rich survey data and found:

  • People in the UK have low levels of participation in the five ways to wellbeing, compared to peer countries such as France and Germany particularly on Take Notice. With the exception of those aged 65 and over.
  • Having children seems to limit people’s opportunities to take notice in the UK in ways that do not apply in the rest of Europe.  
  • People of working age in the UK connect less than their peers in the rest of Europe, though this deficit also applies to those not in employment, suggesting that it cannot be explained purely in terms of working patterns.
  • Those in the UK aged 25-64 were much less likely to connect than their peers in other countries
  • Young women (15 – 24), parents, and people doing housework or childcare in the UK reported very low rates on Take Notice (whether people take notice and appreciate their surroundings). This finding was not replicated across Europe, suggesting there may be particular barriers in the UK for these population groups which may be amenable to policy.

The figures show the UK’s levels of five ways participation ‘Connect’ compared to other countries. Countries with a GDP per capita of below $30,000 are shaded in lighter blue. Given that the UK has a GDP per capita of almost $40,000 one would expect it to achieve higher participation in five ways than those countries.

connect
Previous research has found that generally, in the UK:  

  • Males are more likely to be active, whereas females are more likely to give and connect.
  • People from lower socio-economic groups are less likely to be active, give and keep learning.
  • The older people are, the less likely they are to keep learning and be active.
  • However, for both Connect and Give, the trend follows a U curve, with people aged 16-25 and 65-74 most likely to engage in these activities.
  • People with qualifications are more likely to keep learning and give.

Guest blog: The benefits of healthy advice?

Here, James Sandbach, Research Manager for the Low Commission reflects on the impact advice services can have on our wellbeing and health.

IMG_0388(3) (1)The VCSE (Voluntary, Community, Social Enterprise) review on partnerships for health and wellbeing has been the latest in a number of strategic studies looking at how bringing in a wider range of community based services into the health system can contribute to improving health, wellbeing and care outcomes.

The recent Kings Fund report on “Supporting integration through new roles and working across boundaries” is also an important piece of work highlighting some of the issues about the interface between non-clinical support workers and health professionals within the health system. As new care models emerge outlining different strategies to provide the right services by the right teams at the right time targeting individual needs and delivering place-based population health systems, searching questions are being asked about what sort of partners should commissioners and provider bodies be working with to deliver social value and reduce health inequalities.

An important sector that tends to get overlooked in this debate is the contribution of the advice sector, ie organisations providing free welfare, money/debt and legal advice, information and assistance. Evidence for example of the value of placing a local Citizens Advice service outreach within GP surgeries has long been amassing for several decades.[1] However it is only in the past couple of years, especially as ideas around social prescribing have taken root, that there has been any discernable interest in looking more systematically about how advice services can add value or support improved health and wellbeing outcomes in health settings and contexts. Last year the Low Commissionimage001 (2) – an independent Commission on the future of the advice sector – undertook an extensive evidence review on the relationship between advice and health outcomes, and models of good practice in collaboration and service delivery. It found that:

The effects of welfare advice on patient health are significant and include: lower stress and anxiety, better sleeping patterns, more effective use of medication, smoking cessation, and improved diet and physical activity.”

The review looked at provision of welfare advice provision in primary health settings, mental health services and also in secondary and tertiary care settings for example in supporting the discharge planning process and rehabilitation. Evidence of the value of advice based interventions were particularly strong in the mental health context, perhaps unsurprisingly given the amount of empirical data collected in recent years focussing on the relationship between indebtedness and poor mental health, and also in areas like homelessness prevention, income maximisation, community support and reduced in-stays and repeat appointments. Of course as you might expect the evidence base is somewhat varied, with much of it in the “grey literature” territory, but also some more robust data emerging from advice services capturing specifically capturing health outcomes generally gathered from before and after follow up assessments with clients, most commonly using the Warwick–Edinburgh Mental Wellbeing Scale (WEMWBS).

Critically from a policy perspective the research found considerable variation across commissioners in their approach to engaging the advice sector or requirements when commissioning services; at one end of the spectrum there are examples of commissioning partners making considerable investments in advice services to address deprivation and health inequalities and at the other end of the spectrum advice service providers are struggling to engage key commissioners, and services are being decommissioned due to financial pressures. I’ll leave it to readers to study the report and decide for themselves about whether welfare advice in health settings is a good example of “what works in wellbeing,” but it is worth repeating Michael Marmot’s clarion call from the report’s foreword “to broaden our thinking in the future if we are really to put patients and their whole experience and needs at the heart of everything we do.”

James Sandbach was Research Manager for the Low Commission which ran from 2013-2016 

[1] Veitch T. & Terry A. (1993) Citizens’ advice in general practice. Patients benefit from advice. British Medical Journal 307, 262.

→Review: the VCSE’s role in improving wellbeing

→ Join our forum 

Improving Public Health through our Public Places

Here, Lauren Pennycook, Policy Officer, Carnegie UK Trust talks about the Place Standard tool and how our public places impact our wellbeing.

‘Health is something that is created by people within the everyday settings of their life’, according to former Chief Medical Officer for Scotland Sir Harry Burns. But are the places we live in actually designed to promote good health and actively reduce heath inequalities in our communities? And how can we assess if our public spaces are contributing to our individual and community wellbeing?
The Scottish Government, Architecture and Design Scotland and NHS Health Scotland have been working in partnership to address how we can put our public spaces to the test, by developing the new Place Standard tool. The aim of the Place Standard tool is to support the delivery of high quality public spaces and to maximise the potential of the physical and social structures in our communities to promote good health, wellbeing and a good quality of life. The tool asks users to answer questions around key themes such as access to greenspace, housing, and availability of areas for play and recreation to help map out how well our communities are currently designed to promote public health. But as well as looking back, the tool allows users to look forward and identify areas for development in their communities.
At the Carnegie UK Trust, we were keen to ensure that the tool was accessible to community groups, in line with our century-long commitment to improving the availability and nature of public spaces for the benefit of individuals and communities. To that end we agreed this summer to pilot the tool with three of the Scottish winners of our Carnegie Prize for Design and Wellbeing. With the help of expert researchers Blake Stevenson Ltd we tested and evaluated the tool with the award-winning groups in Auchencairn,Greenock, and Kirkcaldy. This process enabled us to gather feedback on the content and usability of the tool, and also to catch up with how the projects have developed since last year. The exercise also helped the groups to identify what improvements could be made to their local areas to help reduce health inequalities and improve quality of life.
At Belville Community Garden in Greenock, the tool highlighted that more seating would be welcome to encourage older people to visit the garden, and that access to the garden for younger children could be improved by a safe crossing point from a busy road. In Kirkcaldy, the Pathhead Street Design project found that the tool helped to shine a light on the fact that the space could be used to encourage more social interaction between residents – with the help of more seats, a café or even just a community noticeboard. In reflecting on how far the project had come, one participant raised the fact that that the tool would have been useful at the beginning of the development process, noting ‘we would have probably have eventually reached the same set of actions but we would have done so in a more planned way’.
2016 sees the Scottish Government celebrate the Year of Innovation, Architecture and Design and in all likelihood will see the implementation of the Community Empowerment (Scotland) Act – both of which present an opportunity for communities across the country to embrace the Place Standard tool and work with developers and local councils to improve public health and wellbeing through public design. The tool is not designed to set up a league table of communities across Scotland or to help communities to create a list of demands of their local council a time when the public sector must do less with fewer resources. Instead, it is designed to be an empowering conversation starter across sectors and community demographics to identify what can be improved for the wellbeing of all. Because, as the Joseph Rowntree Foundation has observed, ‘people make places… [a public space] only comes into being when it is activated by the presence of people’.
Re-posted from the Carnegie Trust UK blog

The Wellbeing of Future Generations in Wales

Earlier this year he Welsh Government passed the Wellbeing of Future Generations Act. This sets out 7 wellbeing goals which 44 public bodies across Wales must work towards.

This video sets out what the act is all about:

Welsh people were asked what mattered to them through the Wales We Want national conversation which informed the legislation.

How do you measure a nation’s progress?

There consultation on the indicators by which the progress towards these goals is open until 11th January 2016

→Take part in the Consultation


We have a couple of new case studies and a debate to share so we can help people learn from practice:

Darnall Wellbeing: “there are other ways to stay healthy“, a community health organisation in Sheffield who’s aim is to reduce health inequalities by helping people build their knowledge and resilience to manage their own health and wellbeing

Can ICT help community cohesion?, looking at rural areas and a new project looking at creating community wellbeing in areas of urban deprivation both from the New Europe Centre at Aberdeen University.

What is a good life? Can science and medicine tell us? filmed debate as part of Battle of Ideas 2015 with our Director, Nancy Hey.

→Share learning and insights from your work

Community Wellbeing: Creating Pro-Social Places

Our guest blog sets out ideas for creating Pro-Social places in a paper originally produced for the Urban Design Group Directory 2015-17

RhiannonCorcorranRhiannon Corcoran is a professor of psychology and Graham Marshall is an award winning urban designer and a visiting senior research fellow; both at the University of Liverpool Institute of Psychology, Health and Society. They co-direct the Prosocial Place Programme with the aim of understanding and addressing the pernicious impacts of low-resource urban environments on the health and wellbeing of individuals and communities with the aim of developing an evidence-based approach to urban design. Professor Corcoran is part of the Centre’s team looking at community wellbeing.


To support the collective social wellbeing set out in the Marmot Review, Fair Society Healthy Lives (2010), we need to foster a culture that regards and manages places as essential infrastructure. We have entered a critical era where greater thought leadership in our place-making culture is essential.

Dubbed “Toxic Assets” by CABE, Britain’s poorly performing urban places and communities continue to absorb much of our GDP, where land, places and people are exploited and treated like commodities.

In his book Collapse: How Societies Choose to Fail or Survive, Jarred Diamond discusses the dangers of continued exploitation and the outcomes for societies that could not change their behaviour patterns: certain extinction.

With expenditure outstripping income, we have entered a long period of economic depression with high levels of ‘welfare’ costs signifying a nation under stress. Whilst the government’s economic austerity measures may rebalance the budget on paper, their short-term nature does not address the fundamental health and wellbeing issues that impact individuals, communities and the wider stability of the nation.

The Marmot Review emphasises the impact of urban quality on matters of equity, health and wellbeing giving urban designers an important role to play, but not through the technocratic fixes that they are typically trained to deliver. So, where do we start when thinking about the relationship between place-making, health and wellbeing?

THE URBAN PENALTY

Probably the most fundamental principle is embodied in the Government’s “No Health Without Mental Health” policy. Social scientists have consistently found urban areas to have higher prevalence’s of both diagnosed mental health conditions and a lowered level of wellbeing known as “languishing”. Public health research identifies this failure as the ‘urban penalty’, or the ‘urbanicity effect’, arguing that it results from poor social integration, social isolation, discrimination and deprivation – things we intuitively grasp as urban designers.

However, if we explore these issues through the lens of Life History Theory developed by evolutionary psychologists, we can begin to see things a little differently and to understand better the adaptive nature of human behaviour in context. Research has found that where resources are stable, reliable and predictable, people can plan their futures, enabling greater resilience and the capacity to adapt in response to inevitable life stresses, to change and to cooperate with similarly future oriented people they encounter in their communities. It should be no surprise that public spending is lowest in places where people are prosperous, well-educated and healthy.

When we study low resource environments through this same lens, we find that people live their lives and forage in a different adaptive way. This can be difficult for design professionals to understand and, furthermore, the outcomes of this way of being are typically disapproved of by society. The insecurity of resources promotes an adaptive strategy, termed ‘future-discounting’ in those who live in these harsh environments. In other words, in these environments immediate gratification of wellbeing needs is an ingrained, sensible strategy to pursue.

In general people who live in harsh environments will tend to thrill seek, shun long term educational goals, have children younger, act impulsively etc. However, together, harsh environments and the behaviours they prime have significantly negative impacts on sustainable individual and community wellbeing. Harsh environments also tend to get harsher as people make only defensive, short-term investments in them. This includes the managerial actions that public authorities imposed upon these places.

And when we talk about resources we mean more than money – we refer to the whole resource of our human habitat and relationships. A gated, well healed estate is just as capable of promoting low levels of wellbeing as public housing can.

WHAT IS WELL-DESIGNED?

In short, Life History Theory shows how the qualities of an environment directly determine our life strategies and our wellbeing. In so doing, it emphasises the utmost importance of urban design, but when government policies demand places are ‘well designed’, what do they expect from this nebulous phrase? In 2012, Dr Steven Marshall published a paper interrogating urban design theory and found it “based on assumption and consensus, open to wide and personal interpretation by all players in the built environment and pseudo-scientific at best” – assuming built environment practitioners apply any principles at all.

The time to address the weaknesses in our urban design practices and prejudices is overdue. We need to widen our knowledge base and work with social scientists to understand our intrinsic human ecology and the predictability of its ‘pattern language’. Whilst many secure professionals can successfully ‘forage’ in the ecological niche that is the ‘built environment’ or ‘regeneration’ industry, we embrace higher concerns that will advance thought leadership in place-making.

We need to design, manage and maintain ‘psychologically benign’ environments that reduce feelings of ‘threat’ to optimise opportunities for people to interact and cooperate. This is prosociality; co-operative social behaviour towards a common goal that benefits other people or society as a whole, such as helping, sharing, donating, and volunteering. Prosocial communities are central to sustained wellbeing and themselves encourage future focussed perspectives in the individuals who live in them.

AN EXEMPLAR

The BBC documentary series The Secret History of Our Streets provides a good illustration of the issues we face today. Silo thinking, unaccountable planning (eg highways), starchitecture (remote), all create harsh environments that are barriers to our intrinsic preference for cooperation and interaction.

In the episode on Duke Street in Glasgow (2 of series 2), we can watch an unfolding story of a place that developed from nothing during the Industrial Revolution, suffered social policy failures and then was dismantled bit-by-bit by planning and design policy failures. The scenes near the end of the programme show a townscape that has been ‘un-placed’. An uplifting aspect of the programme is the positive response from the community against this threat, demonstrating the powerful force of prosociality where it prevails.

A WELL-DESIGN PLACE

It is important to note the fore-sighting that tells us that at least 80% of the buildings that we will inhabit in 2050 have already been built. Moreover, many of the new buildings erected between now and then will be constructed within existing fabrics and infrastructures, and so be quickly assimilated to become ‘existing’ too and subject to the same management regimes. We therefore need to:

  • Stop ‘UN-PLACING’ townscapes
  • Remove barriers to ‘PROSOCIALITY’ caused by short-sighted renewal and management programmes.
  • Embrace the social sciences to focus ‘CO-DESIGN’ leadership on urgently regenerating existing places within an ‘accountable people-focussed agenda’.
  • Create ‘OUTCOME’ oriented policies to deliver objective, evidence-based place-making principles that embed community wellbeing.
  • Together we might instigate a ‘WELL-DESIGN’ process for place making rather than an indefinable ‘well designed’ output.
  • Instead of being distracted by Utopian (‘no–place’) dreams on green fields, we need to pursue the‘Eutopian’ (well-place) dream that is achievable through inter-disciplinary thinking, knowledge mobilisation and sensitive management of our existing townscapes.

Creating Prosocial Places – Manifesto 06.15