How well is your economy? Moving beyond GDP as an indicator of success

by Scott Faulds

Since the early 20th century, the predominant method of evaluating the success of a country has been through the metric of Gross Domestic Production (GDP). This measurement is based upon the assumption that economic growth is the key indicator of a successful country.

In recent years, this assumption has been challenged, with politicians and economists, arguing that the focus on GDP has led to the development of policy which values economic growth at the expense of the wellbeing of society.

Following the 2018 OECD World Forum, Scotland, Iceland and New Zealand, have formed a group known as the Wellbeing Economy Governments, to share best practice of how to build an economic strategy that will foster societal wellbeing.  Additionally, organisations such as the OECD, European Commission and United Nations, are all conducting research into the development of policy beyond GDP. Therefore, it is clear that the previously held consensus surrounding the use of GDP has begun to break down, with countries across the world searching for different ways to evaluate the success of policy.

We must forge ahead with progressive economic policies that defy common stereotypes about costs and benefits and keep on promoting gender equality as part of a forward-looking social justice agenda

Katrín Jakobsdóttir
Prime Minister of Iceland

 

What’s wrong with GDP?

According to the International Monetary Fund (IMF), GDP is the measurement of the monetary value of all final goods and services produced within a country during a given period. However, it should be noted that this measure excludes unpaid work and the economic activity of the black market. Simon Kutzents, the modern-day creator of GDP, argued that whilst GDP was effective as a measure of productivity, it should have never been used as an indicator of the welfare of a nation.

Critics of GDP contend that the measure is overly simplistic, due to its interpretation of a successful country as one which is experiencing economic growth, arguing that some countries with growing economies have many social problems. For example, in China GDP grew by 6.6% last year whilst levels of inequality rose faster than in other countries, and society faces a great deal of political oppression. Therefore, it can be said that GDP does not provide a true picture of the success of a country, as it fails to consider societal problems, such as inequality and political freedom.  

The wellbeing approach

As a result of growing criticism of the use of GDP, several countries have started to look at alternative approaches of measuring success which considers factors beyond economic growth. This has led to international interest around the concept of wellbeing, a desire to create policy to improve the wellness of society.

This can manifest in a variety of different forms, from Scotland’s National Performance Framework to New Zealand’s Wellbeing Budget –  both policies designed to help improve the health of society rather than solely increasing economic growth.

However, this should not be interpreted as a movement away from encouraging businesses to grow; rather the Wellbeing Economy Governments believe that by improving the wellbeing of society they will indirectly stimulate sustainable economic growth.

“We need to address the societal well-being of our nation, not just the economic well-being

Jacinda Ardern
Prime Minister of New Zealand

As a result of creating a budget justified by improvements in societal wellbeing, New Zealand has invested record levels of funding into supporting the mental wellbeing of all citizens, with a special focus on under 24s. Additionally, the budget prioritises measures to reduce child poverty, reduce inequality for Māori and Pacific Islanders and enable a just transition to a sustainable and low-emissions economy. New Zealand believes that by tackling these inequalities, economic growth can be stimulated in ways that benefit all New Zealanders, where improvements in mental health alone could lead to an increase in GDP of 5%.

Therefore, whilst GDP isn’t the main priority of policy making under the wellbeing approach, it is possible for economic growth to occur as a result of implementing policy designed to improve the wellbeing of society. After all, according to the World Health Organisation, a healthier and happier society is a more productive society.

How well is well?

It is evident that the use of GDP as a measure of a country’s success has faced a great deal of criticism in recent years. However, some economists are not ready to give up on GDP quite yet. They argue that whilst GDP is not a perfect representation of a country’s success, neither is the wellbeing approach as it can be incredibly difficult to quantify societal wellness.

For example, if we compare one citizen who is in poor health and lives in an area experiencing low-levels of crime with another citizen who is healthy and lives in an area with high-levels of crime, how can we quantify which citizen has the better level of wellbeing?

In short, critics of the wellbeing approach argue that whilst it is vital that society’s wellbeing is considered during the policy-making process, basing policy solely around wellbeing is ineffective and would be incredibly difficult to measure, due to the personal nature of what constitutes wellbeing.

“Growth in GDP should not be pursued at any or all cost … the objective of economic policy should be collective well-being: how happy and healthy a population is, not just how wealthy a population is.”

Nicola Sturgeon
First Minister of Scotland

Final Thoughts

In summary, whilst there is a great deal of international interest in the possibility of a movement away from GDP, no consensus has yet formed as to whether the wellbeing approach is the way forward. With all new forms of policy, other countries often wait to see if early adopters succeed before following their lead. Perhaps it will be left up to smaller countries to prove that an economic policy focused on wellbeing can be successful.

Until then expect to see a great deal of interest in New Zealand’s implementation of the Wellbeing Budget and the results of the second meeting of the Wellbeing Economy Governments in Iceland this autumn.


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Good enough is not enough: International Making Place Conference

International Making Place Conference, Glasgow. Image: Jason Kimmings

There is now a growing body of evidence to indicate that our physical environment – the places where we live, work and socialise – affects our health and wellbeing and contributes to creating or reducing inequalities. But even without the research, it’s plain to see how a neighbourhood with lots of facilities for pedestrians and cyclists, a choice of shops and good public transport connections could benefit health in ways that one with an excess of pubs, fast food shops and car traffic would not.

The importance of place-based approaches to improving health and reducing inequalities was the theme of an international conference held in Glasgow last week.

The venue for the conference – Glasgow’s Old Fruitmarket building – is a shining example of how a great place can be repurposed and reinvented. Originally a wholesale fruit market, the building has been reborn as a unique setting for cultural and business events, but has retained many of its original features, including a lofty vaulted roof and a cast iron balcony.

David Crichton, Chair NHS Scotland
Image: Jason Kimmings

Facing up to the challenge of place

In his introduction, David Crichton, Chair of NHS Scotland, pointed to the sobering statistics that throw the importance of place into sharp focus. He noted that while the health of Scotland’s population was generally improving, people living in 10% of the country’s poorest areas are four times more likely to die prematurely than those in more prosperous places. The city of Glasgow knows all too well about these stark health inequities. A person living in the deprived area of Calton has an average life expectancy of 54 years, while someone growing up in affluent Lenzie, just 12km away can expect to live to 82.

Glasgow Lord Provost Eva Bolander
Image: Jason Kimmings

Glasgow’s Lord Provost, Eva Bolander, acknowledged the challenges facing the city, but also noted that Glasgow is at the vanguard of place making. The city council’s Avenues Project aims to transform 17 key streets, prioritising space for cyclists and pedestrians, introducing sustainable green infrastructure and improving public transport connections. Glasgow is also investing £20m in its Community Hubs programme to bring multiple support services together in areas experiencing high levels of poverty.

Aileen Campbell, the Scottish Government’s Cabinet Secretary for Communities and Local Government, highlighted projects such as Clyde Gateway in Glasgow and the Bellsbank Initiative in East Ayrshire as successful examples of placemaking. Their success, said the minister, lies in focusing on what’s important to the people and communities of these areas, with the support of government and local authorities.

This international conference also heard from Monika Kosinska from the World Health Organisation, who noted that the problems facing Scotland are not unique. Around the world, countries and communities are experiencing the challenges associated with ageing populations and health inequalities. In this sense, she observed, all countries are developing countries.

Sir Harry Burns
Image: Jason Kimmings

A sense of coherence

The World Health Organisation’s assertion that health is a complete state of wellbeing, not merely the absence of disease, was at the heart of a powerful presentation delivered by Sir Harry Burns, Director of Global Public Health at the University of Strathclyde.

His research has underlined that poverty is not the result of bad choices. The real problem is that, without a sense of coherence and purpose, people are not in a position to make good choices.

As Sir Harry explained, a child experiencing chaotic early years (featuring parental substance abuse and/or domestic violence) is already on a path to mental health problems which can culminate in a loss of control and long periods of worklessness and poverty. But the implications can be even more serious: “The more adverse experiences you have as a child, the more likely you are to have a heart attack.”

A eureka moment for Sir Harry Burns occurred when he read a book by an American sociologist. Aaron Antonovsky spent the latter half of his career in Israel studying adults who as children had been in concentration camps. He found that the children who survived had developed what he termed a “sense of coherence” – a feeling of confidence that one has the internal resources to meet the challenges of life, and that these challenges are worth engaging with.

That sense of coherence, Sir Harry believes, lies in giving people in poverty greater control over their own resources: “People who have a sense of purpose, control and self esteem are more positive and secure about the places they live in, and a greater ability to make the right choices.”

He concluded that rather than being passive recipients of services, all of us have to be given the opportunity to become active agents in our own lives: “‘Ask people to take control of their lives, build their trust, and people can make choices that support their health. We must create places that do that’.

Woodside Health Centre
Image: Jason Kimmings

Placemaking in action

This theme of active engagement in placemaking was demonstrated during a site visit to a new health centre in Woodside, one of the most deprived parts of Glasgow. The aim of the new health centre is to reshape health services from the patient’s point of view, helping them to manage their own health and improve the care they receive. The new centre will bring together GP services, along with dental, pharmacy and physiotherapy services.

The health centre and its surroundings have been created by engaging with the local community. Using ideas from local people, the exterior of the building features designs reflecting the natural and industrial history of the area. Natural light from large windows in the roof floods the centre of the interior, giving a sense of brightness and tranquility, while wooden slats feature designs linking the centre with natural features nearby.

Claypits Local Nature Reserve. Image: Jason Kimmings

That connection with the natural environment will be reinforced with the development of a community green space close to the new health centre. The Forth and Clyde Canal is just a few minutes’ walk from the health centre, and a new foot and cycle bridge linking the centre to the local nature reserve is under construction. Other features will include new and improved pathways and new wildlife habitats. The natural space is already attracting walkers, joggers, families and cyclists, and local people report feeling they can now visit this area in greater safety than ever before.

Mark Beaumont and Glasgow Disability Alliance. Image: Jason Kimmings

The Place Standard

One of the threads running through this conference was the Place Standard, a practical tool developed in Scotland to help communities assess and redesign their own places.

For the final session of the afternoon, round-the-world cyclist Mark Beaumont introduced members of the Glasgow Disability Alliance (GDA) who shared results from their day as the Place Making Team using The Place Standard Tool. The results highlighted some of the elements of place that are important to people with disabilities – but also to others: lack of accessible toilets, poor transport links, networking events with no seating, inaccessible information, no social care support.

Final thoughts

This conference provided some important ideas on what’s wrong with our places, and some examples of places that are getting it right. And even for those that are on the right track, everyone was left with a clear message: when it comes to placemaking, good enough is not enough!

Merchant City, Glasgow
Image: Jason Kimmings

Museums as facilitators of health and wellbeing in communities

GNM Hancock, Newcastle

Great North Museum Hanckock, Copyright Rebecca Jackson

It’s estimated that there are over 2500 museums in the UK, ranging from world-famous collections in major cities to small local ones on niche themes. Over 50% of adults have visited a museum or gallery in the last year and there were an estimated 7.5 million visits by children and young people under the age of 18 to the major museums in England.

As well as their educational and leisure value, and their role as drivers of the tourism economy, there is a growing body of research which is considering the wider societal role of museums and in particular, their potential positive impact on health and wellbeing.

Museums and the rise of social prescribing

Within health and social care, we have seen increasing recognition and interest in the role of psycho-social and socio-economic determinants on health and wellbeing. Treatments now often look at the whole person and their lifestyle, not just at the specific medical condition to be treated. This awareness of the impact of lifestyle has led us to view spaces like museums and theatres in a new way and consider how they can be used as a tool to help people to live well.

March 14th was social prescribing day in the UK. And Museums on Prescription is one of a number of culture-led projects which encourage people to use assets in their local communities such as museums, galleries and theatres to help manage conditions linked to depression and social isolation, in combination with traditional clinical medicine.

Arts-for-health settings can have an impact across a number of different areas, including supporting children who have been exposed to trauma and abuse, helping communities integrate and improve social cohesion through the co-production of exhibitions, and helping support people with mental or cognitive illnesses, as well as those who suffer from dementia and Alzheimer’s.

V&A Dundee

V&A Dundee, Copyright Rebecca Jackson

Helping people feel better

As the number of projects increase so does the evidence of positive benefits. There is a growing body of literature highlighting examples of how cultural experiences are supporting both physical and mental health.

A report from Art Fund looking at the calming impact of museums and galleries found that 63% of people surveyed have (at some point) used a visit to a museum or gallery to ‘de-stress’, however, only 6% visit a museum or gallery regularly (at least once a month). Over two thirds of survey respondents (67%) agreed that taking time out for ourselves and choosing to pursue a leisure activity is good for our personal wellbeing and this is where museums and galleries, along with a whole host of other providers like theatres, music venues, public gardens and parks can step in.

Funding is a challenge

A report (2018) from the English Civic Museums Network highlights that services often deemed  “non-essential” (like museums and libraries) actually encourage and foster personal and communal resilience: they stop the crime, the illness, the loneliness from happening in the first place.

However, despite the significant and positive preventative role that participation in cultural activities can play, over the past five years spending on culture in England and Wales has fallen by over 30%, and this has had an impact on museums and the services they can provide.

Natural History Museum, London

Natural History Museum, London, Copyright Rebecca Jackson

Galleries and museums must keep striving to do more

The growing realisation of the potential of museums and galleries to have a positive impact on the health and wellbeing of communities presents a significant opportunity for them to develop programmes and exhibitions which reflect the diversity of experiences within communities and look to develop new ways to engage new audiences. Ensuring that people feel represented and that exhibitions appeal to a broad base of the community is also important in making sure people feel they are able to visit exhibitions and can feel the benefits of doing so.

In their 2015 report, the National Alliance for Museums, Health and Wellbeing, led by UCL, outlined the priorities of the alliance and showcased some examples of the work being done by partner organisations. In February 2019 it was announced that some schools in London are planning to give pupils “theatre vouchers” which entitles them to one free theatre visit per year. Museums themselves are also trying to do more to help engage members of the community and encourage them to engage with new exhibitions.

Are healthy people more culturally active, or does being culturally active make people healthier?

Museums and galleries have the potential to make an enormous contribution to improving people’s lives and enhancing physical health and mental wellbeing. The body of research around the role cultural activities like attending museums can have on health and wellbeing is growing, but there is still scope to do more, and work is ongoing with a number of high profile museums across the UK to promote the link between cultural activities and health and wellbeing.

The question of which comes first – being well initially which allows you be more culturally active, or cultural activities facilitating wellbeing in their own right – will be discussed and disputed by academics and clinicians. But the existing studies highlight the significant positive impact that engaging with museums and exhibitions has had on study participants, particularly those who suffer from mental ill health or degenerative cognitive diseases like dementia.

Museums and galleries, it is clear, have a far greater communal role to play and can evidence their value far beyond being a source of knowledge transfer or a leisure activity. Museum curators and funders need to recognise this as they prepare and plan for exhibitions and outreach projects in the future and clinicians need to be aware of the potential positive impacts for patients when considering care and treatment plans.


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“The ‘frustrated’ housing aspirations of generation rent”

house prices

A key change in the UK’s housing market over the past twenty years has been the growth of the private rented sector (PRS), with more living in the sector than ever before. This growth has led to the view that there is now a ‘generation rent’ who are priced out of home ownership and stranded in insecure short-term lets for prolonged periods of their lives – fuelling concerns about intergenerational inequality.

At a recent seminar, hosted by the Public Services and Governance research group at the University of Stirling, Dr Kim McKee, a co-investigator for The UK Collaborative Centre for Housing Research (CaCHE), presented the key findings from her research on ‘generation rent’ and precarity in the contemporary housing market.

Who are ‘generation rent’?

The UK 2011 Census highlighted that 40% of private renters were young people under the age of 35. With a challenging labour market, rising student debt and welfare reforms, home ownership and social housing is increasingly out of reach for these young people, who end up stuck private renting for much longer than the previous generation.

It was noted by Dr McKee that there is a clear age dimension to the recent shifts in housing tenure, but that the ‘generation rent’ label is more complex than portrayed. Income and family support were emphasised as just as critical in the understanding of young people’s experiences and future plans, as was geography.

Indeed, other research has highlighted that income and family background have a huge impact on young people’s housing market experiences. The Resolution Foundation’s recent report highlights that young people from wealthier families are more likely to become homeowners, suggesting that there are also intra-generational inequalities.

Dr McKee’s study focused on the inequalities facing these young people through qualitative research with 16 young people aged 35 and under living in the PRS in Scotland or England. Those on low incomes were explicitly targeted with the aim of giving them a voice, which was considered to be largely absent in previous research.

Aspirations vs expectations

There was a long-term aspiration for home ownership among the majority of participants, with a smaller number aspiring to social housing. But private renting was seen as the only short-term option as a host of challenges thwart them from realising their ambitions:

  • mortgage finance
  • family support
  • labour markets
  • student debt
  • welfare reform

The fact that housing tenure was highlighted by respondents rather than housing type or location, as previous research has highlighted, suggests there is a general dissatisfaction with living in the PRS. Indeed, it was noted that the PRS was discussed largely negatively, perceived as the ‘tenure of last resort’.

Despite the continued aspirations for home ownership, there was a marked difference between aspirations and expectations. There was a levelling down of expectations to own and a gap emerging between what the young people aspired to as their ideal and what they expected to achieve. A small minority even remarked that a more realistic goal may in fact be improvements in the PRS. The study showed that such expectations were due, mainly, to low earnings and insecure employment, combined with a lack of family financial support.

While the short-term nature of private renting makes it a very flexible rental option, it also makes it insecure and precarious, creating barriers for tenants who want to settle into a home and community. This is particularly worrying for families with children, who can be greatly affected by the upheaval of having to regularly move.

Emotional impacts

The study was particularly interested in the more intangible and emotional impacts on ‘generation rent’ and how the frustrations in realising their aspirations impacted negatively on their wellbeing.

It was stressed that issues in the PRS are having serious negative impacts on the wellbeing of young people – insecure, expensive and poor quality housing are contributing to depression, stress and anxiety. Moreover, for those on the lowest incomes, such issues are even contributing to homelessness.

Not only is mental wellbeing affected but their physical health has also been impacted by poor quality housing. Problems with rodents, damp and mould, broken white goods and poor quality accommodation in general were all reported by participants.

The experiences of the young people in the study were described as a “sad reflection of housing in the UK today” and raises questions over whether the PRS can really meet the needs of low income groups in particular.

Geography matters 

Another key finding was that where people live really matters, not only because of the spatial nature of housing and labour markets, but also as tenancy rights and regulations vary across the UK.

Recent reforms in Scotland have provided tenants with greater security of tenure and more predictable rent increases. England was highlighted as lagging behind the rest of the UK in terms of regulation and tenants’ rights as it lacks any national landlord registration scheme. Letting agent fees in England were also highlighted as a real issue in relation to affordability.

It was suggested that the rest of the UK could learn much from the Scottish experience, although there is a need to go further, particularly in relation to affordability.

Way forward

A key message from the study was that security of tenure really matters for those living in the PRS but reform of the housing system can only go so far. Participants identified more affordable housing, more protection for renters and income inequalities as areas where the government could intervene to improve things.

Based on the findings, six key policy recommendations were made:

  • ensure security of tenure;
  • take action on rents;
  • provide better education for tenants on their rights, and indeed for landlords;
  • provide more affordable housing; and
  • ensure greater understanding of intra-generational inequalities.

If the wider inequalities within society are also addressed, perhaps the PRS could become an aspiration rather than the ‘tenure of last resort’.


If you enjoyed reading this, you may also be interested in our previous posts on build to rent and meeting demand and improving data in the private rented sector.

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“For many children we are the first point of contact”: supporting children’s mental health in schools

A 2018 evidence review from Public Health England reported that one in 10 young people have some form of diagnosable mental health condition. This, the report suggests, equates to as many as 850,000 children and young people with a diagnosable mental health disorder in the UK. It also reported that half of all mental health problems emerge before the age of 14, and children with persistent mental health problems face unequal chances in life.

Research has also highlighted the impact of “key factors” like poverty and adverse childhood experiences (ACEs), including emotional trauma, abuse or neglect (which people living in higher areas of deprivation are more likely to experience) on an individual’s chance of developing a mental illness. However, an additional factor often cited in surveys around child mental health and wellbeing is the impact of school, including exam stress, and bullying. Mental ill health has also been found to have an impact on attainment, behaviour and a child’s ability to learn. As a result, teachers are often part of the front line of supporting adults for children who are suffering from mental ill health, with increasing pressure being placed on teachers and schools to identify and signpost children to other services.

Schools, as well as teachers,  are increasingly becoming a focus for the delivery of Child and Adolescent Mental Health Services (CAMHS) in their community. Often schools are at the centre of their local community, so it is logistically convenient to coordinate services there; it can for some be a less intimidating or stigmatising environment than attending a clinic at a GP surgery, for example. School is the primary developmental space that children encounter after their family, and children’s learning and development and their mental health are often interrelated, so it makes sense for teachers to take an interest in terms of attainment and progress in learning. In December 2017, the Department of Health and Department for Education (DfE) published the Green Paper Transforming children and young people’s mental health provision which highlighted the role of schools as key in promoting a positive message about mental health and wellbeing among school age children and young people.

Good work is already being done, but how can we do more?

Research has shown that there is already a lot of good and effective practice being done in schools around children’s mental health. Many schools already work in partnership with local health teams to provide in house CAMHS support in the form of mental health nurses and social workers who are posted on site for children to access. One of the major recommendations in a 2018 Audit Scotland report on child mental health in Scotland was to encourage more of this type of partnership working. The report stressed the importance of joint working between public services if child mental health is to be improved, and where possible to include as wide a spectrum of public services in the delivery of CAMHS support, including criminal justice and housing practitioners, as well as health and social care and education staff.

In some schools senior pupils and designated members of staff are being offered mental health first aid training, and wear lanyards to help students identify them should they ever need to talk to someone. While it is important – particularly for students who participate in mental health first aid programmes – to be made aware of the challenges the role may entail, it can be a rewarding experience for young people to participate in and can also be a vital in-road to support for some students who would otherwise feel uncomfortable talking to a member of staff.

Other programmes like those developed by the Anna Freud National Centre for Children and Families, Centre for Mental Health and the ICE PACK and Kitbag tools (which have been used widely in UK schools) look at resilience building  and promoting coping mechanisms among young people, as well as encouraging the creation of trusting relationships which focus on nurturing and normalising mental illness to encourage children and young people to feel comfortable discussing their feelings and thoughts. These programmes also integrate early intervention and prevention approaches, hoping to identify children and young people who are suffering from mental illness as early as possible and signpost them to appropriate support.

The specific role of teachers

Teachers need to remember that they are not health or social care professionals and that – as much as they would like to completely solve all of the problems of their students – they can only do what they can, and that is enough.

It is also very important for teachers to practise what they preach in as much as teacher self-care is as important as signposting children and young people who are struggling with mental health issues. A 2016 survey by the National Union of Teachers (NUT) found almost half of teachers had sought help from their doctor for stress-related condition. Teacher stress and burnout and those leaving the profession due to conditions like stress do not help to create an environment that is supportive of good mental health in the classroom. Teacher wellbeing is so important and building their own resilience is one way that teachers can start to embed good mental health in their practice. If you are doing it yourself it will be easier to help and show children how to do it if they come to you for advice!

Teachers simply being there and offering a safe space and first point of contact for many children is important. Listening and signposting can be so valuable for those pupils taking the first step and teachers should not be put off by any personal perception of a lack of expertise in mental health – a small amount of knowledge or understanding of what to do next is more than enough. In some respects, teachers should feel almost privileged that a student has chosen to come to them, someone they feel they can trust and talk to.

A poll conducted as part of a webinar held for educational practitioners found that rather than requiring more information about mental illness, what teachers actually wanted was more practical examples of how to apply support in the classroom and how to embed mental health into their teaching and the learning of their students.

A unique opportunity

Schools and teachers are on the front line of public services and have a unique opportunity through regular contact with children to help to build and promote resilience among pupils, and embedding this within the whole school can be an effective way of ensuring pupils feel the benefit without being singled out. Taking nurturing approaches to learning and teaching, and promoting the creation of trusting relationships is key to some of the already effective practice going on in schools. Sharing the learning and best practice that is already happening will be vital to ensuring that support for children suffering from mental ill health improves and adapts to changing needs in the future.


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Creating caring places: placemaking in our town centres

What do caring places look like? How can planners, developers and project organisers contribute to the discourse around creating caring places? And what responsibility do they have to communities to help develop places that put people at their heart?

They are just some of the questions being increasingly raised by organisations in Scotland, trying to identify if there is a new way to focus on place and wellbeing in Scotland’s towns. Projects such as Carnegie Trust’s Kindness, Scottish Towns partnerships’ Town Centres First, or Architecture and Design Scotland’s Creating Caring Places are all exploring the importance of the quality of a place to the wellbeing of people who live there. But what does this mean for people who actually plan these areas, and what could they consider in the future to help develop more caring places?

The 3 P’s: place, people, practice

Many of the discussions around creating places which foster wellbeing and wellness centre around 3 key concepts:

Place: Understanding place and the impact that it has on wellbeing is a significant part of this agenda. The environment in which people live day-to-day has a significant impact on individuals and can be both a positive or negative influence. It can help to facilitate positive community interaction, creating stronger community ties and helping organisations and people to feel more valued within their community.

In order for places to be caring a number of factors have been identified, and these are common across research done by a number of organisations including Architecture and Design Scotland and the Carnegie Trust. These include: a sense of support (from people); a sense of purpose (stuff to do); a sense of place (familiar surroundings); and a sense of worth (feeling wanted).

People: Loneliness or social isolation has the same impact on health and mortality as smoking 15 cigarettes a day. Traditionally, it has often been assumed that older people are most often victims of social isolation (as they are less mobile and less willing or able to participate in community activities). Recently however more research has been produced which highlights the growing isolation of younger people. Understanding the nature of isolation, which impacts across the whole community, can help us to identify effective solutions which benefit and engage multiple groups.

Practice: This particularly relates to care within communities. The process of deciding where and how we care for the old or ill is a vital part of how we function as a society. Effective care extends far beyond the physical act of caring for someone, although this is obviously a key element. It also includes creating more and better jobs within the sector, and encouraging people to enter the profession as a worthwhile career choice; shifting the focus from acute to primary care settings and away from hospital-based emergency care; and giving people greater choice about how and where they receive care through increasing and improved personalisation of services.

There is a responsibility on both spatial and community planners to identify need and to create places which facilitate wellness, choice and care at home. This could be through the building of new infrastructure or more effective transport, or it could be through the creating of a community centre which offers recreational classes to someone who would otherwise have no contact with the outside world. Putting place at the centre of discussions provides an opportunity for a community approach to wellbeing, with strategies on placemaking being linked to other approaches such as asset-based, or strengths-based, planning.

Thinking about people like we think about the environment

Even as little as 10 years ago, the prevalence of environmental impact assessments for development projects was limited. Now we take for granted that we measure the impact of a project on the environment. What if we thought about people and in particular the risk of isolation, in the same way during planning processes? What if developers, planners and project organisers considered the “isolation impact” of a project, how it would impact the people of a local area, and whether it would specifically impact one group more than another (either for good or for bad), and reported on the steps they were taking to mitigate any adverse impact?

It is a striking notion, but creating a set of criteria to measure the social impact of developments, may be hugely useful if we are trying to place an increasing emphasis on inclusion and community within our town centres.

In fact, planners are beginning to realise the critical role they play in connecting services to people, and the necessity of understanding which services are needed in an area and how to make them as accessible for the whole community as possible. And while it is down to the community to use the resources they are given by planners to create connections and networks that help to combat things like poor mental health and social isolation, the decisions that planners make about how and where to plan in services and infrastructure can be the difference between someone leading an active and engaged life, and someone living a life where the only human contact they have in a day is a carer.

Planners can and should recognise the significant role they can play in making someone’s life more livable.

Final thoughts

Creating caring places for people to live and grow old in is vital to the success of our communities. Effective and thoughtful decisions on investments such as infrastructure and community planning projects can have a significant positive impact on wellbeing and reduce loneliness not only among older people, but throughout the community.

Increasingly, policy makers in Scotland are being asked to consider the human element of planning in their work. Creating places that allow people to feel safe, valued and happy is key for planners to help bridge the gap between the creation of places, and the wellbeing of people who live in them.


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Science in the city: applying neuroscience to urban design

Cities have long been considered primarily in terms of their buildings and infrastructure.  However, in recent years, a more ‘human-centric’ view has been adopted – focusing on the people who inhabit the city, and how they perceive and respond to the city that surrounds them.

Research from a variety of disciplines agree that buildings and cities have a significant impact upon the people – from their physical and mental health, cognitive development, and wellbeing to their levels of productivity.

Neuroscience offers a new way to further explore this impact – and by doing so, help urban design professionals to create places that promote human health and wellbeing, whilst mitigating the negative impacts of the city environment as far as possible.

 

What is neuroscience?

But what exactly is neuroscience?  And how does it relate to urban design?

A recent report by FutureCatapult looks at how neuroscience can be used to improve the design of urban places, and thus increase human wellbeing and productivity.

It defines neuroscience as “a multidisciplinary branch of biology and is the scientific study of the brain and nervous system, including its interaction with the other parts of the body”.

There are various ‘scales’ or ‘levels’ of neuroscience – from cognitive psychology, right down to the study of individual cells in the brain.  Each level of neuroscience studies different aspects of how the brain functions, and thus offers different ways to explore and understand how humans perceive, respond to and are affected by their surrounding environments.  It has many applications in real life – and one such application is informing city strategy, design and policy.

 

Applying neuroscience research to urban design

Take mental health, for example.  It is a prime example of an area in which neuroscience can be used by city planners and policymakers to help improve human wellbeing.

As FutureCatapult point out in their report, cities have a greater prevalence of mental health problems than rural areas.

They note that several factors associated with cities have been found to contribute to mental health problems. These include certain toxins (produced by traffic, industrial parks), environmental stressors (noise and light pollution), climate conditions (urban heat islands) and social conditions (isolation).  Neuroscience offers a greater understanding how these factors impact on human health and wellbeing, thus creating an evidence base for the design of healthy places.

There are many other ways in which neuroscience research can inform city design.  For example, it has been found that:

  • poor air quality has serious detrimental effects on the natural developments of children’s brains
  • social isolation can accelerate cognitive decline in older people
  • an increase in noise decreases worker productivity
  • light influences brain function during specific cognitive tasks, especially those requiring sustained attention

Such findings can help inform the decisions made by city planners and policymakers, and help create cities that maximise human health, wellbeing and productivity.

Research into the brain’s ‘wayfinding’ processes – that is, how the brain processes visual information and makes sense of unfamiliar environments – is also of interest.  For example, how do people choose which paths to follow?  Are they influenced by street size, shape, colours, noise, or the number of cars? Such information could be used to inform the design of streets and places that are easier to navigate. This is of growing importance given the drive towards the design of inclusive and dementia-friendly places.

Relatedly, neuroscience offers a way to gain a deeper understanding of how non-neurotypical brains process and respond to different environments – for example, people with dementia or autism.  Understanding these different perspectives and responses is key to the creation of spaces that are truly inclusive.

 

Neuroscience in action

But how exactly does one go about examining how brain cells respond to an urban environment?

There are a variety of neuroscience tools that may be used to gather information about human’s experience of the city.

A key tool is mobile electroencephalography (EEG).  Previously, EEG involved equipment that could only be used in a laboratory.  However, technological advances have seen the development of mobile EEG ‘headsets’ that can be worn as research participants navigate different streets and environments of the city.

Mobile EEG enables researchers to measure brain function and activity, as well as the responses of the autonomic nervous system (heart rate, skin conductivity, endocrinological levels).  This can be used to understand how individuals experience urban environments.

For example, mobile EEG has been used to help understand the urban experiences of people with visual impairments.  Other mobile EEG studies have looked at whether using quiet, low traffic streets has a different effect on pedestrians than using streets busy with shops, traffic and other pedestrians.

Eye tracking machines are another tool providing research findings of interest to urban designers.  They study gaze behaviours and cognition, which are in turn related to attention, memory, language, problem solving, and decision making.  Eye tracking can help researchers to understand which features catch and hold attention, visual preferences and experiences. For example, one eye-tracking study found (perhaps unsurprisingly) that humans prefer lush greenery in urban environments.

As these neurological research and related technologies advance, their application will undoubtedly become more sophisticated and widespread.

 

Building upon evidence

The urban population around the world is expanding rapidly and finding solutions to the mental and physical health challenges that cities present is crucial.

By understanding the insights that neuroscience can provide, city planners, policy makers and others involved in urban design can access a growing evidence base upon which to build future cities that are healthy, attractive and inclusive places to live.


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Writing and recovery: creative writing as a response to mental ill health

 

“You don’t put yourself into what you write, you find yourself there.”
Alan Bennett

Mental illness, for so long regarded as secondary to physical health, is now being taken more seriously. Media stories about loneliness, anxiety and depression have highlighted increasing concerns about mental ill health, and the issue has also been rising up the political agenda.

In 2017, a survey by the Mental Health Foundation found that only a small minority of people (13%) reported living with high levels of good mental health, and nearly two-thirds of people said that they had experienced a mental health problem.

Prescribed medication is one response to mental health problems, and it’s been reported that the NHS is prescribing record numbers of antidepressants.  But while psychiatric drugs can be of real value to patients, especially those whose condition is very severe, the mental health charity Mind has suggested that alternatives, such as physical exercise, talking therapies and arts therapies, are often more beneficial.

Last month, a conference at the University of Glasgow explored ways in which creative writing is being used to respond to mental ill health, and discussed what makes writing interventions helpful for coping and recovery.

Voices of experience: coping and recovery through writing

“Making and consuming art lifts our spirits and keeps us sane”.
Grayson Perry

Several speakers at the Glasgow conference testified to the effectiveness of writing in dealing with mental ill health and in finding a way to recovery.

In 2012, James Withey experienced a set of circumstances which brought him close to taking his own life. In the darkness of his depression, James felt that he might never recover. But after spending time at Maytree, the UK’s first “sanctuary for the suicidal”, he found that writing about what he was going through offered an antidote to the lies being spun by his depression.

He started a blog, and when he posted a letter to himself, beginning “Dear You.” James found that writing the letter gave him space to express his feelings and to listen to himself.

Before long, readers of James’s blog were responding with their own “Dear You” letters. The word spread that the letters offered a different perspective on recovery, and in some instances, had prevented suicide.

Today, The Recovery Letters project is still going strong, with a website, one published book and another in the pipeline. James is realistic about the project:

The letters are not a cure for a chronic illness, but they do provide support in helping sufferers of depression accept where they are.”

Policy positions: the view from Wales

“If poetry and the arts do anything, they can fortify your inner life, your inwardness.”
Seamus Heaney

Another speaker at the conference was Frances Williams, a PhD candidate at Manchester Metropolitan University, where she is studying arts and health. In her presentation, Frances explored some of the policy frameworks and public discourse surrounding the field of therapeutic writing in Wales.

She highlighted a recent report, Creative Health, The Arts, Health and Well-being, which  makes a case for the healing power of the arts in many different healthcare and community contexts.  In this report, a creative writing tutor explained some of the ways in which writing can help people experiencing bereavement, including keeping a journal, writing unsent letters, describing personal belongings and resolving unfinished conversations:

“Writing can be a valuable means of self-help, with the page as a listening friend, available any time of the day or night, hearing whatever the writer wants to say. The results of this can be powerful, and include people being able to return to work and adjust more effectively after their loss, acquiring skills for their own self-care which will serve them through the rest of their life.”

Frances also noted that the battle of priorities between impact and value-for-money has driven advocates of arts therapy programmes to defend them in terms of cost effectiveness and social value.

A mapping project by the Arts Council of Wales has taken this to heart, producing in 2018 an audit of the principal arts and health activities currently taking place in Wales.

Writing to the rescue

“By writing, I rescue myself”
William Carlos Williams

The Glasgow University conference underlined the health-giving properties of creative activities and the potential for creative writing to support people suffering with mental ill health. There was no pretence that writing offers a quick-fix solution. As James Withey noted, “…writing is just one element in a toolkit of responses to mental ill health.”

The All-Party Parliamentary Group on Arts, Health and Wellbeing fully supports this concept, and has recommended that policymakers recognise its importance:

“…the arts can make an invaluable contribution to a healthy and health-creating society. They offer a potential resource that should be embraced in health and social care systems which are under great pressure and in need of fresh thinking and cost-effective methods. Policy should work towards creative activity being part of all our lives.”


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Opportunity or necessity… what’s fuelling the growth in self-employment?

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With unemployment reaching its lowest level since 1975, it may seem like the state of the labour market has improved in recent years. However, a closer look at the statistics suggests that this is not necessarily the case.

The strong performance in the labour market in part reflects the growth in self-employment, which has been a distinguishing feature of the labour market’s recovery since the last recession.

Growth in self-employment

There were almost 750,000 more self-employed in the UK workforce at the end of 2014 than at the start of the global financial crisis in 2008, representing a high proportion of the total net growth in jobs over this period. Self-employment accounts for over 15% of those in work in the UK – 4.8 million of a workforce of around 32 million. Between March 2008 and March 2017, self-employment accounted for almost a third of total employment growth.

The significance of the contribution of self-employment is highlighted in a recent article published in Regional Studies, which notes that of the 920,000 net new jobs created between quarter 1 of 2008 and quarter 2 of 2014, 693,000 were in self-employment.

There has also been a rise in the share of female self-employed and those that work part-time, in addition to growth in a broader range of industries and occupations among the self-employed.

Recent ONS figures also show that the growth in self-employment between 2001 and 2016 has been driven mainly by those who have a degree (or equivalent), leading to the share of the self-employed with a degree or equivalent increasing from 19.3% in 2001 to 32.6% in 2016 as a share of total self-employed. As a share of total employment (self-employed and employed), the figures show that relatively highly-qualified individuals are becoming more concentrated in the self-employed.

Earnings growth?

The reasons for this growth has been the subject of much debate, particularly as research suggests many fail to earn a decent living. This recent analysis by the New Economics Foundation found that 54% of all self-employed people are not earning a decent living. It also found that the percentage of the labour force in ‘good jobs’ had decreased from 63% in 2011 to 61% in 2016, suggesting that the quality of jobs is perhaps declining.

Similarly, the ONS figures suggest that the self-employment labour market remains financially insecure for its workers. They show that the distribution of self-employed income appears centred around £240 a week, much lower than that for employees, which is centred around £400 a week.

And, according to a recent report from CIPD, their real incomes have fallen more since 2008 than those of employees.

Perhaps, then, the self-employment growth has been driven by necessity rather than choice due to a lack of opportunity in the full-time labour market.

However, the evidence suggests it is not this simple.

Despite the widening gap in earnings between the self-employed and employed, the self-employed continue to have higher levels of job satisfaction than employees. The ONS figures also indicate that self-employed workers were more likely to supplement their income from elsewhere.

This would suggest that choice probably plays a large part in self-employment.

‘Push’ or ‘pull’ effect

There has been much discussion over whether the growth in self-employment is predominantly a result of choice or necessity.

It is often seen as a sign of labour market weakness, with self-employment perceived as a ‘last resort’ where a regular job can’t be found. The evidence suggests that this motivation accounts for just a small proportion of the change, however, with most of the rise in self-employment appearing to be out of choice rather than necessity.

Indeed, the recent analysis in the Regional Studies article, which examined the extent to which self-employment was associated with local ‘push’ or ‘pull’ effects, found little or no suggestion of any net ‘recession-push’ effect on self-employment. It suggests that:

  • ‘pull’ factors are more significant in driving transitions into self-employment;
  • self-employed business ownership appears not to function as a significant alternative to unemployment where paid employment demand is weak; and
  • entrepreneurial activity prospers where local wages are higher and unemployment lower.

The uncertainty surrounding Brexit could also be having an effect as declining employer confidence has contributed to a growing number of short-term contracts – potentially making self-employment appear the better choice.

Final thoughts

As the CIPD report highlights, there are probably more opportunities for self-employment now than there were a decade ago. And the self-employed are more likely to value highly aspects of the work, such as its variety, and choice over their working hours and pay.

Across the range of job-related characteristics, it is shown that the self-employed are as satisfied or more satisfied with their working life than employees, resulting in higher levels of overall job satisfaction – a finding that is consistent both over time and from different data sources.

In a time where work-life balance is of increasing importance, it is perhaps no surprise that self-employment is the path of choice.


If you enjoyed reading this, you may also be interested in our previous blogs on the gig economy, ‘the self-employment boom’ and ‘olderpreneurs‘.

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Housing models for the future

Housing is one of the challenges of our time. The task for architects and designers is to create affordable, robust housing that can accommodate the needs of a rapidly growing, but also ageing population. And it’s not as easy as simply building. The demands and expectations on house builders to also be community builders and the architects of mental and physical wellbeing through design have led architects and designers to consider alternative ways to house us in the future. This includes innovative use of materials and construction methods, addressing the issue of financing through co-operative living models and using bespoke design to create lifetime homes which can be adapted to accommodate the changing needs of our population.

Large-scale development

One of the big challenges for urban areas is large-scale development strategies for designing and delivering housing to meet need. For developers and planners going forward there are a number of factors to consider: the type of investment introduced to an area; how the schemes fit with a wider development plan for the city; and the importance of engaging the community in any plans to develop or regenerate an area.

“Placemaking”, not just house building is central to large scale development discussions, emphasising to planners, architects and developers the fact that they are not just building houses, but creating communities. As a result, designers and developers should be mindful of their important role in community building, to build the right sort of homes in the right places, at affordable prices and with a legacy in mind. They should, create high quality, long lasting units, which will stand the test of time but that also can be easily adapted to accommodate people’s changing needs.

Alternative construction and design

Innovative models and options for future builds have been discussed for a number of years but they are becoming an increasingly mainstream way to build affordable housing that meets the current need, particularly of students and young professionals, and of older populations looking to downsize or move into assisted care accommodation.

Offsite manufacture or modular homes  Offsite manufacture of timber framed houses is becoming increasingly common, with the constituent pieces of the house manufactured off site, then transported to the site and constructed on a concrete block where foundations and services such as plumbing have already been created. Offsite housing can either be open panel, which requires the finishing such as bathroom and kitchen installation to be done on site, or closed panel which provide the entire section complete with decoration and flooring (this is becoming a common way to build cheap, efficient student housing).

Custom build  Custom build projects are similar to self-build in that they give clients flexibility to select their own design and layout, However, custom build provides slightly more structure and certainty which can make it easier when considering elements like financing and planning applications. In essence, customers select the spec of their house in the same way they might make custom modifications to a car.

Build to rent  This model has been adapted from the United States, where build to rent is popular. The model is based on self-contained flats, with central and shared amenities, entrance and communal space. Designed to attract graduates and young professionals, these are being increasingly designed using a “user first” approach. Developers identify the sort of person they want to live in the development, identify what sort of things they might look for in a development, including floor type, furniture, layout, amenities, gadgets, and then build the development around that.

Dementia friendly – Building homes that are safe and affordable, but allow for independence in old age, is one of the major demands on house builders currently. Housing stock is seen as not suitable for current need, but building bespoke sites for people with illnesses like dementia has been seen as a bit of a niche previously. Virtual Reality (VR) is being used by some architects and developers to try to help them understand the needs and requirements of people with dementia and how they can build homes suitable for them to be able to live as independent and full lives as possible. Building dementia friendly homes not only means making them accessible and open plan, but also adapting the layout, adding signage where appropriate and if possible locating the homes within a wider community development. Dementia villages like those seen in Amsterdam are being used as the model for this.

Co-housing

Co- housing offers an alternative to communities in Scotland, and while lessons can be learned from elsewhere in Europe, where co- housing models have been successful, there are also pockets of good and emerging practice in the UK too. More traditional examples include Berlin, where almost 1 in 10 new homes follow the Baugruppe model, and Amsterdam (centraal wonen) where some of the oldest co-housing projects originate. In Denmark, 8% of households use co-housing models.

Co-housing provides the opportunity for groups of people to come together and form a community which is created and run by its residents. Each household has a self-contained, private home as well as shared community space. Residents come together to manage their community, share activities, and regularly eat together. A “Self-build Cooperative Group” is a joint venture between several private households who plan and build their own house together. Usually they are supported by an architect. Often co- housing groups are able to realise high-quality living space at prices below local market rates, although it is not really considered suitable for large-scale development within the current UK market.

Opportunities for a new way forward

Practitioners are often challenged to push the boundaries of design and building in their field. Looking to new models for future building design provides an opportunity to think creatively about alternative uses of materials and space and to consider options for construction, funding and investment in the built environment that challenge the norm. Learning lessons and exchanging ideas from elsewhere, architects and planners have the opportunity to come together to consider how the built environment in Scotland can help to create places  not just buildings  and how this can contribute positively to the wider wellbeing and happiness of people living in Scotland in the future.


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