Auswahl der wissenschaftlichen Literatur zum Thema „Neighbourhood deprivation“

This thesis is an attempt to better understand the inter-relationship between deprivation, locality and health. This study explores the views of different residents in St Ann s, a deprived neighbourhood in Nottingham, to find out how they make sense of their health. The thesis is based on some participant observation in the area but mainly draws on qualitative interviews with diverse residents in St Ann's: (including, in particular, working-class older adults of different ethnicities; some working-class parents with children; middle-class younger adults living in the area; and activists and professionals providing services to the area, such as volunteers running the food bank, the local priest and GPs. As I asked all of my participants questions about their lives and their health, as well as their perceptions of what health was like in St Ann s generally, I realised they did not mention what talk about things that I, or public health professionals, would expect them to i.e. whether they took regular exercise or ate fruits and vegetables. Rather than individual lifestyle choices , people mostly talked about places, doing rounds and routines. They also talked about other groups, which allegedly were less healthy than them. Further, different groups of people in the area spoke about health quite differently. It is these broader discussions and concerns, and differences between groups of people, that I make sense of throughout my thesis. I argue that existing quantitative research on health, deprivation and the physical environment typically focuses on how health varies across different neighbourhoods. Some of these studies examine how factors, such as the proximity of supermarkets or leisure facilitates, produce health inequalities. However, while I found residents in St Ann s mentioned the proximity of shops, I also found that health and place had broader meanings to people in terms of gathering together and structuring routines. Additionally, I found that different people had conflicting ideas about health, place and one another. Addressing health therefore needs to take these conflicts into consideration rather than implementing public health policy that mainly articulates the views and habits of the middle-class. I use concepts from Bourdieu (1979), such as habitus , field and symbolic violence to make sense of these conflicts, arguing that the reasons why people act as they do is beyond their cognitive and rational understanding. In circumstances such as those in St Ann's, where the working-class residents were most at home in their given social space where habitus meshes with field - their apprehension of their social environment is more practical than it is theoretical and more tacit than it is explicit. In other words, I argue that residents in St Ann s are curtailed by their habitus. Additionally, I argue that there is insufficient previous work which has acknowledged and validated the experiences of residents in deprived neighbourhoods. Residents may articulate deprivation and lack of understanding of what constitutes health, but they also draw attention to important issues that, whilst often mentioned in the literature (e.g. social cohesion and health), have not been sufficiently accounted for, such as the importance of sociability, community activities, amenities and services. Finally, it should be acknowledged that these issues are not equally or similarly important for all residents, so that middle-class residents are unlikely to mix with locals at the community centre for example and that also older and younger residents considered different places important. So, instead of accepting the premise inherent in much public health research that seeks to identify the barriers to change with individuals, there first needs to be a more rigorous examination of the practices and lifestyles of the working-class residents within deprived communities such as St Ann s. We should seek to understand that their current practices are important for their well-being and sense of community. However, and, at the same time, we should seek to identify appropriate approaches that can improve their health that does not only fit the middle-class agenda. A key element of this is to take the various elements of their practical, tacit knowledge more seriously as part of these conditions of possibility. Then, it may be possible to more fruitfully identify how and why such practices are created, and what might be the conditions of possibility for change.

Obesity is becoming a worldwide concern, with more than 300 million individuals who are obese and a further 750 million who are overweight. This increase is important as obesity has been linked to an increased incidence of cardiovascular disease, type two diabetes mellitus, stroke and some cancers. One factor receiving increasing attention to explain variation in obesity prevalence is the role of the built environment. This involves examining how features of the built environment such as green space or food premises vary by neighbourhood area. The presence of such resources within a neighbourhood can influence obesity through encouraging a healthy or unhealthy environment. It is important to understand how neighbourhoods influence obesity. This will allow the creation of effective public policy and urban design initiatives to reduce the obesity prevalence. Little research has examined how the quality of these resources varies between neighbourhoods and their effect on the prevalence of obesity. This thesis addresses this using a systematic site survey tool to investigate how the quality of built environment resources varies by neighbourhood deprivation. It also employs a questionnaire to examine residents’ perception of their neighbourhood as these can influence obesity through the utilisation of healthy resources. Three key findings were identified: there is a significant relationship between deprivation and the number of neighbourhood resources; the quality of these resources increases as deprivation increases; and residents in a high deprivation neighbourhood had a more positive perception of the neighbourhood. As a result, high deprivation neighbourhoods may be less likely to promote obesity as they have higher quality resources and residents have a more positive perception of the environment. These findings suggest that the influence of the built environment is context specific and that it may not be as influential on obesity in Christchurch. It highlights the need to consider both individual and environmental factors in explaining the geographic variation of obesity.

Abstract Urban air pollution is a complex mixture composed of hundreds of different solids, liquids, and gases. Some pollutants, such as nitrogen dioxide, are highly variable at a local scale, such that the variability in concentrations within cities can be greater than the variability between cities. Long-term exposures to air pollution have been associated with many health outcomes, and there is evidence that individuals of lower socioeconomic status may be more vulnerable to the effects of exposure. Associations between exposure to ambient air pollution and the incidence of breast cancer have not been investigated adequately despite findings from occupational studies that have suggested increased risks among women exposed to some contaminants found also in ambient pollution. Only about one-third of new cases of breast cancer are attributable to known risk factors; thus much breast cancer aetiology remains unexplained. The task of assigning exposure to air pollution to individuals is the principal challenge in studying associations between air pollution and health, due in part to the fact that levels of pollution vary over small areas. Thus, this dissertation develops and describes improved methods for modelling local-scale variations in concentrations of ambient air pollution. First, samples of nitrogen dioxide were collected at 129 locations across Montreal, Quebec, Canada on three occasions. A spatial model was developed that described approximately 80% of the variability in concentrations of nitrogen dioxide across Montreal. Next, spatial associations were identified at the neighbourhood scale between patterns of ambient air quality and indicators of social deprivation (e.g., percentage of people living alone) and material deprivation (e.g., low income households). Lastly, this dissertation demonstrates an association between the incidence of postmenopausal breast cancer and long-term exposure to concentrations of intra-urban air pollution. Women
Résumé La pollution atmosphérique urbaine est un mélange complexe d'une centaine de différents polluants primaires et secondaires. Certains polluants, dont le dioxyde d'azote, sont présents en quantités très variables localement. Ainsi, la variabilité des concentrations à l'échelle intra-urbaine peut être plus prononcée que celle des concentrations à l'échelle inter-urbaine. Une exposition prolongée à la pollution atmosphérique a été associée à plusieurs effets néfastes sur la santé dont la réduction de l'espérance de vie et un taux de mortalité plus élevé chez les personnes atteintes de maladies cardio-pulmonaires et de cancer du poumon. Les liens entre l'exposition à la pollution atmosphérique et l'incidence du cancer du sein n'ont pas été étudiés adéquatement, malgré les conclusions d'études professionnelles qui indiquent une augmentation du risque de développer le cancer du sein lors de l'exposition à certains contaminants présent dans l'air ambiant. Environ seulement un tiers des nouveaux cas de cancer du sein sont imputables aux facteurs de risque connus. L'étiologie du cancer du sein demeure donc inexpliquée. Le principal défi d'une étude concernant les liens entre la pollution atmosphérique et la santé est de quantifier l'exposition à la pollution atmosphérique ambiante au niveau de l'individu. Cela est dû en partie à la variabilité des concentrations de polluants à une échelle géographique réduite. Cette dissertation a pour but de (1) développer et décrire une méthodologie améliorée pour modéliser les variations locales des concentrations de pollution atmosphérique à petite échelle; (2) identifier des liens entre la qualité de l'air ambiant et des indicateurs de privation sociale et matérielle à l'échelle local pour la ville de Montréal (Québec, Canada); (3) démontrer le lien entre l'incidence du cancer post-ménopausique du sein et l'exposition prolongée à la pollution at

Much of the public policy discourse about immigration in the UK has drawn on the experiences of post-war immigrants from the former British colonies. The volume and composition of immigration flows has changed significantly in recent years with substantial increases in the number of immigrants, particularly from countries without links to the UK, and as a result of the large scale immigration from the EU Accession countries in Central and Eastern Europe. Immigration remains a contested issue with public and political debates focusing on the nature and impact of immigration and its perceived negative effects on employment, public services and social cohesion. In spite of the growing number of studies examining the experiences of new immigrants in local neighbourhoods and labour markets there is a lack of comprehensive evidence about how these experiences differ across immigrant groups and the role of place in shaping the experiences and outcomes of new immigration. This research draws on a variety of data from the census, national surveys, administrative sources and qualitative interviews to explore the settlement patterns, labour market outcomes and neighbourhood experiences of new immigrants. The findings show that new immigrants are more likely to locate in ethnically diverse and socially deprived neighbourhoods upon arrival although there is variation in the factors determining immigrant settlement by world area of origin in line with differences in migration motives and entitlements in the UK. The findings from the qualitative interviews highlight the range of motivations and constraints that shape immigrant settlement patterns and how these change over time with secondary migration and family formation. Analysis of the labour market position of immigrants defined by country of origin and ethnicity shows the persistence of ethnic penalties in the labour market. Immigrants from ethnic minority groups both from established and new immigrant groups are found to be more disadvantaged in the labour market than white immigrants and the White British. The neighbourhood context, specifically neighbourhood deprivation and ethnic diversity, is associated with poorer employment outcomes, with the relationship between area deprivation and employment shown to depend on ethnicity. The qualitative evidence highlights the role of social networks and a range of other factors in facilitating and hindering the socio-economic integration of new immigrants. The findings, particularly in relation to immigrant social networks, access to welfare, settlement intentions and housing aspirations, challenge common perceptions about new immigrants living in deprived areas in the UK. The research evidence contributes to a better understanding of the settlement patterns and experiences of new immigration and has implications for national and local policies.

Most studies of 'cohesion' between urban residents focus separately on either social network structure or ideations with very little attention given to the intersection between spatial, structural and ideational dimensions of networks. This is problematic on two levels: firstly because attitudes and practices are formed in the context of personal social networks; and secondly because social interactions between residents are physically embodied and therefore spatially constrained. This thesis explores empirically the relationship between spatial cohesion (the extent to which a network is geographically localised or dispersed), structural cohesion (the extent to which a network is tight-knit or fragmented) and ideational cohesion (the extent to which residents have similar attitudes and practices). The social networks, attitudes and practices of white-British residents living in deprived urban localities of North Manchester are studied (survey, n=409; interview, n=53). Variances in forms of cohesion were found to have consequences for residents and localities. At the individual level, the spatial and structural shape of a resident's network was linked to their attitudes and behaviours. Attitudes and practices were 'framed' in the context of personal network structure exhibited through a set of resident 'roles'. This matters for urban cohesion because a person's social network structure influenced whether they liked their neighbourhood, trusted other residents, felt a sense of community or had found jobs through contacts. Previous studies have argued that contemporary urban networks have become fluid, dynamic and spatially dispersed. Yet this research found that although some people had networks that were geographically spread, most resident networks were made of localised, tight-knit, stable, long-term relations. Moreover, people with these cohesive, localised networks framed their experiences of urban cohesion differently to those with geographically spread and/or disconnected social networks. Particularly because the attitudes and practices of residents with localised, cohesive networks were very often habitual and socially reproduced. Social networks focus people's activities in such a way that not only constrains or enables current attitudes and practices but can also affect an individual's ability to change their future behaviour. At the locality level, the type of 'deprived' locality seemed to influence network structure. The structural, spatial and ideational distribution of cohesion at locality level provided neighbourhoods with different portfolios of social capital. Qualitative differences were observed between homogeneous-deprived (very low income, white areas) and socially mixed-deprived (white deprived areas with some class/ethnic mix) localities. People living in deprived-homogenous localities concentrated their networks within the local area and had few ties to residents of bordering areas, a sign of social distance. Conversely, residents of socially mixed-deprived localities had more potential to bridge ties to other neighbourhoods because their networks were not overly focused within the local area. Given that attitudes and practices are framed in the context of social network structure, it was argued that residents of deprived-homogeneous and socially mixed-deprived areas may experience and interpret urban cohesion differently and this has implications for universal policies of cohesion in deprived neighbourhoods. The thesis illustrates the interplay between spatial, structural and ideational forms of cohesion and highlights consequences for individual action and the generation of neighbourhood social capital. The originality of analysis and data synthesis are used to advance a relational and contextualised theory of urban cohesion and contribute to wider academic and policy debates on urban social networks and neighbourhood deprivation.

Background: The human secondary sex ratio has been the subject of long-standing medical, environmental and social scientific curiosity and research. A decline in male birth proportion in some industrialised countries is linked to endocrine disruption and is validated by some empirical studies. Increasing parental age and population stress and associated decreases in sex ratio have also been demonstrated. A thorough literature review of 123 relevant and diverse studies provides context for these assessments. Methods: A spatial-temporal investigation of birth sex ratio in Scotland and potential determinants of endocrine disruptor pollution, socio-economic factors including neighbourhood stress, deprivation, smoking, and maternal age, was conducted. This involved review of national and regional sex ratio time trends, and stratified/spatial analysis of such factors, including the use of GIS tools. Secondary data were sourced from Scottish Government web portals including Scottish Neighbourhood Statistics and the Scottish Environmental Protection Agency. Results: Regional differences in sex ratio between 1973 and 2010 are observed which likely lever the national male birth proportion downwards, with the region of poorest air quality from industrial emissions, the Forth Valley, displaying the greatest sex ratio reduction. Further analysis shows significant upwards skewing in sex ratio for the population cohort experiencing the least and 2nd most deprivation. Localised reductions in sex ratio for areas of high modelled endocrine disruptor pollution within the Central Region in Scotland are also displayed. Discussion: Limitations of the analyses include the danger of ecological fallacy in interpreting from area-based measurement and the simplified pollution modelling adopted. Despite this, and given elevated incidence of testicular cancer in Scottish regions mirrors the study’s results, tentative confirmation of the endocrine disruptor hypothesis can be substantiated. Further, elucidation on advanced parental age as a contributory factor to secondary sex ratio change is also given. Recommendations are made with respect to environmental monitoring and health protection, and preventative health strategies in Scotland.