European Centre for Environment and Human Health, University of Exeter Medical School, Truro TR1 3HD, UK.
Wellbeing and Public Health Service, Cornwall Council, Truro TR1 3AY, UK.
Int J Environ Res Public Health. 2022 Mar 23;19(7):3816. doi: 10.3390/ijerph19073816.
Housing is a social determinant of health, comprising multiple interrelated attributes; the current study was developed to examine whether differences in mental wellbeing across housing tenure types might relate to individual, living, or neighbourhood circumstances. To achieve this aim, an exploratory cross-sectional analysis was conducted using secondary data from a county-wide resident survey undertaken by Cornwall Council in 2017. The survey included questions about individual, living, or neighbourhood circumstances, as well as mental wellbeing (Short Warwick-Edinburgh Mental Wellbeing Scale). A random sample of 30,152 households in Cornwall were sent the survey, from whom 11,247 valid responses were received (38% response), but only 4085 (13.5%) provided complete data for this study. Stratified stepwise models were estimated to generate hypotheses about inequalities in mental wellbeing related to housing tenure. Health, life satisfaction, and social connectedness were found to be universal determinants of mental wellbeing, whereas issues related to living circumstances (quality of housing, fuel poverty) were only found to be related to wellbeing among residents of privately owned and rented properties. Sense of safety and belonging (neighbourhood circumstances) were also found to be related to wellbeing, which together suggests that whole system place-based home and people/community-centred approaches are needed to reduce inequalities.
住房是健康的社会决定因素，包含多个相互关联的属性；本研究旨在探讨住房保有类型的心理健康差异是否与个人、居住或社区环境有关。为了实现这一目标，我们利用康沃尔郡议会在 2017 年进行的全县居民调查的二级数据进行了探索性横断面分析。该调查包括个人、居住或社区环境以及心理健康（短沃里克-爱丁堡心理健康量表）等问题。康沃尔郡的 30152 户家庭随机抽样发送了调查，共收到 11247 份有效回复（38%的回复率），但只有 4085 户（13.5%）提供了本研究所需的完整数据。我们采用分层逐步模型来生成与住房保有相关的心理健康不平等的假设。研究发现，健康、生活满意度和社会联系是心理健康的普遍决定因素，而与居住环境（住房质量、燃料贫困）相关的问题仅与私人拥有和租用住房的居民的幸福感有关。安全感和归属感（社区环境）也与幸福感有关，这表明需要采用基于整个系统的以家庭和以人为中心的社区方法来减少不平等。
