my place through my eyes: a social constructionist...
TRANSCRIPT
i
My Place through My Eyes: A social constructionist
approach to researching the relationships between
socioeconomic living contexts and physical activity.
Queensland University of Technology
Humanities Research Program
Name of Candidate: Julie-Anne Carroll (BA, Post Grad Dip,
Masters)
Principal Supervisor: Associate Professor Barbara Adkins
Associate Supervisor: Associate Professor Elizabeth Parker
2008
Additional Support: This research was supported under the Australian Research
Council's Discovery Projects funding scheme, project number DP0663854, "New
Media in the Urban Village: Mapping Communicative Ecologies and Socio-
Economic Innovation in Emerging Inner-City Residential Developments".
ii
My Place through My Eyes: A social constructionist approach to
researching the relationships between socioeconomic living contexts
and physical activity.
Abstract
There is a growing evidence-base in the epidemiological literature that demonstrates
significant associations between people’s living circumstances – including their place
of residence – and their health-related practices and outcomes (Leslie, 2005; Karpati,
Bassett, & McCord, 2006; Monden, Van Lenthe, & Mackenbach, 2006; Parkes &
Kearns, 2006; Cummins, Curtis, Diez-Roux, & Macintyre, 2007; Turrell, Kavanagh,
Draper, & Subramanian, 2007). However, these findings raise questions about the
ways in which living places, such as households and neighbourhoods, figure in the
pathways connecting people and health (Frolich, Potvin, Chabot, & Corin, 2002;
Giles-Corti, 2006; Brown et al, 2006; Diez Roux, 2007). This thesis addressed these
questions via a mixed methods investigation of the patterns and processes
connecting people, place, and their propensity to be physically active. Specifically,
the research in this thesis examines a group of lower-socioeconomic residents who
had recently relocated from poorer suburbs to a new urban village with a range of
health-related resources. Importantly, the study contrasts their historical relationship
with physical activity with their reactions to, and everyday practices in, a new urban
setting designed to encourage pedestrian mobility and autonomy.
The study applies a phenomenological approach to understanding living contexts
based on Berger and Luckman’s (1966) conceptual framework in The Social
Construction of Reality. This framework enables a questioning of the concept of
context itself, and a treatment of it beyond environmental factors to the processes via
which experiences and interactions are made meaningful. This approach makes
reference to people’s histories, habituations, and dispositions in an exploration
between social contexts and human behaviour. This framework for thinking about
context is used to generate an empirical focus on the ways in which this residential
group interacts with various living contexts over time to create a particular
construction of physical activity in their lives. A methodological approach suited to
this thinking was found in Charmaz’s (1996; 2001; 2006) adoption of a social
iii
constructionist approach to grounded theory. This approach enabled a focus on
people’s own constructions and versions of their experiences through a rigorous
inductive method, which provided a systematic strategy for identifying patterns in
the data.
The findings of the study point to factors such as ‘childhood abuse and neglect’,
‘early homelessness’, ‘fear and mistrust’, ‘staying indoors and keeping to yourself’,
‘conflict and violence’, and ‘feeling fat and ugly’ as contributors to an ongoing core
category of ‘identity management’, which mediates the relationship between
participants’ living contexts and their physical activity levels. It identifies barriers at
the individual, neighbourhood, and broader ecological levels that prevent this
residential group from being more physically active, and which contribute to the
ways in which they think about, or conceptualise, this health-related behaviour in
relationship to their identity and sense of place – both geographic and societal. The
challenges of living well and staying active in poorer neighbourhoods and in places
where poverty is concentrated were highlighted in detail by participants. Participants’
reactions to the new urban neighbourhood, and the depth of their engagement with
the resources present, are revealed in the context of their previous life-experiences
with both living places and physical activity. Moreover, an understanding of context
as participants’ psychological constructions of various social and living situations
based on prior experience, attitudes, and beliefs was formulated with implications for
how the relationship between socioeconomic contextual effects on health are studied
in the future. More detailed findings are presented in three published papers with
implications for health promotion, urban design, and health inequalities research.
This thesis makes a substantive, conceptual, and methodological contribution to
future research efforts interested in how physical activity is conceptualised and
constructed within lower socioeconomic living contexts, and why this is. The data
that was collected and analysed for this PhD generates knowledge about the
psychosocial processes and mechanisms behind the patterns observed in
epidemiological research regarding socioeconomic health inequalities. Further, it
highlights the ways in which lower socioeconomic living contexts tend to shape
dispositions, attitudes, and lifestyles, ultimately resulting in worse health and life
chances for those who occupy them.
iv
Key words: socioeconomic; contexts; physical activity; urban; social
constructionism; grounded theory
v
Table of Contents
Table of Contents................................................................................... v
Tables, Figures, Images, and Graphs .................................................. x
Appendices ............................................................................................ xi
Statement of Original Authorship ..................................................... xii
Acknowledgements............................................................................. xiii
List of Works from this Thesis Accepted for Presentation &
Publication .......................................................................................... xiii
Chapter One: Introduction and Overview of the Thesis................. 20
1. Introduction to the Topic ...................................................................................... 20
1.2 Overview of the Thesis Chapters ....................................................................... 23
Chapter Two: The Literature Review ............................................... 32
2.1 Notes on the Methodology of the Literature Review......................................... 32
2.2 Introduction: The Effects of Living Contexts on the Social Functioning,
Health, and Well-being of Residents........................................................................ 33
2.3 Public Health Perspectives on How Socioeconomic Living Contexts affect
Health Outcomes: The Challenge of Measuring and Conceptualising the
Characteristics of a Place that Determine Well-Being. ............................................ 35
2.4 Physical, Social, and Socioeconomic Characteristics of Living Contexts that
Correlate Significantly with Health-Related Behaviours......................................... 48
2.5 A Review of the Urban Planning and Design Literature that has Investigated
Residents’ Psychological, Social, and Behavioural Responses to their Living
Contexts. .................................................................................................................. 56
2.6 Drawing Conclusions ......................................................................................... 73
2.7 The Research Questions ..................................................................................... 77
Chapter Three: Theoretical Framework of the Thesis.................... 78
3.1 Human Living Contexts as Social ‘Determinants’ of Patterns in Behaviour..... 78
vi
3.2 The Social Construction of Reality .................................................................... 80
3.3 Application of the Conceptual Framework to the Thesis: Asking New
Questions, Exploring New Ground. ......................................................................... 83
Chapter Four: Methodology .............................................................. 85
4.1 Introduction ........................................................................................................ 85
4.2 Why an Inductive Theory-Building Approach? ................................................. 86
4.3 A Social Constructionist Approach to Grounded Theory................................... 89
4.4 A Case Study: The Kelvin Grove Urban Village (KGUV) as a Locale for
Undertaking the Research. ....................................................................................... 92
4.5 Validity and Reliability ...................................................................................... 97
4.5.1 Validity ............................................................................................................ 97
4.5.2 Reliability........................................................................................................ 98
4.6 Data Collection and Analysis ............................................................................. 99
4.6.1 QUT Ethical and Developer Approval ............................................................ 99
4.6.2 Participant Recruitment................................................................................. 100
4.6.3 Reflection on the Role of the Researcher...................................................... 102
4.6.4 Phase One: Survey on Physical Activity....................................................... 102
4.6.5 Phase Two: ‘The Blog’ – Online Qualitative Data Collection ...................... 104
4.6.6 Analysis of the Online Qualitative Data........................................................ 106
4.6.7 Phase Three: In-depth Interviews with BHC Residents (Face-to-Face Data
Collection).............................................................................................................. 108
4.6.8 Phase Four: Community Focus Group.......................................................... 110
4.6.9 Analysis of the Face-to-Face (Interview and Focus Group) Qualitative
Data .........................................................................................................................111
4.7 Conclusion ....................................................................................................... 113
Introduction to the Published Papers...............................................115
Statement of Contribution of Co-Authors .......................................119
Chapter Five: Published Paper One................................................ 120
5.1 Abstract ............................................................................................................ 120
5.2 Rationale and Background: Socioeconomic Inequalities in Physical Activity
Rates and Responses to Population Health Communication. ................................ 121
5.3 The Media Debate: Where should we be Promoting Physical Activity? ......... 124
vii
5.4 Applying Communication Theory to the Problem: Can a social
constructionist perspective help? ........................................................................... 125
5.5 The ‘Blog’ as a Research Tool ......................................................................... 128
5.6 ICT Access and Use for Lower-Socioeconomic Study Participants ................ 129
5.7 Data Collection Method: ‘The Blogging Experience’ ..................................... 129
5.8 Sample of Bloggers .......................................................................................... 129
5.9 Procedure.......................................................................................................... 130
5.10 Data Analysis ................................................................................................. 130
5.11 Findings and Discussion: What are the factors influencing physical activity
levels in lower socioeconomic living environments? ............................................ 131
5.11.1 Structural Realities and Everyday Decisions about Physical Activity ........ 133
5.11.2 Aesthetic and Proximal Social Neighbourhood Influences......................... 134
5.11.3 Local Relevance and Medium of Delivery ................................................. 135
5.11.4 Message Source and Credibility.................................................................. 136
5.11.5 Tastes and Preferences................................................................................. 137
5.11.6 Community ‘Ownership’ and Participation: The Blog as a Tool for
Sharing Stories and Promoting Health at a ‘Grass Roots’ Level ........................... 137
5.12 Final Comments and Implications for Future Communication Efforts on
Physical Activity among Urban Population Groups. ............................................. 138
Statement of Contribution of Co-Authors ...................................... 140
Chapter Six: Published Paper Two.................................................. 141
6.1 Abstract ............................................................................................................ 141
6.2 Introduction ...................................................................................................... 142
6.3 Rationale and Background ............................................................................... 143
6.4 Case Study: What is the Kelvin Grove Urban Village and how does it allow
us to address research questions about urban design and health?.......................... 148
6.5 Methodology .................................................................................................... 155
Study Participants and Data Collection Methods: ................................................. 155
6.6 Key Findings .................................................................................................... 156
Community Capacity-Building and Recreational Activities.................................. 164
6.7 Discussion, Conclusions, and Future Implications .......................................... 164
Statement of Contribution of Co-Authors ...................................... 167
viii
Chapter Seven: Published Paper Three.......................................... 168
7.1 Abstract ............................................................................................................ 168
7.2 Introduction ...................................................................................................... 169
7.3 Re-Thinking Context: A Theoretical Point of Departure ................................. 170
7.4 Methodological Design .................................................................................... 171
7.5 Location of the Study: The Kelvin Grove Urban Village (KGUV) ................. 173
7.6 Study Participants............................................................................................. 174
7.7 The Researchers ............................................................................................... 175
7.8 Entry into the Field .......................................................................................... 175
7.9 Ethical Clearance ............................................................................................. 176
7.10 Data Sources................................................................................................... 176
7.10.1 Online Blog Entries..................................................................................... 176
7.10.2 Interviews.................................................................................................... 178
7.10.3 Outdoor Community Focus Group ............................................................. 178
7.11 Analysis: A Social Constructionist Approach................................................. 179
7.12 Findings: Key Conceptual Categories Mediating Poor Contexts and Low
Physical Activity Levels......................................................................................... 181
7.12.1 On being ‘Flogged up Something Fierce’: Conditions in Childhood as
Catalysts for Patterns in Later Life ........................................................................ 182
7.12.2 ‘Running Away: A Strategy for Surviving and Starting Again in Hostile
Environments ......................................................................................................... 185
7.12.3 ‘Sleeping with One Eye Open’: Living in Poor Neighbourhood Contexts
as Young Adults with Children .............................................................................. 186
7.12.4 ‘You’re Just Fat’: Other Intervening Social Interactions and Influences
on Body Image and Physical Activity.................................................................... 188
7.12.5 ‘Exercise as a Dream’: The consequences of life-course contextual
processes on the negative social construction of physical activity within this
group. ..................................................................................................................... 189
7.13 Reflections on Methodological Limitations................................................... 192
7.14 Discussion and Conclusion ............................................................................ 192
Chapter Eight: Contribution of the Thesis to Knowledge ............ 197
8.1 Were the Research Questions Answered? ........................................................ 197
8.2 Using Social Constructionism: Reflecting on the Conceptual and
ix
Methodological Contribution................................................................................. 199
8.3 What Did a Social Constructionist Grounded Theory Approach Reveal
About the Context of the Lower-Socioeconomic Lived Experience? ................... 201
8.4 What Did Social Constructionism Tell Us About What Physical Activity
Means in Poorer Contexts? .................................................................................... 203
8.5 Implications for Health Promotion and Communication: The Challenge of
Encouraging Behavioural Change in Poor Settings. .............................................. 205
8.6 Implications for Urban Design: What Neighbourhood Traits Work Well for
Vulnerable Demographics? .................................................................................... 210
8.7 Implications for Health Inequalities Research: What Do We Know About the
People, Place, and Health Relationship That We Did Not Know Before?............. 213
8.8 Using the Theoretical Knowledge Built in this Thesis to Develop Effective
Research and Policy About the Relationship Between Poverty and Physical
Activity. .................................................................................................................. 216
8.9 Critical Reflections: Limitations of the Methodology and Future
Considerations........................................................................................................ 218
8.10 Conclusion ..................................................................................................... 220
REFERENCE LIST.......................................................................... 378
x
Tables, Figures, Images, and Graphs
Table 1.1 Summary of Participants and Data Collection Phases ............................... 29
Figure 4.1 Inductive Theory-Building Approach....................................................... 87
Figure 4.2 Ideological Framework Behind KGUV Design ....................................... 93
Figure 4.3 A map of the geographic area in which KGUV is located is depicted
below.......................................................................................................................... 94
Figure 4.4 Master Plan ............................................................................................... 94
Table 4.1 Summary of Health-Related Resources in KGUV..................................... 95
Table 5.1 Ecological and Communicative Factors Influencing Decisions about
Physical Activity among Lower-Socioeconomic Residents in a New Urban Village.
.................................................................................................................................. 132
Figure 6.1 ‘What is KGUV a Case Of’? .................................................................. 150
Figure 6.2 Map of Geographic Area in which KGUV is located............................. 151
Figure 6.3 Master Plan ............................................................................................. 151
Table 6.1 Health Related Resources at KGUV ........................................................ 153
Table 6.2 Participants and Data Collection Phases .................................................. 156
Table 7.1 Summary of Participants and Data Collection Phases ............................. 174
Figure 7.1 Conceptual categories and core category emerging from a social
constructionist grounded theory study into the relationships between poor living
contexts and lower physical activity levels.............................................................. 182
Table 8.1 Aspects of Urban Design important for Healthy Living .......................... 212
xi
Appendices
APPENDIX A: QUT Ethics and KGUV Research Committee Approval................ 222
APPENDIX B: Information and Consent Forms ..................................................... 223
APPENDIX C: The Physical Activity Survey ......................................................... 234
APPENDIX D: The Blog ......................................................................................... 235
APPENDIX E: Interview Schedules and Transcripts .............................................. 295
APPENDIX F: Community Focus Group Schedule and Transcript ........................ 365
xii
Statement of Original Authorship
The work contained in this thesis has not been previously submitted to
meet requirements for an award at this or any other higher education
institution. To the best my knowledge and belief, the thesis contains no
material previously published or written by another person except where
due reference is made.”
Signature:
Date: 17/08/08
xiii
Acknowledgements
There really are many, many people to thank for their support during my PhD
journey. Whether they simply supported the crazy notion of undertaking a doctoral
degree while having and raising three young children, or whether they supported me
in practice, by listening to my woes and fears, encouraging me to keep going, and
most importantly, babysitting… I owe them all a very big THANK YOU.
Thank you firstly, to Associate Professor Gavin Turrell, my first Principal Supervisor,
with whom I had many exciting and interesting discussions about the ideas and
possibilities of doing a PhD on the topic of health inequalities in the West. We spent
many, many hours thinking of angles and ideas, and arguing over methodological
approaches to this fascinating topic. I enjoyed this old school approach to academia:
spending hours discussing ideas over coffee. I formulated many of my ideas and
critical arguments during this time, and so I thank you Gavin, for the investment of
your time, and for the inspiration you gave me to do this thesis in the first place.
I extend my deepest gratitude to my next Principal Supervisor, Associate Professor
Barbara Adkins, who took me on as a student when my confidence was low and I
was plagued with self-doubt. Barbara is an exceptional person and supervisor – for
whom nothing is too much trouble, too complex, or too challenging. Whether you go
to Barbara with a conceptual, theoretical, or every day life problem (I have no
babysitter today, etc ;-) she quickly distils it down, and finds a practical way to work
through or around the problem. Nothing is too much of a big deal for Barbara,
everything can be handled calmly and intelligently, and she listens to you as though
you are the only person in the world during supervisor/student meetings. I thank
Barbara for her no-nonsense approach to dealing with bureaucracy, for sharing her
theoretical genius with me as I tried to fathom my way through my methodology and
analysis, for teaching me what qualitative research is all about, and for her non-
judgemental approach to life and those around her. I feel honoured to have met you
and worked with you Barbara, and am sure we shall continue to work together in the
future. (I must also thank my old mate Glenn Draper for suggesting I go to Barbara
when things got challenging. Thanks Glennie!)
xiv
I also thank Associate Professor Elizabeth Parker and Dr Marcus Foth, both of whom
provided me with much needed support and guidance in other aspects of the PhD
journey. Elizabeth was always there for me, whether I needed to discuss the thesis or
my personal life, and listened to, and supported me throughout. Elizabeth is a warm
and exciting person who is always buzzing with ideas and energy – and a wicked
sense of humour – and I have felt guided and protected by her during the full length
of my PhD. Thank you Elizabeth for your pragmatism, your organisation, your direct
approach, and your friendship. I know we will stay in touch for the rest of our lives. I
must also bow down to Marcus, who already knows how highly I think of him and
adore him! But I shall say it again – thank you Marcus for your endless emails and
encouragement and inspiration and for keeping me on my toes and in-the-know
about presenting at conferences and publishing. I loved writing with you, and share
your outlook about taking every opportunity and giving it all you have. It is a
brilliant approach to life and work. You rock.
Thanks also to Professor Michael Dunne for being on my panel and being an eternal
inspiration to me as a brilliant lecturer and researcher.
I will now thank my beautiful and much loved friends for their support during the
times that I felt this thing was just never going to happen for me. In no particular
order of importance or love, I thank Siro and Ridgie for being there for me forever
and ever, and to Lizzie Macquire ‘The Amazing’ who always made me drink and
laugh a lot during my PhD – thanks mate! Thanks to Jody, for keeping it real, and
doing things like taking my Woodford tent down from around me at 8am and
reminding me that there is always real life to get back to ☺ I must thank Cassandra
Jones – a most eccentric and fabulous individual - with whom I shared a kindred
connection, a million emails, and a passion for ciggies, wine, and Leonard Cohen.
Thanks for lifting me up in those emails Cass, time and time again, no matter how
knocked down I was feeling. Thanks to Michelle Reynolds – my brilliant, non-
judgemental and very funny mate with whom I had many much needed drinks and
chats at the Normanby – mate let’s kept that habit up for years to come! Thanks to
Jamie Reynolds also for putting up with me while I raved about how hard everything
was to his good wife, while sitting on his couch drinking all his wine ;-) Thanks to
Dr Elisabeth Winkler – I have always been honoured to have conversations with you,
xv
m’dear – your intellect is scary and I love it! Let us stay in touch and have clever
conversations for years to come! Thank you for your kindness too, towards myself,
Ben and the kids. You always made me feel OK, even when I was broke. Speaking of
which – thanks to James Cole and Kerry Vinall, for spotting us with short term food
loans when we needed them… you saved us many times, guys – I love you both
forever for that. Make sure I cook you heaps of good dinners in future as some kind
of interest for your support. I look forward to both your PhD graduation ceremonies
and many happy camping trips to Woodford! Thank you to Sir Rob Mann, who made
me feel at home in London and like a Princess in Paris – bless you, Rob for the best
junket ever. I will never forget your kind and generous spirit during the time I
presented at Cambridge University in the UK, and was freaking out about that pretty
much the whole time I was there. Other two important groups I thank – are firstly my
neighbours, who are just the best neighbours ever. Thanks for making Miskin Street
an awesome hippy commune that I love living in – for all those emergency coffees
and ciggies and dunny rolls when stress levels were high! And secondly, I thank the
First Wives Club – Alley Cat, Maree, and Michelle – for the bonding, the
understanding, and the healing. Hats off ladies! It’s to infinity and beyond for all of
us now……..!
I would like to also thank the Collerson, Alcorn, Lowe, Pearse, Stevens, and
Domocol contingent for all their love, support, and practical help. Most especially to
Jane, Jon, and Alex for helping me with babysitting, and to Kate for editing my thesis
so beautifully for me when I was too exhausted to look at it anymore! Thanks to
Louise, Devon, and Fiona for their generous and very fun hospitality in Santa Cruz
while I was presenting in San Fran, and thanks to Nikki for letting me bend her cyber
ear when I needed to. Much love and thanks to this second family that I have happily
adopted through Ben.
And finally, there really are not going to be words that allow me to adequately thank
Ben, Charlotte, Oliver, Annabelle, Mum, Dad, Jay and Fiona. I really am stuck on
what to say here, because I am closer to you all than anyone else in the world, I see
you all the time because you are always bloody there for me (!), I tell you all
everything about everything all the time, and all this tells me how amazingly present
and loving you are in my life. Your support during this challenging and exciting
xvi
journey has been relentless, immense, and unfaltering. I hope that I can provide the
kind of love and support you have shown me during this time for many years to
come, and that the good karma comes back to you double-fold!
I do, however, want to specifically say thanks to Ben for loving me, often silently,
patiently, generously – and above all loyally – we make a very good match in that
way… god knows we couldn’t have two people like me in a relationship! So thanks
for being my eternal ‘opposite’, the yin to my yang, and being all I ever needed you
to be to help me through this thesis.
And finally to my Mother and Father – Mum for teaching me practicality,
organisation, prioritising, simplifying, empathy, generosity, creativity, the Zen art of
cleaning, and above all charm, and the art of persuasion ;-), and Dad for teaching me
to argue, defend, critique, be political, advocate, lead, take initiative, get angry about
things that are unfair, and for teaching me to be academically minded. I thank you
both, my parents, for everything that I am, and everything that I have accomplished.
Oh, and I nearly forgot – thanks to Sauvignon Blanc, without which much of this
thesis would never have been written, and much of the editing would not have been
required!
xvii
List of Works from this Thesis Accepted for Presentation &
Publication
Conferences
Carroll, J.-A., Adkins, B., Parker, E., & Foth, M. (2007, March 20-21). The Effects of a New
Urban Context on Health: An online investigation of into the relationships between
neighbourhood design and physical activity levels of lower socioeconomic residents. Poster
presented at the Third National Conference on Obesity and Health, Manchester, UK.
Carroll, J.-A., Adkins, B., Parker, E., & Foth, M. (2007, Sep 6-8). The Kelvin Grove Urban
Village: What aspects of design are important for connecting people, place, and health? Peer-
reviewed paper presented at the International Urban Design Conference, Gold Coast, QLD.
http://eprints.qut.edu.au/archive/00009843/
Carroll, J.-A., Adkins, B., & Parker, E. (2007, May 24-28). 'Blogging about Jogging': Digital
stories about physical activity from residents in a new urban environment with implications
for future content and media choices in population health communication. Peer-reviewed
paper presented at the 57th Annual Conference of the International Communication
Association (ICA), San Francisco, CA. http://eprints.qut.edu.au/archive/00006317/
Carroll, J.-A., Adkins, B., & Parker, E. (2006, July 8-14). The Effects of a New Urban
Context on Health: A study of the ecological processes connecting people, place, and
physical activity. Invited presentation at the Mixed Methods Conference, Cambridge
University, UK.
Book Chapters
Carroll, J.-A., Foth, M., & Adkins, B. (2008). Traversing urban social spaces: How online
research helps unveil offline practice. In J. Hunsinger, M. Allen & L. Klastrup (Eds.),
International Handbook of Internet Research. Heidelberg, Germany: Springer.
http://eprints.qut.edu.au/archive/00013350/
Journal Articles
Carroll, J., Adkins, B., Parker, E., Foth, M., Jamali, S (2008). My Place through My Eyes: A
social constructionist approach to researching the relationships between socioeconomic
xviii
living contexts and physical activity, The International Journal of Qualitative Studies in
Health and Well-Being, In Press
Media Coverage of the PhD Findings
Science Alert Australia and New Zealand
‘Health Promotion Targets Advantaged’ http://www.sciencealert.com.au/news/20081106-17470.html
Australia Network News
‘Australia Researcher Suggests New Approach to Obesity’ http://australianetwork.com/news/stories/asiapacific_stories_2270584.htm
ABC News
‘Healthy Living Campaigns Patronising: Study’ http://www.abc.net.au/news/stories/2008/06/10/2270459.htm
Queensland University of Technology (QUT) E-News
‘One Size Doesn’t Fit All in Health Promotion’ http://www.news.qut.edu.au/cgi-
bin/WebObjects/News.woa/wa/goNewsPage?newsEventID=17497
India E-News
‘Health Campaigns Lost on the Poor’ http://www.indiaenews.com/australia/20080611/124275.htm
Thaindian News
‘Health Campaigns Lost on the Poor’ http://www.thaindian.com/newsportal/world-news/health-campaigns-lost-on-
the-poor_10059055.html
Sunshine Coast Sunday
Full page article ‘Class Barrier to Fitness’
Workout UK Magazine
‘Health Campaigns too Patronising’ http://dementia.uow.edu.au/activities/guest-lectures.html
Triple J News, 10th
June 2008
A Queensland researcher thinks poorer people aren't getting the message
xix
about living a healthier lifestyle and there needs to be smarter promotion. Interviewees: Julie-Anne Carroll, University of Technology, Queensland Duration: 0.29 Summary ID: S00030985582 This program or part thereof is syndicated to the following 6 station(s):- Triple J (Perth), Triple J (Melbourne), Triple J (Brisbane), Triple J (Adelaide), Triple J (Hobart), Triple J (Darwin) © Media Monitors Radio National, ‘Australia Talks’, Paul Barclay, 9
th June 2008-07-28
PhD Student Julie-Anne Carroll joins the panel to discuss the Kelvin
Grove Urban Village, an inner city residential development based around the QLD University of Technology campus. Interviewees: Caroline Stalker, Director, Architectus Brisbane; Julianne Caroll, PhD Student, Humanities Research Program, QLD University of Technology; Uras* Crest, urban designer and architect Duration: 7.46 Summary ID: C00030973544 This program or part thereof is syndicated to the following 8 station(s):- Radio National (Sydney), Radio National (Melbourne), Radio National (Brisbane), Radio National (Perth), Radio National (Hobart), Radio National (Adelaide), Radio National (Darwin), Radio National (Newcastle) © Media Monitors
20
Chapter One
Introduction and Overview of the Thesis
1. Introduction to the Topic
This thesis calls into question the concept of ‘context’ as it is currently
conceptualised or measured in epidemiological studies examining relationships
between people, place, and health, and proposes a social constructionist approach to
exploring connections between living environments and health-behavioural trends. It
shifts the emphasis from measuring living contexts – at the household or
neighbourhood level - to investigating them as meaningful social places wherein
behavioural trends and lifestyle patterns become clustered over time due to ongoing,
and largely unknown, dynamics within these contexts. To test the potential
methodological contribution of a social constructionist approach to conceptualising
and studying relationships between living contexts and the specific health-related
behaviour of physical activity, a new urban locale was identified as one that typified
the relationships of interest in this study. An intensive study was conducted of a
group of lower socioeconomic residents who had recently moved into a new urban
village designed to increase residents’ physical activity levels. The study makes a
point of departure from the cross-sectional ‘snapshots’ of the links between
households, neighbourhoods, and health provided in the epidemiological literature, to
a study that captures the contextual interactions and processes that go on over time;
tracking people as they traverse through poor living environments, to produce
patterns in health practices and outcomes.
This thesis makes the overarching case that it is one thing to observe a human social
context, its characteristics, its occupants, and people’s behaviour there, and another
to set about trying to understand how and why these fit or operate together in the
orders and patterns in which they appear. In a philosophical and empirical sense,
these two tasks are highly compatible as a means of generating knowledge about the
patterns and processes that link human contexts to health outcomes of interest.
However, research looking at how socioeconomic living contexts influence health
behaviours and outcomes has created a methodological and evidence-based focus on
21
the former phase of contextual analysis: observation. That is, sophisticated statistical
instruments are currently employed to find out which aspects of these contexts
appear to be most salient for health, and which factors in these environments depict
the most statistically significant relationships to outcomes of interest. Thus, this
thesis makes a philosophical and empirical shift to create an emphasis on the latter
phase of contextual analysis to find out why these patterns might be occurring, and to
tap into the psychosocial processes and interactions that give rise to behavioural
trends along a socioeconomic gradient. I argue that, firstly, a more competent
conceptualisation of contexts as propagators of trends in health-related behaviours
along a socioeconomic gradient is needed and, secondly, that a greater emphasis on
qualitative research methods is required in order to establish a competent and
insightful analysis of population trends in health – with the view to designing and
implementing more effective intervention programs in the future.
This thesis emphasises that there are inextricable links between how one thinks about
‘context’ and defines it, and one’s approach to studying the human practices within it.
An important paper devoted entirely to the discussion of context across history and
disciplines by Burke (2002) highlights the different ways in which context has been
discussed over time, and how its definition in a particular context reflects the
underlying political, religious, or cultural persuasions there. As Burke (2002) states
‘interdisciplinary discussions of the problems raised by the notion of context are all
too rare’ (p.164). He argues that a greater understanding of ‘context in context’ is
needed to generate a more profound and interdisciplinary understanding of its
evolution and emphasis across different geographical, institutional, and conceptual
spaces. In keeping with this approach, this thesis describes a journey through a
conceptual and methodological shift from the epidemiological ways of thinking
about and investigating socioeconomic contexts for their power to influence health.
The process moves from a conceptualisation of contexts as static and deterministic to
organic, dynamic, and socially produced by the humans who inhabit them, with
consequences for their health. It begins by taking note of the evidence outlined in
social epidemiological research that characteristics of households and
neighbourhoods are often strongly linked with trends in health behaviours and
outcomes, and makes the case for an intensive study to unearth the micro-level
processes that produce these patterns. With the key research goal of finding out why
22
these contextual or group-bound patterns emerge, a study was designed to ascertain a
subjective viewpoint from people from lower socioeconomic groups about how their
households and neighbourhoods have influenced their lifestyles and their health, with
a particular focus on how physically active they were likely to be.
While much of the literature on health inequalities is concerned with establishing
epidemiological patterns and trends to make the case that unequal economics results
in unequal health, this thesis is interested in addressing the question of how these
trends arise, and unravelling the complex social and cultural landscapes on which
such lifestyles and life and health trends are constructed. Further, I aim to discover
how they are propagated from generation to generation within particular geographic
areas. While it is indisputable that poverty has harsh outcomes for population health
and well-being, there is room in current research efforts to find out how, in Western
contexts, ‘relative’ poverty or inequality creates significant lifestyle differences with
implications for health. It is important to be able to understand what economic
inequality means as an everyday lived experience – or how poverty translates into
lifestyle – in order to understand why such differences in lifestyle and health-related
behaviours emerge. This thesis tackles the overarching philosophical question of
‘what is it about living in poorer neighbourhoods or areas that creates particular
lifestyle patterns that damage or harm health and life chances?’ If researchers are
able to address this question effectively and more comprehensively in future
empirical efforts, the implications for public health are promising.
If empirical research can point to factors and processes mediating the relationships
between poor living contexts and less healthy lifestyles – and thus poorer health
overall – a more sound and convincing argument can be made to redress social and
economic inequalities at a macro or policy level by providing concrete answers about
what is likely to make a difference from a health perspective in these environments.
That is, the politically tenuous ground wherein paradoxical relationships between
poverty and health-risk factors – such as obesity, cigarette smoking, and alcohol
abuse – are identified, needs to be more effectively unearthed to provide insights
about how these relationships emerge in order to elicit a response that is both
effective and appropriate within these settings. Currently, the purely economic
argument to resolve health inequalities is vulnerable to counter-points highlighting
23
the presence of human agency and individual resilience in being able to overcome
difficult living situations as opposed to engaging in self-destructive behaviours
within them. Further, and importantly in light of these challenges, health promotion
and communication advocating behavioural change within these target demographics
tends to be unsuccessful for the most part, as lower socioeconomic groups continue
to be less responsive to public campaigns pushing for behavioural and lifestyle
changes with benefits for health (Finlay & Falkner, 2005; Bauman et al, 2006;
Laitakari, 1998). In addition to the health sectors, urban design research also faces
the challenge of trying to respond to the community and housing needs of poorer
residential groups in ways that are healthy and sustainable. Thus, a more in-depth
examination of the micro-processes sustaining the relationships between poorer
people, poorer places, and poorer health would arguably lead to a more appropriate
and well-matched political, economic, and communicative response within these
complex living contexts on a number of different fronts.
1.2 Overview of the Thesis Chapters
Chapter Two, the literature review of this thesis, reflects on the two disciplines of
health inequalities and urban design to make note of common interests, as well as
differences, in methodological approaches between these fields, fields which are both
concerned with how people relate to, and are affected by, the places they inhabit. It
identifies the different ways these disciplines evaluate how cities and
neighbourhoods affect people’s quality of life and health, and draws out current and
common gaps in knowledge in both fields. It begins with a premise established in the
social epidemiology literature that, in Western countries, people who inhabit poorer
places and living contexts are more likely to suffer from a range of illnesses and
diseases, and tend to experience premature or earlier mortality rates than their more
well-off counterparts. Further, these patterns are primarily explained by the tendency
for higher socioeconomic groups to engage in healthier behaviours and lifestyles, and
to be less exposed to a range of risk factors associated with poor health than people
who comprise less well-off demographics (Slater et al, 1998; Williams et al, 2000;
Dovey et al, 2001; le Claire, 2001; McIntyre, Ellaway, & Cummins, 2002; Reidpath,
2003; Moyses et al, 2004; Leslie, 2005; Tucker et al, 2005; Karpati, Bassett, &
McCord, 2006; Monden, Van Lenthe, & Mackenbach, 2006; Parkes & Kearns, 2006;
24
Cummins, Curtis, Diez-Roux, & Macintyre, 2007; Turrell, Kavanagh, Draper, &
Subramanian, 2007). Whether socioeconomic position is measured at the individual
level, referred to in this body of literature as a compositional measure, or at a
contextual level, that is by family, household, or living area, empirical research
shows that lower socioeconomic individuals and groups are less likely to eat the
recommended amounts of fruit and vegetables, take the recommended levels of
physical activity (PA), drink alcohol within safe limits, or not smoke cigarettes than
higher socioeconomic groups (Kamphuis 2006; Selstrom, 2007). While it is evident
that poverty contributes to poorer health and well-being via a range of lifestyle
choices and factors, what is not properly understood is how this connection has
evolved, and how lower socioeconomic contexts have come to hold ‘deterministic
powers’ in relation to population behavioural and consumption patterns.
Meanwhile, in urban planning and design literature, an emerging interest in
collaborative efforts with researchers concerned with the relationships between
health and place is growing. As noted by Jackson (2003), ‘while causal chains are
generally complex and not always completely understood, sufficient evidence exists
to reveal urban design as a powerful tool improving human condition’ (p. 191). The
urban design literature is less concerned with population health per se, and more
concerned with quality of life, or residential satisfaction, in relation to how people
respond to buildings, architecture, landscaping, and use of public and private space in
cities and neighbourhoods. The urban design literature concludes that what is
currently most in demand by urban populations, and yet what is most difficult to
deliver, includes the ephemeral qualities of community (Gleeson, 1994), diversity
(Luymes, 1997), participation (Al-Hathloul, 2004), sustainability (Van den
Dobbelstein & de Wilde, 2004), identity (Oktay, 2002; Teo & Huang, 1996), culture
and history (Antrop, 2005). The challenge put to designers to deliver urban
communities with these qualities within tightly bound spatial and economic
efficiencies points to the need for research into how to make these goals more
feasible or attainable.
The concerns facing urban designers and researchers are directly relevant to health
researchers wanting to know which aspects of place influence people’s experiences
and lifestyles there. The fields are highly relevant to one another in light of the
25
potential progress that could be made via a dialectical interchange of ideas in both
substantive findings and methodological designs initiated in each discipline. In
particular, this literature review makes note of the direct and subjective accounts of
the people-place relationship put forward in the planning literature, in contrast with
the health literature seeking to establish significant correlations between place traits
and human behaviour and health as a means of finding out what matters in a place
from a public health perspective. While both disciplines have contributed greatly to
our knowledge regarding how people relate to, live in, and respond to places, both
areas still face steep conceptual and methodological challenges. Specifically, the
health inequalities literature is still struggling to ascertain a philosophical grasp on
living contexts as phenomena that produce patterns in health, while urban design
literature is still striving to carve out a clear ‘methodological identity’ for itself in the
field. It was from these substantive and conceptual gaps in the literature review that
the research questions were designed. The questions point to the need for a new
theoretical paradigm in relation to thinking about living contexts as dynamic social
spheres that influence health-related behaviours, and a methodology suited to
capturing the interactions and relationships that produce and sustain the patterns we
are so often able to observe within them.
Chapter Three of this thesis brings together the research questions raised in the social
epidemiological literature regarding how health inequality trends across places are
contextually influenced or produced, with Berger and Luckman’s (1966)
philosophical framework which focuses on the processes via which groups of
humans socially construct language, meanings, and behavioural norms in situ. This
conceptual framework emphasises the role of time, agency, context, and subjectivity
in how particular behavioural patterns arise in particular social settings. Berger and
Luckman offer a contextual, rather than a universal framework for thinking about
and analysing patterns in human behaviour. In doing this, they illuminate contexts as
powerful proponents of human behaviour, and theorise how norms and behavioural
patterns develop within them. For this reason, I propose that their work is directly
suited to studying and analysing how living contexts work to give rise to particular
behavioural and lifestyle profiles.
Chapter Four outlines the methodological approach of this thesis, including the
26
study design, data collection and analysis. It describes both the quantitative and
qualitative methods used to collect and analyse the data contributing to the findings
in this thesis.
The chapter also describes how this conceptualisation of human behavioural patterns
in households and neighbourhoods as socially constructed via the interaction and
communication of the inhabitants was coupled here with the qualitative data
collection and analysis techniques of the social constructionist grounded theory put
forward by Charmaz (2001; 2006), and practised and acknowledged by others (Lesch
& Kruger, 2005; Hallberg, 2006). Charmaz has taken a divergent – and yet
increasingly accepted – means of employing a grounded theory approach, and
acknowledges the need for flexible guidelines, ‘not methodological rules, recipes and
requirements’ (p. 20). She argues that researchers bring their own histories, theories,
values and ideas to the process of generating theory from data. Thus, consideration
must be given to both the researchers’ and participants’ backgrounds when data is
being collected, selected, and analysed. A reflexive, interpretive approach to the data
must be taken if there is an ongoing understanding of it being socially produced
between the researcher and the participant.
In light of the conceptualisation of behaviour in context by Berger and Luckman, and
the principles of Charmaz’s methodological framework, I sought to gain an insider’s
perspective or subjective account of how lower socioeconomic residential groups
perceive, understand and rationalise their responses to a particular living context,
while simultaneously recognising the dialectical construction of data between the
researcher and the participant. I could not find another study that took a social
constructionist grounded theory approach to researching poorer living contexts for
their capacity to influence healthy lifestyles, however research regarding attitudes
and beliefs in relation to sexual practices among a group at risk of HIV using this
methodology has been published (Lesch & Kruger, 2005).
This theoretical framework and mixed methods study design was conducted the
residential population living within the Brisbane Housing Company (BHC) – or
‘affordable housing’ units – within the Kelvin Grove Urban Village (KGUV;
www.kgurbanvillage.com.au) to gain a better understanding of the socioeconomic
27
contextualisation of physical activity. KGUV is an AUD 800 million, medium-
density, mixed-tenure, planned community on 16 hectares situated two kilometres
from Brisbane’s Central Business District (CBD) and comprised of over 1000
residential apartments. It is located adjacent to the Queensland University of
Technology’s (QUT) Kelvin Grove Campus, as well as the La Boite Theatre. The
four blocks of over 200 BHC apartments are situated within the Village, and
accommodate tenants who qualify for government-subsidised housing. The
apartments house families, couples, and single people who are selected based on
having relatively low incomes. The apartments are not, however, managed by BHC,
and tenants liaise with a private rental company regarding payments and maintenance
while living there.
Further, KGUV was chosen as a case study as it was designed on the principles of
New Urbanism. These principles focus on providing heterogeneous, diverse
communities with green spaces, wide, even walking pathways and bikeways to
increase residential mobility. It aims to decrease vehicle use with the overall goal of
creating more sustainable communities. New Urbanism uses a mixed land-use
approach that ensures that a number of working, recreational, and shopping facilities
are within walking distance to peoples’ places of residence. Overall, KGUV was
based on principles encouraging an engagement with the local neighbourhood to
increase physical activity levels, while reducing the impact of medium-density urban
populations on the environment.
Photographs of KGUV and the BHC apartments are depicted below:
Musk Avenue Apartments – Brisbane Housing Company (BHC)
28
McCaskie Park, KGUV BBQ Social Area, KGUV
Ramsgate Residences, BHC Creative Industries Precinct, QUT.
The BHC residents living within the KGUV were chosen due the fact that they
occupied four apartment blocks housing only those who qualified for emergency
accommodation, or who had been on government housing waiting-lists. This
provided a lower-socioeconomic living context for investigation, which, as outlined
in the literature review has been established as exerting powerful ‘contextual effects’
over the health-related behaviours of those who occupy them. The BHC residents
were categorised as ‘lower socioeconomic’ via both housing type and income, with
only those residents earning less than AUD 25 000 per year qualifying for entry into
this housing.
The study took on a mixed methods study design in order to systematically address
the research questions rising out of the literature review of this thesis. Firstly, a
survey was developed and disseminated throughout the Village to determine the
practices of physical activity amongst people living in this new urban environment.
This quantitative approach was taken in order to firstly, determine differences in
29
activities in residents since arriving in the Village, and secondly, to identify any
differences between socioeconomic groups (as defined by housing type) living there.
The first phase involved a gathering a baseline or descriptive data via the
dissemination of a survey on the physical activity patterns of all KGUV residents.
The survey findings indicated that all residents had increased their physical activity
levels since moving to the Village, and that those living in the Brisbane Housing
Company (BHC) apartments – the lower socioeconomic residential group – were
engaging in less physical activity than their more well-off residential counterparts,
despite small increases in activity since moving to the Village. This was followed by
two phases of qualitative research, including online and face-to-face data collection
techniques. Both online and face-to-face qualitative techniques were used to extract
more detailed explanations regarding these initial trends. A summary of the
participants and the data collection techniques I employed are summarised in Table
1.1 below:
Table 1.1 Summary of Participants and Data Collection Phases
Research
Phase
Participants
Recruitment
Strategy
Data Collection Techniques
One
(Quant.)
105 Mail-out to KGUV
residents
Survey on Physical Activity: A pilot
study (N=30) followed by a mail-out to
KGUV population (600 apartments) was
conducted to gauge patterns of physical
activity amongst residents
Two
(Qual. Online)
16 Telephone contact
with those who
agreed to
participate in
further research on
the survey
Blogging: An online mechanism known
as a ‘blog’ was appropriated as a means
where residents wrote answers, stories,
and opinions about KGUV in relation to
healthy lifestyles. There were 214
responses posted on the blog in total.
Blog address:
http://theeffectsofanewurbancontexton
health.blogspot.com/
Three
(Qual. Face-
to-Face)
8 Invitation in the
mail to participate
in research
interviews for
financial incentive
Face-to-Face Interviews: 1-2 hours
in-depth interviews were conducted
with BHC residents in their apartments
about how their living contexts affect
their lifestyles and health.
30
Four
(Qual. Face-
to-Face)
6 Invitation in the
mail to community
BBQ and focus
group
Community Focus Group: Informal,
opportunistic interviewing and
observation notes were taken from BBQ
in local park organized by the
researcher for BHC residents.
Prior to presenting my analysis of the data and findings in Chapters Five, Six, and
Seven, I provide a brief introduction to, and overview of, the published papers. This
short description summarises the findings and illustrates how they answer the
research questions and collectively contribute to the building of the thesis. Chapters
Five, Six and Seven of this thesis by publication outline the systematic production of
findings that evolved as a result of the data collection and analysis in this urban case-
study. The findings reveal what a social constructionist approach to grounded theory
produced in a study investigating the processes connecting people, place, and
physical activity. Each chapter reporting on the findings of the research contains one
published paper reporting on the findings from a selection of the overall data
collected as part of this thesis by publication.
Finally, Chapter Eight reiterates more broadly how the contribution profiled in each
published paper addresses the research questions in Chapter Two, and builds to
generate a thesis about future issues for researching and understanding the
relationships between people, place, and health. The selection of this particular urban
case and the residential group within it reveals findings that point to the need for
further studies that take account of the importance of ascertaining a situated
understanding of health-related behaviours. The findings showed that while
characteristics within the neighbourhood environment are important, and that a
pleasing aesthetic, green spaces, and feeling safe are crucial for enhancing activity
levels, other contextual effects over time within this group of participants contributed
to a negative construction of physical activity as a concept; and that this greatly
inhibited their propensity to engage with the resources available. The histories and
past stories of this group revealed how childhood living environments and
experiences in poor, harsh neighbourhoods made physical activity both a low
priority, and something they were fearful to engage in fully. These previous
contextual influences ensured that inactive lifestyles became a norm amongst this
31
group via a cycle of gaining weight through feelings of low-self esteem and poor
body image, and thus feeling too self-conscious to exercise in public. Further, the
psychosocial dynamics that connect or disconnect poorer people to each other and to
healthier lifestyles are explained in the data produced in this research. The data also
illustrates the importance of pleasing aesthetics and socioeconomic heterogeneity in
the pathways to positive changes to lifestyle and health. The complex interplay of
processes that constitute the findings of this thesis provides a rich and in-depth
description of the everyday lived experiences within poor households and
neighbourhoods with implications for health promotion, urban design and future
health inequalities research.
32
Chapter Two
The Literature Review
2.1 Notes on the Methodology of the Literature Review
This literature review has been generated from exemplary and key articles within the
health and urban planning bodies of research that have paid particular attention to
finding out how the different characteristics of urban contexts impact on the health
and well-being of resident populations. It provides a review and critical analysis of
the aspects of context that have been highlighted as salient in influencing urban
residential health-behaviours, and the methodologies employed to detect and
understand the relationships between these factors.
The review has been divided into the following sections:
• Introduction: The Effects of Living Contexts on the Social Functioning,
Health, and Well-being of Residents.
• Public Health Perspectives on how Socioeconomic Living Contexts Affects
Health Outcomes: The challenge of measuring and conceptualising the
characteristics of a place that determine well-being.
• Physical, Social, and Socioeconomic Characteristics of Living Contexts that
Correlate Significantly with Health-Related Behaviours.
• A Review of the Urban Planning and Design Literature that has Investigated
Residents’ Psychological, Social, and Behavioural Responses to their Living
Contexts.
• Drawing Conclusions: Towards an interdisciplinary approach to researching
the impact of urban planning on the health-related behaviours of residential
populations.
• Identifying Gaps in the Literature: What are the questions that need to be
addressed in order to progress knowledge about the relationships between
people, place, and health?
33
2.2 Introduction: The Effects of Living Contexts on the Social
Functioning, Health, and Well-being of Residents.
Current research and thinking regarding the impact of place on the health and well-
being of a population are being derived from a highly diverse range of academic
disciplines, with different goals and objectives at their core (Caughy, O’Campo, &
Patterson, 2001; McIntyre, Ellaway, & Cummins, 2002; Birrell et al, 2002; Jackson,
2003; Cummins et al, 2004, Waters, 2004; Vogt, 2004; Gleeson, 2004; Macintyre,
McKay, & Ellaway, 2005; Macintyre, 2005; Coen, & Ross, 2006; Monden, Van
Lenthe, & Mackenbach, 2006; Karpati, Bassett, & McCord, 2006; Parkes & Kearns,
2006; Carver, Timperio & Crawford, 2007; Turrell, Kavanagh, Draper, &
Subramanian, 2007; Cummins, Curtis, Diez-Roux, & Macintyre, 2007; McCormack,
Giles-Corti & Bulsara, 2007; Giles-Corti, Knuiman, Timperio, Van Niel, Pikora,
Bull, Shilton & Bulsara, 2007). This literature review will focus primarily on the
research in the fields of public health and urban design that examines the impact of
urban neighbourhood characteristics on the quality of life, satisfaction, lifestyles and
health of residential populations, and the different methodological frameworks they
employ to achieve this. These frameworks relate directly to the core business of both
urban design and public health, and act as empirical tools that allow researchers to
focus on particular challenges identified in the respective bodies of literature. For
example, while city councils and planners are faced with the challenge of designing
and implementing urban environments and infrastructure that both meet the needs of
specific sub-populations while still benefiting the community or region as a whole
(Waters, 2004; Kearney, 2006; Kowaltowski, da Silva, Pina, Labaki, Ruschel &de
Carvalho Moreira, 2006; Erdogen, Akyol Ataman & Dokmeci, 2007 ), public health
researchers focus on locating the best methods by which the characteristics of a place
that are likely to determine population health outcomes can be measured or
conceptualised (Caughy, O’Campo & Patterson, 2001; Diez-Roux, 2002; McIntyre,
2002; Hou & Myles, 2005; Nicotera, 2007). To do this, urban design research has
focussed primarily on assessing the effects of infrastructure on the quality of
community relations and the social functioning of residents, whereas public health
literature has been primarily interested in unpacking the environmental,
socioeconomic, and geographical characteristics of a place that determine health, and
more importantly, health inequalities between regions. However, both have
34
ultimately remained focussed on investigating a range of complex physical and social
factors that contribute to the relationship between place and human functioning and
well-being.
Due to the interdisciplinary nature of this thesis, the perspective and priorities of
researchers from both public health and urban planning will be reviewed in terms of
their concerns for ways in which urban places affect the quality of life and health of
residential populations. The differences in the ways in which outcomes are prioritised
and goals are pursued by each discipline will be noted, and differences in
methodological approaches discussed. This review has been generated by seeking
articles that have a core concern with evaluating the impact of urban place
‘ingredients’ on the psychological, social, and health effects of the people who live
there. That is, the ultimately mysterious and little understood concept of urban ‘place
effects’ on people’s health-related behaviour and outcomes is what will be at the
centre of this review. Via this review, questions were able to be developed that
redressed gaps in the literature regarding psychological and social processes people
engage in as a means of assessing the characteristics of their urban living contexts,
and deciding what they will do there. Specifically, the review is interested in the
ecological processes that guide people towards or away from, behaviours that are
likely to affect their health.
This review aims firstly, to examine the literature that focuses on the relationships
that have established between qualities and characteristics of living places and health
outcomes. Secondly, it will review studies that have researched the physical, social,
and economic characteristics of an area that appear to be strongly related to health-
related behaviours and lifestyles of particular residential populations. And thirdly, it
turns to the body of literature concerned with assessing the impact of urban planning
and built environment of the formation and sustainability of functional and healthy
social relations and psychological well-being within and across communities, and in
particular, how these outcomes can be managed in new urban environments. The
primary goal of the review is to generate an interdisciplinary summary of the key
challenges faced within these research disciplines and locate specific research
questions that stand out as unanswered in literature that examines how both the
physical characteristics and socioeconomic demographics of urban places hold the
35
capacity to affect the health-related behaviour and well-being of its residents. While
the key outcome of interest is health, some of the psychological and social variables
that have been researched by urban designers as desired outcomes will be of interest
as they have been shown in other areas of health research to be important factors for
improving well-being.
2.3 Public Health Perspectives on How Socioeconomic Living
Contexts affect Health Outcomes: The Challenge of Measuring and
Conceptualising the Characteristics of a Place that Determine Well-
Being.
A great portion of public health literature is underpinned by a concern for social and
economic inequalities – both within and between countries – and the impact this has
on the health of individuals, communities, and entire populations (Marmot, 2006).
Specifically, a large body of research has been devoted to the study of how the
socioeconomic position of living areas or contexts ‘determine’ health-behaviours and
outcomes (Slater et al, 1998; Williams et al, 2000; Dovey et al, 2001; le Claire, 2001;
McIntyre, Ellaway, & Cummins, 2002; Reidpath, 2003; Moyses et al, 2004; Leslie,
2005; Tucker et al, 2005; Karpati, Bassett, & McCord, 2006; Monden, Van Lenthe, &
Mackenbach, 2006; Parkes & Kearns, 2006; Cummins, Curtis, Diez-Roux, &
Macintyre, 2007; Turrell, Kavanagh, Draper, & Subramanian, 2007). This body of
literature has evolved around two broad central themes: the first being a pursuit to
define and refine methods for measuring the physical, social, and economic
characteristics under which area comes to affect population health; and secondly, to
determine how these measurements operationalise to produce inequalities in health.
These two key challenges sit in light of the evidence showing that while geographical
factors such at latitude, and environmental factors such as pollution and other
hazards have been found to contribute to population health (Bush et al, 2002; Hanna,
2005; Downey & Willigen, 2005; Ahamed et al, 2005), there is overwhelming
evidence that, in Western contexts, differences in health by area correlate
significantly and repeatedly with socioeconomic differences (Macintyre, 2002;
Turrell, 2003; Lenthe et al, 2005; Breeze, Jones, Wilkinson, Bulpitt, Grundy, Latif &
Fletcher, 2005; Hill, Ross, & Angel, 2005; Wright, Kessler & Barrett, 2007; Galea,
36
Ahern, Nandi, Tracy, Beard & Vlahov, 2007). Health inequalities research has been
able to provide convincing evidence that the socioeconomic position of the area is a
reliable determinant of health outcomes, with poorer and more disadvantaged
communities being increasingly likely to endure worse health and well-being
(Karvonen, 1997; Dunn et al, 2000; Kruger, Reischl & Gee, 2007). The
socioeconomic characteristics of a person’s place of residence that have been shown
to matter from a health perspective, include housing quality, type, and tenure, as well
as overcrowding (Ellaway et al 1996; Waters, 2001; Jacobs, 2006). Further, the
income, employment, and educational levels of residents (both co-dwellers and
neighbours), as well as the socioeconomic measure given to an area, as calculated by
such measures as Accessibility/Remoteness Index of Australia (ARIA) and the
Socioeconomic Index for Areas (SEIFA) have also been identified as salient
determinants of the health and well-being of residents (Finch & Boufous, 2008).
More recently, variables relating to the perceived socioeconomic position of an area,
such as reputation and stigma, have also been identified as salient variables
mediating the place/health relationship (Sooman et al, 1995; Gregory et al; 1996;
Bush et al, 2001).
A large body of research has evolved in response to the inherently complex empirical
relationships that have been established between poorer health and lower
socioeconomic urban contexts, dedicated to understanding how the socioeconomic
status of an area might best and most accurately be measured (Turrell et al, 2004;
Mitchell et al, 2000; Hou & Myles, 2005; Sleigh et al, 2005; Zenk, Schulz, Mentz,
House, Gravlee, Miranda, Miller & Kannan, 2007; Nicotera, 2007). The aim of this
research is to be able to locate some of the descriptive characteristics of the residents
that are most likely to act as reliable predictors of the levels of health and well-being
within that community or social context. There are a number of instruments that have
been devised as observational checklists for describing neighbourhoods, such as the
SPACES instrument developed by Pikora (2004) in Western Australia, and earlier,
more theoretically driven measures (Caughy, O’Campo & Patterson, 2001), as well
as more recent efforts to strengthen methods to evaluate reliability, instrument
content and design, observer training and data collection in measuring a range of
neighbourhood qualities (Zenk et al, 2007). The much-used ‘multi-level’ approach to
detecting which measures are operating at individual, household, neighbourhood,
37
and area levels to produce particular health outcomes has been heralded for its ability
to ‘link the traditionally distinct ecological and individual-level studies and to
overcome the limitations inherent in focusing only at one level’ (Diez-Roux, 2000).
While this approach has allowed an increasingly sophisticated means for locating the
levels at which socioeconomic attributes combine to affect health outcomes (Hou &
Myles, 2005), there is an acknowledgement of the limitations of such cross-sectional,
statistical devices in their capacity to reveal what psychological, social, and
behavioural variables lie in the ‘unspecified black box of somewhat mystical
influences on health which remain after investigators have controlled for a range of
individual and place characteristics’ (Macintyre, 2002). As Diez-Roux (2002) notes,
‘Like other statistical methods, multilevel analysis will help describe, summarize,
and quantify patterns present in the data, but it will not explain these patterns.’ (p.
18). A recent comprehensive review of inter-disciplinary ways of measuring,
describing, and analysing neighbourhoods was conducted by Nicotera (2007), noting
the need for a combination of quantitative and qualitative data collection instruments
including artworks and photography, and potentially the stories from the voices of
children who live there. She concludes that ‘such bridges offer opportunities to
develop interventions that are viable for creating lasting change’ (p. 26).
The challenge in employing the multi-level approach is also highlighted by the
myriad of different and contradictory findings regarding the impact of the
socioeconomic position of individuals and their neighbourhoods on health (Slogget
& Joshi, 1998; Duncan et al, 1995). While research generally supports the
relationship between disadvantage at the individual and area level and poorer health
outcomes, once these are further dissected, complications arise in terms of drawing
conclusions regarding how these effects operationalise in some contexts and not
others. For example, findings by Hou and Myles (2005) demonstrate firstly, the
highly refined abilities of multi-level models in locating the effects of socioeconomic
position on health, and secondly, the perplexing nature of how these factors are
triggered into effect in some contexts and not in others. Specifically, they found that
an individual’s self-reported health rating is likely to improve if they live in a more
affluent area, but where inequality in the area is most significant, that this effect
begins to reverse. They also found that contextual aspects of the area were more
likely to determine health than the compositional characteristics of the individuals
38
who live there (p. 1559).
While further sharpening of such statistical instruments may indeed reveal more
specific detail about the compositional aspects of place that both procure and protect
against ill health and poor well-being, there is also a call in the literature for different
ways of conceptualising the context-effects of area on health in a bid to understand
how this phenomenon works at a psychological, social, and behavioural level. As
Macintyre (2002) stipulates, ‘the whole body of research is marred by weak
theoretical accounts of how and why the characteristics of an area might exert an
influence on the health of its resident population’ (p. 68). Increasingly, however,
researchers are turning to elements of social and cultural theories in an attempt to
bridge some of the knowledge gaps regarding how the lower socioeconomic position
of an area translates into dysfunctional or unhealthy behaviour. Markowitz (2001)
noted that efforts to understand area effects on health had been ‘hampered by lack of
appropriate data and model specification’ and responded by employing aspects of
cultural theory to test residents’ ‘attitudes’ and the concept of ‘social disorganisation’
as a means of unpacking how lower socioeconomic contexts lead to increases in
violent behaviour. He used survey techniques and an ethnographical approach to
determine the causal structure of cultural theories that highlight how the lower
socioeconomic position of residents leads to more violent neighbourhoods. He
concludes that ‘economic deficits lead to sensitivity, or concern with one’s status,
especially among peers and neighbours…. in the absence of conventional economic
opportunities, attitudes that facilitate violence become accentuated’ (p. 152). Such
research assists in developing insights regarding how the socioeconomic position of
an area operates or ‘plays out’ as a determinant of health behaviours and outcomes.
McLaren et al (2004) sought to test more unconventional aspects of area that might
determine how the health of resident populations is affected. They began their
research with the intent of trying to decipher how it is that ‘living in a poor area
appears to have an effect on health that is separate from the effect of being poor
oneself’ (p. 1). They chose to focus their research on the ‘reputation’ of the
community, based on the hypothesis that this may influence the morale, self-esteem,
and health outcomes of residents due to the fact that ‘the way in which one is
perceived by others is important for well-being’ (p. 2). The methodological aim of
39
the study was to develop a quantitative mechanism that could test context factors and
be developed for use in multi-level research on area and health. They analysed print
media that reported on the area and found that ‘social identities of places are
reflected in and projected by the media’ (p.6). The authors advised that while this
progresses the potential usefulness of multi-level approaches, a semiotic or discourse
analysis on reputation is needed to further develop criterion validity. Additionally,
that there is a need to compare media reports with actual characteristics of an area to
find out whether the media is capable of generating artificial negativity about an area
that did not reflect the physical or economic reality of the place.
Further to this work, Cummins et al (2005) conducted a study in an attempt to
identify what types of data might be useful, and more importantly to illustrate that
this data was not currently available from primary sources, in an effort to progress
findings regarding the capacity of urban contexts to determine health. They
combined theory from the urban planning literature with Maslow’s hierarchy (1968)
to gather some ‘front up’ ideas about what researchers might need to know about
area to understand how it affects health. The potential usefulness of such a hierarchy
lies in that variables that are most likely to be able to affect health behaviours and
outcomes were selected as means by which further research focussing on particular
health issues, such as obesity, could be investigated. For example, in this instance,
pathways, parks, (walk-ability), and access to healthy eating options might be
isolated and investigated within the area of interest. The authors also developed what
they termed a variable ‘wish-list’ regarding social capital and transport – and
compiled a table that compared what they were able to find from primary sources
with what they really needed to know about an area to assess its impact on health (p.
258). This initiative might complement efforts to understand socioeconomic
determinants of health by comparing areas with high and low socioeconomic ratings
for the presence of the variables that have been identified here as being likely to
affect health.
Despite differences in the focus and employment of measures, many empirical efforts
have shown that the characteristics of a neighbourhood, but socioeconomic context
in particular, are significantly linked to a range of diverse health outcomes, including
self-reported health (Parkes & Kearns, 2006), traffic-related stress and general health
40
(Song et al, 2007), lowered life expectancies, lung cancer and ischemic heart disease
(Coen & Ross, 2006), obesity (Boehmer et al, 2007; Miles, Panton, Jang & Haymes,
2007), accidents (Jacobs, 2006) and knee-replacement recovery (Wright et al, 2007).
The specific neighbourhood characteristics identified in these studies as contributing
to a diverse range of health and well-being outcomes included social support,
community engagement, social disorganisation, physical environment, facilities and
services, traffic congestion, quality of housing, maintenance, aesthetics, and land-use
respectively. Poverty, or lower socioeconomic position, was also located as a key
factor in this research contributing to experience of the neighbourhood and poor
health, as was gender, with Parkes and Kearns (2006) finding that different social
subgroups respond to the same neighbourhoods, or neighbourhoods with similar
qualities, in different ways. This demonstrates the importance of an empirical focus
on the match between a particular demographic and the nature of their living
environment, as well the need for subjective reports from residents who may have a
unique perspective of their context depending on their specific circumstances or
needs. The salience of subjective measures and contingency factors in the ‘who’ and
‘where’ under investigation is illustrated in a study by Kruger et al (2007) who found
that while neighbourhood deterioration was association with poor mental health, this
relationship depended on, or was mediated by a number of social and psychological
factors. For example, residential deterioration was mediated by social contact, social
capital, and fear of crime, while commercial deterioration was mediated only by fear
of crime.
There is also a large body of research showing that poverty – especially in Western
urban areas – contributes significantly to poor mental, as well as physical health
(Galea et al, 2007; Barnes, 2001; Breeze et al, 2004; Kruger et al, 2007; Wandersman
& Nation, 1998; Hill et al, 2005). An earlier paper from the discipline of psychology
identified social organisation, sub-cultural influence, and psychological stressors in
the neighbourhood as key factors influencing mental health outcomes (Wandersman
& Nation, 1998). In more recent, work Galea et al (2007) found that the incidence of
depression was significantly related to the socioeconomic position of a person’s
neighbourhood, independent of individual socioeconomic or other individual
covariates. Further research is needed to unpack the links between a poor context and
poor mental health, and the types of features within a poor neighbourhood that
41
detract from psychological well-being. Interestingly, Barnes (2001) found that
although living a poor area affected women’s health negatively, receiving regular
welfare benefits actually counter-acted negative attitudes, with recipients of
consistent payments faring better psychologically than their counterparts who did not
receive welfare. This points to the importance of structural relief for those
experiencing poverty at the individual and contextual levels. Research that looked at
how older people fare in poor communities by Breeze and colleagues (2005) showed
that their reported quality of life (QOL) – a concept directly linked to mental health -
was worse than older people living in more well-off neighbourhoods, and that this
could not be explained by differences in physical health. Feelings of safety, and the
lack of a reliable police presence were reported as the factors explaining this
difference in results. A comprehensive study by Hill et al (2005) found that people
from disadvantaged areas were constantly exposed to chronic stressors in the form of
crime, trouble, harassment, and other signs of disorder and decay, and that over time,
this is more likely to lead to psychological and physiological distress that affects
health. Further research is needed into the effects of the every day witnessing of
specific behaviours and aesthetics that are often the properties of poor
neighbourhoods on residential well-being.
While structural and economic factors have been shown to be important in the
relationship between health and place, the presence of certain psychological and
social factors have also been shown to correlate significantly with residential health
in urban neighbourhoods (Cho et al, 2005; Stafford, 2005; Cohen, Inagami & Finch,
2006; Wood, Shannon, Bulsara, Pikora, McCormack & Giles-Corti, 2007; Chiu &
West, 2007; ) In particular, the variables that have been grouped together under the
concept of ‘social capital’ have featured as one of the core means of both
understanding and addressing how a community functions in a sense that enhances
the health and well-being of its residents (Lindstrom, 1995; Hawe et al, 2000; Cattell,
2001; Altschuler, Somkin & Adler, 2004; Prentice, 2005; Carpiano, 2006; Araya,
Dunstan, Playle, Thomas, Palmer & Lewis, 2006; Lindström, Lindström,
Moghaddassi & Merlo, 2006). In their much sourced paper, Hawe and Shiell (2000)
have provided a summary of what social capital is – the relational, material, and
political aspects- and how it holds the potential to allow epidemiological research
into health inequalities to attach itself to social theories and hypotheses that can help
42
in understanding how contextual aspects of socioeconomic position impact on the
health of populations. They also note that the political aspect of social capital has
been under recognised and requires further investigation, and that, at that historical
point in the literature, they perceived that the concepts underpinning it had been
inadequately captured in investigations on its impact on health.
Although findings from Tasmania by Turrell et al (2004) show that social capital as
measured by public and private trust, social trust, neighbourhood integration, safety
and isolation did not correlate significantly with mortality rates in the area, this does
not mean that quality of life, or health by other definitions is not improved as a result
of the presence of this variable, and to this end, social capital may well retain its
usefulness as a tool for improving quality of life, rather than length. The limitations
of the effects of social capital on health have been acknowledged by Cattell (2001),
who reminds that ‘despite the capacity of social capital to buffer its harsher effects,
the concept is not wholly adequate for explaining the deleterious effects of poverty
on health and well-being’ (p. 1501). While there is little doubt that the incidence of
morbidity and mortality is increased in areas of socioeconomic disadvantage, the
challenge remains to unearth the pathways via which this phenomenon occurs. While
social capital was found here not to have a significant effect, perhaps elements of
social capital that are more obviously or directly associated with health behaviours,
such as community sporting memberships, walking groups, and collective attendance
to removing litter and environmental hazards, may reveal further insights regarding
how health behavioural profiles and outcomes differ.
Drukker et al (2003) found in a study in the Netherlands that one of the key reasons
that social capital tends to be higher in higher socioeconomic areas is that it appears
to emerge from residential stability, which is more likely to be present in areas when
tenure and home ownership is higher (p. 835). They found also that neighbourhoods
that experience residential stability tend to be more cohesive and safer than those
with high levels of instability. However, more recently, Drukker et al (2005) followed
up on results by Ross et al (2000), that showed that in the U.S., stable
neighbourhoods and socioeconomic deprivation correlated significantly with
psychological distress, whereas in unstable areas no effect was found between these
variables; thus implying a type of positive effect of instability on people in
43
disadvantaged situations. The authors proposed that ‘stability in poor
neighbourhoods is perceived by residents as tantamount to being trapped and
powerless in a dangerous and frightening place’ (p. 122). Drukker et al’s study on the
same phenomenon showed that for the outcomes of health-related quality of life,
perceived health, perceived mental health, vitality, mental health, and life satisfaction
instability appeared to alleviate the effects of socioeconomic disadvantage.
Additionally, Prentice (2005) found that the socioeconomic composition of
individuals living in a neighbourhood was less able to explain differences in health
outcomes and use of primary care services than the aspects of the living contexts
identified in this study as being i) neighborhood information networks, (ii)
neighborhood health behavior norms, (iii) neighborhood social capital and
(iv)neighborhood healthcare resources. They noted that social capital and healthcare
resources significantly predict an individual's primary care access. Since differences
in primary care access may explain individual-level health disparities between
neighborhoods, policies designed to improve primary care access must account for
both individual and neighborhood effects.
These findings have important implications for those designing and producing
housing for disadvantaged people, as well as for those who battle with the transient
and unstable residential habits of some lower-socioeconomic groups. Geographical
mobility may be a key psychological tool that serves to entertain notions of freedom
and autonomy; and one that needs to be considered when designing and generating
living areas for people who are socioeconomically deprived. Perhaps this desire for
mobility could be satiated by addressing the amount of public space, walkable areas,
and number of low-cost recreational options available to people who otherwise feel
trapped or limited by either their own poverty, or the poverty of the area.
Other researchers have focussed on specific features of disadvantage that may
contribute to the experience of living in particular areas and how this impacts on
their well-being. Cattell (2001) examined the variable of ‘exclusion’ as one that
might be central to the apparently causal relationship between poverty and health.
She noted that exclusion was something more likely to be experienced by poorer
communities whose relationship with their own low social status and their area
become compacted over time in a sense that causes them to feel isolated from the
44
broader community. Cattell argues that exclusion ultimately affects social networks,
which have been located as important mechanisms for improving health and well-
being. Siegrist (2000) proposed a more detailed framework for how poverty,
exclusion and health are linked by discussing the distinct absences of fulfilling roles
for those living in disadvantaged contexts. He states that ‘loss of core social roles…
impair personal self-regulation and trigger a state of ‘social reward deficiency’ (p.
1283). He goes on to describe more specifically how these psychosocial conditions
might lead to stress-relieving, addictive, health-damaging behaviour.
In an Australian study, Wood et al (2007) found that the built environment played a
small but significant role in increasing social capital and being associated with
increased levels of walking in neighbourhoods. The key aspect of built design
contributing to this was the number and perceived adequacy of a variety of
destinations. Additionally, the researchers found that high levels of neighbourhood
upkeep and maintenance were associated with increased levels of perceived safety
and social capital. Further research is needed to explore both the links between
poverty and neighbourhood design and aesthetics, and the psychological and
emotional effects these aspects of living environments have on health behaviours
and outcomes.
Cohen, Inagami & Finch (2006) found in Los Angeles that ‘collective efficacy’ – a
measure of social capital - was associated with particular features of the urban
environment that could be expected to have direct connection to health outcomes.
They challenged usual assumptions about direct causality between different measures
of neighbourhoods, noting that ‘collective efficacy is frequently considered a
“cause”, but we hypothesized that environmental features might be the foundation
for or the etiology of personal reports of neighborhood collective efficacy’ (p. 1).
They went on to find that parks were associated with high self-efficacy, while a high
number of liquor stores were associated with low self-efficacy in neighbourhoods,
concluding with the insights that ‘certain environmental features may set the stage
for neighborhood social interactions, thus serving as a foundation for underlying
health and well-being. Altering these environmental features may have greater than
expected impact on health’ (p. 1).
45
A further study on the experience of place by older women by Young et al (2004)
looked at the effects of a sense of belonging on more specific physical and
psychological health outcomes and found that two variables in particular formed
reliable correlates of these measures; a sense of neighbourhood and feelings of
safety. They offer these factors as ‘valid measures of aspects of the social
environment of older women’ (p. 2627). However, more detailed investigations,
arguably of a qualitative nature, might be needed to reveal how such aspects lead to
differences in health.
Such empirical and theoretical developments demonstrate that the most productive
insights into the area effects on health are necessarily gained by examining how a
place influences people’s tendencies to behave in ways that affect and determine
health outcomes. Additionally, it points to a distinction that is not often made in this
area of the literature: that the studies which are interested in the effects of contextual
factors on mental health, including self-rated health, are primarily concerned with
quality of life and social functioning, and perhaps need to be conceptualised as being
categorically different from studies that are specifically concerned with how these
factors determine the health-behaviours and morbidity and mortality rates of
residents. However, their ultimate compatibility as a means for determining how well
people are likely to be in any particular place is unquestioned.
How residents perceive their neighbourhood has also proven to be significantly
linked with self-rated health and emotional status among adult Koreans (Cho et al,
2005). Cho and colleagues found that perceptions of neighbourhood, as categorised
and tested by overall neighbourhood satisfaction, the security of the neighbourhood
and the perceived quality of their relationship with their neighbours affected how
well they perceived themselves to be, as well as how happy or emotionally well they
felt overall. Stafford et al (2005) looked at self-rated health differences between men
and women and examined a number of contextual variables as well as socioeconomic
measures to achieve this. Interestingly, they found that each of the contextual
domains was associated more strongly with self-rated health than any of the
socioeconomic measures used. Additionally, this effect was stronger among the
female group, implying that aspects of a place might be especially salient for women
in terms of how they feel about their own health and well-being. The variables that
46
were found to generate this effect included trust, integration into a wider society, left-
wing political climate, physical quality of the residential environment and
unemployment rate (p. 1681).
However, while such outcome variables lean more towards quality of life than health,
the potential of such psychosocial variables to determine health behaviours, and
ultimately health outcomes remains of paramount importance when attempting to
locate factors that mediate the structural characteristics of place and health outcomes.
Interestingly, the urban planning literature has used the approach of asking
participants whether particular place-traits elicit positive perceptions of people’s own
neighbourhoods, while health research has tested for the significant co-presence of
particular psychosocial variables such as positive perception of place and other
measures of health. It is evident that more direct questioning is needed to determine
which characteristics of a place make residents more likely to lead healthy lives
there.
Cross-sectional endeavours that continue to seek more refined and sophisticated
methods of measuring the compositional levels at which disadvantage affects life and
health chances will no doubt continue to provide data on the correlates of good
health outcomes in the Australian population. However, what they continue to
struggle with, is generating insight into how factors such as the overcrowding, tenure,
income levels, education levels, and employment status of residents makes them
more or less likely to become ill or die prematurely. Even more perplexing, how can
the properties of an area function to buffer or worsen the health of individuals as a
more powerful determinant than their own socioeconomic position? That is, the need
to develop methodologies that allow place and socioeconomic context to be
conceptualised and investigated as a phenomenon that somehow produces
psychological, social and, most importantly, behavioural differences between people
that ultimately affect health is vital in gaining insights on how best to group or ‘un-
group’ those in the lower end of the socioeconomic spectrum who require specific
housing needs, as well as what types of neighbourhood characteristics will provide
them with improved health and life chances. Research is needed that investigates
how the physical urban environment impacts on the social and cultural mechanisms
that work together to enhance healthier behaviours and lifestyles in particular
47
socioeconomic contexts and communities. A new and more sophisticated method for
conceptualising and empirically testing the effects of place on health would provide a
timely and useful point of departure from the vast body of knowledge provided by
cross-sectional, multilevel research that reliably informs us that the lower the
socioeconomic position of an area and its residents, the poorer the health behaviours
and outcomes of those who live there are likely to be.
Additionally, research needs to be more specific about its intentions for improving
the lives of socioeconomically disadvantaged groups, and more earnest in its
attempts to find mechanisms that improve both happiness and health. If being
residentially unstable, ‘socially dysfunctional’, and engaging in high-risk health
behaviours improves the happiness of poorer people and communities, the goal of
changing behaviour becomes increasingly difficult as a sense of self and happiness
are couched within such consumption profiles. If they cease smoking cigarettes,
become more socially ‘functional’ in their behaviour, and achieve residential stability
while reporting less psychological satisfaction and well-being, is this goal then
achieved from a public health perspective? While structural researchers investigating
the health divide have used dysfunctional behaviour as evidence for the ill-effects of
poverty on people, there remain other aspects of life that are equally devastated by
deprivation, and perhaps focusing on how people can feel good about who they are
and where they live might be a more sympathetic and realistic starting point for the
long journey to permanent lifestyle and behavioural change.
Finally, much of the statistical research in this area of study makes assumptions
about the direction of the relationship between place characteristics and observable
health outcomes, and in doing this, assumes a passivity or lack of agency among
residents wherein place is the actor that affects how well they are likely to be able to
be. However, research is needed that questions these assumptions, and asks whether
people ultimately dictate the health of a place by basing their decisions regarding
where they want to live on what they want to do. The question of whether or not
people consciously choose places – or move to or away from them upon such
realisations – based on tastes, preferences, consumption patterns and lifestyle would
reveal much about what epidemiological research unearths as ‘place effects on
health’. That is, a more open-ended exploration of the direction of the relationship
48
between health and place would allow critical developments in the pursuit to identify
the area variables that most prominently affect the well-being of residents.
2.4 Physical, Social, and Socioeconomic Characteristics of Living
Contexts that Correlate Significantly with Health-Related
Behaviours.
The previous section of this review has outlined the many ways in which area effects
on health outcomes have been conceptualised and empirically tested.The variables of
socioeconomic status, reputation, stigma, social capital, social cohesion, belonging,
stability, and security or safety within a particular area were all found to have an
impact on health outcomes – either directly on physical health, or on self-reported
wellness and psychological or emotional states. However, due to a well-established
connection in the literature showing that health-related behaviours tend to be strong
generators of patterns in health outcomes, this thesis is specifically interested in how
the physical and social characteristics of urban contexts tend to be related not only to
the health outcomes of people living there, but patterns in their health-behaviours and
lifestyles. In particular, this thesis aims to question how ‘area’ generates a
relationship between lower socioeconomic groups and poorer health via trends
towards less healthy lifestyles in terms of broader patterns of activity and
consumption. The way in which behavioural profiles and lifestyles shift when the
variables attributable to place do, begs the research question of ‘why?’. What are the
mechanisms at play and how do they work together to influence health-related
behaviour as well as broader patterns of consumption, recreation, and lifestyle of the
people who live there?
While this project is ultimately interested in the health-related aspects of this
relationship, the primary aim of the work is to develop theory and a new set of
variables that can be grouped together or conceptualised to further explore and
empirically test the effects of urban places on people’s reported experiences of living
there and what they do (and consume) on a daily basis. Researchers in this section of
the review have focussed on area determinants of health-related behaviour, and while
some of these studies look at behaviours known to directly affect health, such as
physical exercise and drug use, others have investigated behaviours that are related to
49
the broader social health and well-being of a community, such as degree of
participation in community events, and levels of crime, graffiti, and violent
behaviour (Buchecker, 2003; Feigelman, 2000). Therefore, the next section
reviewing the literature will examine the work that has examined how the physical,
social, and economic characteristics of various places have been found to affect the
types of activities residents are likely to engage in. Again, there is a need to
emphasise that the literature addressing this question stems from a multitude of
disciplines and contains different research goals at their core.
From a preventative medical perspective, the urban environment has emerged in the
research as a salient determinant of the amount of physical activity residents
reportedly engage in via subjective and objective measures of walking, jogging, and
use of public space for exercise (Hess, 1999; Berrigan et al, 2002; Brownson et al,
2004; Duncan et al, 2005; Titze, 2005; Bedimo-Rung et al, 2005; Giles-Corti et al,
2005; Kloek, van Lenthe, van Nierop, Koelen & Mackenbach, 2005; Roemmich et al
2006; Hillsdon, Panter, Foster, and Jones, 2006; Abildso, Zizzi, Abildso, Steele &
Gordon, 2007; McCormack, Giles-Corti & Bulsara, 2007). Generally, this topic has
focused on the individual, social, and physical aspects of environment, and how they
work – both separately and together – to influence behaviour. While many of these
studies consider the individual-behavioural perspective along with contextual factors,
it is argued here that a large body of research into health behaviour and health
promotion has already examined the reasons why some individuals are more likely to
be motivated to pursue healthier behaviours than others, and that the effects of a
variable like ‘place’ on health require a more ecological perspective. That is, the yet
‘uncaptured’ capacity of a place to determine health via the social, economic, and
environmental mix of its residents and its features necessitates an examination of
context that allows these ingredients to be tested both separately and together for
their effects on lifestyle and well-being. In a recent review of the concepts and
evidence of the relationships between the social environments of neighbourhoods
and physical activity, McNeill, Kreuter, and Subramanian (2006) identified five key
factors mediating neighbourhoods and the health-related behaviour of physical
activity, including social support and social networks, socioeconomic position and
income inequality, racial discrimination, and social cohesion and social capital. They
concluded that ‘the specificity of terminology and methods in social environmental
50
research on health will enable a more systematic inquiry and accelerate the rate of
scientific discovery in this important area’ (p, 1011). Future research methodologies
that investigate the way in which these social concepts operationalise and interact
with the physical environment to influence behaviours that affect health will also
inform more practical responses from urban designers and community-based
interventions.
Studies that investigated the impact of the physical and aesthetic features of urban
neighbourhoods in their capacity to affect behaviours such as jogging and leisure-
running, have found that having an aesthetically pleasing neighbourhood (Titze,
2005), access to recreational facilities (Hoehner et al, 2005), park features (Bedimo-
Rung et al, 2005), destination proximity and mix ( Cerin, Leslie, du Toit, Owen, &
Frank 2006; McCormack, Giles-Corti & Bulsara, 2007) and access to green areas
(Jackson, 2003) are all likely to affect the amount of physical activity reported by
residents. Giles-Corti et al (2005) found access to attractive public open spaces to be
associated with higher levels of walking in a community, and more recently,
McCormack et al (2007) found that proximity and a mix of destinations was
associated with increased amounts of walking for transport, but not walking for
recreation or physical activity. Further, Hoehner et al (2005) found physical activity
for transportation and recreational purposes were significantly related to objective
measures of the environment characteristics including the number attractive features
and physically active people in the neighbourhood as well as perceived access to
recreational facilities (p. 105), while Cerin et al (2006) found that access to
destinations were positively associated with walking, and that these were contingent
upon socio-demographic factors and types of destinations, with workplace proximity
greatly contributing to working to work. And Owen et al (2004) found that the
aesthetic attributes, convenience of facilities, and accessibility of destinations all
appeared to contribute to walking for all purposes. Such findings generally follow
with recommendations regarding changes to the physical environment of an area in
accordance with the contributing variables. However, such measures are not always
objectively assessed or processed by residents. Thus, one of the core issues in this
research is the impact of perceived versus objective measures of the physical
neighbourhood as predictors of the utilisation of public space and pathways for
exercise (Hoehner et al, 2005).
51
Leslie et al (2005) compared objective and subjective measures of place and found
that perceived levels of density, access, diversity and street-connectivity were higher
in high-walkable neighbourhoods as assessed by Geographic Information System
(GIS) databases. Hillsdon et al (2006) also used GIS measures to assess a
relationship between the distance to and size and quality of green spaces and physical
activity in middle-age residents in different areas and found no significant
relationships between these variables. They found a converse relationship between
access to green areas and physical activity levels, which raises a number of questions
about how these factors are measured and conceptualised in such research. It also
sheds light on the weakness of the relationship between objective measures of
neighbourhood and health-related behaviours, where one cannot assume that access
will result in engagement. Interestingly, Kirtland et al (2003) infer from their
findings that behaviour of the individuals living in an area and the physical attributes
of that area, such as distance and access, affected how a place is perceived by
residents. They proposed a number of reasons for the lack of agreement between real
and perceived measures of an area and behaviour, including that ‘objective
neighbourhood data and perceptions of neighbourhood do not match because people
judge the environment according to their own desires and expectations’ (p. 329). This
raises the important point regarding the direction of these effects on each other and
on people’s health-related behaviour. As noted at the end of the previous section of
this review, cross-sectional studies that find correlations between real and perceived
characteristics of a place and human behaviour and health are not able to imply
causality. They can, however, deduce whether or not specific variables relating to
place appear to contribute to the behaviours of residents by matching the presence of
certain factors with the presence of certain behaviours. However, whether or not
behaviour determines perception or whether perception determines behaviour, and
how this relates to what is actually there in a causal sense, is relatively unknown.
Roemmich et al (2006) found, using accelerometers and measures of the
neighbourhood in New York, that a greater distance between homes and increased
amounts of green areas correlate with a greater propensity to be active. However,
there are many other potential economic and social factors at play in explaining these
findings; in particular that it is likely that increased spacing between houses is
52
more common in more well-off areas, and children who are richer are more likely to
be more active, and less likely to be overweight. Further, Hillsdon (2007) found that
in the UK the availability of physical activity facilities declines with level of
deprivation. Interestingly, however, an Australian study found no differences in the
amount of open green-spaces available for active play between higher and lower
socioeconomic areas (Giles-Corti et al, 2006), even though in Australia, physical
activity levels are reportedly higher amongst wealthier people, while obesity rates are
higher amongst poorer people (Department of Health and Ageing, 2004). When
viewed in combination these studies all pose interesting questions about the complex
and little-understood relationships between place, wealth, and health.
The physical attributes of an urban environment have provided a ‘common-sense’
base to the research on place effects on the physical activity of residents; however,
research has also shown that the social characteristics of a place also play a role in
the overt levels of this behaviour. The issue of perceived safety has emerged as a
strong correlate of whether or not residents will use public space to exercise
(Kirtland et al, 2003). Further, a study by Chandola (2001) found that perceived
levels of neighbourhood safety contributed over and above socioeconomic and
behavioural factors to self-reported health in the UK. They concluded that this social
characteristic may be a key mechanism for understanding area-differences in health-
related behaviours. In addition, Giles-Corti et al (2002) found in their study on the
environmental and individual determinants of physical activity that individual and
social factors appear to be more important in determining activity levels than
physical ones, and that while ‘access to a supportive physical environment is
necessary, it may be insufficient to increase recommended levels of physical activity
in the community’ (p. 1793). Social variables that were tested in this study include
club membership and likelihood of partner and other significant relations engaging in
physical activity. Such findings point to the potential salience of social influence on
health behaviours, and need to be considered in future research into the impact of
contexts on behaviour. Fuzhong et al (2005) found that the social environment was
important in affecting health behaviours via networking and the development of
relations where levels of physical activity are observed in others. Interestingly, many
53
of the studies that investigated the relationship between urban contexts and physical
activity did not consider socioeconomic position – either of individuals or the area -
among their variables, which is surprising given that it has been established as a
factor that correlates significantly with a variety of behaviours that affect health
outcomes. Although it might seem that the low cost of walking and exercising in
public spaces would deem it insignificant, the empirically significant relationship
between factors such as low-income and decreased rates of physical activity among
Australian adults (ABS, 2003) point to a relationship worth investigating more
deeply in order to understand how this effect is produced.
A more recent qualitative study that looked at the role of perception in lower
socioeconomic living contexts in shaping a range of health-related behaviours
(Kamphuis 2006) found that participants reported the behaviours of spouses and
friends to be paramount in influencing their own health-related behaviours. This
research points to the importance of investigating the social components and
processes inherent within measurable aspects of the physical and economic
environments and neighbourhood as being likely to ‘cause’ particular health-related
patterns or profiles. Specifically, these focus groups held in the Netherlands found
poor neighbourhood aesthetics, safety concerns, and poor access to facilities as being
important for physical activity, while price concerns were raised by lower
socioeconomic participants in relation to their consumption of fruit and vegetables.
In relation to other health-related behaviours, such as cigarette smoking, an earlier
study by Picket et al (2002) found that the class-context of an area contributed more
significantly to the likelihood of women to smoke during their first trimester than the
socioeconomic position of the woman herself. More recently, Selstrom (2007) found
that the chances of women smoking during pregnancy were doubled in poorer
neighbourhoods, and conclude that increased maternal education and intervention is
needed in these areas. While their findings are interesting, it is likely to be more
useful to conduct qualitative investigations into the relationship between poor
mothers and their smoking habits prior to assuming that they need to be educated
about the health-risks. Such research would assist in progressing our understanding
about the phenomenon of poor health behaviours being so deeply embedded in poor
social contexts. These findings sit comfortably with findings on the social effects of
54
an area on health-behaviours, and once again raise the need to investigate how
context exerts influence via the behaviours of others living in close proximity.
Additionally, how the lived experiences of people dwelling in areas with different
measures of status attached to them are affected or guided by norms for health-
related behaviour needs to be further examined.
A qualitative study by Poland (2000) found that social interaction determined much
of the norms and moral attachments to smoking behaviour among residents. He
found ‘interpretation’ of what it means to be considerate as a function of social class
distinction played an important role on how decisions regarding smoking in public
were made. He employed Bourdieu’s analysis of class struggle for social distinction
as an instrument for interpreting the findings. Increasing attention has been given to
the theoretical relevance of Bourdieu by Gattrell et al (2002) & Carpiano (2006) due
to Bourdieu’s attention to examining how statistical relationships are produced in
every day practice and propagated in social class systems through both agency and
social (rein)forces. However, not many studies that investigate urban places and
health-behaviour have utilised philosophical concepts and theories to understand how
highly specific aspects of place and health come to correlate. Frolich et al (2002)
noted the absence of theoretical application to the interpretation of multi-level
findings, as well as the presence of assumptions regarding the direction of the
relationship between ‘higher’ (contextual) and ‘lower’ (compositional) contributions
to health. They claim that the current thinking that conceptualises the impact of
higher on lower variables needs to be re-examined for possible recursive effects, and
that a focus on theory and meaning of how these factors are experienced might allow
further insight into the direction of the relationship between people, place, and
behaviour. They state that ‘higher level effects may be produced by people’s
characteristics at lower levels, which in turn may be reinforced by these same higher-
level effects’ (p. 12). This thesis will be focussed on investigating and
conceptualising the mechanisms via which this recursive pattern operates to better
understand how place affects people and people affect place with consequences for
the health of both, with a theoretical diagnosis of ‘context’ outlined in Chapter Three.
A study into the impact of built urban environments on the likelihood of accidental
drug overdose found that deterioration of the built environment, and in particular the
55
external features of buildings in an area correlated significantly with this cause of
mortality (Hembree et al, 2005). While the authors referred to this independent
variable as a ‘determinant’ of this particular observed behaviour, the way in which
deteriorating building condition influences people not to intervene or support people
in overdose situations is not explored. Hembree et al proposed that disinvestment in
social resources, psychosocial stressors and differences in responses to witnessed
over-doses may explain the observed effects (p. 147). However these are not proven
to be the causes in this particular study. Such studies highlight the need for greater
research into how the physical environment is perceived and experienced by
residents in ways that ultimately affect behaviour, and the need for interdisciplinary
efforts between researchers from different health perspectives about the role of
neighbourhoods in predicting and affecting these outcomes.
Studies into other health-related behaviour in urban populations, including levels of
violence, have found that where this social problem is prominent there is an
increased chance of young people’s involvement in it as victims, witnesses and
perpetrators (Feigelman, 2000). They found that by becoming involved, even
peripherally, in problematic behaviours, young people increased their chances of
participation in violence. These findings are of interest in that they highlight the
important role of social factors, and how they operate in ways that increase risk. The
social context of behaviour in urban areas requires increased attention in the future
research that seeks to understand how urban contexts influence those who live there
at behavioural level.
Work that identifies particular physical, social and economic place-traits that
correlate significantly with human behaviours that are of interest or concern from a
health perspective plays a role in advising planners and health practitioners about
what matters in a place in terms of well-being. However, more research is needed
that addresses the processes that mediate these empirical relationships. If more was
understood about the psychological and social impact of planning and design and the
socioeconomic position of residents on the health-related behaviours exhibited within
urban communities, a more detailed and convincing - and certainly a more social, as
opposed to individual-based - argument could be made when informing policy-
makers of the salience of economics, housing, and urban design in determining
56
population health outcomes. Further, more would be known about the ways in which
urban planning and design can act in a preventative sense against illness and disease
caused by the high-risk behaviours exhibited at higher rates within more
socioeconomically disadvantaged areas.
2.5 A Review of the Urban Planning and Design Literature that has
Investigated Residents’ Psychological, Social, and Behavioural
Responses to their Living Contexts.
Since post-WWII in Australia, housing and urban development has rapidly changed
in its approach to design, function, and degree of community participation, especially
in terms of the declining tendency to rely on collective efforts to create and build
public places and spaces for every day living and working (Gleeson, 2004). Thus,
this weighing up of compact efficiency with social sustainability has become a key
focal point for both planners and researchers concerned with the impact of design on
the well-being and functioning of neighbourhoods and communities, both in
Australia and around the world (Luymes, 1997; Vogt et al, 2004; Fang, 2006; Kato,
2006; Goebel, 2007; Braubach, 2007). This section of the review will examine
research that has looked at aspects of urban planning and design that have emerged
as influential in their capacity to affect residents’ psychological and social responses
to a place that either enhance or detract from their attachment to the place and their
overall satisfaction with living there and how this relates to overall well-being.
Further, it will discuss the increasing pressure on urban planners to be able to
incorporate, or at least consider, social and affective aspects of design when
implementing and building master planned communities, which have become a
rapidly increasing lifestyle trend in Western contexts.
In a comprehensive review of the literature that examined the relationship of urban
design to human health, Jackson (2003) concluded that ‘while causal chains are
generally complex and not always completely understood, sufficient evidence exists
to reveal urban design as a powerful tool for improving human condition’ (p. 191).
She looked at the impact of design on three spatial scales: physical health, mental
health, and social and cultural vibrancy, and drew the key conclusions that greenery
and ‘access to it physically and visually’ is vital for health as it enhances civic life
57
and levels of physical activity in compact areas. Further, she concluded that cultural
and business relationships need to be cultivated within urban infrastructure by using
social and technical networks that reduce dependence on automobiles. She
emphasised a need for increased communication between the disciplines of design
and health in order to achieve a more collaborative and informed effort to generating
healthy and socially sustainable urban communities, saying ‘further research is
needed to strengthen the associations between design and health’ (p. 190).
In an article by Scopelliti and Giuliani (2004), the importance of the dynamic social
characteristics of urban places, and how people respond to them, were shown to be
an important predictor of how people rate the quality of the time they spend there.
This study highlighted the need to focus on place as ‘experience’, as well as
‘environment’, and concluded from participant interviews that affective and social
dimensions of a place are salient contributors to well-being. These researchers found
that the way in which the physical and social characteristics of a place interact are
more important than the separate factors said to typify the place, in terms of
contributing to the restorative effects on people who go there. Importantly, they
emphasised the affective dimensions of a positive experience, with particular
reference to both relaxation and excitement (p. 431). Such findings provide both
planners and health researchers with insights into the importance of the task of urban
design as the creating of a product or outcome that needs to ‘come alive’ on
completion and fulfil particular social and affective human requirements or demands.
Further, it highlights the dynamic relationship people have to place, and the
consequent need to study place variables as ones that are ultimately not static, but
that are given life and meaning and movement by the people who go there and the
ways in which they respond to it and each other. What remains challenging, however,
is for urban designers to find out what physical traits trigger positive interactions,
and for health researchers to locate both the physical traits and types of interactions
that improve well-being.
While public health research into the effects of place on health are less concerned
with general quality of life, broader urban literature has spent much time on how this
can be accomplished through design, with debates over the use of subjective and
objective measures at the core of these research efforts. Marans (2003) produced a
58
paper that discussed the ways in which quality of life was used to evaluate
environmental quality in the Detroit Area Study (DAS, 2001), with particular
reference to the use of both objective and subjective measures of place. He noted that
quality of life could not be examined using a single measure, and that a number of
different perspectives were needed to truly reflect this variable. Also, Marans
concluded that quality is experienced and reported as a highly subjective notion and
does not reflect the material or economic reality of a place. He states that ‘rather, it is
the meaning of those conditions to the occupants’ (p. 75). This is an important
consideration for researchers investigating how the physical traits of urban contexts
determine health outcomes and behaviour in that, often, the subjective interpretation
of the material structures are not considered in this research as one of the key
mechanisms driving the observed behavioural patterns.
The way in which residential satisfaction is measured as a means of assessing the
functioning and well-being amongst urban populations is debated in the literature,
however, there is a general agreement that asking people about their satisfaction with
their housing or neighbourhood is a valid way to gain feedback for future
developments (Lueng Ng, 2005; Kowaltowski et al, 2006; Kearney, 2006; Adriaanse,
2007; Braubach, 2007). The latest research from the WHO large analysis and review
of European housing and health status (LARES) study showed that the key indicators
for residential satisfaction were lack of noise, recreational areas, low perception of
fear, and well-maintained neighbourhoods (Braubach, 2007). Interestingly, the key
correlations were between sleep disturbance and noise exposure, lack of recreational
areas and the perception of fear, while depression was related to both noise exposure
and safety perceptions. Based on the findings from the Housing Demand Survey
(HDS) in the Netherlands, a new residential satisfaction measure has been devised by
Adriaanse (2007), who found that the most significant factor indicating residential
satisfaction was ‘residential social climate’. The inter-relationships between
indicators such as these and perceived fear and availability of green space require
further research.Other research into the relationship between quality of life and
residential satisfaction in Hong Kong found type, size, age of home and period of
occupancy to be significantly related to satisfaction, as well as university attendance
(Leung Ng, 2005), with university students being more satisfied than other residents
with their dwellings in a high-density urban environment. These findings point to the
59
need for a good match between demographics, lifestyle and design. In a low-income
public housing project in the region of Campinas, Brazil researchers found that
economic factors such as housing affordability and utility bills are related to
neighbourhood satisfaction, but that community spirit in this area was high and sense
of identity strong and positive, and that these social factors were ‘self-built’ by
residents who live in a low-infrastructure area (Kowaltowski et al, 2006). They also
found that these poorer residents prefer houses to units, and this may be linked to the
fact that poorer people tend to have higher numbers of people – including children
and older family members – in their care. And a review of a ‘cluster housing’
development in the US found that nearness to green spaces was not as important for
residential satisfaction as opportunity to visit nearby shared spaces and views of
nature from home (Kearney, 2006). These findings emphasise the need for a ‘good
fit’ between people’s individual needs and a community-level approach or response
from urban designers or neighbourhoods.
Research in Edirne, Turkey (2007) found that there are three vital components to
assessing quality of life and happiness amongst residents with where they live, and
these are the individual characteristics and demographics, a description or measure of
the characteristics of a place, and reported residential satisfaction. They argue this
provides a useful framework for rectifying places with design problems and creating
more positive and successful neighbourhoods in the future. The need for these robust
measures can be seen in an earlier study in this region that explored perceived quality
of place by residents in the third-world urban setting of Istanbul (Turkoglu, 1997)
which found that a significant difference between how people living in the same
urban residential area rated a number of independent variables about the place,
depending on the quality of their own dwelling type. For the variables of physical
condition of dwelling, access to shops and services, recreational and educational
services, social problems, and climatic control, squatters rated all of these aspects of
the place less highly than residents of legal dwellings. Such research highlights the
importance of personal circumstance for how a place is perceived and experienced,
and poses interesting questions for further research into the need to address the
physical living conditions of disadvantaged people in order to improve their lived
experiences in socioeconomically heterogeneous urban settings. Further, the variable
of ‘perceived quality of own dwelling’ may be a useful measurement device for
60
health researchers interested in understanding the relationship between poverty,
place, and well-being, and further, those wanting to study poverty as a meaningful,
lived experience that has a highly aesthetic and socially comparative component.
Building on the other studies described in this section, it appears that subjective
experience, meaning, and social and cultural networks are key factors that affect the
quality of life reported by residents.
One key psychosocial goal of urban planners that emerged from the literature is to be
able to instil in residents a positive sense of place identity (Wester-Herber, 2004; Teo
& Hung, 1996; Popke & Ballard, 2003; Popay, 2003; Lemanski, 2006, Goebel,
2007). While social networks and functioning are highly valued as behavioural and
communicative outputs, the psychological attachment people forge with the place in
which they live is considered by designers to be both vital, and on occasions,
ellusive. In a review of an award-winning, high-rise, high-density township in
Singapore, Seik (2001) evaluated a planning strategy that considered land-use as well
as elements of design that focussed on creative ways of constructing resources, such
as car-parks and high-rise living areas, and found these considerations to have a
positive effect on efficiency of use of resources and efficient movement of people. It
also claims to have found that the creative design resulted in an ‘aesthetically
pleasing visual identity’ (p. 33). However, it is noted here that this finding was not
actually based on specific measures or scales of identity, and the only element of this
study that reviewed resident opinion of the place was a five-item survey that
examined satisfaction with design, recognition of neighbours, and general feelings of
safety – which were then interpreted as measures of identity. However, there are
other examples in the literature that have examined identity more specifically as one
of the key mechanisms via which places are experienced, interpreted and
experienced.
In a comprehensive coverage of a critique of the loss of identity in the planning and
development of new urban landscapes, Oktay (2002) comments that ‘…buildings are
designed with little concern for their relationship to each other…spaces left between
them have become undefined, undesirable, useless, and unliveable’ (p. 261). She
emphasises identity as one of the ‘social components of design’ and an element of
planning that surpasses the quantitative aspects of buildings and neighbourhoods to
61
allow the place to have meaning; the context to evoke belonging. She reinforces the
importance of participation and collective experience as vital elements of successful
design, and advocates the need for a deeper consideration of the kinds of affective,
social, and communicative networks a place is likely to be able to accommodate.
Oktay cites districts, public spaces, and streets as key physical components of the
psychological identities people will construct between themselves and place while
living and working there. Her conclusion is that these aspects are therefore worth the
higher financial investments required to maximise their ability to positively reflect
this processing and constructing of the self in place. In this conclusion, she states that
public urban places determine quality of life, as well as reflecting the culture, the
times, and the well-being of residents – and recommends that ‘we should start to
measure the city by analysing them’ (p. 270).
Such a perspective highlights the need for a departure from the epidemiological
nature of the methodologies typically investigating urban places and health, which
exalt the notion of ‘measurement’ as a means for determining traits of a context that
affect well-being. What is needed, according to this alternate perspective, is a
theoretical lens that would allow the relationship between people and place to be
analysed for meaning, symbolism and reflection of self. Such conceptualisations of
people in place and their responses to urban environments as mirrors that shape the
self via interactions with both the place itself and the people who live there, would
provide a particularly salient paradigm for future studies into how the lower
socioeconomic position of a place determines poorer health, as it is in such contexts
that this image is likely to be less flattering. Further, these sorts of frameworks for
thinking about what influences people’s responses to a place provide a visual or
aesthetic component that is often omitted from more numerically derived
categorisations of status, which are, in the health literature, increasingly valued with
their ability to be measured.
In an evaluation and critique of The Housing Development Board’s (HDB) efforts to
bring a greater sense of variety to the monotony of the skylines and blocks of public
housing in Singapore, Teo and Huang (1996) investigated the effects of using
artwork and motifs on each estate as a means of generating a sense of identity for
residents and creating a sense of belonging to the place. Additionally, physical
62
infrastructure, such as courtyards, walkways, and pavilions were created as a means
via which people could increase their interactions and get to know each other better.
Teo and Hung found that while the goal of creating a sense of individual identity
between residents had been successfully created, a sense of belonging had not. In a
methodology that questioned residents directly about the effects of the paintwork on
their sense of identity and belonging to the place, they did not find that a strong sense
of community had been created via these developments in the physical appearance
and design. While this study points to the fact that specific changes to physical
infrastructure are insufficient as a means of generating psychological and social
catalysts that increase people’s sense of attachment to a place, it is noted here that the
approach may have been too simplistic at the outset in terms of wanting to alter
community consciousness by changing the colour of the buildings. Further, aiming
for both increasing the individual identities of the buildings while at the same time
hoping for increased connectivity between them may have been at odds from the
outset. The results that show that identity was achieved while belonging was not
seem less surprising when the initial goals and strategies are placed together in this
comparative sense. Further, it highlights the complexity of achieving a sense of
place-attachment as something that cannot necessarily be generated by altering the
physical or architectural aspects of design alone.
In a bleak and despairing account of modern day South Africa, the urban city of
Durban provided the case study for Popke and Ballard (2004) to explore the impact
of negative place-identity on residents. They employed a methodology that examined
ways in which the media handles this rapidly changing and apparently deteriorating
city. This qualitative study found three central themes that capture the contemporary
identity of the city namely, ‘chaos, congestion and pollution’ (p. 99). They
interviewed local residents and analysed the ways in which the place is described,
revealing what they refer to as ‘more deeply seated cultural anxieties, which have
been brought to the fore in the context of South Africa’s transition’ (p. 99). While this
particular case is fraught with political and historical complexities that make the
place-effects arguably unique, the observations concerning the changing nature of the
society on how residents use and interpret space are relevant to researchers interested
in the impact of more macro societal changes in urban places on the social
functioning of people. Durban is marked by the major cultural shift from being a
63
‘whites’ only territory during apartheid years, to becoming ‘the home of a multi-
racial population, and has been transformed by new forms of economic interaction,
social affiliation and cultural meaning’ (p. 102). These changes have reportedly had
profound effects on the affective and social bond people have with the place, and
further, on the psychological processing or ‘organising’ of the activities and
behaviours of fellow residents. In graphic accounts of what participants viewed as
non-acceptable conduct, activities are described as follows:
‘…extremely obese women suckling their offspring, multi men displaying their
wares of various sorts emitting a putrefying stench everywhere…’
And ‘ You’ve got a whole nation living in Umgeni Road that are washing, cleaning,
cooking, going to the toilet… the infestation, the germs, the stench –they are living
there.’ (p. 106).
A more recent empirical account of the challenges in South Africa on the housing
front by Goebel (2007) shows that there are ongoing barriers present to the provision
of sustainable low-cost housing , such as macro-economic conditions, lingering
legacies of racial and class divisions coupled with rapid urban growth. These have
implications for an ongoing cycle of depression, violence, poverty and ill-health in
this area. While a new policy that has been named Breaking New Ground, which is
encouraging inter-departmental co-operation within the government and with key
private and public stakeholders has shown some success – allowing people to live
near transport routes and economic opportunities with clean, safe water – the
situation overall shows little sign of abating. These economic, social and design
challenges pose great difficulty to the people living there in terms of their well-being
and everyday lived experiences, and often lead to frustration, conflict, and open
political struggle as they view and experience ongoing forced evictions and
instability. Further to this, Lemanski (2005) conducted evaluative research on
Westlake, a development in a wealthy area in Cape Town, where new residents had
been afforded government housing there in lieu of their previous dwellings which
were demolished to make way for mixed-use land developments. She found that
integration between new and established residents was difficult and slow to evolve,
but attributed this more to socio-historical issues linked to place, history and identity,
64
rather than race relations per se. She concludes that ‘…for while residents of low-
cost housing development are drawn from all over the city and thus have no socio-
historic affiliation to their new space, black residents moving into middle-class
suburbs do not have an equal sense of ‘belonging’ to the cultural space as their
‘white’ neighbours and thus are constantly striving to fit into white spaces rather than
experience an equal ‘right’ to shared cultural space’ (p 432). Such findings highlight
the importance of capturing the ways in which residents experience place at the
micro-level, and view and interpret the behaviours of other residents as vital
components in how they process their sense of peace and belonging where they live.
These methodological approaches and descriptive reports are likely to be helpful in
the field of research that looks specifically at place effects on health-related
behaviours, as little has been done to capture the ways in which the activities of other
residents characterise general perceptions of a place, and further influence the overall
lived experience, identities, and behaviours of those who dwell there.
In further work that illustrates the importance of both restoring and creating
community identity, Al-Hathloul et al (1999) addressed the two major challenges
facing urban planners: 1) What is community identity? 2) How can it be created in a
new community? They conducted an in-depth analysis on the case-study of a small
town, Al-badai, in the Riyadh region to examine the components of the place that
helped retain, or were at least conducive to, community identity. They concluded
with a definition of community identity as ‘a reflection of national, ethnic and
cultural identities’ (p. 217), and located the variables of road networks, presence of a
city centre, landscape architecture, systems of walkways, pathways, and plazas as
well as the character of public buildings as those most effective in building identity.
However, they do warn that, with reference to the last point in particular, that it is not
simply a case of copying architecture to retain a sense of cultural or place identity,
but that ‘we need to pay more attention to the real tradition of places, the deep
structure’ of the social fabric in order to effectively (re)create a true reflection of the
values and ideals of the residents who will, or do already, live there (p. 201). Antrop
(2005) studied this specific issue in the context of what he referred to as ‘changing
cultural landscapes’ and concluded that the complex way in which people perceive
their environment and the symbolic meanings it holds for them are central in
planning sustainable urban futures. He puts forward the idea that people require
65
‘legible’ components in a place that can be read as points of identity and meaning,
and that the management of landscapes must work with this view in mind.
The reasons why such effort into creating and sustaining place-identity should be
made at all has been researched and described by Chadirji (1984) who summarised
the following social phenomena as being those that underpin people’s need for a
sense of place that reflects a positive sense of self:
• Politics and ideology
• Need for a sense of belonging
• Resistance to change and preference for continuity
• A need for cultural variety, as opposed to the increasingly homogenous
designs being produced
• Pride in national, racial, ethnic, or other social identities.
These complex social, psychological and affective variables combine to generate a
steep challenge for urban planners who often work within economical and spatial
constraints and without the substantial research investments that are required to allow
the historical and cultural intricacies of the place to be unearthed, described, and
consequently restored. Such research also raises the question of whose responsibility
it ultimately is to generate and sustain such elusive qualities, and within whose range
of capabilities they lie. Further, and in strong agreement with many other researchers
investigating the social aspects of urban planning, Al-Hathloul et al (1999) advocated
in their conclusion for more research into how residents can be allowed to play an
increasingly participative role in the urban planning process as a fundamental
component in creating a strong sense of identity with the community.
Literature in both the public health and environmental science disciplines has noted
an important relationship in urban contexts between people’s sense of connection
with, and identity in a place, when high-risk land-use ventures are either possible or
present (Bush et al, 2002; Hanna, 2005; Downey & Willigen, 2005). Wester-Herber
(2004) argued that while many high-risk industrial changes or developments are
researched for their effect on the real or perceived health of the residential
population, increased emphasis is needed on the role these ventures play in
destroying people’s connection or positive feelings about the place. She notes that
66
‘identity can be affected in a negative way if changes are made to a landscape by the
introduction of a high-risk and stigmatised industrial venture’ (p. 109). While Wester-
Herber focused on changes in landscape as a means of jeopardising place-identity,
Bush et al (2001) drew on Goffman’s writing on stigma to examine how public
perceptions to air-pollution in a highly industrialised town affected people’s views of
the place. These researchers did not seek to investigate place-identity from the outset,
but found it to emerge as a ‘complex, multiple and re-enforcing concept’ via their
grounded theory methodology. Downey and Willigen (2005) also found that
industrial activity has negative effects on people living in poorer neighbourhoods,
and that poorer neighbourhoods are more likely to be exposed to pollution. They
concluded that it exacerbates ‘feelings of neighbourhood disorder and personal
powerlessness’ in lower socioeconomic communities (p. 289). However, these
researchers were examining the effects of environmental hazards on a poor
neighbourhood, whereas Hanna (2005) found that pollution does not decrease
housing prices or have negative effects if the area is not poor. These findings
highlight the salient effects of poverty in neighbourhoods, and indicate a need for
future research that considers the subjective, psychological response of people to
their place of residence and their overall health and well-being. Further, researchers
in urban planning and environmental health have made the point that while public
health as a discipline has moved away from the environment and onto individual
behaviour as a source or focus of avoidable illness, there remains a need for
collaborative efforts between those interested in health outcomes and those interested
in quality of life and environment (Augustinus et al, 2003). And more recently,
Picket et al (2004) have called for the employment of the metaphor of ‘resilient
cities’ as a focal point via which urban planning and the social sciences can share the
goal of maintaining quality of life and health of residents by striving to create cities
that become systems that are able to ‘adjust in the face of changing conditions’ (p.
381.)
Recent changes to urban environments as a result of a focus on the need to create
economical living spaces has led to research that evaluates people’s usage of public
spaces – to improve both life and health – in both the health and urban planning
disciplines to optimise new ways in which spaces can be created and features
developed to achieve these goals. A recent qualitative study in Melbourne, Australia,
67
explored the ways in which both physical and social urban characteristics contributed
to the children’s use of different urban spaces for active free-play (Veitch, 2005).
Veitch found that urban design factors such as the quality of parks and playgrounds,
and social factors, such as children’s attitudes to active free-play were important
themes in how decisions were made about how to use these public spaces. It is noted
here that the children were not asked about their attitude to the place, or the appeal of
the urban design features in place, but rather, questions focussed primarily on the
health-related behaviour itself. This appears to be a common trend in the health/place
literature, and one of the emergent benefits of an interdisciplinary approach to this
area of study would be the methodological emphasis on people’s response to place
employed by urban planners as a means of assessing this process as reliable and
salient psychological mechanism linking place and the types of behaviours that are
observed there. An earlier article by health researchers discussed children’s activity
in, and use of, public space, and advocated for an emphasis to be placed on
environmental change as a means of increasing usability and safety of public places,
rather than targeting the behaviour of children to fit into a static environment.
However, no mention was made of how children evaluate, interpret, and respond to
what is available, or of asking children what they would like to be made available in
the future, as a means of making the most user-friendly changes possible. In a review
of the ‘Streets that Work’ program in Seattle, Antupit et al (1996) found that both a
proactive and ‘retrofit’ approach is required when designing with the aim of
increasing activity within public spaces, with planners needing to anticipate, and
respond to, use of pathways by residents for walking as opposed to relying on a
vehicle. These studies highlight the subtle, yet important differences between urban
planning and health literature wherein the former views residents as having higher
levels of agency, and seeks to increase participation in the processes of both research
and practice, whereas the health literature has leant towards a more deterministic
view of the effects a place has on what is viewed as a somewhat passive population.
In more recent work on the ways in which children engage with their urban
neighbourhoods and living environments in ways that affect their health, researchers
have focussed on the psychological relationships parents and their children have with
place in relation to safety, play, and how much physical activity they are able to get
done (Min & Lee, 2006; Roemich, Epstein, Raja, Yin, Robinson, & Winiewicz,
68
2006; Weir, Etelson & Brand, 2006; Carver, Timperio & Crawford, 2007). A
qualitative, observational study of 91 children living in a high-rise, high density
planned neighbourhood of 5277 families in South Korea showed that children are
more attached to, and show greater affinity for places that support the behaviours
they are interested in engaging in, and places that allow them to interact with other
children (Min & Lee, 2006). The provision of open play areas in high-density living
is important for children to develop a sense of their own safe territories and
belonging in a neighbourhood, and allows them to form social attachments and
engage in ongoing games, rather than experiences short-lived and transient
interactions that do not allow a meaningful attachment to people or place to develop.
Carver, Timperio & Crawford (2007) also researched safety – both real and
perceived – amongst children and their parents living in Australia in relation to the
amount of time they spend outdoors playing. They found safety and the concept of
‘stranger-danger’ to be a major factor impacting on the amount of play children did
in their local environments. This research is supported by Weir et al (2006) who
found that inner city parents in New York have high levels of anxiety about letting
their children play outdoors and about neighbourhood safety, which may be simply
congruent with the nature of the living context. The challenge of making
neighbourhoods safe, and having residents feel safe within them is vital from an
urban design and public health perspective if people are to enjoy a higher quality of
life in residential areas and to engage with these areas in ways that increase health
and combat rising epidemics of overweight and obesity.
Much research has recognised the role of danger and fear levels – both real and
perceived in mediating the relationship between a residential population and the
depth of its engagement with the neighbourhood (Roh & Oliver, 2005; Rosenfeld,
Richman, Bowen & Wynns, 2006; Ferguson & Mindel, 2007; Waiker & Hiller,
2007). Rosenfeld et al (2006) found that exposure to, or witnessing of violence in the
local neighbourhood affected school attendance and satisfaction, but not grades, of
high-school children in the U.S, however, it was not clear from the study whether the
area was relatively poor, and whether other factors relating to poverty were present.
Ferguson and Mindell (2007) found social capital to be a key factor in alleviating
feelings of fear in a New York neighbourhood, with characteristics such as a high
police presence, social support networks, and neighbourhood satisfaction correlating
69
significantly with decreased sense of fear. Interestingly, Roh and Oliver (2005) found
the mediating variable of police presence to be a key connection between high-
danger neighbourhoods and feelings of vulnerability, with a police-presence reducing
fear where perceived personal vulnerability was high. Further, Waiker and Hiller
(2007) found that trusting, reciprocal relationships between older women and their
neighbours aided their ability to live effectively in the community and positively
impacted on their health.
One of the leading researchers in the urban planning literature has noted in his paper
on the challenge of planning neighbourhoods in a changing world, that the ideal of
incorporating public responses to a place, as well as intricate social and cultural
needs, into urban design is becoming increasingly difficult (Saleh, 2004). He states
that these goals are now ‘restricted between retaining traditions of architecture,
urban design and planning with the necessary social, economic, and technological
changes in urban formation, mainly the vernacular and the modern’ (p. 625). He goes
on to critique some of what he sees as limitations within the ‘new urban’
philosophies. While he acknowledges the importance of the goal of community,
which is at the heart of new urbanism in Western contexts, he advocates for a New
Vernacularism, which has been specifically designed as an ideological framework for
generating communities that are compatible with Islamic principles. For example, in
this context, spaces would be made for women that are both private and separate in
some parts from the rest of the community. While such design considerations may
not be viewed as important in new urban Western places, the integration of religion,
ideology, and politics of a living area into urban infrastructure remains a desirable
goal for those seeking to maintain high levels of place-identity and quality of life for
residents.
As one of the researchers particularly concerned with the psychosocial and affective
aspects of design and construction in urban living spaces, Gleeson (2004) has called
explicitly for a deeper consideration for how the ‘hard-wiring’ of urban infrastructure
impacts on social development in communities where those communities have no
prior stake in the process of building the settlements. This challenge has been
recognised as one that firstly, demands a re-thinking or ‘deprogramming’ of the way
in which infrastructure and lifestyles are currently generated and pre-packaged as
70
ready-made community commodities for sale; and secondly, it places an inquiry
around the types of mechanisms that might be required or employed in a catalytic
sense to elicit involvement by community members in terms of how their physical
worlds are shaped and experienced.
There has been a noted decline in participation in urban residential developments -
especially in the case of the increasing trend towards developing community
enclaves for narrowly defined target groups with highly specified needs, such as
those seeking retirement, security, affordability, and even ‘childless’ environments.
Gleeson (2004) argues that this has resulted in an industrial and service-based
response to the demand for prêt-a-port lifestyles in Western contexts with stipulations
in place about who might, and might not, qualify for inclusion in these communities
and realms of space. Thus, while there is now a means of purchasing ready-built
lifestyle packages on demand – a process that reduces people participation to a point
– there is simultaneously in this process a means of purchasing exclusivity (or
isolation); a process that reduces diversity. As Gleeson notes, diversity is a factor that
is often consciously omitted from these design equations, as sub-populations are
catered for, and development is generated around demands for highly specific (and
occasionally acute) living needs. In the broader international context, this has meant
that people move to planned areas that suit their needs, such as the Portuguese
communities that have flocked to Mississuaga, in Toronto, Canada to live in single
family households in what they perceive to be ‘good neighbourhoods’, and in doing
so, new Portuguese homelands have been created in the suburbs detracting from the
design goal to create diversity and contact between a range of ethnic groups
(Teixeira, 2007). In China, Fang (2005) found that while in the West there is an
assumption that high residential dissatisfaction leads to high residential mobility, and
that taste and preference dictate where communities form and how they respond to
pre-packaged developments, in China survey research on four redeveloped
neighbourhoods showed great dissatisfaction with living in these replanned
communities, with residents feeling that they had little chance of moving elsewhere.
This sheds light on the importance of considering the broader economic and cultural
influences on the shape, nature, and level of satisfaction in planned communities.
Meanwhile in Australia, although neighbourhood communities might be classified as
culturally and socioeconomically heterogeneous, there is an increasing focus by
71
urban policy makers to consider the challenge of maintaining a balance between
rapidly diminishing urban spaces and the demand for economic efficiency with what
Gleeson terms the incessant ‘yearning’ (p. 315 ) to maintain healthy, diverse social
relationships and communities.
In a critical review of the marketing rhetoric surrounding the increasing trend
towards master-planned ‘enclave communities’, Luymes (1997) has noted that
research investigating the social role of such ventures have, on occasion, found them
to be symbols of ‘paranoia, self-interest, and elitism’ (p. 192). Further, after
examining the advertisements for such communities in a number of Canadian media
sources, he found that their promises of ‘privacy, security, image, prestige, and a
sense of community’ (p. 194) were only found in the research to deliver on the points
of privacy and image, and were in fact, located as components contributing to the
breakdown of civic public life. He concludes by raising the question of whether these
gated suburbias should be regarded as a ‘healthy’ or benign cancer spreading through
an unhealthy body, or whether they present a decaying effect to otherwise vibrant,
diverse, and unpredictable cities. Vasquez (2006) wrote a critical review of the
rhetoric or built narrative surrounding New Urban planned communities that it was
not so much the design principles of New Urbanism, but the rhetoric in which it was
shrouded that was driving its positive reception and success in the U.S. New
Urbanism has been defined by Steuteville (2004) as ‘a reaction to sprawl… based on
principles of planning and architecture that work together to create human-scale,
walkable communities. The New Urbanism includes traditional architects and those
with modernist sensibilities. All, however, believe in the power and ability of
traditional neighbourhoods to restore functional, sustainable communities.’ (p.1)
However, empirical research into the design principles of New Urbanism has
revealed positive health effects within these neighbourhoods. Researchers have
found that while there was no significant difference overall in the amount of physical
activity achieved between the residents of these neighbourhoods and those in
conventional neighbourhoods, New Urban residents were using their neighbourhoods
much more for walking to get to various destinations, and achieving high levels of
physical activity within their immediate living environments (Rodriguez, Khattak,
Evenson, 2006). The implications of this type of neighbourhood design for
72
populations who are less likely to pursue deliberate exercise may hold important
implications from a population health perspective. Meanwhile, the success of key
New Urban developments in Middleton Hills and Michigan in the U.S are still under
evaluation and debate (Lydon, 2005; Michigan Land Use Institute, 2007).
While enclave and master planned communities are facing a sizeable amount of
criticism for their struggle to create community, a new urban phenomenon generally
referred to as ‘clusters’ that are central to the New Economy have been heralded for
their impact both on urban theory and the social and economic experience of those
living among them. Characterised by high levels of creativity, technology, and
diversity, such communities are increasing in Western contexts in their popularity
and demand, from both profit and pleasure-seekers (Porta, 1999; McCann, 2002;
Hutton, 2004; Kato, 2006). Hutton reports on fieldwork conducted on such new
industry clusters in London, San Francisco, Vancouver and Singapore, and notes that
the location and nature of these new economy industries in close proximity to one
another in urban environments, is having a profound impact both on urban theory
and on the socioeconomic changes and outcomes for workers and residents in these
areas. While much of this ‘new urban reality’ has been conceptualised by Florida
(2002) – Hutton makes the point that the physical and economic, as well as the
theoretical aspects of these changes will need to be taken into account by urban
planners in the near future. Among the benefits of this new economic direction,
Hutton includes improved wealth for individuals, retention of heritage buildings,
increased vitality, and the emergence of cultural and knowledge-based sectors (p.
106). Evidence to support some of the success stories emerging from evaluations of
planned communities following the concept of ‘new towns’ in America that attempt
ambitious plans for social diversity and integration are documented in research by
Kato (2006). New towns use larger amounts of land and space, and focus on mixed
land-use in their planned design, and have been shown to enjoy a greater success of
diversity and integration between different social residential groups than other
master-planned or conventional neighbourhoods.
Such rapid changes in how urban design is evolving – both in theory and practice –
means that researchers will need to increase their effectiveness at developing
methodological instruments that are best able to capture the effect these changes are
73
having on residential populations, and moreover, the ways in which people are
driving and responding to the changes via their demands for particular types of
lifestyles or experiences. In a recent article that reflects on the methodologies that
have been employed to date within the urban planning literature, an interesting point
is made by Pinson (2004), who admits having a reticence about the drive towards the
integration of this discipline with other research areas whose interests depend on the
future directions of urban planning. His reason is that he does not feel that urban
planning has been allowed to develop fully from a methodological perspective, and
therefore would be unlikely to offer advice on aspects of itself that it is not yet sure
of. Specifically, he warns that ‘urban planning may forget to formulate an inventory
to build its own theoretical and practical assets’ (p. 503). This review is mindful of
the evolving nature of this discipline, however it strongly emphasises the common
interests between health researchers and urban planners. It makes the case that
researching to bring about policy changes that will result in greater equalities in
health must necessarily go beyond health into other areas that are able to effect major
change in the quality of life, health, and life chances of vulnerable populations. Thus,
an interdisciplinary approach between health and urban planning to generate a case
for change is crucial.
2.6 Drawing Conclusions
This literature review outlined an epidemiological focus on the factors that influence
health behaviours in place, while the urban design literature was proposed as a means
of complementing this literature. This is because urban design as a discipline requires
an understanding of the relationships between place and human behaviour as
reflexive; and in order to inform design, the research usually takes an intensive
approach. That is that, in order to inform design in situ, studies are conducted on
reflexive person/environment relationships. Thus, this study lies at the intersection of
the concerns of epidemiology regarding the factors and causal processes pertaining to
health-related behaviours, and the theoretical and methodological approaches
embraced by urban design. Specifically, the study takes on an in situ, intensive focus
on a sample of urban life and embraces a conceptualisation of behaviour as
reflexively constructed between people and place. This approach will be brought to
bear on the health-related behaviour of physical activity, as place and space are
74
integral to this activity.
What has been noted in reviewing the urban planning and design literature is the
substantive and methodological ways in which it both connects with, and builds on,
work being done in the health inequalities literature concerned with health and place.
The concerns in the two disciplines are fundamentally very similar however the
urban planning research tends to display a more direct methodological approach, in
that it seeks to unearth subjective accounts of the people-place experience in order to
evaluate their current experiences there, and to guide the kinds of changes that are
needed, if any. It pays close attention to the nuanced, situated and highly sensitive
relationships between what is in a place and how people interpret it, respond to it,
and engage it in. On the other hand, the health and place literature primarily seeks to
locate statistically significant relationships between people and place variables in
order to clearly depict trends between place and health. This raises crucial questions
about the detailed nature and direction of these relationships. These differences in
approach are underpinned by differences in the kinds of research questions that are
being asked in each discipline. For example, in urban design literature a question
such as ‘Do you use this playground for recreational activities?’ might be asked,
whereas health inequalities literature tends to ask ‘Does the presence of this
playground correlate significantly with the amount of recreational activity the
population living there reports doing?’ In essence, the health inequalities research
literature concerned specifically with health-place relationships have prioritised
objective accounts of households and neighbourhoods as they pertain to health
outcomes of interest. These descriptive accounts of the aspects of living contexts that
pertain to health create a convincing evidence-base that factors within context, such
as the socioeconomic position of the area and the people who live there, or the
presence of physical features or resources, are powerful predictors of the kinds of
health-behaviours and outcomes we can expect to find there. The urban design
literature seeks rather to capture the responsiveness or otherwise of people to aspects
of places; to find out how aesthetics, uses of space, resources, architecture,
landscaping influence the ways in which people respond to, or connect with places.
Both bodies of literature are also interested in how the less tangible aspects of place,
such as identity, history, culture, community, and social networks and capital are
generated in places over time, and how they mediate relationships between people
75
and place.
This thesis draws on the reflective and evaluative approaches taken within the urban
design literature and applies them to gaps in knowledge raised in the public health
literature regarding what the social processes and interactions are within poorer
living contexts that create barriers to healthier living. It does not seek to highlight a
tension between objective versus subjective approaches within empirical efforts in
social science or public health, nor to generate a quantitative versus qualitative
argument: but rather to highlight the compatibility and validity of both approaches to
gaining a deeper understandings of how the places in which people live influence
both the quality of their lives and their health. Further, aside from factors or measures
within living contexts being important for health, what are the perceptions of the
people who occupy them about what influences how they live there? That is, the
literature review revealed the need for research that asks what health, and in
particular the health-behaviour of physical activity, means within lower
socioeconomic living environments. How is it ‘treated’ there as a concept and as a
practice? What are the interactions and social processes that have contributed to
how it is conceptualised there over time? What are the everyday lived experiences
that account for its particular position within that context? What goes on in lower
socioeconomic contexts on an every day basis to preclude health? Thus, the need to
gain a subjective account of lower socioeconomic living contexts to establish the
meaning of physical activity there was identified, and research questions were
developed around achieving this aim. By that, I mean that questions were developed
to gain an insight – according to residents themselves- about the relationships
between their perceptions of physical activity, their own practices of physical
activity, and aspects of their past and current households and neighbourhoods
influencing this.
Guided by the methodological emphasis in the urban design literature to gain an
insider’s nuanced perspective of the ways in which they relate to, and interact with
the places they inhabit, and to draw out the meanings they attribute – not only to the
characteristics of that place – but to how they see themselves as being there, the need
to focus on a particular urban locale was apparent. Thus, an urban environment that
encapsulated the qualities of diversity, socioeconomic heterogeneity, and having a
76
number of resources available to improve the health and physical activity of its
residents was chosen as a locale to investigate questions rising out of the literature
review. This way, the questions rising out of the epidemiological literature about how
to effectively conceptualise, understand, and study living ‘places’ as social contexts
that produce particular health outcomes could be addressed in situ. That is, an
intensive study of the responses and adaptations of newly arrived lower
socioeconomic residents (as measured by housing type and income) to a new urban
environment designed to increase physical activity levels was proposed to address
the research questions identified in this review. Because the urban environment that
was chosen to address the research questions was designed to promote pedestrian
mobility and autonomy and thus increase physical activity, it seemed logical and
useful to focus on physical activity as the core health-behaviour of interest in this
study.
The health-related behaviour of physical activity was chosen for three other primary
reasons. Firstly, research shows that obesity and related illnesses are on the rise in
western countries such as Australia, with a need for increased success in health
promotion campaigns targeting sedentary lifestyles (Chan, Ryan, & Tudor-Locke,
2004; Spinks, Macpherson, Bain, & McClure, 2006; Mummery, Schofield, Steele,
Eakin, & Brown, 2005; Department of Health and Ageing, 2004). Secondly,
epidemiological research shows that poorer populations are less likely to engage in
physical activity levels likely to have beneficial health effects than their more well-
off counterparts, and that contextual measures of socioeconomic position, such as
household or neighbourhood are more reliable predictors of this phenomenon than
individual measures of socioeconomic position (Lindstrom, Hanson, Ostergren,
2001; Romero, 2005; Jacoby, Goldstein, Lopez, Nunez, and Lopez, 2003; Karvonen
& Rimpela, 1997; Giles-Corti & Donovan, 2001). Thirdly, research has shown that
even in neighbourhoods where facilities to engage in physical activity are present
and superior to surrounding suburbs, poorer residential groups are less likely to
engage with them as a means of pursuing healthier lifestyles (Giles-Corti, 2003). As
such, the following research questions were generated:
77
2.7 The Research Questions
• What are the patterns of physical activity amongst a lower socioeconomic
residential group living in a new urban environment?
• What does a lower socioeconomic residential group report as being the
obstacles (tangible and intangible) within their living contexts – both past and
present – that have made the pursuit of physical activity a lower priority, or
difficult to achieve?
• What happens to messages promoting the increase of physical activity
amongst a lower socioeconomic residential group?
• Which aspects of households and neighbourhoods does a lower
socioeconomic residential group report as being able to alleviate or
exacerbate barriers to leading more active lifestyles?
• How do the inhabitants of a lower socioeconomic housing group describe the
relationships between their attitudes, beliefs, and practices in relation to
physical activity and their place of residence?
• What are the everyday interactions and processes that mediate the
relationships between a lower socioeconomic residential group, their place of
residence, and their propensity to be physically active?
• How is physical activity as a concept ‘treated’ or socially constructed within a
lower socioeconomic residential group over time? What are the processes that
have contributed to this construction or perception of it over the course of
their lives?
78
Chapter Three
Theoretical Framework of the Thesis
3.1 Human Living Contexts as Social ‘Determinants’ of Patterns in
Behaviour
Questions were drawn out of gaps in the literature regarding the reasons for different
patterns in health-related behaviours by different social demographics, and across
different living contexts. Research repeatedly shows that contexts matter in their
capacity to generate particular population behavioural profiles, depending on
whether particular people-place traits are present or absent. However, this thesis
addresses the question of why people who live in poorer areas are less likely to
engage in recommended levels of physical activity – even when the facilities or
resources to achieve this are present. Thus, in line with the research questions
identified in Chapter Two, this thesis employed a conceptual framework for thinking
about these patterns that highlights not only the significance or strength of the
variable relationships to one another, but the overall meaningful explanation as to
why this is. That is, this thesis aims to develop a theoretical understanding of how
poorer living contexts operate to produce less healthy and active lifestyles, and to
draw out the most pertinent experiences, interactions, and processes that shape
people’s relationships and attitudes to physical activity.
This raises the question of how ‘context’ itself, as a concept, is being thought about
in this context. An article by Burke (2002), which devotes itself entirely to the
concept of context as it is understood and studied across disciplines, makes the point
that ‘interdisciplinary discussions of the problems raised by the notion of context are
all too rare’ (p. 164). The task of this thesis involves an emphasis on this recognition:
that context is not thought about, discussed or studied in necessarily the same way
across disciplines, and to make a critical point about how epidemiological
methodologies treat ‘context’ in order to understand how it works to affect health
behaviours and outcomes. However, to make this criticism effectively, a new
philosophical lens for thinking about residential or living contexts as they influence
79
health is needed, and the provision of a new framework needs to be shown to work –
both conceptually and methodologically – if it is to be deemed useful for studying
the relationships between socioeconomic contexts and health behaviours in the
future.
As noted in the literature review, population-level data reporting on factors within
living environments that correspond significantly with health behaviours of interest
have described these statistical relationships as contextual effects on health. These
have been contrasted with what are described as compositional effects – that is,
measures or descriptive characteristics of the individuals that occupy an area that
have a significant relationship to health behaviours or outcomes. The different ways
in which measures of place and measures of people have been discussed as they
relate to health has led to the debate about whether it is composition or context that
matters more in relation to health – whether it is people or place that should be
addressed. In other words, should we be targeting poor people or places as a means
of redressing current health inequalities?
The research questions that are being asked in this thesis, however, demand a
theorisation of context that dilutes this tension by creating a shift towards a
methodology aimed at unravelling insiders’ perspectives on how their own
circumstances, as well as their household and broader living environments, shape
their propensity to be physically active. I argue that this dichotomy is essentially a
false one, brought about by methodologies that can either measure aspects of the
environment, or traits of the people, and which cannot capture the processes and
dynamics between these that shape the people, place, and health connection. To
access these insights, ‘context’ is conceived of here as being comprised of not only
compositional or contextual factors, but also the interactions and forces that connect
them to one another in an ordered and meaningful way. That is, that it is made up of
people’s backgrounds, circumstances, and dispositions on the one hand, and the
social spaces they inhabit and interact with on the other. This thesis draws a
conceptualisation of context as the psychosocially constructed lenses through which
human beings perceive, interact with, and respond to particular settings. This dilutes
conceptual tensions between people and place, by conceiving of contexts as the
subjectively constructed dimensions of various social settings, and moving to address
80
questions such as ‘What does this living context mean to you?’ and ‘What does
physical activity mean to you in the context of your life or lived experiences?’.
A socially theorised view of context takes into account that while people are free to
exercise agency in a social setting – according to their subjective beliefs or
expectations about what is appropriate there – contexts are also powerful in exerting
social forces on those who occupy them, or pass through them. This view of context
as socially co-operative and yet fundamentally subjectively constructed and
perceived via a number of complex psychological and social processes, shifts the
methodological emphasis from a focus on measurement to a focus on meaning. As
such, questions such as ‘What is the context of the lower-socioeconomic lived
experience?’ and ‘What is it like to be poor, to live in a poor neighbourhood, and
how does this influence one’s physical activity levels?’ are able to be addressed.
These types of questions and a socially theorised view of context constituted the
framework for the methodological design which was employed to retrieve subjective
accounts of life in an urban context, and the psychosocial processes and interactions
through which different lifestyles and realities are produced and sustained there.
3.2 The Social Construction of Reality
In line with this holistic, socially situated conceptualisation of context, the 1966
work of Berger and Luckman, entitled The Social Construction of Reality: A Treatise
in the Sociology of Knowledge, was employed to guide a methodology aimed at
retrieving the social and psychological processes linking people, place, and physical
activity. This early, seminal work, which viewed human behaviour to be contextually
determined and socially constructed, was implemented here to study the reasons for
reportedly lower physical activity levels within lower socioeconomic living contexts.
In a broad sense, social constructionism views behavioural patterns that evolve over
time to be a product of a collective acceptance within social contexts that ‘this is how
things are’ or an internal logic that ‘this is the way things are done’. That is, what
human beings perceive to be reality, or the only way to do things in a particular
context, are, according to this theory, produced and sustained via a combination of
individual agency and environmental social forces over time (Berger and Luckman,
1966). A social constructionist view of a context helps us ascertain not only its
81
overall scope, definition, and meaning, but how behavioural interactions and orders
are decided upon and sustained within it. Thus, it is the study of the processes and
meanings that tie practices to their respective contexts that will allow us to see things
from the perspective of those who inhabit them, and to operate more effectively
within them in future.
Social constructionism was identified for the purposes of this study as a useful
conceptual tool for bringing into question how norms and status quos regarding
physical activity in poorer living contexts have developed over time. The framework
is not being used to make the case that poorer people have somehow ‘made up’ a
negative relationship to health, but rather that complex interactions, economic and
circumstantial constraints, and aspects of the environment particular to this
demographic have interacted over time to construct health in a poor light, or as an
unattainable goal. Importantly, it allows the researcher to take a ‘ground up’ approach
to finding out which aspects of context matter in the construction of this specific
relationship with, or version of, physical activity, by retrieving subjective accounts
from those who generate and sustain these patterns, procedures or rituals. It points to
the importance of focussing on how objective realities or an evidence-base – such as
that established in epidemiology that poorer people are less likely to engage in
recommended levels of physical activity than their more well-off counterparts – have
come into being over time.
A social constructionist standpoint takes the perspective that physical activity means
different things in different social contexts due to the interactions and processes that
have gone on there over time to generate those meanings. This does not make the
assumption that the relationship between a group of people and a particular concept
or behaviour is artificially constructed or contrived, but rather, that over time, due the
needs of the people and the nature of their living environments, phenomena take on
their salience, or otherwise, as deemed relevant by those in that situation. While a
social constructionist standpoint focuses on what different things mean in different
contexts, and thus by default emphasises the subjective nature of ‘reality’, this does
not mean that reality no longer exists, or that positivist descriptions of the health-
place relationship are invalid.
82
For example, having a low income level, a low education level, or living in a poor
neighbourhood are all objective realities; however, to understand how this is
experienced and what this means in an everyday sense, subjective accounts, such as
the narratives and stories of residents, are required to shed light on this reality in a
meaningful way. Therefore, what a social constructionist approach allows this thesis
to do, is to engage with and study a group of lower socioeconomic residents living in
a new urban context to find out what physical activity means to them, and how, if at
all, their social, economic, or geographic place in society – that is, the context of
their lives – has contributed to this particular meaning and practice.
Berger and Luckman also argued that people are able to exert individual choices, and
exercise agency, but also respond to social, contextual influences. That is, while
people are able to exercise agency in a social setting, they tend to consult with the
group to negotiate the best or most appropriate way of doing things there. They
describe the processes via which people co-operate to develop the ‘best’ or the
‘normal way’ to do things in that context as habituation. They further postulated that
over time, this process of habituation causes behaviours and codes of conduct to
become institutionalised within contexts, and as such, provide a frame of reference
that allows for more automated, or economical responses from its inhabitants or
occupants. That is, little conscious thought is required about what to do there, or how
to achieve basic goals there. As a result of these processes, conceptual frameworks or
‘social lenses’ are developed via which people perceive and interpret the behaviour
of others within the contexts they enter over time. Berger and Luckman referred to
the perspectives, attitudes, and dispositions that people carry with them as a result of
the shared experiences that have shaped their outlooks as historicity.
I relate this theorisation of human behaviour in context to what epidemiology tells
us: that particular characteristics of social and living contexts appear to be influential
in relation to the health-behaviours of the occupants. That is, contexts matter in
relation to lifestyles and health. A social constructionist view would suggest that this
is due to the dialectical tension between human agency and the human tendency to
refer to the group for information about how to do things, or the best way of going
about something. If a social context is well-formed and powerful – that is, if the
people within it acknowledge its existence (even subconsciously) and demonstrate
83
this by operating in predictable ways within it – then there is a case for investigating
how this sense of context formed, and the processes and interactions that go on there
to produce the norms and patterns evident there. The premise underpinning the
investigative approach of this thesis is that while agency is present, social forces are
powerful proponents of behaviour in different social and economic contexts. As such,
there is a need to study the social processes within contexts that have been identified
as being in need of intervention as these are fundamentally the driving forces behind
the behaviours, consumption patterns, or lifestyles able to be observed there.
Berger and Luckman also placed a question mark on how objective humans are able
to be about the behaviour of themselves and others, and noted the highly
contextualised, subjective nature of the laws that govern human conduct. They
outline that human beings produce – through a combination of agency and social
reinforcements – language, norms, and codes of conduct which they then tend to
perceive as an objective reality. Berger and Luckman refer to this as ‘humanly
produced and constructed objectivity’ (p. 2). Thus, people perceive and experience
reality in different ways, depending on their frame of reference, and other derivative
influences, such as backgrounds, cultural frameworks, and established belief
systems. This theoretical framing begs the question: are the backgrounds, cultural
frameworks and belief systems of poorer people different to richer people and does
this directly affect how active and healthy they are likely to be? If so, what are their
qualities, and how do these qualities work as barriers to better health? These kinds of
questions bring a methodological focus to the contextualised interactions and
processes that had influenced a particular residential demographic over time. I asked
‘How have these attitudes, beliefs, and behaviours in relation to physical activity
come to formulate as they have amongst this social group?’ and ‘What are the
subjective meanings attributed to physical activity in this context that contribute to
the objective reality that it is not done to levels that would benefit health?’
3.3 Application of the Conceptual Framework to the Thesis: Asking
New Questions, Exploring New Ground.
Thus, by re-conceiving context as social, dynamic, and charged with meanings,
associations, and attributions that develop via both agency and cooperation over
84
time, new questions can be asked of the socioeconomic-health relationship, and new
methodologies introduced that are compatible with this approach or world view.
Such an approach moves beyond asking questions, such as ‘Is it this, or that, or
“these people” within this environment that are determining these patterns?’ to
opening up the context with the view that it is affected by both the people, their
circumstances, their needs, and the interactions of these over time, to ask ‘What goes
on in here that affects how people live with consequences for their health?’
Importantly, this shifts the focus away from assessing the context for the presence of
causal relationships between people, places, and health, to one that seeks to locate
why people respond to a situation or a place in the way that they do. And to do this,
we must ask the people themselves how they perceive their circumstances, their
households, their dwellings, their location, their neighbours and the resources present
and why they respond in particular ways to environments with particular qualities.
The urban design literature was an important factor in directing a focus in this thesis
to the emotional and psychological relationships people develop with the places they
visit or inhabit, and the re-conceptualisation of these contexts as socially created or
generated over time drove the methodological directions to seek subjective accounts
of these contexts. This indicated a way of opening up these contexts to ascertain
what meanings are attributed to what qualities in the environments which, up until
now, have been attended to in health inequalities research only with the desire to be
able to accurately ‘measure’ them. A methodological approach that acknowledged the
subjective associations and meanings human beings attribute to both artefacts in
place and human behaviours there was needed to develop a substantive and
theoretical knowledge base around which new studies, economic and social policy,
and health interventions could be based on in the future.
85
Chapter Four
Methodology
4.1 Introduction
Chapter Three located and described the point of departure from conceptualising and
researching contexts as aggregates of environmental characteristics, or variables, to a
focus on the social and psychological processes and relationships that draw human
behavioural patterns within living contexts into being. Chapter Four now moves to
outline a methodological approach suited to capturing these relationships. It
progresses from the gaps identified in the literature – substantive, conceptual, and
methodological – to an innovative response to investigating the processes
underpinning the relationships between people, place, and health that have been
convincingly established in social epidemiology. To commence the task of finding
out what kinds of daily events and interactions might account for the research
situation as it currently sits in the empirical literature, and to develop a way for
thinking about these processes, a grounded theory approach was chosen for
conducting this study. Specifically, a social constructionist version of grounded
theory by Charmaz (2006) was coupled here with the Berger and Luckman (1966)
framework outlined in Chapter Three to guide data selection, collection and analysis,
and to reveal how the place and role of physical activity as a concept is moulded and
created over time within lower socioeconomic residential groups. Chapter Three
made the case that social constructionism is a useful and relevant conceptual
framework for making a point of departure from epidemiological notions of context,
which points to the need for methodologies that are able to begin exploring the
processes ‘from the ground up’. This allows us to find out what goes on – and what
has gone on in the past within poorer living contexts – to make physical activity a
relatively low priority in the lives of its occupants.
Chapter Four outlines the inductive, theory-building nature of this investigation, as
well as the emergent – as opposed to hypothesis-testing – methodological approach
used in this study. It goes on to describe the urban case study in which this research
was carried out. Because the rigour of grounded theory lies in its responsiveness to
86
the situation in which the research gets done (Dick, 2007), I chose an urban setting
that bore traits pertinent to the questions being asked in this research project. The
Kelvin Grove Urban Village (KGUV) was identified as a case study with residents
from mixed socioeconomic backgrounds who are co-located within a neighbourhood
designed to increase pedestrian mobility and physical activity in the green
recreational spaces provided. This chapter goes on to describe the methods of data
collection within this research setting, including the survey and online and face-to-
face techniques used in this process. It also describes the concurrent analytical
process, the comparing and contrasting of case-data, the emergence of theoretical
categories, data triangulation, saturation, and the identification of key themes and a
core category.
4.2 Why an Inductive Theory-Building Approach?
The key aim of this study is to ascertain a detailed portrait of what life is like inside a
lower socioeconomic residential context in order to locate the daily occurrences and
interactions that go on there to shape attitudes, beliefs, perceptions and practices in
relation to physical activity. Thus, a methodology was needed to tap into the
everyday processes and interactions that gave rise to particular attitudes, beliefs,
norms, and routines around the practice of physical activity. The view that has been
detailed in Chapter Three that behavioural patterns in context are produced via
consultation and interaction with the human social world through a combination of –
often subconscious – human agency and socio-cultural forces led to the requirement
of a qualitative approach to studying this phenomenon. That is, a shift was made
from making objective measures, to taking subjective accounts; from quantitative
multi-level analyses of contextual factors, to a qualitative investigation of the
processes that pin various contextual factors together with implications for health.
According to Miles and Huberman (1994) ‘One major feature of qualitative research
methods is that they focus on naturally occurring, ordinary events in natural settings,
so that we have a strong handle on what “real life” is like’ (p. 10). Given that the
point of departure for this thesis was highlighted in Chapter Three as a move away
from testing whether variables are salient in the extent to which they mediate
socioeconomic context and physical activity, and towards an opening up of ‘context’
87
for investigation and emergent theorisation, a grounded theory approach was chosen.
What I wanted to find out – beyond the ‘how many’ and ‘what’ of health-place
relationships – was ‘what is the greater social context in which these patterns occur?’
and ‘how can we gain a more proficient theoretical understanding of how these
contexts operate to affect health-behaviours?’ Thus, a deeper, more micro-level
investigation of the operations within a social context was required to investigate the
experiences, interactions and processes within lower socioeconomic households and
neighbourhoods that result in less healthy and active lifestyles. According to Glaser
(1967) a grounded theory approach should ultimately help the people in the situation
to make sense of their experience and to manage the situation better. The relevance
of this insight is clear as it relates here to developing a greater understanding of how
particular contexts and living circumstances generate barriers to healthier living, and
what needs to happen for these to be overcome or ameliorated. Figure 1 below
depicts the methodological location of this research project within the cycle proposed
by Blaikie (2000) regarding theory building and testing by researchers.
Figure 4.1 Inductive Theory-Building Approach
88
There are a number of methodological approaches that are able to be employed to
capture the interactions in situ that give rise to the broader social patterns captured in
epidemiological work; however, in this phase of theory building, the techniques are
necessarily centred on the logic of induction. That is, phrases and utterances
collected in the data are analysed for the processes they represent, and the
psychological and social constructions upon which norms, habits, and routines are
built and sustained. It is the process of analytical induction – in which ever
methodological school it is located – that reveals the insights that shed light on the
‘what is going on here?’ that researchers seek to find out to explain social
phenomena, and more effectively intervene in patterns or problematic trends
identified via statistical methods. According to Katz (2001) ‘Analytic induction is a
way of building explanations in qualitative analysis by constructing and testing a set
of causal links between events, actions, etc. in one case and the iterative extension of
this to further cases’ (p. 164).
For the purposes of this research project, I sought to ascertain a more developed
knowledge about the causal links between characteristics of particular living
contexts, and the lifestyles exhibited there. So far, statistical methods have developed
insights about the aspects of these contexts that might, or might not, be important for
influencing lifestyles and health via the detection of correlations between particular
people, place, and health variables. However, a process of analytical induction via
qualitative research and analytical techniques was needed to develop a sense of the
pathways, processes, and factors mediating these relationships. That is, what are the
interactions within a particular context over time upon which attitudes, beliefs, and
norms are constructed? And what account of these living contexts in relation to the
health-related behaviour of physical activity is given by people who comprise them?
Katz (2001) goes on to explain that ‘Analytic induction is a research logic used to
collect data, develop analysis, and organize the presentation of research findings. Its
formal objective is causal explanation, a specification of the individually necessary
and jointly sufficient conditions for the emergence of some part of social life’ (p.
165). Thus, this research project conducts a qualitative, grounded theory study based
on these analytical principles, which results in various theoretical models and tables
informing the disciplines of public health, urban design, and sociology about what
aspects of living contexts are important for healthier living amongst vulnerable
89
demographics.
4.3 A Social Constructionist Approach to Grounded Theory
This investigative approach was designed on the core principles of grounded theory
research originally proposed by Glaser and Strauss in the 1960s, and then revised
under an arguably less positivist framework in the 1990s by Strauss and Corbin.
Although there are many debates around these respective approaches, researchers
generally agree that they are both ‘emergent methodologies’ (Dick, 2007), and Mills,
Bonner, & Francis (2006) make the case that all variations of grounded theory exist
on a methodological spiral and reflect their methodological underpinnings’ (p. 2).
These methodological underpinnings refer to an inductive approach to data selection,
collection, and analysis. Although there are commonalities amongst these
approaches, there is a well-recognised continuum in grounded theory approaches,
from the more positivist approaches of Glaser and Strauss, to newer, more
constructivist perspectives (Hallberg, 2006). At the constructivist end of this
continuum, increasing attention is being paid to the work of Charmaz, who advocates
a social constructionist approach to grounded theory, and whose techniques were
identified as relevant to this research project due to the initiative in this study to build
theory around the question of how physical activity is socially constructed within
poorer living environments. Thus, Charmaz’s constructivist approach to grounded
theory seemed to be most fitting with this particular conceptual approach, or ‘world
view’. This is because constructivist grounded theory allows for a more flexible
methodological approach, and brings questions to the research process from the same
school of thought as the Berger and Luckman philosophy outlined in Chapter Three
of this thesis. Thus, the Berger and Luckman (1966) social constructionist
conceptualisation of how human behavioural patterns are formulated in contexts over
time was coupled here with the constructivist qualitative data collection and analysis
techniques put forward by Charmaz, and practised and acknowledged by others
(Lesch & Kruger, 2005; Hallberg, 2006).
However, it must be noted that Charmaz did not specifically advocate using the
Berger and Luckman framework. Instead, she takes a broader constructivist approach
to grounded theory, in which the subjectivity inherent within analysis and theoretical
90
development is acknowledged, and reflection on the role of the researcher in the
production of data is emphasised. Charmaz has taken a divergent, and yet
increasingly accepted means of employing a grounded theory approach, which she
refers to as a social constructionist approach to grounded theory, and emphasises the
need for flexible guidelines, ‘not methodological rules, recipes and requirements’ (p.
20). Charmaz (2006) reminds us that taking a social constructionist approach to
research means acknowledging that this subjectivity applies also to the researchers,
who are only able to interpret interpretations, and construct constructions provided
by the participants. She argues that researchers bring their own histories, theories,
values, and ideas to the process of generating theory from data. Thus, consideration
must be given to both the researchers’ and participants’ backgrounds when data is
being collected, selected, and analysed. A reflexive, interpretive approach to the data
must be taken if there is an ongoing understanding of it being socially produced
between the researcher and the participant. Further, she emphasises the need to keep
returning to the study site to build on the data collection, and to constantly check,
compare, and contrast data between individual cases, to make sure that the themes
are developing in ways that reflect the experiences of those the researcher is
interested in.
The essence of Charmaz’s contribution to this methodological approach could be said
to be the acknowledgement that no theory is objectively created – without
consultation with one’s own historical, social, and cultural context. For this reason,
Charmaz could be described as a relativist, and herself says ‘Data do not provide a
window on reality. Rather, the “discovered” reality arises from the interactive
processes and its temporal, cultural, and structural contexts’ (Charmaz, 2000, p. 524).
However, Glaser openly and strongly opposes and critiques her angle on grounded
theory, and has said that ‘constructivist data, if it exists at all, is a very, very small
part of what grounded theory uses’ (Glaser, 2002, p. 1). With these strategic and
methodological tensions in mind, this research project drew on aspects of Charmaz’s
approach in conjunction with the Berger and Luckman framework, while still
adhering to the key principles of a traditional grounded theory approach in relation to
the treatment of the data. The unique methodological approach of this study is that it
is guided by the specific version of social constructionism introduced by Berger and
Luckman to build theory using a grounded theory approach. It acknowledges the
91
iterative, and relatively subjective process of theory building, but is primarily
concerned with gaining insights into the perspectives of people who inhabit a poorer
living context to tell us what physical activity – as a concept and practice – means
there. It acknowledges that the data is co-produced between researcher and
participant, and thus the importance of comparing, contrasting, and returning to the
field to verify theoretical conclusions regarding emergent categories and their
properties is paramount.
Grounded theory is not usually coupled with any particular conceptual framework,
however, I wanted to build theory around a very specific aspect of context – and thus,
the Berger and Luckman framework that highlights the processes responsible for the
development of norms and routines in a context provided a useful ‘scaffolding’
around which to focus on ‘health in human social contexts’, and to develop theories
through this particular lens. In light of conceptualisation of behaviour in context by
Berger and Luckman, and the principles of Charmaz’s methodological framework, I
sought to gain an insider’s perspective or subjective account of how this group of
participants perceive, understand, and rationalise their responses to a particular living
context, while simultaneously recognising the dialectical construction of data
between the researcher and the participant. Charmaz’s approach allowed for a focus
on processes, interactions, and narratives, while the Berger and Luckman framework
focussed the analysis around the concepts of historicity, habitualisation and
habituation. These are defined as they relate to this study below:
• Historicity – the importance of examining people’s shared or common pasts
to understand how and why they exist and behave as they do in the present.
(What goes on in the past for lower socioeconomic groups that influences
their health-practices now?)
• Habituation – The processes via which people come to see things as the
norm and behave in ritualistic, routine fashions. Over time, people’s
behaviour habituates into patterns in various contexts. (What are the
processes via which particular patterns emerge?)
• Institutionalisation – This is the stage at which people see their code of
conduct or everyday practices as logical, normal, and objective – with little
reflection on other ways to do or see things. (How do they account for, or
92
explain these patterns?)
Other researchers have also discussed and employed the constructivist approach to
grounded theory in health research ( McCann & Clark, 2003; Nelson & Poulin, 1997;
Noorton, 199l; Stratton 1997) however, I could not find another study that took a
social constructionist grounded theory approach to researching poorer living contexts
for their capacity to influence healthy lifestyles. I did find an article on research
regarding attitudes and beliefs in relation to sexual practices amongst a group at risk
of HIV using this methodology (Lesch & Kruger, 2005). While these authors
followed Charmaz’s (2006) approach, they made no reference to the Berger and
Luckman (1966) conceptual framework.
4.4 A Case Study: The Kelvin Grove Urban Village (KGUV) as a
Locale for Undertaking the Research.
This study investigates the residential population living within the Brisbane Housing
Company (BHC) units within the Kelvin Grove Urban Village (KGUV;
www.kgurbanvillage. com.au). KGUV is an AUD 800 million mixed-tenure, medium
density, inner urban planned community based on the design principles of ‘new
urbanism’ located approximately two kilometres from the Central Business District
(CBD) in Brisbane, Australia. It sits on approximately 16 hectares and contains
around 2000 residential properties from both the public and private sectors.
According to Steuteville (2004) ‘New urbanism is a reaction to sprawl. It is based on
principles of planning and architecture that work together to create human-scale,
walkable communities. The new urbanism includes traditional architects and those
with modernist sensibilities. All, however, believe in the power and ability of
traditional neighbourhoods to restore functional, sustainable communities’ (p. 23). A
further key feature of the new-urbanist aspirations of the development is a planning
focus on diversity and heterogeneity in housing types, land uses, and social groups
(De Villiers, 1997). KGUV has been built with the aims of achieving a vibrant,
healthy, diverse, and socially sustainable urban community that has access to a range
of cultural, health, and educational resources.
A wide range of demographics has been included in the accommodation options,
93
including student accommodation, disability support options, aged accommodation,
and people living in government assisted housing via the Brisbane Housing
Company (BHC). In addition, there are apartments that have been sold on the private
market ranging in price from $310, 000 – $950, 000 AUD. This diverse range of
people live in close proximity to a range of resources including retail outlets, the
Queensland University of Technology, associated health clubs and services, libraries,
parks, wide paths and bikeways, and the well-known La Boite Theatre. The official
KGUV website can be viewed at: http://www.kgurbanvillage.com.au/.
Figure 4.2. below provides a conceptual overview and description of the key social,
educational, cultural, and health-related features of KGUV that underpin this unique
urban design.
Figure 4.2 Ideological Framework Behind KGUV Design
Figure 4.3 below outlines the geographical region occupied by the KGUV and its
proximity to Brisbane’s Central Business District (CBD), and Figure 5 shows an
aerial view of the master plan of the Village.
94
Figure 4.3 A map of the geographic area in which KGUV is located is
depicted below
Source: (KGUV Innovation Implementation Report, Garred, 2007)
Figure 4.4 Master Plan
Source: Official Kelvin Grove Urban Village website
95
http://www.kgurbanvillage.com.au/.
In addition to the characteristics and qualities within this master-planned community
that encourage mobility and physical activity, KGUV has a number of other health-
resources situated within it, or currently being built for use by researchers at QUT
and KGUV residents. The specific health-related resources that are located in KGUV
are outlined in Table 4.1 below.
Table 4.1 Summary of Health-Related Resources in KGUV
Health Resource Description Building Progress
Centre for
Physical Activity
and Health
The Centre for Physical Activity and Health will be
located alongside McCaskie Park, and will contain an
indoor pool, indoor multi-purpose courts, a
gymnasium and health clinics. The primary function
of the Centre will be for Queensland University of
Technology’s teaching purposes, however, it will be
available for use by the broader community as well.
Building near
completion
School of
Optometry
QUT’s School of Optometry offers services to the
community by students at no cost. Additionally,
glasses and contact lenses are available from the
clinic at discounted prices.
Complete
Nutrition Clinic
This QUT clinic offers nutritional assessment, dietary
advice for both weight gain and loss, diabetes,
cholesterol lowering, sports nutrition and healthy
eating.
Complete
Podiatry Clinic
QUT’s Podiatry Clinic, which is a part of the School of
Public Health, offers prescriptions and patient care.
Complete
96
Network of
Pedestrian and
Bike Links
There is a planned network of bicycle links within the
Village to surrounding areas. These features have
been designed in accordance with the overall
philosophy to increase individual autonomy and
mobility, as well as improving health and well-being.
Complete
Landscaped Parks
and Open Spaces
Within the Village, are a number of green, open
spaces for social gatherings, BBQs, and exercise for
residents. The Roma Street Parkland and the Victoria
Park Golf Course are adjacent to the precinct, and
also provide opportunities for outdoor recreation and
physical activity.
Complete
Red Cross
In a recent media release
(http://www.kgurbanvillage.com.au/about/plan.shtm
) it was announced that in 2007 the Australian Red
Cross Blood Service would be locating a $70M facility
adjacent to the Institute of Health and Biomedical
Institute (IHBI) at the Kelvin Grove Urban Village.
This will provide university researchers with increased
opportunities and access to resources for conducting
biomedical and public health research. This is a
promising example of how new stakeholders will
invest interests and resources into the Village, based
on the collaborative initiatives and potential they see
the community as holding.
Construction
underway
According to Yin (2003), a case study is a single-bounded entity, studied in detail,
with a variety of methods, over an extended period, and is selected because it is
theoretically representative of the relationships to be investigated. A case study treats
something as a ‘system’ and this opens it up for examining the processes and
elements that comprise the system. The Urban Village provides a microcosm that
generates aspects of human behaviour that are of interest in an investigation
exploring the dynamics between lower socioeconomic living contexts and the
propensity to be physically active. The case study of the Urban Village enabled an
identification of the key relationships at stake in the adaptation of affordable housing
residents to a ‘healthy environment’. For the purposes of this study it provides an
opportunity to examine the adaptations of newly arrived, lower socioeconomic
97
residents (affordable housing residents) to a space specifically designed to promote
physically active lifestyles and to increase pedestrian mobility, while decreasing
automobile dependence. Also, it provides an urban example of a socioeconomically
heterogeneous living environment, and given the emphasis on how socioeconomic
contexts work to produce aspects of lifestyle with implications for health, the Urban
Village was identified as an ideal ‘social laboratory’ for addressing the research
questions in this thesis. Thus, the grounded theory techniques were applied within
this context, because this particular neighbourhood site was seen as theoretically
representative of a development that encapsulates the relationships that were the
focus of this study.
4.5 Validity and Reliability
4.5.1 Validity
Theoretically, this case study allows us to propose that what we find out about this
scenario may be relevant to other similar settings and urban environments. The
knowledge produced via the investigation of this case study will be used for future
testing to see how widely the theories or key concepts are able to be applied. The
findings are valid within the case study, and cannot be generalised to other urban
environments and contexts. However, it does allow a case for producing knowledge
for testing in other populations and areas. More specifically, a rigorous analysis of
the validity of the chosen data collection instruments were assessed in the following
ways:
Survey: No studies evaluating the validity of IPAQ and AA surveys could be located
in the literature. Overall, the lower levels of PA practice reported by the lower
socioeconomic group in this survey on the original measures were duplicated and
reflected in the qualitative data produced following this initial study phase. That is,
they went on to give reasons for lowered levels of physical activity, and the
qualitative data in this study did not contradict the findings produced in this survey.
This indicates that the survey measures had a reasonably high level of face validity in
terms of people understanding what was being asked of them.Blog and Face-to-Face
Qualitative Techniques: The grounded theory analytical method of comparing and
98
contrasting answers (Creswell, 1998) by both the same and different participants to
each other, and going back to participants for further interviewing and clarification if
answers are not in agreement. During the interview process, much clarification was
sought, as I both recorded and made notes on participants’ answers. Where
participants’ used terminology and words that were not transparent in their
translation, I asked them to rephrase and explain their use of terminology, eg ‘getting
flogged up somethin’ fierce’ was re-interpreted by that participant as ‘domestic
violence’, and so on.
4.5.2 Reliability
In the initial quantitative phase of the research, a survey was designed to measure the
physical activity levels of residents both before and after they moved into KGUV.
The survey consisted of both established International Physical Activity
Questionnaire (IPAQ) measures, Active Australia (AA) survey measures, (Brown,
Trost, Baumen, Mummery & Owen, 2005), as well as questions devised specifically
for the research being conducted in this particular urban setting. The IPAQ and AA
measures used in the survey addressed levels and frequency of physical activity
levels, and have been assessed for reliability to determine categories of ‘active’,
‘insufficiently active’ or ‘sedentary’ in a review of the test-retest reliability of four
population health surveys targeting physical activity patterns. They were tested using
interclass correlations for minutes on each item, as well as minutes of physical
activity overall. (Brown, Trost, Baumen, Mummery & Owen, 2005). Reliability for
all four instruments was concluded by the authors as being ‘very good’ with IPAQ
measures scoring the highest level of reliability at 79% where n=1-4.
In relation to the second phase of the research, the qualitative phase, a research
assistant was hired to code the data within the guidelines of the social constructionist
approach and in accordance with the research questions. Coding was compared and
contrasted until agreement was reached between the principal researcher, and the
research assistant about the categorisation of quotes, memos and notes into various
emerging themes. These were further checked and coded by an independent research
student who had not been involved in the study prior to this point. After this process,
clear and agreed upon categories had emerged from the transcripts for theoretical
99
development.
4.6 Data Collection and Analysis
Both quantitative and qualitative data was collected to answer the research questions
outlined in this project. A survey was mailed out, and both online and face-to-face
qualitative techniques were used to collect data from the residents in the Urban
Village. Table 4.2 below outlines a summary of the participants involved and the data
collection techniques used in the overall study design. Data collection and analysis
occurred simultaneously until the research questions had been addressed via the
identification of a number of conceptual themes typifying or representing the
relationships between this particular urban demographic and their propensity to be
physically active. The collection, analytical processes, and theoretical development
are outlined in detail below.
4.6.1 QUT Ethical and Developer Approval
Ethical exemption for the study was granted by The Queensland University of
Technology (QUT) on 24th April 2006 to run the online data collection phase, and, as
the need for further investigations arose, an updated application was granted on 31st
August 2007 to conduct the in-depth interviews. Permission from the committee
over-seeing all research to be conducted in the Urban Village was approved in
writing on 29th March 2006. These are available for viewing in Appendix A of this
thesis. All participants received information sheets and signed consent forms. Copies
of these forms are in Appendix B of this thesis.
The data collection phases – including the survey, the blog, the interviews and the
focus group - did not identify any of the participants, nor did they include details
about participants beyond demographic measures, such as socioeconomic position as
measured by income and housing type. The blog participants contributed using
numbers only to identify themselves, and signed consent forms to have their
comments posted on that website. Interviews and the focus group revealed no details
about participants beyond their socioeconomic position. Participants all received
reimbursements for their time and contributions, and were informed and willing
100
contributors to the research. During the research process, many participants received
assistance in terms of being linked to social and community services to help them
with counselling, childcare, and financial support.
4.6.2 Participant Recruitment
While the survey component of the data collection phases in this study targeted the
entire Urban Village population, only the residents housed in the affordable housing
– or government-supported housing options – within the Village participated in the
qualitative components of this study. Entry into this housing option is based on
income-criteria, with only low-income singles, families, and pensioners qualifying
for entry. Participants were all from disadvantaged backgrounds, on low incomes,
and clustered together in a lower socioeconomic residential context within the
broader context of the Village, thus providing an opportunity to study this group of
people, their low-income living context, and their perceptions and practices in
relation to physical activity.
Residents participating in the first phase of the data collection filled out surveys that
were mailed to their apartments, and returned them to boxes that were left in the
foyers of their apartment blocks. Following this, respondents who agreed to
participate in further research on the last page of their surveys were contacted via
telephone to contribute to the blog: the online qualitative phase. Thus, this initial
group was relatively accessible and enthusiastic to be involved with further study.
While a relatively heterogeneous mix of people within the affordable housing option
at KGUV was recruited for the blog, the following two processes of participant
recruitment for the qualitative research were refined to seek out people who were
most disadvantaged and the poorest in the group, in order to ascertain insight to
experiences in their lives that prevented them from pursuing physical activity.
Charmaz (2006) refers to theoretical sampling more as a strategy than a process, and
for our purposes, it worked well to not only develop categories that emerged in the
first phase of data collection, but to fill in gaps that became evident in early phases of
collection and analysis.
The participants in phases three and four constituted the ‘hard-to-reach’ group via
101
whom we sought to tap into the processes giving rise to the evidence base depicting
low activity levels amongst poorer populations. Invitations were posted in their
mailboxes offering AU$30 per interview, and AU$10 for participation in the focus
group. The affordable housing residents responded to this offer, primarily by
contacting the researchers from the public telephones in the Village. Participants in
stages three and four were difficult to interview in the first instance as they were
initially slightly mistrusting of the researcher; few had home telephones connected;
and a number were often involved in court cases and social services, which made
their daily schedules unpredictable. However, over time a good rapport with the
residents was established, and they also benefited by receiving food parcels,
children’s clothing and referral to local welfare services.
A further six affordable housing residents participated in an outdoor focus group held
in one of the recreational areas in the Village. In addition to the grocery vouchers,
they were provided with a lunch during this interview phase. In this session the
interviewer focussed on the more notable similarities and differences that had
emerged in the initial interviews regarding the nature of the urban village
environment for pursuing physically active lifestyles, and directed the discussion
around clarifying these points. This process of theoretical sampling allowed for the
saturation of the emerging conceptual categories. The participants spent some time
negotiating their perceptions of the Village, their experiences in previous
neighbourhoods, and their propensity to physical exercise, as a group.
102
4.6.3 Reflection on the Role of the Researcher
As a means of reflecting on the researcher-participant relationship, it was apparent
that I was in a higher socioeconomic bracket than the people I was interested in
interviewing for the study. The potential barriers created by the social and economic
differences between the researcher and participants needs to be acknowledged and
addressed in the research process (Lesch & Kruger, 2005). However, my background
experience in counselling and home-visiting in the area of housing provision for low-
income families helped me to develop a comfortable relationship with the
participants over the course of the data collection process. Further to this, in my own
life, I have experienced much financial hardship, having been relatively poor as a
teenager moving to a new country, and then again experiencing poverty while raising
three young children on a low income. These experiences both inspired my interest
in the topic, and provided me with empathy for the people whom I had recruited for
my study. In this sense, I found that the psychological distance I had from them was
diminished, and while this may have increased the subjectivity involved in my
pursuing this study, I also feel it offered me insights into what to ask, what kind of
conduct is approved of in these contexts, and how to develop a rapport with
participants that made them feel at ease about discussing these sensitive topics.
I found that by sharing and swapping personal stories and comparative experiences
in a few visits prior to each interview, trust was established and a sense of safety, and
the ability to be open in conversation was established. I also found that keeping the
relationship as informal as possible, and dressing casually for home-visits also
helped with making participants feel at ease and able to talk openly. I often had to re-
visit the participants if the time I arrived was unsuitable for an interview – often due
to intra-household conflict. Reflective notes were written on the constant divergence
between my research focus on physical activity, and the focus brought to the
interviews by the participants on other aspects of their lives that were salient to them
in shaping their current attitudes and beliefs in relation to health.
4.6.4 Phase One: Survey on Physical Activity
Initially, this study included a survey of the KGUV residents about their physical
103
activity levels and patterns. This was meant to gauge the patterns of physical activity
amongst the residential population of KGUV prior to studying the processes that
produced them; with the latter phase being crucial as a means of generating a unique
contribution to this area of research.
The survey was developed using measures from the International Physical Activity
Questionnaire (IPAQ) , the Active Australia (AA) Survey, as well as some new
measures developed for the specific goals of this research. Both the IPAQ and the AA
measures used in the survey addressed levels and frequency of physical activity
levels and have been assessed for reliability to determine categories of ‘active’,
‘insufficiently active’ or ‘sedentary’ in a review of the test-retest reliability of four
population health surveys targeting physical activity patterns (Brown, Trost,
Baumen, Mummery & Owen, 2005). Reliability for all four instruments was
concluded by the authors as being ‘very good’ with IPAQ measures scoring the
highest level of reliability at 79% where n=104. However, additional questions were
created to expand the data collection beyond traditional measures of physical activity
for two reasons: firstly, to determine the context in which various levels were
conducted (ie the actual settings in which incidental and deliberate activity was
carried out), and secondly, to determine the specific interpretations and uses of local
resources by residents, for example, to assess whether wide pathways were used by
residents and the context in which this occurred,
A pilot study was conducted (n=30), followed by a mail-out to the entire KGUV
residential population (650 apartments). No changes were made to the survey
following the pilot study, as these participants expressed no concern regarding the
clarity or meaning of the questions, and their answers made it evident that they were
interpreting the questions in the way in which they were intended to be read and
understood, a high level of face validity was evident.
However, due to a low response rate (105 people returned their surveys out of 650
mailed out, ie 16% response rate)– attributed to the newness of the Village, and
residents going through a transition and evaluation stage – the data has not been
published and was not used in the development of the thesis overall. The n was
insufficient to determine significant differences between groups. However,
104
percentages were calculated to gain a sense of physical behaviour patterns and depth
of engagement with the health-related resources across the Village for all of the
demographic or socioeconomic groups living there.
The survey is available for viewing in Appendix C of this thesis.
From this descriptive, statistical baseline, qualitative research data collection
methods were used to find out the types of social, psychological and contextual
processes that were at work to produce these early trends or indications, and to
ascertain a more in-depth view of the nature of lower socioeconomic residential
contexts as they pertain to health.
4.6.5 Phase Two: ‘The Blog’ – Online Qualitative Data Collection
Sixteen affordable housing participants self-selected for the online qualitative data
collection phase, or blog, by ticking the box on the survey saying that they would be
willing to participate in further research. A ‘blog’ is an online public forum
traditionally used by a single author for writing a diary, and is often accompanied by
photographic accounts to tell stories and share interests and viewpoints with others
(Bachnik et al, 2005, p.1). We chose this Information and Communication
Technological (ICT) medium as it offers participants the opportunity to write their
stories, opinions, and answers to the research questions in an online forum where
they are able to view the anonymous input of other members of the community, and
from where we could study their answers as a collective. Photographs of the
neighbourhood were posted, as well as questions for participants to answer, which
followed the following key themes:
• Self, Health and Space: What Moves You?
• Social and Psychological Aspects of Physical Activity
• Depth of Engagement with Neighbourhood Resources for Physical Activity
• Moving into a New Urban Environment.
• The Effects of a New Urban Context on Health
The following insertion is a sample from the blog to demonstrate its appearance on
105
screen:
Social and Psychological Aspects of Physical Activity
This is the last post for questions about the Kelvin Grove Urban Village and the
amount of physical activity you do. Please write as much as you can...
1. Would you say that, in a general sense, you are aware of how much physical
activity or exercise you achieve during the day, and do you worry about it, or try to
increase the amount? Do you ever consider taking more exercise, or are you content
with how active you are?
2. If you see an ad on the TV telling people to do more physical activity, or hear a
health promotion message about it on the radio does this make you want to become
fitter? Do you ever act on these messages, or do you forget about them soon after
hearing them?
3. What types of thoughts do you have that would make you want to increase your
physical activity levels? What kinds of things play on your mind or which life events
might suddenly make you motivated to exercise?
4. If you see people out and about exercising, does this inspire you to become more
active? Do you compare yourself to others’ bodyweights in and around the area that
you live? How does this make you feel?
5. How interested would you be in being part of a social group that organised group
walks, or bicycle rides, or games in the local park? Why/why not? And would you
106
like to hear about such events online, by mobile/home phone, texting, or pamphlet in
the mailbox?
posted by Julie-Anne @ 8:32 PM 73 comments
A total of 214 comments were made by participants on the blog.
Participants wrote comments, anecdotes, stories, and their opinions about each of
these topics, which sought to investigate their psychological relationship to both
physical activity and the general pursuit of health, and the quality of the KGUV
environment for allowing them to engage in various types of physical activities.
Because the participants were from a lower socioeconomic group, most did not have
access to a computer, and QUT laptops were loaned to them for use in their homes
over a period of days or weeks until their contributions were complete. Participants
were enthusiastic to learn the skills to participate in this online data collection
process, and showed great interest in the development of the blog. All posts were
anonymous, and while participants could view the contributions of others, they were
not able to identify them.
All data can be viewed at the blog site:
http://theeffectsofanewurbancontextonhealth.blogspot.com/
A full copy of the blog and all the contributions by participants are attached in
Appendix D.
4.6.6 Analysis of the Online Qualitative Data
The blog data was copied and transferred into the NVivo software program for
coding and analysis. The data collected on the blog was treated as ‘initial entry’ and
scoping data that gave an overall impression of the participants and their relationship
with their place of residence and physical activity. In line with the emphasis on
uncovering more about the nature of the contexts of a lower socioeconomic
residential group who had recently moved into a new urban village, the online
contributions of participants were scanned and distilled for themes or basic topics
that epitomised how important they saw physical activity being as part of their daily
107
lives, and the extent to which they responded to and interacted with their
neighbourhoods in these early stages of moving to the Village. The blog data
provided a basic assessment of whether their relationship with a new environment,
which contains a number of specific design characteristics, was shaping their
lifestyles in ways that made them more physically active. Moreover, it addressed the
question of what were the processes and relationships at work in this living context
driving changes in lifestyle, or intervening with current attitudes, beliefs,
perceptions, and practices.
Although the participants’ responses were relatively diverse in the sense that the
barriers they saw existing in their lives that prevented them from being ideally active
were different in nature, they were still able to be grouped under themes. For
example, not being able to leave the house for reasons of physical illness, treatment
programs, anxiety or depression, were captured within the broader category of
‘physical and mental illness’. The data was analysed under three broad ‘key-
categories’ which were further divided into sub-categories with various properties,
giving further detail to the nature of the individual, neighbourhood, and broader
ecological contextual influences shaping this group’s relationship to physical activity,
and the relative importance of it in their lives. The analytical process involved a line-
by-line evaluation of the written phrases and stories to explore the interactions and
processes between their relationship with physical activity and their relationship with
their living environment. Specifically, I wanted to find out the extent to which they
felt comfortable engaging with their environment as a particular social demographic
within a mixed-tenure context. To illustrate, quotes such as ‘If I see other people
exercise I feel bad, as they are fitter and better looking than I am and I feel if people
see me exercising I will just look fat and stupid, so it quietly motivates me to better
myself but makes me feel bad…’ shed insight as to some of the tensions between
wanting to become involved in activities around them, but being held back by a lack
of confidence or low self-esteem.
Utterances such as these were transported into shared or common categories that
were identified through a process of comparing and contrasting sections of the data.
For example, focussed coding resulted in conclusions such as the participants
holding a shared belief that while health promotion around physical activity was
108
largely to be mistrusted, physical activity was an important part of life that they
would like to be able to do more of. Further, a theme emerged that participants were
held back by circumstantial factors in their lives and personal beliefs that made
achieving an active and healthy lifestyle difficult. As these quotes explain:
• ‘I am unable to leave [husband] unattended even to take a quick walk around
our pathways.’
• ‘I rarely use the parks or BBQ areas because I tend not to have the time.’
• ‘I do not use the BBQ areas yet because I cannot do that because I am alone.’
• ‘The news always says that people are being attacked, so I don't go out…’
The analysis followed a relatively standard grounded theory approach, and this can
be illustrated by the following extract of coding, note-taking and memoing:
Quotes Coding Notes
‘I have also been motivated to
go for a run in the area, which I
haven’t done for years due to
illness, and have found the
pathways useful for this as they
are broad…’
Mental Illness
Inhibition
Health-Resources as
‘Intervention’
Positive aspects of KGUV
neighbourhood as respite from
condition
This was a young woman who
had been battling anxiety and
depression for many years. She
used to enjoy track and field
events in her high-school years,
however, the mental health
problems had prevented her
from having success in the
workforce or from pursuing
running, which she had
previously enjoyed.
4.6.7 Phase Three: In-depth Interviews with BHC Residents (Face-
to-Face Data Collection)
Eight affordable housing residents responded to a mailed invitation to participate in
the interviews, saying that they would be willing to be involved in this stage of the
research (a 25% response rate). These participants had not participated in the survey
or blog aspects of the research, and were unlikely to have agreed to participate
without a financial incentive (an important note for future researchers trying to
109
access groups who do not self-select for research participation, but who do contribute
to trends in morbidity and mortality). This provided an opportunity to explore
individual and household relationships, as well as broader contextual neighbourhood
influences on how active participants were likely or able to be. It allowed for
questions to be asked at the individual level, and then opened up to questioning the
whole household about the factors that played into whether or not the family
achieved an active and healthy lifestyle. Individual interview schedules were drafted
around the following key areas of investigation:
• Experiences living in previous neighbourhoods – impressions and opinions
• Families of origin – how important was an active and healthy lifestyle in the
family you came from?
• Living in KGUV now – impressions, experiences, opinions
• How important is healthy living, and what do you do to keep healthy?
• What images come to mind when you think of keeping fit and healthy?
• Which health promotion campaigns can you think of that are effective?
• What are the current barriers to increasing the amount of physical activity
that you achieve, and what would you be interested in doing if there were no
barriers?
• What kinds of activities would your children be interested in doing and what
could KGUV do to improve options for parents and children keeping fit and
active?
Then questions pertaining to the role of the whole household in shaping lifestyle and
physical activity were drafted around the following key points:
• Describe a typical day
• Describe a typical weekend
• Who is keen to do more physical activity in the family?
• What are some of the things that make it difficult to do things together and
stay active?
• If someone in the family suggested doing more physical activity, would the
rest of the family be likely to follow that suggestion?
110
While these core issues were addressed in each interview, participants were
conversed with about a diverse range of issues within their living situations and
contexts that affected their relationship to health, and due to the lifestyles of this
particular group, a range of health-risk behaviours such as smoking, drug and alcohol
abuse, and dietary intakes were also discussed at length. An important aspect of the
interviews is that they explored the influences of various living ecologies in each of
the participants’ pasts – including families of origin and previous neighbourhoods in
their adult lives – on their current lifestyles. Each interview with the participants and
the members of their households took between one and a half and two hours and
were transcribed and transferred into NVivo software for analysis. The interview
schedules and transcripts are available in Appendix E of this thesis.
4.6.8 Phase Four: Community Focus Group
A BBQ was held with the aim of conducting informal, opportunistic interviews with
residents to verify and clarify themes that had arisen in the blog and face-to-face
interviews. An invitation was mailed out to the residents in the affordable housing
units, and while many turned up, only six ended up participating in the recorded
focus group. A rough interview guide was used to direct the discussion with a range
of people who contributed over the course of this social event to a general
conversation about the potential of the Village to improve the health and lifestyle of
the affordable housing residents. BBQ attendees were keen to voice their opinions
about how their lives in the apartments within the Village were progressing and
affecting their health. This provided an opportunity to anonymously bring up the
themes raised in the interviews to see if there was a general consensus around them,
and to invite other perspectives and ideas to be voiced on these topics.
The outdoor focus group discussion centred on the following key questions, and is
available in Appendix F.
• Describe an ideal neighbourhood for your current family living situation
• What do you value in KGUV?
• What do you dislike?
• What makes a difference to healthy and active living in a neighbourhood?
111
• What would you like to have more access to?
• How influential is the behaviour of neighbours in affecting your lifestyles and
health?
• How important is being healthy to you and your family?
The discussions were recorded, transcribed, and transferred into NVivo software for
analysis.
4.6.9 Analysis of the Face-to-Face (Interview and Focus Group)
Qualitative Data
According to Charmaz (2006), a core benefit of the social constructionist grounded
theory approach is gaining an insider perspective of the meanings behind the patterns
of behaviour that can be observed in a particular context. This approach allows a
focus on time, culture, and context; challenging the use of traditional, positivist
methods (Hallberg, 2006). In an analytical sense, I adhered to the Berger and
Luckman (1966) approach to studying human practice in context by noting the
patterns of practice there, and then exploring the social influences involved in the
construction of these over time. I explored the historicity of a particular social group
to unearth the habituation of their conceptual relationship with physical activity as it
evolved over time. We analysed the data for clues as to how this important health-
related behaviour came to be institutionalised within their living contexts as a
negative or low priority construct. Thus, concepts were built out of the stories told by
the participants about their childhoods, their teenage years, their experiences in
previous poor neighbourhoods, and their perceptions and practices around physical
activity in their current neighbourhoods at this point in their lives.
The data from the blog and the transcripts from the interviews and focus group were
transferred into NVivo software for coding and analysis. An inductive analysis fitting
with the constructionist approach that emphasises the importance of respondents’
narratives of their experiences was used (Charmaz, 2006). In line with the emphasis
Charmaz (1995) places on processes, actions, and consequences, I conducted a line-
by-line coding procedure which provided subjective, temporal accounts of how
physical activity as a concept was shaped and reinforced over time amongst these
112
participants. The phrases and narratives they provided revealed how the different
social and living contexts through which they travelled had created harsh and hostile
barriers to feeling confident about both their body image and their ability to become
physically active. I also used focussed coding, which is a more directive means of
locating emerging themes and codes in the data, to identify the key processes
mediating the people, place and health relationship in this case. Charmaz (2006) uses
this focussed approach to develop the conceptual categories, which, according to
Moghaddam (2006) become the ‘building blocks’ for the theoretical development
later in the process. This focussed, or conceptual, coding involves an abstraction of
the data as it has been collected, organised, and analysed into sets of shared
phenomena underpinning the narratives (Charmaz, 2000). These analytic codes or
categories allowed me to develop a conceptualisation of the data as it was collected,
recorded, and analysed. I developed a number of conceptual codes that appeared to
underpin the collective experiences representing the evolution of the attitudes,
beliefs, and behaviours in relation to physical activity amongst that residential group.
This was followed by an exploration of how these conceptual categories relate to one
another within the context of the groups’ experiences over time. In other words,
while I could gather together key shared experiences and phenomena – such as
abuse, neglect, early homelessness, or feeling afraid in one’s neighbourhood – I then
had to explore their connectedness to one another in order to develop the theory. In
other words, how do these concepts tie together in a meaningful way and what is the
core category mediating these subsets? To do this, I developed sub-categories, for
example ‘types of abuse’, and ‘different experiences and contexts of abuse’ that tied
to this important category. The next important category of ‘leaving home early and
homelessness’ was analysed as relating to the previous category and a strategy, or
consequence of the initial conditions of early childhood abuse and neglect. The key
categories that typified their experiences of growing up poor and how these related to
one another in an almost catalytic sense were revealed in this part of the analysis.
Finally, a core category of identity management was located as the constant framing
and reframing of self against others in poor contexts; the striving of participants to
mould their identities as more palatable or less stigmatised than those around them,
with strategies to do this often failing and resulting in even more unhealthy and harsh
113
living situations. Theoretical coding was used to bring together the primary
conceptual categories as they relate to the core category as a means of building
theory and insight about how contexts affect physical activity levels. This process
resulted in the production of a model for framing thinking and approaches in future
research.
In addition to the analysis conducted on the data from the blog and the interviews,
memos and observation notes were made to aid a reflection on the relationship
between the goals of the research and the things that mattered most to participants in
their living context. A consistent divergence from the topic of physical activity to
‘what matters to me here and now’ was noted, and the events and reactions of
salience to participants were categorised. Notes on the participants – such as smoking
habits, weight, age, family dynamics, and the nature and contents of the households –
were also made.
The details of these qualitative data collection phases, including the findings and the
implications are outlined in Chapters Six and Seven of this thesis in the form of
published papers:
Carroll, J., Adkins, B., Parker, E., Foth, M. (2007). The Kelvin Grove Urban Village:
What aspects of design are important for connecting people, place, and health? In:
Proceedings International Urban Design Conference: Waves of Change – Cities at
Crossroads, Jupiters Casino, Gold Coast.
Carroll, J., Adkins, B., Parker, E., Foth, M., Jamali,S (2008). My Place through My
Eyes: A social constructionist approach to researching the relationships between
socioeconomic living contexts and physical activity, The International Journal of
Qualitative Studies in Health and Well-Being, In Press.
4.7 Conclusion
This chapter has outlined the methodological framework, research design, data
collection, and analysis. As this is a thesis by publication, the data has been written
up in articles, reviewed and published as an ongoing part of this PhD research
project. The following three chapters contain three full peer-reviewed articles that
114
were published from the above data collection and analysis efforts. These contain
detailed versions of the data collection, analytical phases, and key findings resulting
from the research.
115
Introduction to the Published Papers
The findings from the data collection and analysis techniques outlined in Chapter
Four of this thesis are presented in the following three published papers.
The first published paper from the thesis was produced from an analysis of the online
data from the blog ‘The Effects of a New Urban Context on Health’. The paper was
internationally peer-reviewed and published in the International Communication
Association (Health Division) Conference Proceedings (2007). The paper, entitled
Blogging about Jogging: Digital stories about physical activity from residents in a
new urban environment with implications for future content and media choices in
population health communication made the case for a social constructionist grasp on
the relationship between the nature of particular living contexts and the position, or
social location, of ‘physical activity’ as a concept within them. It was argued that this
conceptual and methodological approach would result in more meaningful, and well-
matched health communication programs within these contexts – be they defined as
social, economic, geographic, or cultural.
Three key contextual or ecological factors shaping how active and healthy this
residential group were likely to be were identified in the data. Firstly, structural or
circumstantial factors in their lives, such as disability, illness, work constraints,
caring for others, and fear about living alone that prohibited them the time, autonomy
or mobility to use the resources provided for physical activity. Secondly,
characteristics of the neighbourhood such as an appealing aesthetic, positive
reputation in the media, close proximity to a reputable University, and positive
relationships with others living and working in the Village all contributed to
participants’ enthusiasm to engage with their environment in ways that would allow
them more physical activity. However, personal factors and reflections, such as self-
consciousness about exercising in public or body-image were located under the
concept of ‘social comparison’, which deterred them from being as active as they
might potentially be there. Finally, and perhaps most importantly, one of the most
powerful deterrents was the general consensus of hostility amongst the group to any
promotion of physical activity in the media. Distal media influences – whether
commercial or governmental – were treated with mistrust and suspicion by the group.
116
This highlights the need for a particular approach to increasing physical activity
levels in neighbourhood or community contexts where the resources are present, but
a number of complex social and psychological processes are acting as inhibitors to
engagement. The findings point to the importance of engaging in in-depth
investigations of the social processes governing patterns in health-related trends prior
to creating and disseminating messages about health or behavioural change.
The second published paper draws on an analysis of the blog data and emerging data
from face-to-face in-depth interviews, and was published in the conference
proceedings for the International Urban Design Conference, held on the Gold Coast,
2007. The paper, entitled The Kelvin Grove Urban Village: What aspects of design
are important for connecting people, place, and health? extended the work that went
into producing the first layer of findings, by deepening both the data collection and
the analysis of contextual or ecological influences on the lifestyles and physical
activity levels of this lower socioeconomic residential group. I collected data via
face-to-face interviews, and a focus group. Staying within the social constructionist
approach, I asked participants to draw out specific aspects of design within KGUV
that they saw as contributing to, or inhibiting their physical activity levels. Questions
were open-ended and allowed participants to reflect on their new neighbourhood at
length, and to bring to the forefront what they saw as salient in this environment in
terms of their quality of life there, and their propensity to lead physically active
lifestyles.
Participants’ accounts of the Village revealed that living in close proximity to other
lower socioeconomic residents within the same apartment block was highly
detrimental to their quality of life, and generated strong barriers to engaging with the
neighbourhood to increase physical activity levels. High levels of intra and inter-
apartment conflict, a high number of police and ambulance call-outs, discarded
intravenous (IV) drug needles on the ground and the water tanks, and anti-social
behaviour amongst residents meant that the people we interviewed were reluctant to
leave their apartments, and spent a great amount of their time trying to keep safe and
manage risk. However, on the other hand, participants did report positively on the
design of the broader Village, with special mention being made to being close to the
University, close to shops, having access to parks and public transport, being close to
117
the CBD, and the place’s positive reputation in the media. Two key recommendations
were made. Firstly, more sensitive considerations need to be made to mixed tenure
design being more appropriately and subtly integrated into planned communities.
Secondly, for an increased interdisciplinary co-operation between public health and
urban design, wherein designers heed findings from studies into ‘area effects on
health’ and health communicators conduct more in-depth contextual analyses of
living areas prior to the design and dissemination of information about increasing
physical activity levels there.
What was evident in this analysis was the relatively low priority status given to
physical activity in their everyday lives, and their preoccupation with other, more
immediate problems and challenges. At this stage in the research, we identified the
need for a more in-depth examination of the nature of these lower socioeconomic
contexts, and how they had influenced the participants over time to generate the
kinds of attitudes, dispositions, and indeed disregard for physical activity that we
were observing. Despite the design of KGUV to promote a physically active
lifestyle, it was apparent that the nature of the contexts these people were used to
inhabiting were more powerful than physical infrastructure in moulding health-
behavioural patterns.
Findings from the final stage of data collection and analysis are provided in an article
which has been accepted for publication on 11th August 2008 by Professor Hallberg
(Editor) following international peer review in the International Journal of
Qualitative Studies in Health and Well-Being, and is currently in press. The article is
entitled My Place through My Eyes: A social constructionist approach to researching
the relationships between socioeconomic living contexts and physical activity. This
analysis was taken from the blog data as well as interview and focus group data with
residents living in the government supported housing option within KGUV. I
continued the social constructionist grounded theory approach to data selection,
collection, and analysis to unearth firstly, what the patterns in their current attitudes,
beliefs, and practices were in relation to their likelihood to take up a physically active
lifestyle in the KGUV environment, and secondly, to reveal the interactions, social
processes and other contextual influences that had led to their particular construction
of physical activity as it stands now. Paying particular attention to Berger and
118
Luckman’s (1966) text, The Social Construction of Reality, I employed the concepts
of historicity, habituation, and institutionalisation as analytical tools drawing out how
the contextual influences on these women over time that carved out their particular
relationship to the health-related behaviour of physical activity. A focus on
subjectivity, agency and time was highlighted as a key conceptual and
methodological contribution to unearthing findings not accessible via traditional
positivist methods. I followed Charmaz’s (1995; 2006) social constructionist
approach to grounded theory to reveal categories ‘being flogged up something
fierce’, ‘running away’, ‘sleeping with one eye open’, ‘you’re just fat’ and ‘exercise
as a dream’ as key contextual influences mediating socioeconomic context and
physical activity levels. A core category of ‘identity management’ was located. The
paper made a substantive, conceptual and methodological contribution to the ways in
which we understand, think about, and study the contextual relationships between
socioeconomic living environments and physical activity.
119
Statement of Contribution of Co-Authors
The authors listed below have certified* that:
1. they meet the criteria for authorship in that they have participated in the conception,
execution, or interpretation, of at least that part of the publication in their field of expertise;
2. they take public responsibility for their part of the publication, except for the responsible author who accepts overall responsibility for the publication;
3. there are no other authors of the publication according to these criteria;
4. potential conflicts of interest have been disclosed to (a) granting bodies, (b) the editor or publisher of journals or other publications, and (c) the head of the responsible academic unit, and
5. they agree to the use of the publication in the student’s thesis and its publication on the
Australasian Digital Thesis database consistent with any limitations set by publisher requirements.
In the case of this chapter:
Publication title and date of publication or status: ‘Blogging about Jogging’: Digital
stories about physical activity from residents in a new urban environment with
implications for future content and media choices in population health
communication. In: Proceedings 57th Annual Conference of the International Communication Association, San Francisco, 2007.
Contributor Statement of contribution
Julie-Anne Carroll
29th July 2008
Conducted revisions, assisted with structure and the presentation and conducting of analysis and findings, sentence-level-editing and writing corrections. Presented the article at the 57
th Annual Conference of the
International Communication Association, San Francisco, 2007.
Dr Barbara Adkins
Assisted with the methodological design and the refining and application of the conceptual framework to the investigation. Made revisions to the article, and assisted with the overall structure of the article and the presentation of analysis and findings.
Associate Professor Elizabeth Parker
Conducted revisions, assisted with structure and the presentation and conducting of analysis and findings, sentence-level-editing and writing corrections.
Dr Marcus Foth
Conducted revisions, assisted with structure and presentation of analysis and findings, sentence-level-editing and writing corrections.
Principal Supervisor Confirmation I have sighted email or other correspondence from all Co-authors confirming their certifying authorship.
Dr Barbara Adkins 29th July 2008
Signature Date
120
Chapter Five
Published Paper One
Title: ‘Blogging about Jogging’: Digital stories about physical activity
from residents in a new urban environment with implications for future
content and media choices in population health communication.
Authors: Carroll, Julie-Anne and Adkins, Barbara A. and Parker,
Elizabeth A.
Published: In Proceedings 57th Annual Conference of the International
Communication Association, Health Division, San Francisco, 2007.
5.1 Abstract
This paper contributes conceptually and empirically to the problem of constructing
effective health promotion communication to lower socio-economic groups about
increasing daily levels of physical activity. Epidemiological research has
demonstrated that people living in lower socioeconomic neighbourhood contexts are
less likely to engage in recommended levels of physical activity. However, the
reasons for differences in uptake across contexts remain relatively unknown and
poorly conceptualised, with poorer groups remaining less likely to respond to
interventions and communication campaigns in a sustainable way. This paper firstly
outlines a gap between our understanding of this domain from epidemiology, and the
nature of the knowledge required to construct contextually sensitive messages in
health communication around this problem. Secondly, we apply social constructionist
theory to the development of a theoretical and methodological framework for
investigating the issue, and thirdly, the paper reports on findings from an online
qualitative study which uses a ‘blog’ to record digital stories from a lower
socioeconomic group of residents living in a new urban village, Brisbane, Australia,
about their daily patterns of physical activity. The findings are discussed with
implications for media and content in future health communication efforts on this
121
topic, and an analysis of the role of the ‘blog’ as both a tool for data collection and a
medium for health promotion is provided.
5.2 Rationale and Background: Socioeconomic Inequalities in
Physical Activity Rates and Responses to Population Health
Communication.
Within recent discussions on the increasing number of sedentary adults and rising
obesity rates within Western countries (Chan, Ryan, & Tudor-Locke, 2004; Spinks,
Macpherson, Bain, & McClure, 2006; Mummery, Schofield, Steele, Eakin, & Brown,
2005; Department of Health and Ageing, 2004) critical points are emerging on health
promotion’s apparent lack of integration with communication theory to achieve its
mass media goals of reducing these rates (Finlay & Faulkner, 2005; Bauman et al,
2006; Laitakari, 1998). While the media via which messages promoting physical
activity are best delivered remain under debate (Pinto et al, 2002; Spinks et al, 2006),
and within the context of mixed empirical findings (Marks et al, 2006; Glasgow et al,
2001), criticism is arising around the need for designers of population health
communication to take a less simplistic, or ‘blanket-approach’ to public message
delivery, and to adopt a more social constructivist approach to the design and
dissemination of health information or knowledge (Dahler-Larsen, 2001). Finlay and
Faulkner (2005) report in their review of mass media campaigns that ‘little in-depth
consideration [had been given to] the comprehensive media processes involved in
creating media processes and meaning’ (p. 121). They conducted a critical media
studies analysis on a systematic literature review of campaigns to increase physical
activity and concluded that there was an absence of a ‘more sophisticated
understanding of the media processes of inception, transmission, and reception’ (p.
121). They also note that with this recommendation comes the need for an increase in
the number of qualitative studies being done around the promotion of physical
activity in order to gather more knowledge about the contexts in which such
messages are sent and interpreted. Further, Bauman et al (2006) make the point that
‘most important, and most often neglected, is the formative stage of developing
effective communication messages that are relevant for the proposed target
populations’ (p.1). Thus, there is an established need for increased research within
122
the area of communication and rhetorical design in terms of a creating a better match
between message content and media and target group, as well as a continued
uncertainty regarding the best means of delivery.
This need for contextually specific health communication is particularly evident in
light of the inequalities recorded in epidemiological data and research which depict
socioeconomic differences in the amount of physical activity people achieve on a
daily or weekly level (Karvonen & Rimpela, 1997;O’Loughlin et al, 1999; Giles-
Corti & Donovan, 2002).While the phenomenon of decreasing physical activity
levels and soaring obesity rates among both adults and children in developed
countries is ultimately a ‘whole- population’ public health issue, research and
statistics show significant differences within demographic subgroups of western
populations, with lower socioeconomic groups - as measured by income, education,
employment, occupation, ethnicity or area of residence - being less likely to respond
to health campaigns and messages promoting an increase in the amount of moderate
and vigorous physical activity individuals achieve on a daily or weekly basis.
Further, people living in lower socioeconomic contexts have been shown to under-
use environmental resources and facilities available to them for increasing physical
activity (Lindstrom, Hanson, Ostergren, 2001; Romero, 2005; Jacoby, Goldstein,
Lopez, Nunez, and Lopez, 2003; Karvonen & Rimpela, 1997; Giles-Corti &
Donovan, 2001). For example, a study by Giles-Corti and Donovan (2001) found that
although people living in a lower socioeconomic area had superior access to health-
related resources for physical activity, such as sidewalks and parks, they were less
likely to utilise them for exercise or the pursuit of health. They also found that
although this group walked more for transport than their wealthier counterparts (not
significantly so), they were 36% less likely to undertake vigorous physical activity.
Further, a study by Karvonen and Rimpela (1997) found that characteristics in poorer
neighbourhoods were more significantly connected with a range of higher-risk health
behaviours than individual measures of disadvantage, with adolescent girls more
likely to be physically inactive where overall unemployment levels were high, and
more likely to be active where owner-occupied housing rates were high (p. 1089).
Such empirical findings raise important questions about what needs to be considered
in the design and implementation of communication campaigns to increase urban
123
population physical activity levels, such as ‘what are the psychological and social
components of a poor environment that create less healthy lifestyles?’ and ‘what do
we need to know about the reality or aesthetics of living in a less wealthy home or
neighbourhood context prior to devising rhetoric or implementing interventions
aimed at behavioural change?’.
There is general agreement within the health inequalities literature that the reasons
for which people living in different socioeconomic and geographic contexts do not
respond equally to health promotion efforts, nor why health-behaviour patterns are
clustered differently among such contexts have not yet been fully explained by
empirical efforts (Mcintyre, Ellaway, & Cummins, 2002). Research has not yet been
able to convincingly explain why higher socioeconomic groups appear to respond
more quickly and in a more sustainable way to mass communication about health-
related practices and behaviours (Picket et al, 2002; Frolich et al, 2002). And while
much research is committed to locating factors in the urban environment responsible
for low receptivity and uptake (Jacoby et al, 2003; Romero, 2005; Lindstrom, 2001;
O’Loughlin et al, 1999; Kamphuis, 2006), Giles-Corti et al (2002) found in their
study on the environmental and individual determinants of physical activity that
individual and social factors appear to be more important in determining activity
levels than factors in the physical environment. They noted that, while ‘access to a
supportive physical environment is necessary, it may be insufficient to increase
recommended levels of physical activity in the community’ (p. 1793). In a recent
paper on the people versus places debate, Giles-Corti makes the comment that
‘comprehensive interventions targeting both people and places are required to
increase physical activity’ (p. 357). Within the health communication literature on the
topic Booth et al (2006) posit that research needs to take account of the specific
qualities of a target group to ‘provide more relevant and appealing options for those
who might other-wise be missed by ‘one–size-fits-all’ physical activity promotion
strategies’ (p. 131), and although adequate recognition is being given to the need for
different cultural (O’Loughlin, Paradis, Kishchuk, Barnett, & Renaud, 1999) and age
(Burke, Beilin, Dunbar, and Kevan, 2004; Brawley, Rejeski, & King, 2003) groups in
relation to communicating about the promotion of physical activity, we argue that
similar contextual sensitivity, and attention to appropriate content and media be
given to poorer demographics.
124
5.3 The Media Debate: Where should we be Promoting Physical
Activity?
While the differing attitudes, beliefs and structural realities of target groups remains
a challenge for health communicators, the most appropriate media or mode of
delivery are also researched extensively for their effectiveness in promoting physical
activity and exercise among different social groups (Marks et al, 2006; Reger et al,
2002). Recently, a discussion in the literature has emerged regarding the nature of
both the message content and media used to deliver messages about physical activity,
with much research being done to evaluate paper-based versus online formats
(Marshall, Owen, & Bauman, 2004; Pinto, Friedman, Marcus, Kelley, Tennstedt &
Gillman, 2002). For example, while Glasgow et al (2001) have found the association
between children utilising Information and Communication Technologies (ICTs) and
over-weight to be a problem, other researchers advocate the Internet as an effective
mechanism for mass message dissemination among sedentary adults, with Marcus et
al (2000) making a comprehensive argument for future considerations of interactive
modalities that might eliminate the paradox of using an inactive channel to generate
physical activity among people (p. 125).
Interestingly, however, Marks et al (2006) found that a paper-based intervention was
more effective than an Internet-based campaign aiming to increase the physical
activity levels of adolescent females in the U.S. Two groups of young women had
either online reminders or paper work books delivered to their homes, and while both
interventions yielded a significant increase in physical activity self-efficacy and
intention, the paper based intervention was the only one to see an increase in reported
levels of physical activity.
Other mass media efforts that integrated the use of the Internet in their campaigns
have found that while they are successful, they are not sustainable due to a ‘decrease
in the number of participants that use the system’ (p. 113). However, little work has
been done using more mobile technologies, such as cell phones and instant
messaging, or sms, which do not restrict people or tie them to a geographic location,
or web-based commitment that participants may be reluctant to sustain. Overall,
there is somewhat of a consensus that combinations of different media and integrated
125
efforts are most likely to succeed in future, with room for further research into online
formats for getting messages and persuasion about healthy lifestyles to different
social groups. However, future efforts that plan to rely on online mechanisms for
promoting physical activity will depend greatly on the ICT access and ability of the
participants, and there is currently little research into the impact of the technological
divide on the success of Internet-based campaigns as communication vehicles to
promote healthier lifestyles. Issues of power, control, and the democratic nature of
such media remain under scrutiny as the majority of Western populations embrace
the Internet, email, chat-programs, online discussion forums and interactive games,
while sub-groups within these populations fall behind in both technological and
health aspects of modern lifestyles (Burbulus, 2006; Azari & Pick, 2004)
5.4 Applying Communication Theory to the Problem: Can a social
constructionist perspective help?
In our review of the current debates in literature regarding media and message in
health communication on physical activity, it became apparent that the problem
needed to be addressed on both these levels, and within a research paradigm that
would allow us to examine lower socioeconomic contexts conceptually and
empirically to determine what would be most likely to resonate within the lived
experiences of these groups. The need for a theoretical body that emphasised the
importance of context in understanding human behaviour and communicative
exchanges became apparent in light of our inquiry into this public health problem,
wherein people living in contexts with particular economic and social qualities are
consistently more likely to engage in a range of health-risk behaviours. While the
importance of contextual awareness and sensitivity is paramount within broader
communication theory, research, and practice (Littlejohn, 1996), with numerous
models and frameworks having been researched and developed with the purpose of
studying, analysing, and understanding human interactions and behaviours in a range
of social and cultural contexts (Berger & Luckman, 1966; Giddens, 1982; Shimanoff,
1980; Bernstein, 1971; Penman, 1992; Goffman, 1963), this emphasis is less visible
in epidemiological research. Within public health research, much of the emphasis
remains on locating population traits that can be significantly linked to particular
health behavioural profiles, with these groups being targeted with increased
126
information and education about the risks of illness and death associated with that
type of lifestyle (Spinks et al, 2006; Kelly et al, 2006). The limitations inherent
within this approach are such that they are not conducive to the generation of
knowledge about a context that is likely to aid the design, production, or delivery of
successful rhetorical and persuasive tactics or campaigns.
For example, while you may be able to use epidemiological methodologies to locate
a statistically significant link between lower education and increased likelihood in
engaging in health risk behaviours, this approach is not suited to revealing the
pertinent properties or social and cultural territory of a low education that leads to
that particular lifestyle; and this is the type of knowledge that is vital in the
preparation of communication messages and media that will resonate in that context.
We argue that the current conceptual and methodological frameworks employed to
identify ‘problem demographics or areas’ are useful only up to and including that
point, and that from there, the communication discipline is more likely to be of use in
the types of thinking and techniques it could offer to study these contexts. Thus, we
do not seek to identify environmental determinants within neighbourhood contexts
that ‘produce’ various physical activity levels, but to find out more about the social
contexts and inherent contingencies around which such norms or patterns are
generated.
A range of communication theories, such as symbolic interactionism, dramatism and
narrative are all likely to be useful in studying human behaviour in context, we have
employed the closely-related family of social constructionism as both an inspiration
and a theoretical and methodological paradigm for this study. The key notion
underpinning theories of social constructionism is that much of what we experience
as reality is a product of our interactions and communications with others (Harre,
1972; Gergen, 1985). Also, that people’s perspectives and interpretations of their
contexts or worlds depend on their social realities and that while human agency is
always present, there are many social forces that shape the way we react and respond
to our immediate environments. Further, that the knowledge that we gain during our
lives is determined by the language that we use and which is used around us, and
what we understand this to mean. Most importantly, the social constructionist
perspective views all human knowledge to be contextual, and something that evolves
127
across spatial and chronological events (Penman, 1992). There has been some health
research that takes a contextual view to understanding how different habits or
responses arise and form among both health practitioners and the general population
(Jordens & Little, 2004), however, most research in this area is reticent to take
account of a contingency-based approach to understanding contextual effects on
behaviour, and seeks rather to locate determining factors within the environment that
treat human agency as less salient in this process.
Thus, because the aim of our study was to investigate contexts as social locations for
generating insights into health or health-related behaviours, and how these are
constructed meaningfully within them, then the methodological research lens needs
to be magnified to capture the micro-processes that are of interest here. A
methodology that allows health behaviours within poorer urban contexts to be
studied as socially constructed, and further, to closely examine the impact of health
communication campaigns on the ears and eyes of those who appear not to be
producing the desired ‘behavioural outputs’- a qualitative approach that aimed to
capture the stories and interactions of residents within such a context - was sought. In
light of the current debates and inquiries in health communication research regarding
the potential or otherwise of online mechanisms to both research and promote health,
we decided to set up a ‘blog’ dedicated to the collection of opinions, insights,
comments, stories and explanations from people living in a low-income government
supported housing option in the Kelvin Grove Urban Village regarding the ways in
which their living environment affects their propensity to take up physical activity or
exercise for health reasons.
By doing this, we are able to address the three primary questions raised earlier in this
paper:
1. What is it about lower socioeconomic contexts that inhibit the uptake of
recommended levels of physical activity for health and well-being?
2. What is the nature of the message content that is most likely to resonate in
a meaningful way within these contexts (what are the self-evaluative and
adaptive rules?)
3. What are the best mediums or communication formats for delivering
128
rhetorical and persuasive campaigns to increase daily levels of physical
activity within these contexts?
This theoretical perspective and methodological framework allowed us to study this
problem with the aim of understanding how physical activity levels and patterns are
socially constructed in situ and governed by norms, habits and practices that evolve
over time within these contexts. Observation methods and notes were also used, but
are not displayed as ‘data’ in this particular paper.
5.5 The ‘Blog’ as a Research Tool
A ‘blog’ is a form of website that is used as a type of diary, with entries made
primarily by the author of the blog. The appeal of the blog is said to be due to the
creation of a space where people can ‘express their opinions and views on different
topics without fear of censorship’ (Bachnik et al, 2005, p. 1) and blogs have been
found to ‘generate a sense of community’ among people with shared interests (Nardi
et al, 2004). Some of the many reasons for blogging include documenting one’s life,
a commentary, catharsis, a muse, and as a community forum. While blogs have
certainly been used among academic and research communities to share experiences
and processes, such as that of the PhD journey (Archives by Thread, Air-1, 2006), or
to share knowledge or resources such as the case of a blog created for learning
research methods (Giarre & Jaccheri, 2005, p 2716), we are not aware of any current
efforts that utilise the blog as a means for actual collection of data.
The blog provided a way to bring individual, online answers to research questions
together in a visually accessible community-based collection of responses. In line
with the research aims of this study, which were to ascertain the contextual processes
in a lower socioeconomic living environment contributing to physical activity levels
of residents, the blog allowed residents to respond to questions on physical activity
and photographs of their neighbourhood and housing options at their own pace, and
with as much reflection as they needed, while simultaneously being able to observe
the answers and comments made by other residents. Additionally, while not true for
all participants, most could write their answers to the questions that were posted
without interference or even the presence of a researcher, while still being able to
129
read the comments of other participants. Implications for the democratic nature of
this method of data collection are discussed in further detail below.
5.6 ICT Access and Use for Lower-Socioeconomic Study Participants
The use of an online data collection mechanism raised the issue of access to
technology and the Internet, with poorer, less-educated residents less likely to have
access to both. Therefore, we provided those participants with no access to a
computer or the Internet with Queensland University of Technology (QUT) library
laptop computers and dial-up access for a period of four hours a day in their homes,
over a period of as many days as they needed to generate their responses. Some IT
support and training was given to participants, and enthusiasm to learn was high.
5.7 Data Collection Method: ‘The Blogging Experience’
5.8 Sample of Bloggers
Following on from the results of a pilot survey on the physical activity patterns and
habits of residents from different demographics within a new urban environment,
‘The Kelvin Grove Urban Village’ (KGUV) in Brisbane, Australia
(http://www.kgurbanvillage.com.au/), a sample of 16 residents from the public
housing group, Brisbane Housing Company (BHC), were chosen to participate in a
qualitative study using a ‘blog’. The participants were chosen in that they represented
residents living within a lower socioeconomic context. Within that sampling
framework however, criterion sampling was used to identify people who represented
a broad range of the characteristics within that demographic. Participants’ ages
ranged from 19 to 77 years, they had an income of less than $25, 000 per annum per
household, and in addition, the following characteristics were present among the 10
residents (these were ascertained from the survey):
• diagnosis of anxiety and depression
• diagnosis of cancer
• wheelchair bound
• mild acquired brain injury
130
• Being a full-time carer
• non-English speaking background
• Lone parent
5.9 Procedure
Participants contributed to a ‘blog’ by addressing questions posted by the researchers
about their relationship between their living environments, health promotion
influences, and their physical activity levels over a four-week period. The blog was
divided up by posts into four themes:
1. Moving into a New Urban Environment
2. Depth of Engagement with Neighbourhood Resources
3. The Social and Psychological Aspects of Physical Activity
4. Self, Health and Space: What moves you?
While themes 1-3 asked specific questions about how the built environment and
social and communicative processes influencing how active their lifestyles are, the
fourth post offered a space for free comments, opinions, stories, and networking
opportunities about their relationship with their neighbourhood and what ecological
influences would be likely to increase their physical activity levels.
The blog containing the data as written in by study participants can be found at:
http://theeffectsofanewurbancontextonhealth.blogspot.com/
5.10 Data Analysis
The comments and stories posted on the ‘blog’ by study participants were copied into
the NVivo 7 software for analysis. A thematic analysis was conducted to ascertain
emerging concepts that appeared in a repeated format within different stories,
explanations or accounts of the reasons for differing physical activity levels. Blog
entries were read in their entirety, and while already themed according to questions
by categories, sub-themes and topics were identified and coded into points of
potential significance for people designing mass or targeted communication aimed at
increasing physical activity levels among lower socioeconomic demographics.
131
5.11 Findings and Discussion: What are the factors influencing
physical activity levels in lower socioeconomic living environments?
As a means of drawing data about many aspects of neighbourhood contexts, as well
as reactions to the communication campaigns and messages that reach these contexts,
answers were sought around a range of place-based, as well as media and
promotional influences on physical activity in the urban environment. Table 1 below
has been drawn up to broadly illustrate the themes and sub-themes that emerged
regarding these influences on physical activity levels, and is discussed in further
detail with illustrative quotes from the data provided to demonstrate how participants
expressed their views on these issues. We propose that Table 1 represents a type of
‘checklist’ or list of factors to consider when communicating with residents living in
a lower-socioeconomic context, rather than a list of variables that are likely to
‘determine’ physical activity in these settings. It is based on the pertinent ecological
and communicative factors raised in the digital stories written by residents. Further, it
captures the importance of a shift from a ‘top-down’ approach to communicating
with lower socioeconomic groups on health, to a mediation of health knowledge and
initiatives in context.
132
Table 5.1 Ecological and Communicative Factors Influencing Decisions about Physical Activity among Lower-
Socioeconomic Residents in a New Urban Village.
Structural
Realities/
Environmental
Factors
Aesthetic
Proximal/Soci
al
Neighbourhoo
d Influences
Local
Relevance and
Media
Message
Source and
Credibility
Tastes and
Preferences
Community
Ownership and
role of ICT
Work duties
Carer roles
Disability/
Illness
Time constraints
Income
Urban design
Health resources
Safety/Lighting
Population
diversity
Body
weight/image
Neighbourhoo
d
relationships
‘Seeing others
exercise’
Social
comparison
Reputation of
place
Activities
available
Local
networks
Online
‘neighbourhoo
d’ forums
Pamphlets on
local events
Scepticism
about
Television
Health
promotion
‘overload’
Unobtrusive
nature of
message
Individual
agency and
choice
Trust in local
sources
Diversity of
activities
Range of
options
‘Lone’ vs
‘group’
exercisers
Self-
consciousness
Inclusive
environments
ICT access and
user ability
Local
dissemination
Neighbourhood
networks
‘Grassroots’
discussions,
decisions, and
initiatives
133
5.11.1 Structural Realities and Everyday Decisions about Physical
Activity
In order to gain an understanding of the kind of lived reality or everyday context in
which a health communication message is ultimately delivered, it is important to
consider potential structural constraints, or factors in the environment that might
support or promote lifestyle change. For this reason, we asked participants to write
about the ecological and urban design features in their environment that either aided
or prevented them from engaging in recommended levels of activity. An interesting
aspect to this finding was the general consensus among this lower-income group that
physical activity and exercise was not something that was pursued as an extra-
curricular activity with goals about health and/or body image, but rather something
that was smuggled into everyday routines, and only increased if the nature of the
routine changed, as this comment illustrates ‘Most exercise consists of getting from A
to B. No particular thoughts influence me to increase my activity except if I'm
running late for an appointment or something similar’ while others simply integrate
it into what has to happen that day: ‘My daughter attends the local school which is
only a short walk away’ and ‘I get to walk to work and that makes me healthy.’
Some participants stated that pathways and bikeways in the vicinity influenced their
physical activity patterns in that ‘I use the paths and bikeways to get from A to B’ and
‘I find them very useful. I have also been motivated to go for a run in the area, which
I haven’t done for years due to illness, and have found the pathways useful for this as
they are broad’. However, others do not relate these aspects of urban design to
health, stating that ‘I find them to be simply a requirement of a small urban area and
not specifically built as a walkway for exercising or riding.’ However, walking for
recreation or around the neighbourhood for sight-seeing or something to do did
appear to have increased as a result of the pleasing aesthetic and clean environment
reported by participants in the following notes: ‘I like the parks surrounding the area
because they are so gorgeous and I feel comfortable and satisfied with the air. I just
walk around and sit down and with the other people resting there’ and ‘I love the
Victoria park, if you walk there at night is it wonderful sightseeing, you can see the
beautiful city.’ Walking also appeared to have increased as a result of private
134
transport being unavailable to some participants, coupled with the close proximity of
public transport, as participants stated ‘It has been necessary for me to become more
physically active because of the lack of private transport. I thoroughly enjoy walking
so this has become an added bonus more than intentional.’
Other constraints within the participants’ homes, such as caring for partners, children
and older relatives was reported as being a structural constraint preventing them from
achieving the levels of physical activity they would like to, as stated by this
participant: ‘I am unable to leave [husband] unattended even to take a quick walk
around our pathways.’ Thus, for those designing the content of health
communication campaigns to increase physical activity in lower socioeconomic
target groups, the apparently low priority of it in people’s lives along with their equal
willingness to incorporate regular, brisk walking into daily routines and recreational
pursuits is useful as a guide for the types of suggestions that are made. Perhaps even
encouraging people to pursue options for respite for relatives requiring care might be
an indirect, yet highly effective means of improve both the health and quality of life
of people in these positions.
5.11.2 Aesthetic and Proximal Social Neighbourhood Influences
Local social networks and the pursuit of recreation and company among neighbours
in the government-supported housing option came through as being important in
terms of how residents felt generally about their well-being in the Village. As some
participants explained, ‘I have met some really interesting people here and have had
a great social experience’, and ‘I had no job when I came here, and I was welcomed
greatly by my neighbours and thought that was a great sign’. In addition, some of the
older people claimed that being in an environment with a diverse range of ages and
backgrounds being present were motivating factors to get ‘out and about’.
Participants noted that just by being in close proximity to others who exercised, or
seeing others enjoy themselves in the neighbourhood, was enough to motivate them,
as well as improving their perceived health, and their overall well- being, as is
demonstrated in the following quote ‘Young people keep you young’ and
‘Encouragement from other people who are doing exercise inspires me so much to
become more active’ and ‘I always think why they can do it and why can I not do it?’.
135
However, an interesting counterpoint was made by one of the younger female
participants, ‘If other people excercise [sic] I feel bad, as they are fitter and better
looking than I am and I feel if people see me excercising [sic] I will just look fat and
stupid, so it quietly motivates me to better myself but makes me feel bad.’ Such
insights are vital for health communicators in showing images to poorer young
women – who are statistically more likely to be overweight – of more well-off,
thinner women engaging in physical exercise. This also has implications for health
communicators who need to advocate to urban designers and town planners to create
diversity in neighbourhoods, and to find communication techniques and strategies
that are effective as ‘growers’ of social networks that can sustain and improve local
physical activity levels, as well as providing resources that make the uptake of
physical activity less socially intimidating.
5.11.3 Local Relevance and Medium of Delivery
An interesting finding that emerged from participants’ stories on the blog, was their
interest in gaining face-to-face visits, local discussions, or even telephone calls
regarding the organising of different options or activities to improve health. As one
participant explained ‘If you don't come and talk face to face or verbally with us then
we won't go, but a home visit is much more important - person to person to talk
about these things and organise activities is better.’ Others stated that an email or
online system that either let them know of things that were going on in the area, or
which allowed them to connect up with other neighbours to organise activities such
as social walking groups would be welcomed, with a participant stating that ‘hearing
about something like Tai Chi online would be good, I do not like having what I
consider junk mail’. Most participants expressed that they had busy lives that were
filled with various duties and obligations, but that they would be receptive to
suggestions and information about what was available for them do locally, with most
agreeing that a pamphlet in the mail, or email reminder being an effect mechanism
for allowing this to happen, as another participant stated ‘E-mail is fine for more
information or pamplets [sic] in the mail’. Overall, it appeared that a message that
was targeting them personally via a proximal rather than distal, or mass media
source, and which applied to their living environment in so far as it pointed to what
avenues of physical activity could be achieved or undertaken realistically in their
136
particular environment being preferred.
5.11.4 Message Source and Credibility
Participants expressed relatively uniform distaste for TV messages about increasing
levels of daily physical activity, with one participant saying that ‘I am not usually
prone to just accept because TV or papers tell me this or that will benefit my health
wise or physically’ while another commented that ‘I never act on advertising and am
not influenced by other people's comments regarding becoming "fitter"’, and further,
‘TV doesn’t sell me on anything.’ The majority of participants associate TV with a
‘hard sell’ approach to health, and were inherently sceptical about these sources.
Interestingly, one participant also doubted the credibility of such health
communication campaigns, stating that ‘I take it on onboard but I am generally
aware of my own health needs from use more reliable sources’. A concept that
dominated this area of questions was that of individual agency, with participants
expressing adamantly that their own knowledge, beliefs, and attitudes to physical
activity were sufficient in terms of what they thought they should be doing, and that
people making suggestions to them to improve these levels were somewhat of a
personal intrusion, with a participant stating that ‘I think there is too much said about
diets and exercise and I think it is only up to one’s own self to participate in looking
after your own body.’
Most felt that, despite the many structural constraints that they faced during a normal
day, they were aware of the potential health effects of any physical activity that could
be fitted into their routines, and sought to increase this at a time in their lives when
they felt that this was right or possible again, with a participant noting that ‘I feel
quite confident regarding my own judgement of how fit I am and will only increase
my activity if I wish to.’ Thus, in light of the preferences described above for more
locally based sources of suggestion and information regarding physical activity,
health communicators might consider working with individual local councils, gyms,
pools, and perhaps use local shop and library outlets to promote options in people’s
neighbourhoods for increasing their physical activity levels.
137
5.11.5 Tastes and Preferences
A notable number of differences in the types of activities and events people might
like to participate in to improve their physical activity and health was evident. While
there was somewhat of a consensus on the need for more locally organised social
networks as a means for generating activities, the types of preferred activities
differed greatly. These are some of the types of suggestions that point to the many
and varied range of interests within one housing complex in this particular urban
village:
• I am very much interested to join if there are people who can organise this
kind of activity. Games in the park would be great.
• I think I would be interested in like an indoor netball team or social soccer
team or something, but not just a social walking group.
• I generally prefer to exercise alone except for Thai Chi which is pleasant to
do as a group.
• Very interested in a social group with walks etc.
• Yes I would be interested in organised walks including, for example, bird-
watching.
Implications of this from a communication perspective are that messages about
increasing physical activity levels may need to include texts and images of a diverse
range of ways that this can be achieved in order to get away from more standard
connotations of exercising such as say, jogging or playing basket ball. Also, it would
be ideal for these suggestions to be contextualised within accessible parts of urban
neighbourhoods, and not just in sporting arenas, swimming pools, or clubs, where
geography and finances are likely to create structural barriers.
5.11.6 Community ‘Ownership’ and Participation: The Blog as a
Tool for Sharing Stories and Promoting Health at a ‘Grass Roots’
Level
While the content from the answers and anecdotes posted on the ‘blog’ by
participants provided a great deal of insight into the way in which they respond to,
138
and manage knowledge about the positive effects of physical activity on health, the
enthusiasm for the use of the ‘blog’ to generate their own stories, as well as read and
respond to stories from other residents, demonstrated the benefit of this type of
technological medium in creating and sustaining health at a local level. While the
maximum benefit of the blog as both a data collection tool, and a forum for
discussing ways of increasing social connectivity and physical activity at a local
level is yet to be revealed, it is still being used as a growing source of stories,
comments, and suggestions made by this group about what they would like to see
happen in their local environment. The experimentation with this type of
communication technology for gathering insight into urban contexts holds great
potential for those seeking to understand statistical trends in the people, place, and
health relationship, as well as those trying to communicate and instigate behavioural
change as a result of them.
5.12 Final Comments and Implications for Future Communication
Efforts on Physical Activity among Urban Population Groups.
We concur with current critiques of health promotion strategies that contextually-
specific communication designs are needed to combat the inequalities inherent
within this public health problem. Further, communication theories need to be more
extensively studied and explored for their suitability to guiding future research into
the reasons for differing levels of uptake among people living in different urban areas
and neighbourhoods. Such knowledge is needed in order to create a better match
between future campaigns and specific geographic or socioeconomic target groups. A
social constructionist critique of contexts would allow research to unearth what a
particular ‘health behaviour’ means within different human settings and
environments, and to gain insights into the perspectives and experiences of those
who are not engaging with current information dissemination and rhetoric designed
to influence particular behaviours. A more socially and culturally-based approach to
targeting of groups about behaviour change or uptake is needed if successful
communication is to be generated that resonates within the lived realities, beliefs,
attitudes and structural constraints of people currently being missed in whole of
population efforts. Finally, the role of ICT and options for online forums wherein a
139
‘ground up’ approach to generating local networks able to organise and instigate
healthy lifestyle programs that are contextually relevant, and are considered
appropriate by to those who know their geographic and social environments best,
needs to be further investigated.
140
Statement of Contribution of Co-Authors
The authors listed below have certified* that:
6. they meet the criteria for authorship in that they have participated in the conception,
execution, or interpretation, of at least that part of the publication in their field of expertise;
7. they take public responsibility for their part of the publication, except for the responsible author who accepts overall responsibility for the publication;
8. there are no other authors of the publication according to these criteria;
9. potential conflicts of interest have been disclosed to (a) granting bodies, (b) the editor or publisher of journals or other publications, and (c) the head of the responsible academic unit, and
10. they agree to the use of the publication in the student’s thesis and its publication on the Australasian Digital Thesis database consistent with any limitations set by publisher requirements.
In the case of this chapter:
Publication title and date of publication or status: The Kelvin Grove Urban Village:
What aspects of design are important for connecting people, place, and health? In Proceedings International Urban Design Conference: Waves of Change – Cities at Crossroads, Jupiters Casino, Gold Coast, 2007.
Contributor Statement of contribution
Julie-Anne Carroll
29th July 2008
Identified a gap in the literature, wrote the research questions, identified a point of departure, designed the methodology (including conceptual approach), collected the data, conducted the analysis, wrote up findings, and wrote the article. Presented the article at Waves of Change – Cities at Crossroads, Jupiters Casino, Gold Coast, 2007.
Dr Barbara Adkins
Assisted with the research questions, methodological design and the refining and application of the conceptual framework to the investigation. Made revisions to the article, and assisted with the overall structure of the article and the presentation of analysis and findings.
Associate Professor Elizabeth Parker
Conducted revisions, assisted with structure and the presentation and conducting of analysis and findings, sentence-level-editing and writing corrections.
Dr Marcus Foth
Conducted revisions, assisted with structure and presentation of analysis and findings, sentence-level-editing and writing corrections.
Principal Supervisor Confirmation I have sighted email or other correspondence from all Co-authors confirming their certifying authorship.
Dr Barbara Adkins 29th July 2008
Signature Date
141
Chapter Six
Published Paper Two
Title: The Kelvin Grove Urban Village: What aspects of design are
important for connecting people, place, and health?
Authors: Carroll, Julie-Anne and Adkins, Barbara A. and Foth, Marcus
and Parker, Elizabeth A.
Published: In Proceedings International Urban Design Conference :
Waves of Change – Cities at Crossroads, Jupiters Casino, Gold Coast,
2007.
6.1 Abstract
There is an emergent trend in both urban design and health-related literature calling
for strengthened connections between these fields, with the aim of meshing social
aspects of urban design with current efforts to generate healthier lifestyles and
behavioural patterns among urban populations (Gleeson, 2004). As Jackson states,
‘while causal chains are generally complex and not always completely understood,
sufficient evidence exists to reveal urban design as a powerful tool for improving
human condition’ (p. 191). The Kelvin Grove Urban Village (KGUV) will be
discussed in this paper as a case-study for responding to this call. The underlying
design principles of KGUV, including its basis in new urbanism, social diversity, and
the availability of wide, even, pathways and green spaces identified it as an ideal
location for addressing some long-standing questions in the research about which
social and physical design features are most salient for increasing people’s propensity
to walk or engage in recommended levels of physical activity. The findings from this
interdisciplinary investigation examining the patterns and processes connecting
people, place and health are presented in this paper, and illustrate the ways in which
142
different urban demographics engage with their immediate environment, in the
pursuit of social, recreational, and health-related goals. Implications rising out of
these findings are two-fold: firstly, for urban designers to heed the findings in
research examining ‘area effects’ on health, and secondly, for health communicators
to give deeper consideration to the design features of the context hosting their target
demographics prior to the design and dissemination of health promotion messages
and campaigns. This way, new urban neighbourhoods stand an increased chance of
creating environments that encourage and allow increased levels of physical activity,
and health communicators are more likely to create campaigns and interventions that
resonate within the contexts in which they are delivered and received.
6.2 Introduction
This paper firstly draws on the current bodies of research in both urban design and
public health to develop the need for a stronger empirical link between these
disciplines in light of existing evidence that points to a connection between urban
neighbourhood contexts and population health and well-being. A review of the
research in the field of urban design that indicates its salience for both real and
perceived well-being is provided, as well as evidence from research in health
demonstrating that household and neighbourhood contexts exert powerful, yet still
largely unexplained influences on human health-related behaviours. The
identification in the literature of this common concern between the disciplines
regarding which ‘ingredients’ of urban neighbourhoods make them dynamic, healthy,
and socially sustainable provided the rationale for this research investigation aimed
at developing insights into ‘what works’ for people in urban settings.
Secondly, the paper provides a description of the Kelvin Grove Urban Village
(KGUV) which is a medium-density, mixed-tenure, urban neighbourhood based on
the design principles of new urbanism, and situated in close proximity to the Central
Business District (CBD) in Brisbane, Australia as the case-study for this
investigation. It outlines the ways in which the qualities and characteristics of this
new urban context allow research into the role of urban design in mediating the
relationships between people, place, and health to be undertaken. The Village will be
discussed for its unique design qualities and its contribution to finding out more
143
about the ways in which urban neighbourhoods and living contexts elicit what have
come to be known as ‘ecological effects’ on health.
Thirdly, the paper reviews methodologies and findings from qualitative investigation
of residents’ experiences within KGUV, with special emphasis on the presence of
health-related resources and a mixed-tenure demographic. Residents participated in a
number of research activities to gain insights into the ways in which the presence of
people from different social sectors, and resources such as parks, BBQs, wide
walking and bikeways and the close proximity of shops and public transport affect
how physically active they were likely to be. Research questions targeted how
residents felt about their own housing and accommodation within the Village, the
overall design of the Village, and their prior housing histories and attitudes to health
and physical activity.
Finally, the paper discusses the potential of KGUV to provide a resource for further
investigations into the relationships between people, place, and health and as a
proponent of healthier lifestyles for vulnerable demographics. In particular, the role
of design on lifestyle and health-related behaviours is highlighted, with future
implications for urban designers who are aiming to generate sustainable communities
with the potential to mediate the relationship between poorer demographics and less
healthy and fulfilling lifestyles. Also, the research aims to highlight the importance
of built design, social mix, and local resources in alleviating ghettoisation, urban
decay, and the increased likelihood of lower socioeconomic groups being highly
transient across both the private and public housing markets. It is the intention of this
study to identify links between urban design, population health, and health
communication that contain the potential to ensure that the needs of vulnerable social
groups are considered in the building and marketing of new developments, and that
health researchers effectively understand the influence of the nature of an urban
environment on the likelihood of populations to respond to community health
promotion efforts in a sustainable way.
6.3 Rationale and Background
Urban planning and design research has identified a number of key ‘ingredients’ that
144
appear to be important in contributing to the overall health and quality of life for
residents living in urban areas (Jackson, 2003). These include, but are not limited to,
the following design components:
• Contours/skylines/variety of height (Al-Hathloul, 1999).
• Land-use (Wester-Herber, 2004)
• Biodiversity (Sandstrom, 2005)
• Building conditions and aesthetics (Hembree, 2005)
• Quality of own dwelling (Turkolglu, 1997)
• Public space and meeting points (Vogt & Marans, 2003)
• Greenery and green connectors (Teo & Hung, 1996)
• Identity Markers (Oktay, 2002)
• Roadworks (Foo, 2001)
These findings are important as they assist planners and designers to incorporate and
consider components that contribute to improved social functioning, satisfaction,
quality of life and health of residents. As Jackson (2003) notes ‘while causal chains
are generally complex and not always completely understood, sufficient evidence
exists to reveal urban design as a powerful tool improving human condition’ (p. 191).
Increasingly, in Western countries, master planned communities have risen in
popularity and demand, and, in the process, have introduced a range of complexities
and challenges for planners hoping to locate and include the types of features that
will generate and sustain healthy and fulfilling lifestyles for residents. Further, urban
planners and designers are currently facing the challenges involved in being able to
deliver the types of ‘communities’ being offered in the marketing rhetoric of these
prêt-a porte lifestyle packages (Luymes, 1997; Gleeson, 1994). Much criticism has
arisen regarding the ultimate inability of urban planners to match the promises
offered in the real estate brochures of these enclave communities. These criticisms
are encompassed in the following quotes by leading researchers in this area:
• ‘Image and product are concepts that are researched and packaged long
before the community even opens for sales’ (Wolford, 1993).
• ‘The theme of ‘community’ found in the marketing rhetoric is absent from the
145
critical literature on enclave communities, and is indeed antithetical to the
warnings about the breakdown of civil public life’ (Luymes, 1997, p. 194).
Therefore, the challenge remains within urban planning and design to be able to
locate the social and affective aspects of design that allow thriving, dynamic, and
healthy communities to be (re)created. Further, the aim is to be able to incorporate
and coordinate the built ingredients known to benefit the well-being of residents,
such as pathways, bikeways, and green recreational areas, in a way that allows
communities to be developed, and positive social networks and functions to be
maintained.
Contemporary design literature points to the following outcomes as 'most in demand',
and simultaneously most difficult to deliver:
• Community (Gleeson, 1994)
• Diversity (Luymes, 1997)
• Participation (Al-Hathloul, 2004).
• Sustainability (Van den Dobbelstein & de Wilde, 2004)
• Identity (Oktay, 2002; Teo & Huang, 1996).
• Culture and History (Antrop, 2005).
With a contemporary focus on space and economic efficiencies and a trend towards
master planned communities, the delivery of these principles in the lived experience
of residents is very challenging from a design perspective. However, the difficulty in
delivering these outcomes is not only a problem at the level of everyday design
dilemmas. Part of the difficulty also lies in the requirement for a framework which
can capture the realities and parameters of design processes on the one hand, and the
lived experience of subsequent designed environments. The work of Henri Lefebvre
in The Production of Space is an important analytical resource in focusing on the
processes of translation of a design into residents' experiences. He distinguishes three
levels at which space is produced: Representations of space – space conceptualised
by planning, design and development professionals; Representational space – space
as it is perceived or experienced symbolically by inhabitants; and Spatial practices –
space as it is lived and the point at which the conceptualised and symbolically
represented space are appropriated in everyday contexts of residents (Lefebvre,
146
1991).
Based on these analytical levels, the notion of community, for example, may figure
in 1) planning and development principles, 2) at the level of marketing and symbolic
representation of a development and 3) may be seen as present or absent in the lived
experience of residents. At each of these levels there is no guarantee that the meaning
of 'community' is translated unproblematically across these levels. In a planning
environment which is intensifying the requirement for identifying 'what works' and
'how it works' in terms of generating healthy and satisfied residents in urban areas, a
framework such as this that can accommodate the logics, understandings and
processes at stake in each of these levels of design is critical for an understanding of
the full set of processes required to deliver principles such as "community". This also
provides for research that is able to examine the processes via which a range and
combination of place characteristics combine to produce these outcomes.
The importance of research that focuses on the different levels at which space is
produced and experienced is very evident from a review of public health literature as
it pertains to urban environments. Public health research has been particularly
interested in the physical, social, and economic characteristics of urban places, as
they have been found, in various forms and examples, to affect both the health
behaviours and outcomes of the people who live there (Macintyre, 2002; Bush, 2001;
Diez-Roux, 2000; Picket, 2002; Titze, 2005; Giles-Corti, 2005). Preventative medical
perspectives have engaged in much research regarding the ways in which the built
features of urban design, such as the presence of pathways, bikeways, public
transport and green meeting spaces can contribute to the likelihood of residents being
physically active in an area (O'Loughlin, 1999; Badland, 2005; Kirtland, 2003),
while social epidemiologists and health promotion researchers have been interested
in locating 'psychosocial' attributes of a place, such as social cohesion and capital,
culture, and a sense of safety and belonging in terms of their apparent ability to
improve the health behaviours and outcomes of those who live there (Chandola,
2001; Markowitz, 2003; Feigelman, 2000; Shiell & Hawe, 2000).
In Western contexts, such as Australia, health inequalities researchers have
repeatedly shown that the socioeconomic qualities of urban places - via area or
147
residential composition – comprise the most powerful variables influencing the
health behaviours that can be observed there, and the morbidity and mortality rates of
that area (Frolich, 2002; Turrell, 2003; Macintyre, 2002). Much effort has been
invested in this area of research on being able to accurately measure and define the
socioeconomic position of an area and its people in order to be able to identify the
specific ecological contexts contributing to worse health for poorer urban
populations (Ecob, 2000; Sleigh et al, 2005; Cummins et al, 2005; Macintyre, 2002).
The socioeconomic characteristics of a person’s place of residence that have been
shown to matter from a health perspective, include housing quality, type, and tenure,
as well as overcrowding (Ellaway et al 1996; Waters, 2001). Further, the income,
employment, and educational levels of residents (both co-dwellers and neighbours),
as well as the socioeconomic measure given to an area, as calculated by such
measures as Accessibility/Remoteness Index of Australia (ARIA) and the
Socioeconomic Index for Areas (SEIFA) have also been identified as salient
determinants of the health and well-being of residents. More recently, variables
relating to the perceived socioeconomic position of an area, such as reputation and
stigma, have also been identified as salient variables mediating the place/health
relationship (Sooman et al, 1995; Gregory et al; 1996; Bush et al, 2001). What is less
established, however, is how these patterns come to exist and what the motivational
linkages or barriers are between the socioeconomic position of an urban area and
what people do there in terms of their health. There are a number of interesting, and
largely unresolved, points regarding the ways in which this variable operationalises
to produce ‘health effects’ in urban areas. Some of these include:
1. The complexity of socioeconomic position as a ‘determinant’ of health:
How is it that higher-risk health behaviours become embedded in the
lifestyles of poorer social demographics?
2. The salience of socioeconomic position of an area: How do factors within
urban neighbourhoods differently affect lifestyle and health?
3. The contextual nature of socioeconomic influences: Why is it that
socioeconomic context is more powerful than individual measures of
socioeconomic position as a predictor of lifestyle and health?
Research that examines how the socioeconomic traits of urban places play out in
148
every day lives of residents to produce the health-related outcomes that have been
repeatedly observed by researchers is needed to further knowledge about the ways in
which place affects people. This way, both urban planners and health researchers and
practitioners can gain insight into not only what appears to matter in terms of the co-
existence of particular traits and health outcomes, but how built resources and
residential composition can be composed and positioned in ways that generate
meanings that are interpreted and enacted by residents as healthier lifestyles. If the
pathways connecting people, place and health can be more adequately understood or
conceptualised, then changes and developments can be made in urban areas based on
the meaningful ways that people are likely to experience such efforts.
In light of this empirical research and the gaps in knowledge that currently remain
within the fields of urban design and population health, the following research
questions were developed for investigation within the Kelvin Grove Urban Village
(KGUV), which was identified as an appropriate urban case-study.
1. What are the contextual social processes that influence lifestyle and well-
being in urban neighbourhoods?
2. What aspects of design are conducive to producing healthier lifestyle
patterns, especially amongst lower socioeconomic demographics?
3. Which aspects of demographic, living context, and everyday life need to
be considered by urban designers and public health researchers working
towards decreased health inequalities and increased social sustainability?
6.4 Case Study: What is the Kelvin Grove Urban Village and how
does it allow us to address research questions about urban design
and health?
KGUV is an $800 million mixed-tenure, medium density, inner urban planned
community based on the design principles of ‘new urbanism’ and located
approximately two kilometres from the Central Business District (CBD) in Brisbane,
Australia. According to Steuteville (2004) ‘New urbanism is a reaction to sprawl. It
is based on principles of planning and architecture that work together to create
human-scale, walkable communities. The new urbanism includes traditional
149
architects and those with modernist sensibilities. All, however, believe in the power
and ability of traditional neighbourhoods to restore functional, sustainable
communities’ (p 23). A further key feature of the new urbanist aspirations of the
development is a planning focus on diversity and heterogeneity in housing types,
land uses and social groups (De Villiers, 1997). KGUV has been built with the aims
of achieving a vibrant, healthy, diverse and socially sustainable urban community
that has access to a range of cultural, health, and educational resources.
While KGUV is based on new urban principles that have proven highly successful in
other international contexts (Michigan Land Use Institute, 2006; Funders Network
for Smart Growth and Liveable Communities, 2007), it is still regarded as somewhat
of a ‘social experiment’ in Australian urban design, primarily due to its complex mix
of residential groups and local resources, services, and retail options. However, it is
optimistically being coined as ‘The Smart Village’ by the State of Queensland’s
Premier, Peter Beattie due to its underlying close philosophical ties with Smart
Growth design concepts. David Manzie, Manager of Department of Housing
Portfolio Management Division states ‘The vision for the Kelvin Grove Urban
Village was for an inclusive and sustainable community where people live, learn,
work and play in one accessible and walkable neighbourhood – and all within two
kilometres of the Brisbane central business district’ (Sectorwide, p. 2).
A wide range of demographics has been included in the accommodation options
including student accommodation, disability support options, aged accommodation,
and people living in government assisted housing via the Brisbane Housing
Company (BHC). Within this latter group there is a great variation among residents
in terms of age, health, education levels, support needs, and number of children and
elderly in their care. In addition, there are apartments that have been sold on the
private market ranging in price from $310, 000 - $950, 000 AUD. This diverse range
of people live in close proximity to a range of resources including retail outlets, the
Queensland University of Technology, associated health clubs and services, libraries,
parks, wide path and bikeways, and the well-known La Boite Theatre. Figure 6.1
below provides a conceptual overview and description of the key social, educational,
cultural, and health-related features of KGUV that underpin this unique urban design.
150
Figure 6.1 ‘What is KGUV a Case Of’?
KGUV covers a geographical area of approximately 16 ha, and contains around 2000
residential units. Figure 6.2 below outlines the geographical region occupied by the
KGUV and proximity to Brisbane’s central business district (CBD). Figure 6.3
shows the design plan for KGUV, and the photographs depicted below firstly show
the resources in KGUV based on new urbanism principles with special attention to
walkways and green places, as well as close proximity to cultural and educational
resources; and secondly the housing options on offer to residents.
151
Figure 6.2 Map of Geographic Area in which KGUV is located
Source: (KGUV Innovation Implementation Report, Garred, 2007)
Figure 6.3 Master Plan
Source: Official Kelvin Grove Urban Village website
http://www.kgurbanvillage.com.au/.
152
Photographs
Source: (KGUV Innovation Implementation Report, Garred, 2007)
Source: (KGUV Innovation Implementation Report, Garred, 2007; photographs from
the ‘blog’ http://theeffectsofanewurbancontextonhealth.blogspot.com/)
The specific health-related resources that are located in KGUV are outlined in Table
6.1 below.
153
Table 6.1 Health Related Resources at KGUV
Health
Resource
Description Building
Progress
Centre for
Physical
Activity and
Health
The Centre for Physical Activity and Health will be located
alongside McCaskie Park, and will contain an indoor pool,
indoor multi-purpose courts, a gymnasium and health clinics.
The primary function of the Centre will be for QUT teaching
purposes, however, it will be available for use by the broader
community as well.
Building
near
completion
School of
Optometry
QUT’s School of Optometry offers services to the community by
students at no cost. Additionally, glasses and contact lenses
are available from the clinic at discounted prices.
Complete
Nutrition Clinic
This QUT clinic offers nutritional assessment, dietary advice for
both weight gain and loss. Diabetes, cholesterol lowering,
sports nutrition and healthy eating.
Complete
Podiatry Clinic
QUT’s Podiatry Clinic, which is a part of the School of Public
Health, offers prescriptions and patient care.
Complete
Network of
Pedestrian and
Bike Links
There is a planned network of bicycle links within the Village to
surrounding areas. These features have been designed in
accordance with the overall philosophy to increase individual
autonomy and mobility, as well as improving health and well-
being.
Complete
Landscaped
Parks and
Open Spaces
Within the Village, are be a number of green, open spaces for
social gatherings, BBQs and exercise for residents. The Roma
Street Parkland and the Victoria Park Golf Course are adjacent
Complete
154
to the precinct, and also provide opportunities for outdoor
recreation and physical activity.
Red Cross
In a recent media release
(http://www.kgurbanvillage.com.au/about
/plan.shtm) it was announced that in 2007 the Australian
Red Cross Blood Service would be locating a $70M facility
adjacent to the Institute of Health and Biomedical Institute
(IHBI) at the Kelvin Grove Urban Village. This will provide
university researchers with increased opportunities and access
to resources for conducting biomedical and public health
research. This is a promising example of how new stakeholders
will invest interests and resources into the Village, based on
the collaborative initiatives and potential they see the
community as holding.
Constructio
n underway
Due to the commitment to developing resources and the basis in design principles
likely to impact on the health of residential populations, KGUV was chosen as the
case-study in which to investigate the research questions outlined above. A case
study is a single-bounded entity, studied in detail, with a variety of methods, over an
extended period, and is selected because it is theoretically representative of the
relationships to be investigated (Yin, 2003). Following this logic, the KGUV
(www.kgurbanvillage.com.au) has been identified as a planning and design strategy
reflecting a desire to achieve a higher level of integration between residential,
commercial, educational, cultural and employment activities (Healy & Birrell, 2004)
with great potential for improving residential health and well-being. In this context
KGUV represents an explanatory case study, which, according to Yin is oriented to
proposing an explanation for an already identified pattern or phenomenon. For this
purpose it is studied as a system of relationships with the key purpose of identifying
key elements and their interrelationships that are responsible for the production of
space/health relationships (Yin, 2003).
As such, KGUV was selected because it was representative of some of the key
relationships that have already been identified as at stake in existing theories
spanning urban space and health. First, as a mixed tenure development, it provided
an opportunity to study residents in subsidised housing, already theorised to be more
155
vulnerable to ill-health, co-located with those from different socio-demographic
backgrounds: middle and high income earners as well as students. Further, in the
context of an inner city development co-located with educational, cultural
recreational and health facilities, it enabled a focus on the role of space, proximity
and service availability in health related practices. Third, in terms of Lefebvre's
analytical levels of spatial relationships, it allowed an understanding of the different
levels of production of space/health relationships: the planning/design representation
of those relationships, the symbolic manifestation of those relationships and
residents' perception of them, as well as the daily spatial practices in which residents
appropriate these relationships.
Thus, KGUV was seen as theoretically representative of a development that
deliberately encapsulated the relationships that are the focus of this study. For this
reason, this urban setting provided a type of 'urban social laboratory' in which to
explore people's reactions to urban places and to evaluate, from a health perspective,
whether ideas about diversity, connectivity, space and creativity are conducive to
outcomes such as improving the health and well-being of residents.
6.5 Methodology
Study Participants and Data Collection Methods:
Participants for the qualitative data collection phases were recruited via both
telephone and mailed invitation, as well as from the returned surveys from the
quantitative research conducted in the KGUV as part of this study. All participants
were current residents in KGUV. A multi-method approach was taken to capturing a
range of information types from within the case-study over the period of one year,
including surveys, online mechanisms such as the ‘blog’, interviews, workshops, and
focus groups. For the ‘blog’, in-depth interviews, and community focus group all
residents were from the Brisbane Housing Company (BHC) apartments, which is a
government-supported accommodation project. By this qualification, these
participants are all on incomes of $25 000 or less per annum, and fall into the
category of lower socioeconomic position as defined by both housing and income.
The workshop, however, included a cross-section of residents from across the
156
Village.
The reason for the focus on the lower socioeconomic demographic is due to the
evidence in health research that shows that these groups are less likely to engage
with their urban neighbourhood in ways that develop their lifestyles and improve
their health and wellbeing. In addition, the salience of socioeconomic context as a
factor influencing health-related behaviours was of key interest in this study that
investigates the role of new urbanism in alleviating such effects. In line with the
theoretical contributions of Lefebvre that emphasise the need to draw on the social
practices that occupy the space under investigation as a means of understanding how
humans interact with the physical and social places they inhabit, methods were
created that tapped into BHC participants’ accounts of everyday practices and the
locales that either enabled or disabled their desires and abilities to lead more active
and healthy lifestyles.
The breakdown of participant numbers and qualitative research activities are outlined
in Table 6.2.
Table 6.2 Participants and Data Collection Phases
Participant
Numbers
Demographic
Details
Data Collection Type
16 BHC residents Blogging: An online mechanism known as a ‘blog’ was
appropriated as a means where residents wrote answers,
stories, and opinions about KGUV in relation to healthy
lifestyles. There were 214 responses posted on the blog in
total. Blog address:
http://theeffectsofanewurbancontextonhealth.blogspot.com/
8 BHC residents Individual Interviews: In-depth interviews were
conducted with lower socioec residents in their apartments
about how their living contexts affect their lifestyles and
health.
6 BHC residents
present.
Community Focus Group: Informal, opportunistic
interviewing and observation notes were taken from BBQ in
local park organized by researchers for BHC residents.
6.6 Key Findings
The data from all collection points was brought together and triangulated for analysis
157
using NVivo software to address the overall research question: which aspects of
design are important for connecting people, place, and health? A content and
thematic analysis revealed the following factors and processes as being crucial in
both understanding how people, place, and health are connected, and which aspects
of neighbourhood ecologies are vital for improving residential health and well-being.
Analysis of relationships between people, place and health were guided by
Lefebvre’s attention to the three levels of understanding the ways in which urban
spaces are created and utilised, in particular, the design and planning elements, the
symbolic or rhetorically created aspects, and the everyday experiences and practices
within these dimensions.
• Overall KGUV Marketing Concept and Place Reputation
The qualitative data from the various sources of collection revealed that the
marketing rhetoric and promotional material, as well as how KGUV was portrayed in
the media and recognised by others in Brisbane affected how they felt about living
there, for example, ‘It makes us feel really good. It makes us feel poshy for once, you
know’ (BHC mother, interview) whereas she claimed that in previous
neighbourhoods ‘You feel down, you feel like you’re nothing, but now here we feel
like we’re something, you know, cause we’re in something nice. It makes us feel
good’ (BHC mother, interview). In addition, another participant stated that ‘All my
friends say oh you’re so lucky to be living there, right near the city, and it has
everything, and we are in the media, and being part of that buzz is great’ (BHC
resident, community focus group).
Not only did it affect how residents felt about living there, but also what they
perceived they would be likely to do there. Participants felt that the promotion and
reputation of KGUV as a development based on the principles of new urbanism with
attention to ‘walkability’, physical activity, and health influence how they expected
their lifestyles to take shape there. This can be demonstrated in the following
quotations:
‘I think in time KGUV will promote physical activity as it is a new concept in living
so I am looking forward to new ideas’ (BHC resident, blogging participant).
158
‘KGUV appears to promote a healthier lifestyle through its advertising promotions’
(BCH resident, interview).
‘I think KGUV does promote health and wellbeing. The parks are encouraging to
have a fun activity, while the pathways are great for a run and there is a gym, more
serious fitness activities. I think it will also promote social activities and be a very
active area’ (BHC resident, blogging participant). This quote in particular highlights
the interface between physical and symbolic aspects of design and how these are
appropriated into spaces that are conducive to health.
In light of what, for the most part, are housing histories steeped in experiences of
crime, fear, violence, and poor neighbourhood reputation, both the perception of
KGUV via successful marketing packages, as well as the design principles appeared
to promote a more active and healthy lifestyle for residents, thus demonstrating the
importance of understanding the psychological and social components of design in
enhancing both perceived and actual health.
• Mixed-Land Use and Proximity to Destinations
Participants spoke frequently and at length on the benefits of having highly-regarded
and desirable destinations within walking distance from their homes. They
mentioned both established venues as well as shows and concerts that were held in
and around the CBD for both themselves and their children, for example ‘We went
and saw a show at The Con (Queensland Conservatorium of Music) and that was
great’ (BHC resident, blogging participant) and one mother told of an outing with
her four children ‘Well I took ‘em to the park, and High Five was on, and I take ‘em
to that, and the shops are closer here…Yes, the kids are more settled here. They can
go to libraries’ n that here and a park just up the road’. And further, she went on to
explain how this affects her well-being and quality of life ‘Well if they’re bored, we
just take ‘em, take ‘em out, instead of stuck here at home, and that stops me from
being a bit stressed. And that’s even better (BHC resident, interviews). Other venues
that came up repeatedly as being destinations of interest that were within walking
distance are illustrated in the following quotes:
‘South Bank and The Lyric Theatre are only 15 mins away for all the activities one
159
enjoys and buses are available every 10 mins (BHC resident, blogging participant).
‘I love the Victoria park, if you walk there at night it is wonderful sightseeing, you
can see the beautiful city (BHC resident, blogging participant).
‘Roma Street Parklands are beautiful and they are just over there, so that is fantastic
to go to’ (BHC resident, community focus group).
Residents also acknowledged that the location of a bus service that is centralised with
buses frequently travelling to a broad range of destinations was an important design
component contributing to the improvement of lifestyle overall. ‘It's good in the
walking sense, even walking to the buses and there are so many bus services here -
you can get to the Bulimba ferry, Valley, city - so it's easy to walk to those things’
(BHC resident, blogging participant).
In addition to desirable, accessible locations, the close proximity of the University
and the La Boite theatre were also raised as destinations and resources that
encouraged activity and engagement with the urban neighbourhood, as one
participant illustrated
‘QUT’s coffee shop and maybe library with its computer access and maybe any
learning programmes such as writing we all will grow and at the same time learn and
also help others (BHC resident, blogging participant). Further, the interviews
highlighted how these facilities give life to social connections between the BHC
residents and other demographics that might not have otherwise met, for example,
‘And you can meet the students and talk to them. The international students have
come to visit us here’ (BHC resident, blogging participant). Another participant
stated that ‘being around the students and theatre-goers makes me feel so young and
good’ (BHC resident, interviews). An activity in the workshop highlighted the fact
that residents felt that the inclusion of social groups as a result of the mixed land-use
at KGUV such as students, theatre-goers, university staff and international visitors
was perceived as a positive contribution to their lived experiences in the
neighbourhood. Both indirect and direct benefits to lifestyle and well-being regarding
mixed land-use and walk-ability to destinations were evident in the data, and
highlight little-understood and yet potentially salient contribution of social and
160
cultural resources to the improvement of people’s health in a place.
• Parks, Green Spaces and Health-Related Resources
Participants highlighted the walkways as being highly beneficial for increasing the
amount of physical activity they were likely to do, for example, ‘I use the pathways
for walking. They are better than the walkways I previously had access to, which was
a hilly area’ (BHC resident, blogging participant) and ‘the walking paths are great
and the parks are well estabished for all sorts of fun and games’ (BHC resident,
blogging participant), and further, one participant links design to motivation to a
renewed focus on fitness ‘I have also been motivated to go for a run in the area,
which I haven’t done for years due to illness, and have found the pathways useful for
this as they are broad’ (BHC resident, blogging participant).
Residents also commented positively on the number, location, and quality of parks in
KGUV for recreational, leisure, and physical activity pursuits, for example ‘On one
of our walks we visited all the parks in the area and I saw that Grey Guns park
would be ideal when small children of my friends and family come to visit as we can
take them for a walk up there and let them kick a ball around and we can sit and talk’
(BHC resident, community focus group) and ‘I usually show visitors around the
parks and often relax as the seating is excellent around the pathways and parks’ and
further ‘I like the parks surrounding the area because they are so gorgeous and I feel
comfortable and satisfied with the air’ (BHC resident, blogging participant). Another
resident commented on the combination of pathways suitable for walking and
desirable destinations for both utilitarian and health-related reasons ‘It is good for
physical activity especially walking and jogging and going sight-seeing is good
exercise. And going to the shops’ (BHC resident, blogging participant). The
psychological, social, and health benefits of wide, even pathways and well-kept
green areas were greatly emphasised in the data, with implications for improving
current neighbourhoods and considering the positive aspects of health-related
resources such as these in the design of future planned communities.
• Housing Histories and Perceived Levels of Danger and Fear in the KGUV
Neighbourhood
161
The transition from previous housing and neighbourhood experiences was contrasted
in the data to current perceptions of life in KGUV, and how both lifestyle and well-
being have been affected. While not all participants were in agreement about safety
issues in KGUV, the data demonstrate the importance of perceived levels of fear and
ideas about neighbours as key in determining whether or not residents were likely to
be active there, for example ‘Absolutely I walk more here, I didn’t have parks or
pathways where I was before, and I never felt safe anyway’ (BHC resident,
interviews). Further, participants reported safety as a key factor influencing how
mobile and active their children were able to be in KGUV, for example, ‘The kids
can go out and we’re not worried about ‘em, in the last places we had to go out
check what they’re doing every five seconds, cause there are too many bad people
around’ (BHC resident, interviews). And ‘I have used the parks to play with my
grandson and enjoy the walks on the pathways as it is very safe and secure’ (BHC
resident, blogging participant). In addition, one participant stated ‘…and it’s nice and
clean here. It’s just got a clean feel’ (BHC resident, interviews).
However, some residents still feel that despite the positive aspects of a clean
environment that is aesthetically pleasing, the close congregation of lower
socioeconomic residents in the BHC apartments recreates a similar problem of fear,
based primarily on a perceived connection between demographic qualities of
residents and likelihood of crime, for example:
‘I hated going out after dark ‘cause it was pretty scary, with a high unemployment
level. Just um walking down the road, they knew you would have a few dollars on
ya, so they’d roll ya for the money for grog or smokes. Because it has a lot of people
living in the same spot it reminds me of that, so after dark you don’t go out by
yourself’ (BHC resident, interviews).
This raises questions for the designers of future planned communities about the
balance between providing health-related resources and a positive promotional
package, and the problematic nature of a mixed-tenure concept, when in fact ‘mixed’
refers to clusters of lower socioeconomic residents located adjacent to clusters of
high socioeconomic residents, rather than a random allocation or physical blending
of accommodation options. While marketing rhetoric that promotes a clean-living,
162
healthy lifestyle and health-related resources are important in creating positive,
sustainable experiences for residents, social and demographic qualities of the area
contribute powerfully to this mix, and need to be considered as important in design
as the provision of material and physical resources.
• Mixed-Tenure
Participants talked at length about the problematic nature of being clustered together
in apartment-style living with people who are experiencing similar social and
economic difficulties, and how when people enduring them are placed in close
proximity, tensions arise, for example ‘Yeah and a lot of these people don’t work here
either. Like you’re meant to live in peace and harmony, but as far as that goes it went
out the window pretty much straight away’ (BHC resident, interviews) and ‘Like the
police have been here, like, in the first week we were living here, like a half a dozen
times. Yeah just through people fighting and bitching and things. And other domestic
violence incidents like 6 o clock in the morning there were people having domestics
downstairs…’ (BHC resident, interviews), while another mother commented ‘But we
were here and people were yelling out any time, doesn’t matter if its midnight, three o
clock on the morning, or whatever, and screaming, barnying, over whatever.’ Another
young mother described the following scenario:
This place, we’ve had a few hiccups along the way, we’ve had a man come in
and it’s the wrong house… with a gun. So that’s why we’ve got the dog here. But
um, someone came in with a gun, and they came into the wrong place, so…it was
a bit full on. It’s a bit like the Bronx here at the moment. Yeah. We’ve had
someone get burnt by hot water by her boyfriend, and the police rock up here like
every day.I think it’s calming down a bit now, but it’s become like pretty full on,
like that all comes with the people who are being moved here as well, like yeah,
we’re all from the same lifestyle but some of us have changed and some of us are
still there. So its difficult in that way, where they have tried to put all lower class
people in one building, where some people have moved on and some people
haven’t.’
This final comment highlights quite pointedly, the psychological detriment of
classifying housing type by demographic category in terms of restricting their
163
perceived ability to ‘move on’ or make changes in their lives. Another theme that
rose during the interviews with young mothers in BHC apartments, was the problem
with a lack of disposal facilities for intravenous drug users in the buildings, with
needles being left lying around spaces where their children play. One participant
stated ‘There is a huge problem with needles, we have to pick them up and put them
in bins, and sometimes they are left next to the bins, and I’ve seen them on the water-
tanks, everywhere.’
Not only the young mothers were affected by the mix of residents in the BHC
apartments, with one middle-age couple describing their government supported
living experiences in the BHC apartments as follows: ‘Our neighbour next door - you
couldn't wish to meet a nicer couple. And the lass with the baby she is fine now that
the baby has a cot - but before she was crying a lot. The smokers drive us mad,
because they are chain smokers. And we had to call the police because a man was
throwing shoes at our louvres at 4am in the morning’ and ‘Someone started a fire in
our refuge. Someone smelt the smoke and saw the burnt paper’ (BHC residents,
blogging participants). And in this poignant comment, a young mother noted the
negative impact on quality of life of being placed in housing that is government
supported and is notably defined as such within a community ‘Yeah it’s funny, I’m a
big addiction person, and um its even like associating in the same complex as those
people then it goes OK, it’s really nice and everything, but you haven’t moved on, it’s
still housing commission’ (BHC participant, interviews). Interestingly, despite BHC
efforts to call it ‘affordable living’ and to move away from the category of ‘housing
commission’, all BHC residents referred to it as such, and spoke of it being a
drawback from the otherwise positive aspects of design at KGUV. One written
comment in a workshop activity regarding the non-BHC housing from a BHC
resident stated that people in private accommodation were ‘Rich, tall, and better than
us. They think.’ While KGUV has been described as mixed tenure, it does not break
the mould from the older style government supported living wherein people from
poorer backgrounds are confined to living together in apartments where privacy is
low and space is limited.
164
Community Capacity-Building and Recreational Activities
Finally, when participants were asked about which aspects of design could be
improved and what might contribute to how active they were able to be in KGUV,
most expressed a need for community-based activities and sport and recreation
centres that were affordable, close, and child-friendly. One mother from BHC
suggested ‘Like something for the kids, more for the kids to do, instead of just a park
and them playing on the slippery slide and they get bored just swinging on swings.
We try to take balls usually, but still they need something that is going to be fun. And
somewhere where I can take them to do something where I can sit down and relax’
while another stated ‘A mothers’ group would be good, or a play group like we used
to have in West End’ and ‘Activities for the kids like sports or martial arts or
dancing’ (BHC participant, interviews). Other older residents from BHC also
expressed a desire for activities that brought them closer to other residents and got
them out of their apartments ‘A community centre with its facilities e.g. card games,
exercise programmes such as tai chi perhaps, just mingling socially perhaps’ (BHC
resident, blogging participant) while another said ‘The community hub would be
great for people to interact with others to organise some activities’ and ‘…very gentle
exercises for families with a B.B.Q afterwards would be an idea for getting to know
the residents’ (BHC residents, blogging participants). Some of the parents from BHC
spoke positively regarding previous experiences with PCYC, and the many resources
it offered to young families, ‘My daughter used to go to the PCYC cause they had
everything there for kids and she did Ju Jitsu there’ (BHC participant, interviews).
These suggestions and illustrations demonstrate a current need in KGUV for
community developers and health promotion workers from government, not-for-
profit, and research areas to generate programs and activities that can build social
capacity and improve lifestyles and health for residents in a way that contributes to a
vibrant and sustainable community.
6.7 Discussion, Conclusions, and Future Implications
At the level described by Lefebvre as representations of space – space as it is
conceived in planning and design – KGUV clearly displays an orientation to
integration between residents and village life and a commitment to the coherent co-
165
location of different tenure developments. This conceptualisation was seen to
intersect in important ways with the field of health through the co-location of health
facilities, the provision of walking and recreation facilities and a design oriented to
encouraging movement and activity. These design values were experienced very
positively at symbolic level by participants. In general, the respondents were very
supportive of their inner-city location, the mixing of tenures, the availability of
services and the diversity of the village in terms of both visitors and residents. Their
descriptions of their housing careers positioned their move to KGUV as a change for
the better in terms of happiness and well-being.
However, when their responses moved to descriptions of everyday experiences of the
space, their utterances revealed a level of ambivalence and negativity. On the one
hand, descriptions of spatial practices revealed some very positive changes for the
better in their housing circumstances and well-being. The quality of the dwellings is
proving to be a positive influence on both real and perceived well-being, as is the
availability of shops and affordable, child-friendly venues, such as the proximity to
South Bank and Roma Street Parklands. Additionally, the overall absence of fear is a
great contributor to the level of engagement with local resources, especially in light
of residents' prior experiences in poorer neighbourhoods and housing histories.
However, on the other hand, interviews found that vulnerable groups perceive the
poverty, ill-health and addictions of others acutely, and see it as a reflection on
themselves when it occurs in close proximity to their living area. Therefore, while
the well-designed units, the presence of the university and the theatre and the
demographics that utilise these resources contributed to an overall improved sense of
well-being for residents, at the level of everyday experience other social aspects of
life at KGUV were experienced as more problematic.
While the Brisbane Housing Company residents were able to physically access a
range of urban resources that are usually linked with improved health and well-being,
such as parks, pathways, and bikeways, at a social level there were a range of
complex processes at work generating barriers to a greater connection between these
people and the lifestyle on offer to them at KGUV. Firstly, a mistrust of other
residents in the same demographic and perception that they were not ‘good people’
was born out of previous negative experiences living in poorer suburbs in the
166
Brisbane region, thus inhibiting social activity and venturing outdoors to participate
more fully in KGUV life. Secondly, close proximity to people with social and health
problems meant that another level of symbolism about the KGUV was created
internally within the apartment blocks; with used needles, over-flowing bins, broken
toys, rummaged-through mailboxes, and even blood stains in some areas comprising
a set of semiotics not conducive to feelings of happiness and well-being. Finally, a
tension was being played out between aesthetics relating to different components of
design, between the physical and the social, and which raise important questions for
both urban designers and public health researchers. Further investigation is required
to understand the effects of social contexts on health-related behaviours in urban
environments, and greater consideration of these effects needs to be taken at a
planning level when considering co-location of different demographics and land-use.
Stronger research links are needed between health and urban design to ensure that
health promotion and intervention takes into account the power of design to
potentially mediate these effects, and for designers to acknowledge the salience of
social context and its impact on a range of goals for future planned community,
including health and sustainability.
167
Statement of Contribution of Co-Authors
The authors listed below have certified* that:
1. they meet the criteria for authorship in that they have participated in the conception,
execution, or interpretation, of at least that part of the publication in their field of expertise;
2. they take public responsibility for their part of the publication, except for the responsible author who accepts overall responsibility for the publication;
3. there are no other authors of the publication according to these criteria;
4. potential conflicts of interest have been disclosed to (a) granting bodies, (b) the editor or publisher of journals or other publications, and (c) the head of the responsible academic unit, and
5. they agree to the use of the publication in the student’s thesis and its publication on the Australasian Digital Thesis database consistent with any limitations set by publisher requirements.
In the case of this chapter:
Publication title and date of publication or status: My Place through My Eyes: A
social constructionist approach to researching the relationships between
socioeconomic living contexts and physical activity In: The International Journal of Qualitative Studies in Health and Well-Being, In Press, 2008.
Contributor Statement of contribution
Julie-Anne Carroll
29th July 2008
Identified a gap in the literature, wrote the research questions, identified a point of departure, designed the methodology (including conceptual approach), collected the data, conducted the analysis, wrote up findings, and wrote the article.
Dr Barbara Adkins
Assisted with the research questions, methodological design and the refining and application of the conceptual framework to the investigation. Made revisions to the article, and assisted with the overall structure of the article and the presentation of analysis and findings.
Associate Professor Elizabeth Parker
Conducted revisions, assisted with structure and the presentation and conducting of analysis and findings, sentence-level-editing and writing corrections.
Dr Marcus Foth
Conducted revisions, assisted with structure and presentation of analysis and findings, sentence-level-editing and writing corrections.
Soad Jamali
Assisted with the sorting of data into NVivo, open and conceptual coding into key categories, editing of article.
Principal Supervisor Confirmation I have sighted email or other correspondence from all Co-authors confirming their certifying authorship.
Dr Barbara Adkins 29th July 2008
Signature Date
168
Chapter Seven
Published Paper Three
Title: My Place through My Eyes: A social constructionist approach to
researching the relationships between socioeconomic living contexts and
physical activity.
Authors: Carroll, Julie-Anne, Adkins, Barbara A., Foth, M., Parker
Elizabeth A., Jamali, S.
Published: The International Journal of Qualitative Studies in Health
and Well-Being, IN PRESS, 2008.
7.1 Abstract
Empirical research has shown that household and neighbourhood characteristics are
significantly linked to particular health-behaviour profiles. Specifically, people living
in lower socioeconomic living contexts tend to be associated with less active and
healthy lifestyles. However, what is not yet fully understood is how living contexts
work to produce and sustain common or shared behavioural patterns. To address this
question, we employed Berger and Luckman’s (1966) social constructionist
conceptualisation of context to study a group of residents who had recently moved
from poorer living contexts to a mixed-tenure, inner city, new urban village equipped
with various resources promoting a physically active lifestyle. This framework was
coupled with Charmaz’s (1995; 2006) social constructionist approach to grounded
theory. An analysis of the qualitative data gave rise to the conceptual categories of
‘being flogged up something fierce’, ‘running away, ‘sleeping with one eye open,
‘you’re just fat’, and ‘exercise as a dream’ as the key contextual influences mediating
poor living contexts and low physical activity levels. A core category of ‘identity
management’ was located. The selection of this case and the findings exhibited here
169
draw attention to the need for a situated understanding of how particular lifestyles
develop in socioeconomic living contexts. The insights need to be drawn from
‘insider perspectives’ in order to ensure more sensitive and effective interventions in
the future.
7.2 Introduction
Research has established that the socioeconomic position of households and
neighbourhoods is a reliable predictor of a range of health-related behaviours and
outcomes (Ioannides, & Zabel, 2007; Kavanagh, Goller, King, Jolley, Crawford &
Turrell, 2005; McCracken, 2001). However, questions remain about the internal
mechanisms, processes, and practices through which poorer living contexts produce
and sustain less healthy lifestyles than wealthier ones (Macintyre, McKay, &
Ellaway, 2005; Coen, & Ross, 2006; Monden, Van Lenthe, & Mackenbach, 2006;
Cummins, Curtis, Diez-Roux, & Macintyre, 2007; Parkes & Kearns, 2006). While
sophisticated statistical methodologies have been used to establish convincing links
between contexts and health (Diez-Roux, Kiefe, Jacobs, Haan, Jackson, Nieto,
Parton & Schulz, 2000; Hou & Myles, 2005), further qualitative studies are needed
to extend this knowledge to something beyond what statistics alone can capture. The
nature of statistical analyses places limits on the insight that can be gained about the
nature and the direction of the relationships linking poorer living contexts with
poorer health. Thus, it is important to complement the epidemiological evidence base
regarding ‘area-effects’ on health with studies that allow an intensive focus on the
situated relationships between context and practice.
Further to the lack of qualitative studies, there has been an associated lack of the
theoretical development needed to understand and conceptualise the relationships
between context and health-related behaviours. A key article by Frohlich, Potvin,
Chabot, and Corin (2002) makes special note of the lack of a useful
conceptualisation of context for the study of health-related behaviours in urban
neighbourhoods. They make the point that to study the ‘social contextuality of
meaning’, methodologies are required that situate health-related behaviours within
the context of the social relations and transactions or interactions of people’s lives by
tapping their subjective experience within their social location (p. 1402). They go on
170
to refer to an article by Poland (1992) to emphasise the point that ‘not only is it a
methodological issue requiring qualitative methods, but it is also a theoretical one in
which the relationship between health-related behaviours, risk, and knowledge can
be analysed in terms of the intersection of structure (norms, codes of conduct and
institutions) and human agency (individual volition, action)’ (p. 1402). In this paper
we make the case that what is needed is a theorisation of living contexts that lends
itself to revealing the internal mechanisms that influence less healthy lifestyles, as
well as qualitative instruments for extracting and analysing the data relevant to
addressing this question. To illuminate, the main aim of the study was to gain
insights into the everyday properties and processes underlying the empirical evidence
depicting an association between lower socioeconomic living contexts and less
physically active lifestyles (Mokdad, Ford, Bowman, Dietz, Vinicor, Bales & Marks,
2003; Lindstrom, Hanson, & Ostergren, 2001). Importantly, we sought to unearth the
key occurrences within poorer contexts that result in a particular construction or
treatment of it there, and conceptualise these within a theoretical paradigm to both
guide, and be tested in, future research.
In accordance with this aim, we adopted a theorisation of ‘contexts’ from Berger and
Luckman (1966) who understand it as a reflexive relationship between people’s
backgrounds and dispositions on the one hand, and the milieu and environments they
inhabit on the other. Second, we describe the coupling of this conceptual and
philosophical shift with the social constructionist approach to grounded theory as
proposed and practised by Charmaz (2006) and others (Hjalmarson, Strandmark &
Klassbo, 2007; Lesch & Kruger, 2005). Third, we outline data collection and analysis
according to the principles that are typical of this qualitative approach. Fourth, we
discuss the identification of the key processes and social interactions within
participants’ housing and neighbourhood contexts which have affected their
propensity to lead active and healthy lifestyles and develop these into conceptual
categories. Finally, we identify a core category, and implications of these findings for
future interventions.
7.3 Re-Thinking Context: A Theoretical Point of Departure
This paper extends work oriented to capturing the relationship between living
171
contexts and health practices by applying Berger and Luckman’s philosophical
framework devised in their 1966 work The Social Construction of Reality to this
empirical problem. Their conceptual framework emphasises the roles of agency,
context, and subjectivity, in how particular human behavioural patterns arise over a
period of time in particular social settings. Berger and Luckman offer a contextual,
rather than a universal framework for thinking about and analysing patterns in
human behaviour. In doing this, they illuminate contexts as powerful proponents of
human behaviour, and theorise how norms, routines, and patterns of practice develop
within them. For this reason, we propose that their work is directly suited to studying
and analysing how living contexts work to give rise to particular behavioural and
lifestyle profiles.
In Berger and Luckman’s 1966 work The Social Construction of Reality, they
proposed that people participate in social processes within a particular context over
time to decide what things mean there, and what ‘the done thing’ is amongst its
occupants. They referred to this normalisation of procedures and responses over time
as habituation, and noted that over time, these habits become institutionalised in that
context and taken for granted as ‘normal behaviour’. They further purported that the
points of reference people use for assessing how to respond to something or
somewhere and their interpretation of the behaviour of others there, depends on their
personal and shared histories and experiences. They referred to this notion as
historicity. The study applied the concepts of habituation, institutionalisation, and
historicity to the problem of researching the responses of a particular socioeconomic
group to a new urban environment, with particular attention paid to the amount of
physical activity they became involved in. In line with this social constructionist
perspective, we sought a subjective account of the world where physical activity has
a low-priority status. A temporal account of poorer social contexts, and the dialectical
tensions between human agency and social forces within them was undertaken.
7.4 Methodological Design
Due to the initiative in this study which sought to build the theory around the
question of how physical activity is socially constructed within poorer living
environments, Charmaz’s constructivist approach to grounded theory seemed to be
172
most fitting with this particular conceptual approach, or ‘world view’. This is
because constructivist grounded theory allows for a more flexible methodological
approach (Mills, Bonner, Francis, 2006) and brings questions to the research process
- with consequences for method and analysis, - from the same school of thought as
the Berger and Luckman philosophy. However, it must be noted that Charmaz did not
specifically advocate using the Berger and Luckman framework, but takes a broader
constructivist approach to grounded theory, in which the subjectivity inherent within
analysis and theoretical development is acknowledged, and reflection on the role of
the researcher in the production of data emphasised. Charmaz has taken a divergent,
and yet increasingly accepted means of employing a grounded theory approach,
which she refers to as a social constructionist approach to grounded theory, and
emphasises the need for flexible guidelines, ‘not methodological rules, recipes and
requirements’ (p. 20).
Charmaz (2006) reminds that taking a social constructionist approach to research
means acknowledging that subjectivity applies also to the researchers, who are only
able to interpret interpretations, and construct constructions provided by the
participants. She argues that researchers bring their own histories, theories, values
and ideas to the process of generating theory from data. Charmaz herself says ‘Data
do not provide a window on reality. Rather, the ‘discovered’ reality arises from the
interactive processes and its temporal, cultural, and structural contexts’ (Charmaz,
2000, p. 524) Thus, consideration must be given to both the researchers’ and
participants’ backgrounds when data is being collected, selected, and analysed. A
reflexive, interpretive approach to the data must be taken if there is an ongoing
understanding of it being socially produced between the researcher and the
participant. Further, she emphasises the need to keep returning to the study site to
build concepts via the process of theoretical sampling, and to constantly compare and
contrast data between individual cases, and to reflect on the relationship between
researchers and participants as the theory is being developed.
While this study lies on the constructivist end of the Glaser-to-Charmaz approach to
grounded theory (Hallberg, 2006), the unique methodological approach of this study
is that it is guided by the specific version of social constructionism introduced by
Berger and Luckman (1966) to build new theory around the relationships between
173
poor living places and poor health. It acknowledges the iterative, and relatively
subjective, process of theory building, but is primarily concerned with gaining
insights into the perspectives of people who inhabit a poorer living context to tell us
what physical activity – as a concept and practice – means there, and how this
meaning was socially constructed over time. Importantly, it aims to use a social
constructionist lens to build a theory with the capacity to hold explanatory power in
relation to what has been described by McIntyre et al (2002) as ‘a black box of
mysterious influences on health’ (p. 125). Other studies on health-behaviours using
Charmaz’s approach to grounded theory were located (Hjalmarson, Strandmark &
Klassbo, 2007; Lesch & Kruger, 2005), however these authors made no reference to
the conceptual framework of Berger and Luckman as a means of guiding the
selection, collection or analysis of the data.
7.5 Location of the Study: The Kelvin Grove Urban Village (KGUV)
This study investigated the residential population living within the four blocks of
‘affordable housing’ apartments within the Kelvin Grove Urban Village (KGUV;
www.kgurbanvillage. com.au). KGUV is an AU-$800 million mixed-tenure, medium
density, inner urban, master planned community based on the design principles of
‘new urbanism’ located approximately two kilometres from the Central Business
District (CBD) of Brisbane, Australia. It sits on approximately sixteen hectares and
contains around 2000 residential properties from both the public and private sectors.
KGUV was designed according to the principles of new urbanism, thus promoting
pedestrian mobility and activity through the provision of wide-pathways, bikeways,
parks, and green recreational spaces. The KGUV provided a microcosm that
generates aspects of human behaviour that are of interest in an investigation
exploring the dynamics between lower socioeconomic living contexts and the
propensity to be physically active. The case-study of KGUV enabled an
identification of the key relationships at stake in the adaptation of affordable housing
residents to a ‘healthy environment’. Thus, the grounded theory techniques were
applied within the KGUV context, because this particular neighbourhood site was
seen to be theoretically representative of a development that encapsulated the
relationships that were the focus of this study.
174
7.6 Study Participants
Only the residents housed in the affordable housing – or government supported –
housing options within the Village participated in this study. Entry into this housing
option is based on income-criteria, with only low-income singles, families, and
pensioners qualifying for entry. They were all from disadvantaged backgrounds, on
low incomes, and clustered together in a lower socioeconomic residential context
within the broader context of the Village, thus providing an opportunity to study this
group of people, their low-income living context, and their perceptions and practices
in relation to physical activity.
While a relatively heterogeneous mix of people within the affordable housing option
at KGUV was recruited for the initial phase of data collection, the following two
processes of participant recruitment were refined to seek out people who were most
disadvantaged and the poorest in the group, in order to ascertain insight to
experiences in their lives that prevented them from pursuing physical activity.
Further, Charmaz (2006) refers to theoretical sampling more as a strategy than a
process, and for our purposes, it worked well to not only develop categories that
emerged in the first phase of data collection, but to fill in gaps that became evident in
early phases of collection and analysis. A table summarising the participants and data
collection phases is depicted below:
Table 7.1 Summary of Participants and Data Collection Phases
Participant s
Data Collection
16 Blogging: An online mechanism known as a ‘blog’ was
appropriated as a means where residents wrote answers,
stories, and opinions about KGUV in relation to healthy
lifestyles. There were 214 responses posted on the blog in
total. Blog address:
http://theeffectsofanewurbancontextonhealth.blogspot.com
/
8 Face-to-Face Interviews: 1-2 hours in-depth interviews
were conducted with BHC residents in their apartments
about how their living contexts affect their lifestyles and
health.
175
6 Community Focus Group: Informal, opportunistic
interviewing and observation notes were taken from BBQ in
local park organized by researchers for BHC residents.
7.7 The Researchers
The researchers were all of a higher socioeconomic background than the participants
in the study. The potential barriers created by the social and economic differences
between the researcher and participants needs to be acknowledged and addressed in
the research process (Charmaz, 2006; Lesch & Kruger, 2005). However, the
background experience in counselling and home-visiting in the area of housing
services by the first author who conducted all the interviews helped develop a
comfortable relationship with the participants. By sharing and swapping personal
stories and comparative experiences in a few visits prior to each interview, trust was
established and a sense of safety, and the ability to be open in conversation was
established. Reflective notes were written on the constant divergence between the
researcher’s focus on physical activity, and the focus brought to the interviews by the
participants on other aspects of their lives that were salient to them in shaping their
current attitudes and beliefs in relation to health.
7.8 Entry into the Field
The first round of participants were recruited via a survey, which was distributed in
an earlier phase of this research project. Respondents returned their surveys, and
agreed to participate in further research. Thus, this initial group was relatively
accessible and enthusiastic to be involved with further study. However, the
participants in phases two and three were the ‘hard-to-reach’ group via whom we
sought to tap into the processes giving rise to the evidence base depicting low
activity levels amongst poorer populations. Invitations were posted in their
mailboxes offering AU-$30 per interview, and AU-$10 for participation in the focus
group. The affordable housing residents responded to this offer, primarily by
contacting the researchers from the public telephones in the Village. Participants in
stages two and three were difficult to interview in the first instance as they were
176
initially slightly mistrusting of the researcher; few had home telephones connected;
and were often involved in court cases and social services, which made their daily
schedules unpredictable. However, over time a good rapport with the residents was
established, and they also benefited by receiving food parcels, children’s clothing and
referral to local welfare services.
7.9 Ethical Clearance
An ethics application was approved by Queensland University of Technology (QUT)
to conduct the study. Data was collected over a six month period, including the
online and face-to-face phases.
7.10 Data Sources
7.10.1 Online Blog Entries
Sixteen residents in the affordable housing option at KGUV who had agreed to
participate in further research following the completion of the survey were selected
for the online qualitative data collection phase through a web log (‘blog’). A blog is
an online public forum traditionally used by a single author for writing a diary, and is
often accompanied by photographic accounts to tell stories and share interests and
viewpoints with others (Bachnik et al., 2005, p. 1). We chose this medium as it offers
participants the opportunity to write their stories, opinions, and answers to the
research questions in an online forum where they are able to view the anonymous
input of other members of the community, and from where we could study their
answers as a collective. Photographs of the neighbourhood were posted, as well as
questions for participants to answer following these key themes:
• Self, Health and Space: What Moves You?
• Social and Psychological Aspects of Physical Activity
• Depth of Engagement with Neighbourhood Resources for Physical Activity
• Moving into a New Urban Environment.
• The Effects of a New Urban Context on Health
177
The following insertion is a sample from the blog to demonstrate its appearance on
screen:
Social and Psychological Aspects of Physical Activity
This is the last post for questions about the Kelvin Grove Urban Village and the
amount of physical activity you do. Please write as much as you can...
1. Would you say that, in a general sense, you are aware of how much physical
activity or exercise you achieve during the day, and do you worry about it, or try to
increase the amount? Do you ever consider taking more exercise, or are you content
with how active you are?
2. If you see an ad on the TV telling people to do more physical activity, or hear a
health promotion message about it on the radio does this make you want to become
fitter? Do you ever act on these messages, or do you forget about them soon after
hearing them?
3. What types of thoughts do you have that would make you want to increase your
physical activity levels? What kinds of things play on your mind or which life events
might suddenly make you motivated to exercise?
4. If you see people out and about exercising, does this inspire you to become more
active? Do you compare yourself to others' bodyweights in and around the area that
you live? How does this make you feel?
178
5. How interested would you be in being part of a social group that organised group
walks, or bicycle rides, or games in the local park? Why/why not? And would you
like to hear about such events online, by mobile/home phone, texting, or pamphlet in
the mailbox?
posted by Julie-Anne @ 8:32 PM 73 comments
A total of 214 comments were made by participants on the blog.
All data can be viewed at the blog site:
http://theeffectsofanewurbancontextonhealth.blogspot.com/
7.10.2 Interviews
One to two hour semi-structured, in-depth interviews with eight additional
participants allowed an exploration of previous and current households and
neighbourhoods as they related to the health and physical activity levels of
participants. Questions were open-ended, and further questioning encouraged
participants to talk at length about their previous experiences in households and
neighbourhoods. Participants were left to emphasise what they felt was important to
them, and raised topics, contextual characteristics, and past events that they recalled
as being salient in terms of how it affected their propensity to be physically active.
Notes and memos were written up both during and immediately after the interviews
were conducted and recorded.
7.10.3 Outdoor Community Focus Group
A further six affordable housing residents participated in an outdoor focus group held
in one of the recreational areas in the Village. In addition to the grocery vouchers,
they were provided with a lunch during this interview phase. In this session the
interviewer focussed on the more notable similarities and differences that had
emerged in the initial interviews regarding the nature of the urban village
environment for pursuing physically active lifestyles, and directed the discussion
179
around clarifying these points. This process of theoretical sampling allowed for the
saturation of the emerging conceptual categories. The participants spent some time
negotiating their perceptions of the Village, their experiences in previous
neighbourhoods, and their propensity to physical exercise, as a group.
7.11 Analysis: A Social Constructionist Approach
According to Charmaz (2006), a core benefit of the social constructionist grounded
theory approach is gaining an insider perspective of the meanings behind the patterns
of behaviour that can be observed in a particular context. This approach allows a
focus on time, culture, and context; challenging concepts to examine using
traditional, positivist methods (Hallberg, 2006). In an analytical sense, we adhered to
the Berger and Luckman (1966) approach to studying human practice in context by
noting the patterns of practice there, and then exploring the social influences
involved in the construction of these over time. We explored the historicity of a
particular social group to unearth the habituation of their conceptual relationship
with physical activity as it evolved over time. We analysed the data for clues as to
how this important health-related behaviour came to be institutionalised within their
living contexts as a negative or low priority construct. Thus, concepts were built out
of the stories told by the participants about their childhoods, their teenage years, their
experiences in previous poor neighbourhoods, and their perceptions and practices
around physical activity in their current neighbourhoods at this point in their lives.
The data from the blog and the transcripts from the interviews and focus group were
transferred into NVivo software for coding and analysis. An inductive analysis fitting
with the constructionist approach that emphasises the importance of respondents’
narratives of their experiences was used (Charmaz, 2006). In line with the emphasis
Charmaz (1995) makes to focus on processes, actions and consequences we
conducted a line-by-line coding procedure which provided subjective, temporal
accounts of how physical activity as a concept was shaped and reinforced over time
amongst these participants. The phrases and narratives they provided revealed how
the different social and living contexts through which they travelled had ensured
harsh and hostile barriers to feeling confident about both their body image and their
ability to become physically active. We also used focussed coding, which is a more
180
directive means of locating emerging themes and codes in the data, to identify the
key processes mediating the people, place and health relationship in this case.
Charmaz (2006) uses this focussed approach to develop the conceptual categories,
which, according to Moghaddam (2006) become the ‘building blocks’ for the
theoretical development later in the process. This focussed, or conceptual coding,
involves an abstraction of the data as it has been collected, organised and analysed
into sets of shared phenomena underpinning the narratives (Charmaz, 2000). These
analytic codes or categories allow us to develop a conceptualisation of the data as it
is collected, recorded, and analysed. We developed a number of conceptual codes
that appeared to underpin the collective experiences representing the evolution of the
attitudes, beliefs and behaviours in relation to physical activity amongst that
residential group.
This was followed by an exploration of how these conceptual categories relate to one
another within the context of the group’s experiences over time. In other words,
while we could gather together key shared experiences and phenomena – such as
abuse, neglect, early homelessness, or feeling afraid in one’s neighbourhood – we
then had to explore their connectedness to one another in order to develop the theory.
In other words, how do these concepts tie together in a meaningful way and what is
the core category mediating these subsets? To do this, we developed sub-categories,
for example ‘types of abuse’, and ‘different experiences and contexts of abuse’ that
tied to this important category. The next important category of ‘leaving home early
and homelessness’ was analysed as relating to the previous category and a strategy,
or consequence of the initial conditions of early childhood abuse and neglect. The
key categories that typified their experiences growing up poor and how these related
to one another in an almost catalytic sense were revealed in this part of the analysis.
Finally, a core category of identity management was located as the constant framing
and reframing of self against others in poor contexts; the striving of participants to
mould their identities as more palatable or less stigmatised than those around them,
with strategies to do this often failing and resulting in even more unhealthy and harsh
living situations. Theoretical coding was used to bring together the primary
conceptual categories as they relate to the core category as a means of building
theory and insight about how contexts affect physical activity levels. This process
181
resulted in the production of a model for framing thinking and approaches in future
research.
In addition to the analysis conducted on the data from the blog and the interviews
memos and observation notes were made to aid a reflection on the relationship
between the goals of the research and the things that mattered most to participants in
their living context. A consistent divergence from the topic of physical activity to
‘what matters to me here and now’ was noted, and the events and reactions of
salience to participants were categorised. Notes on the participants, such as smoking
habits, weight, age, family dynamics, and the nature and contents of the households
were also made.
7.12 Findings: Key Conceptual Categories Mediating Poor Contexts
and Low Physical Activity Levels
A model illustrating the results of the data analysis, the emergent key conceptual
categories described above, and the core category of identity management are
provided in Figure 7.1 below. Figure 1 demonstrates the key categories that
emerged as typical of experiences within poor contexts over the life-course that
generate barriers to physical activity, as mediated by the core category of ongoing
identity management in this process. It depicts the key conceptual categories that
typified the experiences of the participants in this study from their childhood living
environments to their current circumstances and experiences. The model indicates
the catalytic chain of events that characterised the stories of all participants, and even
if the abuse or neglect came in various forms, it was an ever-present trait of their
childhood experiences. Their descriptions of their previous living contexts go some
way to explaining their current perceptions, constructions and practices of physical
activity and their experience of their body image in public spaces. The data analysis
revealed the role of ‘context’ – be it defined or measured socially, economically, or
geographically – is a powerful factor influencing people’s sense of identity and
health-related practices such as physical activity. Their sense of self, place, and
health appeared to be inextricably linked in the data, pointing to the need to intervene
on a broad front to improve self-worth and health in these contexts.
182
Figure 7.1 Conceptual categories and core category emerging from a
social constructionist grounded theory study into the relationships
between poor living contexts and lower physical activity levels
The following quotes from the data demonstrate how the coding process developed,
and how the conceptual categories formed from the stories told by participants about
their previous living contexts, and their current attitudes and norms in relation to
active and healthy living in their new neighbourhood environment.
7.12.1 On being ‘Flogged up Something Fierce’: Conditions in
Childhood as Catalysts for Patterns in Later Life
An important historical theme that emerged in the data was how participants were
treated by others over the various social and living contexts they traversed
throughout their lives. Their sense of ‘self’ had been greatly damaged in the first
instance by spending their formative years in violent, neglectful, and psychologically
and emotionally damaging places. As Goulding (1999) suggests, it is important to
183
ask of early scenarios that emerge in the data ‘what is happening in this data? What is
the basic socio-psychological problem?’ Each contextual scenario that participants
described revealed a process wherein their sense of self and identity was being
damaged by the various dimensions and properties of poverty. Further, their strategic
responses for managing their circumstances and their sense of self meant that they
were less able to focus on a health-related behaviour such as physical activity as a
priority. For example, we began the interviews by asking participants about the
extent to which being physical activity had been a priority in their childhood living
environments, and the answers they provided all went similarly along the following
tracks:
When you were growing up, how important was a healthy lifestyle in the family you grew up in?
Were your parents or carers encouraging you to be fit and healthy or was it not really talked about
that much.
Not really talked about. We used to bring ourselves up. My mother was a real, you know. She wasn’t a
very nice person. We brung ourselves up and looked out for each other.
So you had a lot of other things to worry about, besides health?
Yeah, well my mum used to get flogged up somethin’ fierce, so...
Can you tell me what you mean by that?
She used to get, what’s it called? Like, what do they call it on the TV? Like, domestic violence.
Oh, your mum was beaten up? By your dad?
Yeah, by my stepfathers. Not my real father, cause I didn’t know who my real father was until I was 18.
I’ve never met my father.
The relatively jarring re-orienting of the answers by participants that describe
abusive and harsh childhood households from questions that inquired about health
and physical activity, shed light on the powerful contextual influences in these early
years that directed a priority from healthy living to sheer survival. The pictures
painted for us by the participants of their roles as small, frightened child-figures in
places that were meant to be safe, but were in fact filled with fear, darkness, and
dread, go some way to answering questions about how poor contexts block pathways
to physically active and healthy lifestyles. These rich narratives tell us that sexual,
emotional, and physical abuse were powerful forces shaping their sense of self as
children, and the extent to which they were able to feel confident about their
identities and their bodies, as another story reveals:
184
When you were growing up, how important was it in the family you came from, or the household
you grew up in to be healthy? Did your parents or carers emphasise this as a goal, or was it not so
important?
Um, I as a, well, growing up in my household, well there were lots of problems we faced on a daily
basis.
What kinds of problems?
My stepfather abused us, um, my mum ended up staying with him for twelve years, which we in the
end, just you know, got to the point where we were sick of it, cause we had enough. And my mum
ended up carrying on a few of his traits, and me and mum clashed a lot, so…
Right…
I did have a weight problem when I was young, but I did something about it, I went and joined Jenny
Craig and you know, and started losing weight, and you know, I dealt with it myself, because my mum
used to call me horrible names about being overweight and that didn’t help me.
Thus we can see in this example, how the combination of abuse, household stress,
and parental bullying held great implications for her perceptions of her body, her
sense of self, and her general well-being.
The pertinent properties of lower socioeconomic contexts were identified in this
study as abuse, neglect, alcoholism, violence, and parental bullying - often about
participants’ weight or body images. Thus, it became evident that poverty was as
much a property of these contexts as poor health practices were, with the
psychosocial processes such as abuse and neglect being the powerful mediating these
types of tangible ‘outcomes’. That is, the outcomes which are so often tended to in
quantitative studies are merely the identifiable results of violent processes that
diminish participants’ sense of self, and leave them with the ongoing psychological
battle of trying to improve this condition or perception in harsh and hostile contexts
that constantly threaten their ability to feel positive about who they are and what they
are capable of achieving. Abusive and neglectful early years meant that participants’
sense of self and personhood in the world remained in a constant state of risk, with
the chain-reaction effect that ensured poverty, low physical activity levels, and poor
sense of self ensued for the most part of the rest of their lives.
185
7.12.2 ‘Running Away: A Strategy for Surviving and Starting Again
in Hostile Environments
In the descriptions of scenes in which abuse and neglect were the norm, participants
struggled to find ways out of the conflict via their own resources. They all reported
leaving home early, between the ages of eight and fourteen. This participant gave a
vivid account of the conditions of her childhood, and the strategies she employed to
deal with that living context:
Cause with alcoholism, I got molested by an uncle and I felt the best thing to do was to tell my
mother? And I remember the guy saying, you can tell you and she’s not going to believe you, and I told
my mum and she would not believe me and I was really just hurt in the heart. I ran away. That was it,
you know. She didn’t believe me. Although before she died, before she died she knew that I was telling
her the truth.
How old were you when this happened?
Eight years old.
Eight? And you ran away?
Eight. And I kept on running away and running away.
All participants reported running away from home as a means of escaping contexts
that were not a feasible option for them to continue inhabiting:
I ended up going into a homeless shelter…
The consequences of the strategy of escape or flight from these situations led in all of
the cases to starting a ‘new family of their own during their teen years, thus
cementing their difficulties in relation to poverty due to limited options to develop
further education, working skills or an earning capacity.
I didn’t live at home, but I ended up falling pregnant. I was a runner.
So where did you live, when you were 13, but still at school, and being a runner?
I lived with Tom. They let me run for a couple more months, but then I ended up getting bigger and
they said it would be too stressful
In year 9?
Yeah, going into Year 10. I ended up getting out of school in year 10
186
Further, many turned to drugs to cope during these teenage years:
…then I ended up in rehab.
So you got into some drug use and then rehabilitate?.
Yup and haven’t been near it since I was sixteen. Nearly ten years.
7.12.3 ‘Sleeping with One Eye Open’: Living in Poor Neighbourhood
Contexts as Young Adults with Children
Participants went on to describe living in and moving through neighbourhoods that
were poor and unsafe. When we asked them to describe their relationship with these
places, what they meant to them, and how they influenced their activity levels,
participants reported high levels of danger and fear.
Before I was living in Fortitude Valley, and it was very unsafe there.
OK, and what were the dangers?
People robbing you of money, and stalking you.
And
Everythink. You can’t even walk out your backdoor…
For fear of?
For fear of the kids, they can’t ride their pushbikes ‘cause they will get bashed and robbed for ‘em. If
you’re out, after a certain time you will get rolled for shoes, your money, your wallet, different things
like that. It was just… a lot of the areas aren’t safe no more.
They describe living in fear due to the presence of a range of factors, such as
discarded intravenous drug needles and crime, but also because of the relational
dynamics that centre round intra and inter-household conflict and violence. For
example:
I always had to sleep with one eye open, you know?
Another participant told many stories of crises occurring amongst neighbours, with
police and ambulance call-outs:
187
But when the neighbours at night n that are having big arguments, and a lot of the time they come and
there’s the police or the ambulance and you can see the lights when the ambulance comes, and at
times like that, I feel like I am in Once Were Warriors or something like that…
Importantly, one participant described the importance for her of needing to find a
way out of her associations with poverty, danger, fear, and stigma. Her disapproval of
being placed in government supported housing with people in similar circumstances
is clear here:
They think ‘Oh you live at that community housing place’.
And do you think it reflects on you?
Oh it does. Yeah. I think well they think I’m a drug addict just like everyone else is around here. And I
feel like ‘I’m not one of them!’ And I don’t want to be categorized into that.
And another stated:
…but you haven’t moved on, it’s still housing commission.
As a result of the nature of these living environments, belief systems, attitudes, and
norms developed around the importance of keeping to oneself and staying indoors to
manage risks and stay safe – physically and emotionally. As one participant
described her housing history:
It’s a roof over your head and you keep to yourself
While another explained her reasons for not wanting to socialise with neighbours:
That’s just a personal thing for myself because I’ve been involved and been friends with neighbours
and it doesn’t turn out a good thing.
Oh, OK?
For myself, it always turns out it always seems to be a bad thing, and I dunno whether it’s the people I
meet or whether it’s just myself, who knows? (Laughs)
As a strategy of everyday risk-management in these contexts, participants expressed
a preference for staying indoors. As one participant explained, she is not even
comfortable being seen outside of her apartment:
188
I’m not out here much. I very rarely venture out onto the balcony. Susie [her daughter] will come out
here for fresh air to have her cigarettes. When you’re out here, who knows who’s watching you and
from where.
This relationship between sense of place and sense of self-being reflected in where
you live, what is there, who is there, and what goes on there appeared to be salient in
the data, with great implications for whether or not they are willing to leave their
houses and feel safe, positive, or confident about engaging with the resources in the
neighbourhood in ways that would ultimately improve their health.
7.12.4 ‘You’re Just Fat’: Other Intervening Social Interactions and
Influences on Body Image and Physical Activity
As is evident in this data, the contextual influences that shaped their relationship to
managing their weight and being physically active are complex, and are comprised of
a number of situational dynamics and environmental characteristics, which over
time, have shaped their perception, or conceptual relationship with this particular
health-related behaviour. The data reveals a psychosocial relationship between
growing up in poor environments, experiencing difficulty with body weight and
image, and a self-consciousness and general fear of others that then prohibits a
propensity to be more physically active. Our data shows a connection between the
characteristics and traits of poor households and neighbourhoods, such as violence,
neglect, abuse and other dangers, and being less active, more over-weight, and
consequently less likely to feel confident to engage in physical activity. One
participant described the kinds of social challenges that arise from being overweight
in public:
The thing that hit me the most in terms of my weight was when I went to the shopping centre just a
couple of weeks ago, and I was putting on makeup because I was going for interviews for a job and I
was with my girlfriend at the time and I said to her ‘Quick!’ cause she loves to try on all the make-up
all the time, and I said ‘Quick! I gotta go to the toilet!’ and a lady turns around and says ‘Well that’s
what happens when you are expecting!’ And I was like ‘I’m not pregnant.’ And it just hit me like a ton
of bricks, so I felt so horrible.
189
Another participant described her experience when she went to visit a doctor about
trying to manage her weight.
She [doctor] just turned around to me and said ‘Lay up on the bed’ and she grabbed my stomach and
said ‘You’re just fat, you need to lose some weight, can you do that?’ It shouldn’t be like that.
These kinds of social interactions and experiences deterred this group from wanting
to be out in public too often, or from seeking assistance from health professionals to
better manage their weight. There are clearly power differentials apparent in this last
example that highlights the relationships between social status and feelings about
body image, weight and exercise. This data also sheds light on potential reasons
behind statistically proven weight differences between higher and lower
socioeconomic demographics.
7.12.5 ‘Exercise as a Dream’: The consequences of life-course
contextual processes on the negative social construction of physical
activity within this group.
Interestingly, the participants expressed the salience of the relationship between self
or body-image and their reluctance to engage publicly in physical activity for health
and fitness reasons. They felt that the people who were able to do this must have had
access to other means to looking as fit as they do, and that the participants were
outside the realm of these recreational pursuits. Consider the following extracts:
If I see other people exercise I feel bad, as they are fitter and better looking than I am and I feel if
people see me exercising I will just look fat and stupid, so it quietly motivates me to better myself but
makes me feel bad…
Or:
I think, I would love to go for a jog or a run, but I dunno… I think when I look at them [other people
running] that they’ve probably had liposuction… (laughs).
This self-consciousness seems to be contributing to a sense of ‘us’ and ‘them’ in
terms of their own physical appearance or ability versus belonging to the social
190
group that constitutes the ‘fit type’.
Yeah well we’re really not a fit type like other people you see running around here and that (laughs).
While another participant has considered the potential of having community games
organised in the local parks, she did not feel that she would automatically qualify for
inclusion, as is expressed here:
Games in the park would be great. But I wonder if they would invite me…
However, it is entirely not clear who the ‘they’ in her sentence is, aside from them
having some kind of authority over the resources in relation to her requiring an
invitation to participate. Further research is needed to unpack the relationship
between the socioeconomic profile of co-located residents and their relative
willingness or confidence to engage in the local neighbourhood to create more active
lifestyles.
Primarily, participants expressed their sense of having a poor body image, or feeling
overweight as a phenomenon that was incompatible with what they perceived
physical activity to be about or associated with, as this participant explained:
My weight is a huge factor in my not wanting to exercise
There seemed to be a relationship between looking and feeling good, and being
prepared to be out and about and active, as is revealed to some extent here:
When I go into the bathroom now I don’t even want to put make-up on because I just don’t see the
point. I only go out if I have to go out.
The group generally felt that exercise was for people who had ideal body weights, or
who looked like models and other celebrities, as this participant explained:
So what kinds of images or people come to mind when you think of physical activity?
As soon as I think of exercise, I think of models.
So for you it’s mainly about body image and appearance?
191
I think that that’s the time we live in now, the bigger you are, the more down you get put.
Further, participants expressed that the pursuit of physical activity for health and
fitness reasons was out of bounds for most of them, who did not perceive it as a
realistic or accessible goal in a ‘real life’ sense:
No, yeah, I would love to be fit. I walk past gyms and see fit people, and it really makes me think of
going in, joining in…
Ah yeah, really?
But as soon as I walk past it, I think it’s just a dream.
In light of their negative [dis]associations with physical activity, body image and
weight-control, we explored their relationship with media sources and health
promotion on the topic of physical activity. There was a strong agreement amongst
participants that neither commercial nor government sources of information or
promotion of physical activity were to be trusted. As these participants stated:
• No. T.V. does not sell me on anything. I think there is too much said about diets and exercise
• I am not usually prone to just accept because TV or papers tell me this or that will benefit me
health wise or physically
• I never act on advertising and am not influenced by other people's comments regarding
becoming fitter.
• Jenny Craig, or the ads where they are selling all these gym products ‘You can look like this,
just 20 minutes three times a day’ and that is just like ‘Yeah right!’
Participants did, however, say that they enjoyed watching the show “Australia’s
Biggest Loser” as they could relate to the struggles of the people in the show to
combat their obesity, and felt that these were just ordinary people like them, with
similar weight issues and inhibitions regarding physical activity. They especially
liked the attention given to participants on the show in terms of advice on their
everyday diets, and expressed a desire for help from GPs to better manage their
weight, as this participant explained:
Yeah I don’t want them to sit there and tell me you need to eat this on this day, and this on this day, but
192
if they could just write down a list of what the most healthiest foods are, I could make my own list.
The data unpacked a negative construction of physical activity in this context, and
found that it was a concept that did not make them feel positive about themselves,
and for which there were currently few avenues or trusted sources for seeking
assistance for changing its awkward position in their lives. The stories told here
describe links between structural features of poor environments, a decreased
propensity to be physically active, an increased propensity to be overweight, and a
negative social construction around the concept and promotion of physical activity
by health professionals.
7.13 Reflections on Methodological Limitations
Theoretically, this case study allows us to propose that what we find out about this
scenario may be relevant to other similar settings and urban environments. The
knowledge produced via the investigation of this case study will be used for future
testing to see how widely the theories or key concepts are able to be applied. The
findings are valid within the case study, and cannot be generalised to other urban
environments and contexts. However, it does allow a case for producing knowledge
for testing in other populations and areas.
7.14 Discussion and Conclusion
The aim of this study was to begin to unearth the properties and processes within
poorer living contexts that give rise to less active and healthy lifestyles. Thus, the
qualitative approach taken here allowed us to open up a microcosm of urban life to
examine what goes on in these poorer contexts – both past and present – to equip
socioeconomic contexts with powers to predict lifestyles and health, and in
particular, physical activity. In the online and face-to-face stories told by the
participants, these contextual factors were revealed as the social properties of poverty
that were most harmful to participants’ sense of self and their chance of survival – let
alone good health, and which provoked particular reactions to try and counteract the
hostile aspects of these environments. As seen in the data, the ironic and invariable
consequences of these various strategies resulted in worsening circumstances for the
193
participants in a type of downward spiral effect. For example, child abuse leading to
homelessness, leading to drug abuse and dependence, early pregnancies, and ongoing
poverty and so on.
Participants had generally shared similar contextual experiences in relation to
difficult and hostile physical and social experiences which formulated identities
around being fat, unfit, and separate from people who had the luxury of looking good
and being able to exercise in public. There are qualities attached to harsh
socioeconomic environments that affect children from a young age in relation to their
sense of place, their sense of self, and their identities in relation to health and healthy
living. Aside from suffering from a poor body image and a ‘fat’ identity, the kinds of
social interactions within these contexts triggered an interesting psychosocial and
behavioural response in participants. The high levels of neighbourhood conflict in
poorer areas created a tendency to ‘stay indoors and keep to yourself’; these kinds of
strategies of-course being counterproductive to staying fit and active and maintaining
a healthy body weight. This essentially introverted response to the context had two
key underlying motivations: firstly, physical protection, and secondly, identity
protection.
What appeared paramount to participants in these contexts was defining ‘us’ against
‘them’ no matter how similar their circumstances were to that of their neighbours.
This managing of identity in light of their poor individual circumstances within the
broader context of an equally poor and disadvantaged context was a crucial part of
their every day psychological survival there. The demarcation participants constantly
made between themselves and the other occupants of poorer living environments
shed light on how important it was to them to appear to have ‘moved on or up’ and to
somehow have shed the baggage of having grown up with and lived through similar
hardships as those around them. Poorer contexts appear to act as powerful and
unwanted mirrors of their pasts, their present and ongoing struggle with poverty, and
their fear of a future wherein things do not improve, or perhaps get worse. It appears
that poor ‘composition’ (individual measures of socioeconomic position) is
negatively compounded by poorer ‘contexts’ (group measures of socioeconomic
position), the latter of which acts as some kind of psychological maze of mirrors
from which individuals feel unlikely to escape or move on from into environments
194
that generate stronger, more positive, and ultimately healthier identities. Future
studies need to consider socioeconomic position and contexts – however they are
‘measured’ – as meaningful social properties and environments in which self is
constructed and health is affected in a cyclic and reinforcing manner.
For our purposes, the Berger and Luckman premise laid the groundwork for
investigating the social processes and dynamics via which the ‘treatment’ of physical
activity by a particular group is habituated and institutionalised in those contexts
over time. It brought into question what physical activity as a concept or practice
means in that setting, if anything, and why. The Berger and Luckman framework
navigated a focus onto the context itself in order to try and understand what goes on
there, and what happens to physical activity there. For example, whereas as health
researchers and practitioners hold a behaviour, such as physical activity, high on their
list of goals and priorities, and have a fervent interest in reducing the obesity
epidemic, this is not necessarily the case in lower socioeconomic living
environments. Nor does the simple provision of health-related resources for people
living in poor contexts mean that they will immediately become more physically
active, or interpret and engage with those resources in ways that improve their health.
A linear relationship between access and use cannot be assumed. Researchers and
practitioners need to understand where ‘health’ is in poorer living contexts – and the
processes by which it got there – in order to create more informed and insightful
intervention responses.
The unearthing of the core category of identity in this study names a central
psychosocial phenomenon mediating the relationships between people, place, and
health. Identity is affected in an iterative and ongoing sense wherein people’s sense
of self is moulded and compounded by where they live, who they live with, and how
they perceive the composition of this context or environment. This development of
self-in-place-in-society affects how people view themselves, how confident they are
about their bodies, and their use or exhibition of their bodies in public space. Their
consequent health-related behaviours and practices then feed back into their sense of
identity, with the individual developing and living at the core of the people, place and
health dynamic.
195
In a substantive sense, this data revealed that highly sensitive programs are needed
for people who have experienced poor or hostile living contexts, and who have
negative body images and associations with exercise. Affordable spaces that are
socially, psychologically, and physically safe for them to become active within and
achieve a greater sense of both health and self are needed. In an empirical sense, the
research conducted here provides contextual depth or ‘background information’ to
the evidence established in social epidemiology that notes that people from lower
socioeconomic backgrounds are more likely to be overweight than their wealthier
counterparts (Mokdad, Ford, Bowman, Dietz, Vinicor, Bales & Marks, 2003), are
less likely to engage in recommended physical activity levels (Lindstrom, Hanson, &
Ostergren, 2001), as well as with findings from a study showing that people living in
poor neighbourhoods are less likely to be physically active, even in cases where their
access to facilities is superior to those living in wealthier areas (Giles-Corti &
Donovan, 2002).
In a conceptual or theoretical sense, this qualitative study demonstrated how being
poor or unhealthy or living in a poor place are all dimensions of context that
comprise an individual’s social and psychological experiences and construction of
self over time; and that this process cannot be understood effectively in a linear, or
causal sense. It pitches the concept of context as something people carry in their
heads, and which develops over time to comprise their frames of reference, their
boundaries, and their individual and social identities. Contexts in this sense are far
more related to a person’s outlook, perspective, and lifestyle than they are a measure
of geographical region or socioeconomic position. While ‘poorer contexts’ in a
geographical sense exist for economic reasons, ‘unhealthy contexts’ are generated by
the social interactions and psychological processes that make unhealthy lifestyles the
cultural property of poorer territories over time. We propose that a conceptualisation
of ‘contextual effects’ as the social and psychological constructions of self in place
over time, with implications for health is likely to produce more insightful studies
into socioeconomic health inequalities, and generate more sensitive and refined
interventions amongst poorer groups in the future.
The substantive knowledge that has been unearthed brings implications for health
promotion, health inequalities research, and urban design. The conceptualisation of
196
contexts as socially constructed, and the attention paid to agency, time, and the
human production of collective responses to a social context provided an abstraction
or theoretical paradigm for thinking about poorer households and neighbourhoods as
they pertain to health in future. We advocate the use of post-positivist approaches,
such as the methodological framework devised by Charmaz (1995; 2006) that was
followed here as a means of exposing in greater detail the mechanisms linking
various measures of socioeconomic position, especially overtly social, contextual
measures, such as area of residence and occupation, to unhealthy behaviours. Greater
collaboration between quantitative and qualitative researchers is needed in order to
understand and more effectively intervene in lower socioeconomic contexts in the
future.
197
Chapter Eight
Contribution of the Thesis to Knowledge
8.1 Were the Research Questions Answered?
As argued in the beginning of this thesis, a competent contextual analysis involves
efforts to both observe and understand patterns of human behaviour. The
epidemiological efforts that go into tracking trends in population behaviours that
affect health are crucial as they highlight target groups who are engaging in higher
risk behaviours, and note inequalities within and across different population groups.
However, this thesis demonstrates that observational efforts alone are insufficient, in
that they are unable to capture the processes and mechanisms – the everyday
reasoning, norms, rituals, and decision-making processes – that go on within
different living contexts to produce these patterns or disparities. Ideally, population
health research needs to mesh with disciplines such as urban design and sociology,
and embrace qualitative approaches if it is to be successful in effectively
conceptualising, researching, and ultimately understanding the trends and
inequalities it so accurately observes. Without this interdisciplinary, mixed-methods
approach aimed at capturing both patterns and processes, future interventions and
policy responses are unlikely to be contextually sensitive or socially informed or
effective.
This thesis began with the question of ‘What are the patterns of physical activity
amongst a lower socioeconomic residential group living in a new urban
environment?’ This research question stood to be best addressed by a quantitative
approach to measuring the levels of physical activity amongst the group of interest,
and potentially the use of analytical tools to assess differences between higher and
lower socioeconomic residential groups living within this particular urban context.
While a survey was conducted, the N was too small overall to demonstrate
significant differences between socioeconomic groups in the area. However, it was
able to display early trends and patterns amongst the lower socioeconomic group,
wherein moving to the urban village appeared to be having a positive effect on their
physical activity levels, with graphs depicting an increase in walking and daily
198
exercise since moving there. In a reflective sense, this stage is a vital component of
contextual analyses, and the importance of a mixed-methods approach is strongly
advocated for future research efforts into health inequalities.
While the quantitative aspect of the thesis did not reveal statistically significant
relationships between place and physical activity variables, the evidence-base in the
literature review indicating that lower socioeconomic contexts are powerful
proponents for leading less active and healthy lifestyles made a convincing case for a
deeper examination of poorer contexts to unearth the processes producing these
patterns. The case of the poorer residents living within a new urban village provided
a research opportunity to reflect on how previous disadvantaged living contexts had
affected residents’ propensity to lead active lifestyles now. Thus, the flow of research
questions that followed on from the initial question about the current state of play in
physical activity patterns, focused on exploring people’s relationships with place,
their responses to the physical and social components of their neighbourhood, and
which aspects of – or relationships within – these contexts most strongly influenced
their lifestyles with implications for their health. A subjective, insider’s view was
sought to ascertain the detailed social processes that influenced how residents
identified within a place, how they managed their sense of self there, and how the
dynamic interplay between self and place influenced health.
Importantly, and in line with the social constructionist framework, the research lens
remained focused on how physical activity had been socially constructed within
residents’ poorer living contexts over time. The research methods successfully
unearthed a series of events, interactions, experiences, and incidents that had shaped
what physical activity and healthy living had come to mean to them over time, and
why in many respects it remained elusive and within the social and cultural territories
of more well-off or successful population groups. It also highlighted the interplay
between experiences in harsh living contexts in the past, and their moving into a new
urban village that contrasted these experiences – aesthetically, socially, and
economically. As well as providing a useful and effective conceptual framework for
researching and understanding how patterns in health-related behaviours within
different population groups are constructed over time, and the role of socioeconomic
and design factors in these processes, the study held strong implications for health
199
promotion. The study highlights that when it comes to health promotion ‘one size
does not fit all, and that in-depth qualitative analyses are required prior to the
development of health-promotion campaigns and rhetorical strategies designed to
result in behavioural change. Without this type of research, the current trends that
separate the rich from the poor in terms of lifestyles and health are set to continue, if
not widen.
8.2 Using Social Constructionism: Reflecting on the Conceptual and
Methodological Contribution
The gaps identified in the literature of this thesis pointed to the need for questions to
be addressed about how and why poorer living contexts are reliable predictors of less
healthy living for the people who occupy them. To achieve this, it argued for a shift
in focus from objective depictions of how people, place, and health are connected
statistically, to an emphasis on how people interact with places according to who
they see themselves as being, where they come from, and how they see the world.
Further, it explored what these interactive processes mean for how active and healthy
different people (both individuals and groups) are likely to be in various contexts. It
noted the need for a philosophical conceptualisation of socioeconomic living
contexts which would allow the processes connecting the ‘people’, ‘place’, and
‘health’ variables within them to be more effectively investigated. Methodological
approaches from within the urban design literature provided direction for a focus on
the subjective ways in which people interpret and respond to their living
environments, as well as an emphasis on the nuanced and sensitive relationships
between people’s perceptions of a context and their practices there. In line with this
methodological approach, the thesis focussed on unearthing descriptions of living
contexts as people perceived, understood, interacted, and responded to them, and
what this ultimately meant for how physically active they were likely or able to be.
Subjective accounts and narratives of people’s strategies for managing their
individual circumstances within the social and living spaces they inhabit was sought
in order to develop an insider’s view of how particular health-behavioural patterns
within different contexts are constructed and sustained over time.
A social constructionist perspective on how patterns or orders in human behaviours
200
develop in social contexts led to the development of a methodological approach with
an empirical focus on the processes and interactions via which particular physical
activity profiles had developed amongst a lower socioeconomic residential group:
temporally, geographically, socially, and psychologically. Berger and Luckman
(1966) argued that social scientists should not ignore the ways in which people
exercise agency and consult with others in a particular context to develop patterns of
behaviour that they take for granted as being the normal or done thing there, and
which they ultimately perceive as being some kind of objective reality, or normality.
They made the case that there is nothing inherently natural about the order of human
behaviour; rather that we construct it according to our needs and goals in particular
situations. Further, that as time goes on, these established procedures provide new-
comers with the benefit of having ‘norms’ to refer to for their code of conduct there;
norms which then act as powerful forces for influencing what others will do there.
However, in order to understand these patterns of functioning within a particular
context, it is necessary to ask those who perform them as ‘routine’ and understand
them to be ‘normal’ how and why their perspectives have formulated in the fashion
that they have over time.
Thus, as the focal point for the thesis was to gain an understanding of the relationship
between people living in poor contexts and low levels of physical activity, there was
a need to acknowledge the researcher’s role as ‘outsider’ and clear the way for a new
conceptualisation of what a lower socioeconomic context is according to those who
comprise them. Specifically, it opened up an opportunity to study lower
socioeconomic living contexts as defined, described, and explained by those who
inhabit them. It instigated a ‘ground-up’ approach to studying the ways in which
occupants of these social spaces managed their own circumstances in light of their
broader living environments, and how their living contexts had shaped and
influenced their beliefs, attitudes and practices over time. Participants were invited to
tell their own stories about what it was like to live in poor households and
neighbourhoods as they were growing up, the kinds of things that happened to them
there, and what this meant for their health and well-being. As the focus of the thesis
was on the behaviour of physical activity as a concept and practice with unique
meanings across different contexts, I sought to unearth how it had been socially
constructed within these types of living environments over time. Thus, the social
201
constructionist framework and grounded theory methodology allowed insights to
both the nature of these contexts as well as the meaning and relative importance of
physical activity there. The findings outlined how the qualities of, and experiences in
these living contexts efface values of being fit and healthy and created barriers to the
treatment of physical activity as a high-priority or a feasible or attainable goal.
8.3 What Did a Social Constructionist Grounded Theory Approach
Reveal About the Context of the Lower-Socioeconomic Lived
Experience?
For my purposes, the Berger and Luckman premise laid the groundwork for
investigating the social processes and dynamics via which the ‘treatment’ of physical
activity by a particular group is habituated and institutionalised in those contexts
over time. It produced an interpretive, reflexive view of how the contextual
relationships between poorer groups and physical activity are formed, or not formed,
over time. It allowed me to look at physical activity within a lower socioeconomic
urban demographic, and examine the dynamics and processes within these social
contexts that either connect or disconnect the people there from engaging in that
behaviour in ways that would improve their health. It brought into question what
physical activity as a concept or practice means in that setting, if anything, and why.
The Berger and Luckman framework navigated a focus onto the context itself in
order to try and understand what goes on there, and what happens to physical activity
there. For example, whereas health researchers and practitioners hold a behaviour,
such as physical activity, high on their list of goals and priorities, and have a fervent
interest in reducing the obesity epidemic, this is not necessarily the case in lower
socioeconomic living environments. Nor does the simple provision of health-related
resources for people living in poor contexts mean that they will immediately become
more physically active, or interpret and engage with those resources in ways that
improve their health. A linear relationship between access and use cannot be
assumed. Researchers and practitioners need to understand where ‘health’ is in
poorer living contexts – and the processes by which it got there – in order to create
more informed and insightful intervention responses. Further analyses of the social
construction of everyday life in poor contexts, and this contextual relationship to
202
health behaviours such as physical activity, are likely to provide more sensitive and
sophisticated community-level responses in the future.
A social constructionist framework allowed me to examine how poverty was
understood, experienced, and interpreted at a social level where poor residents live in
close proximity to one another. In this condensed-poverty housing situation, I was
able to explore how poverty was managed in situ on an everyday basis. It also aided
in the opening up of associated variables or properties of poverty, and the
understanding that aside from having a low-income or living in a poor area, poverty
is manifested and understood in relation to the presence of factors such as drug
addiction, mental illness, physical illness, disability, fear, mistrust, violence, and
having high numbers of children in care. Aside from understanding that the
participants were ‘poor’ in the sense that they met the requirements for government
supported housing according to their incomes, I explored the experiences of that
poverty – the psychological and social properties – that were keeping them from
being able to pursue physically active, healthy lifestyles. Further, I unearthed the
impact of past experiences in poor contexts on how participants anticipated and
perceived new living environments, their understanding of them, and what they
sought to do there. By pursuing the perspectives of the poorer residents, a sensitised
picture of contextual influences on physical activity emerged; and a clearer
illustration was drawn of how the subjective construction of the aesthetics, semiotics,
and social dynamics within a new urban neighbourhood acted as barriers to engaging
in the neighbourhood in ways conducive to health and well-being.
Families of origin, as well as previous neighbourhoods were described in rich detail
during interviews, and were linked by participants to their current ‘code of conduct’
in a neighbourhood. Participants reported the importance of looking for signs in the
neighbourhood, which interestingly were usually a mix of demographic factors and
health-risk behaviours, such as IV drug use, alcohol abuse, high unemployment
levels, domestic violence, and a high number of children in care, and if these were
present to keep a low profile by staying indoors and not talking to neighbours. The
shared mantra of ‘it’s a roof over your head and you keep to yourself’ was attributed
to a range of experiences ending in intra- or inter-household conflict in previous
living contexts, as well as experiences in places with high levels of theft. Thus, these
203
coping mechanisms and strategies for managing risk on a daily basis were greatly
cultivated by previous living ecologies, and strongly influenced the level of
engagement with neighbours and neighbourhood resources.
Participants reported a heightened sensitivity to being exposed to other people with
mental illness and drug addiction – with a perception that any behaviours that
indicated a struggle or an abnormality were directly reflective of themselves – and
were eager to define themselves against the ‘others’ living in the complex. Each
participant, although clearly experiencing their own difficulties with both poverty
and health in different ways, was quick to identify as not belonging in the apartment
block, because they were not that ‘poor’ or that ‘bad’. Identities were constructed
around the ways in which they could define themselves against the group, who they
defined based on previous experiences with poverty – in their families and in their
neighbourhoods. They feared that the stigma of the apartment block, or a poor
reputation due to a high number of police call-outs and ambulance visits would
reflect on them and their families, but weighed this up with the benefits of living in
the framework of the broader Village, near the University and near the city, which
they said created a positive emotional and psychological response to their living
place. A social constructionist framework assisted in unearthing the processes via
which neighbourhood ‘realities’ were anticipated, created, and reinforced in poor
areas, and further, the barriers this created to living active and healthy lifestyles.
8.4 What Did Social Constructionism Tell Us About What Physical
Activity Means in Poorer Contexts?
By reflecting on the participants’ childhood and adolescent experiences with poverty,
and by paying attention to the role of historicity in shaping attitudes, beliefs,
practices and indeed the habituation and institutionalisation of a negative
relationship with physical activity over time, a better understanding of the tenuous
relationship between poor contexts and poor health was ascertained. Early on in the
interviews, it became apparent that the kinds of abuse, neglect, and general
maltreatment participants had experienced in their early lives made the pursuit of
behaviours to improve their health almost ludicrous in light of the everyday
challenges they were facing. Physical activity to improve or maintain health was not
204
a priority amongst their carers, and as such was not emphasised or even mentioned as
being something of importance. The difficulties participants highlighted – mostly
including abuse and neglect – contributed to most of them leaving home by their
early teens, and having to cope with poverty and independence at very young ages.
Again this ensured the exclusion of health-related behaviours as a goal or a priority.
Further, the nature of these early experiences had resulted in many of them being
overweight, and suffering from other kinds of illnesses and disabilities, including
diabetes, anxiety, depression, and even some cancers. These made the pursuit of
physical activity – especially in public places, no matter how ideal the resources –
difficult, if not impossible. Due to feeling ill, afraid, depressed or self-conscious
about their weight they were reluctant to engage with the neighbourhood to improve
their health or fitness levels. Further, many of them had caring roles as a result of
having many young children early in their adult years, or having ill relatives to care
for. As such, a number of structural constraints and negative social experiences had
led to the construction of physical activity as out of reach, and an almost impossible
goal.
Further to experiences in their household and neighbourhood environments that had
created barriers to more active and healthy lifestyles, experiences in broader aspects
of society aided in cementing high levels of inhibition about being physically active.
From the broader mainstream media depicting images of models and celebrities with
body weights and shapes that this group felt were ‘ideal’ but unattainable, to having
to deal with being overweight in public, many broader contextual experiences
contributed to the tendency for the female participants to stay indoors. Some
participants were bullied about their weight by family members at an early age, and
this continued through schooling and broader social and neighbourhood experiences.
Aside from living in neighbourhoods in which they feared for their lives and safety,
the participants also expressed a great reluctance to be outside due to their
perceptions of themselves as being ugly or overweight. Even in cases where some of
the participants sought medical help to lose weight, their experiences were
unpleasant, and they reported feeling powerless and misunderstood in doctors’
surgeries when discussing their weight. As such, the participants would require
assistance to become active that took these histories and experiences into account,
and worked in conjunction with the highly sensitised social construction of physical
205
activity in these social settings.
The conceptual and methodological approach that was used to gather these insights
would be highly suited to exploring any social context of interest to find out how and
why particular health behaviours are clustered within them. It could be applied to
occupational contexts as well, such as blue-collar males, who have been shown to
consume dangerous levels of alcohol on a daily basis (Najman, 2007). A social
constructionist grounded theory approach would be able to explore the nature of that
context and the meaning of alcohol and binge drinking within it amongst that
demographic of male workers. This would be a useful approach for ensuring more
effective and well-matched intervention programs in future. Further research is
needed that employs a social constructionist perspective to contexts in which
behaviours of interest are identified as being problematic in order to understand what
they mean in those contexts, and how both the health behaviour of interest and the
social contexts are created and understood by those who occupy them. This would
lead to more effective health communication and promotion amongst vulnerable
demographics in the future, as well as more effective responses at the level of
planning and development for diverse, urban populations.
8.5 Implications for Health Promotion and Communication: The
Challenge of Encouraging Behavioural Change in Poor Settings.
From a communication perspective, it is crucial to have a sound understanding of the
context in which you are delivering a message in order for that message to be
effective. Thus, the theoretical framing of a context in order to be able to examine
what happens there, what is important there, and where health sits as a priority there,
is vital in gaining insights into future efforts aimed at effecting behavioural change.
The following sections highlight some of the key factors and processes emerging
from the data with implications for communicating about, or promoting healthy
lifestyles amongst, poorer groups. These bring clarity to how lower socioeconomic
position, and its various properties, operate at the individual, household and
neighbourhood level to generate both real and perceived barriers to being more
physically active.
206
• Individual-level barriers
A range of properties of individuals were located as salient inhibitors of increased
levels of physical activity. Participants discussed not being able to afford a gym
membership or a regular activity due to low incomes. While this was mentioned
briefly in the blog, it was discussed in some depth in the in-depth interviews with the
BHC women, who all expressed a desire to do more exercise and focus on their own
physical fitness and well-being, but who could not due to lack of money to join a
gym, as well as other costs of childcare while they exercised. Many participants, both
older and younger felt that they did not get enough time out of caring roles to engage
in recommended levels of physical activity, and lamented the benefits they felt they
were missing out on, such as endorphin release that made them feel good, and not
feeling overweight, unattractive, and self-conscious in public. However, all seemed
to have sporadic attempts at exercising via one-off gym visits as parts of special
offers by commercial outlets, or by purchasing home gym equipment, which they
ended up not having space for, or time to use with young children at home. Other
individual-level barriers included physical illness, mental illness, disability, and time
constraints from shift-work or casual work. Many of these factors are inextricably
linked to their low incomes, and are effective in sustaining both poverty and less
healthy lifestyles. It was observed that all the women interviewed were all
overweight and smoked cigarettes, and during the interviews these health and
lifestyle factors were also cited as inhibitors of physical activity; thus demonstrating
the complexity and close interconnection between a range of factors in poor contexts
that sustain poor health, and a need to intervene in a contextually sensitive way on a
number of fronts.
• Household and neighbourhood factors influencing physical activity
Households and neighbourhoods were studied for their capacity to allow individuals
to act on messages promoting physical activity for health and well-being. As outlined
in vivid quotations in the published papers, previous households and neighbourhoods
exerted a powerful and negative impact on health and health-related behaviours due
to the hostile nature of these early childhood and teenage environments. Families of
207
origin for all participants comprised contexts of abuse, neglect, alcoholism, drug
abuse, and poverty. These difficult beginnings led to what might be called a ‘series of
unfortunate events’ in that they acted as catalysts for early homelessness, early
pregnancy, drug experimentation leading to addiction, and time in and out of hostels
and rehabilitation centres. Having a high number of children in their care while still
young greatly limited what the women in the interviews were able to achieve on a
daily basis, and coupled with little or no partner support – some partners had been
incarcerated – and a low income, they are living in situations not conducive to health
and well-being.
Further to this, having neighbours in similar situations and facing similar hardships
acted to reinforce their situations in psychologically detrimental ways. In
neighbourhoods where many of the residents are poor, or who have drug and alcohol
dependencies, the collective struggles of people within these contexts generate an
atmosphere of hopelessness and frustration, making it difficult to make health-
behaviours a priority. Encouraging people to use the neighbourhood resources for
physical activity is a steep task when they fear theft, violence, used needles lying on
the ground, and regular police call-outs on a daily basis. Such factors need to be
considered by those attempting to promote active and healthy lifestyles in hostile
contexts. Importantly, interventions need to occur at a community-response level,
rather than at an individual one, where resources, supportive services, and social
assistance comprise as much of the program as messages about behavioural change
for health reasons.
There were aspects of the broader KGUV neighbourhood that appeared to alleviate
some of these difficult structural factors present within the BHC apartment blocks,
indicating that a neighbourhood environment supportive of physical activity and
residential mobility does dilute some of the more potent effects of poverty on health.
Residents reported that they enjoyed having access to green spaces, were
appreciative of the wide, even pathways for walking, enjoyed being in close
proximity to a number of useful and desirable destinations and felt positive about
being associated with the University and other locations such as the La Boite
Theatre. These aspects of the environment gave a great lift to residents, many of
whom had only ever lived in poorer neighbourhoods that were situated far from
208
central shopping areas and parks, with little or no facilities for walking or recreation.
This feedback from residents demonstrates the importance for strategic links between
health promotion experts and urban designers, wherein residents require an
environment supportive of physical activity, while simultaneously gaining the social
support they require in order to be able to respond to the design of their
neighbourhood in ways that benefit their health.
• Attitudes, beliefs and responses to mass-media health promotion of
physical activity
Overall there was a deep scepticism displayed by participants, in both the blog and
offline data about mass media efforts promoting physical activity for health. There
was a general merging amongst participants regarding information about physical
activity from both government and commercial sources, with references to both
government health promotion pamphlets and advertisements for diet foods and
exercise equipment being made in response to questions about health-related
messages. With regards to official sources promoting health, such a pamphlets in
doctors’ surgeries, participants claimed that they read them, but then forgot about
them afterwards, or did not have the time to follow up on the advice they had read.
They made numerous references to commercial sources of information, which they
felt were trying to take their money, and therefore they tended to switch off from
messages delivered on the television about getting fit or creating an active lifestyle.
Most participants also felt the pursuit of fitness was akin to the eating disorders of
celebrities and a pressure to stay extremely thin in accordance with unrealistic weight
goals set by supermodels, and felt that the concept of physical activity belonged
largely in the arena of the famous and the wealthy, and was not a part of their social
territory or concern. A few participants reported starving and binging habits to try
and achieve the weight of models or TV celebrities, and some felt that ideal weights
were obtained by surgery or diets given by nutritionists that were financially out of
reach. Shows such at The Biggest Loser, however, were cited as inspirational in
terms of showing that losing weight was difficult, but that it could be achieved.
Overall, however, participants had their own methods of managing their lifestyles
and health in accordance with what they could manage and what made them feel
good, and were not receptive to outsiders, especially those as far removed as
209
government health officials or mass media advertisements, making suggestions for
how they could be ‘fitter’ or more active.
The social constructionist theoretical framework was particularly useful in teasing
out how physical activity is conceptualised or treated in the everyday lives of
participants in this study. The amalgamation of highly commercialised sources of
images and information with official government sources is of particular interest, as
there is little differentiation amongst them about which sources are reliable,
trustworthy, credible, and most of all achievable. When asked what kinds of images
came to mind, or what they thought about when someone said ‘physical activity’
most of the women interviewed spoke about models and thinness, or people
promoting health who they felt must have somehow ‘cheated’ to look that thin or fit.
Because of the low income and high caring responsibilities present in their lives,
there is little or no chance of leaving the house to pursue exercise, so achieving a
thinner body weight is discussed or fantasised about, but not acted on. Even though
participants engage critically with what they see in the mass media about physical
activity, they held a cynicism to these messages overall. They felt that those
promoting physical activity were akin to companies trying to sell ‘Thigh Masters’ or
other ‘get-thin-quick’ gimmicks, and were to be ignored. Given the power of the
food, exercise, and fashion industries to blur and distort messages about active
lifestyles and a healthy body image, health promotion will need to conduct further
research into how they can differentiate their messages from the bombardment of
commercial media in all living contexts. Further, the unrealistic images of models
and expensive home gym equipment or memberships need to be counterweighted by
affordable and accessible options to stay strong and healthy, given the restrictive
circumstances of poorer groups.
Finally, the diversity of interests in terms of types of physical activity was notable,
with implications for a broad range of affordable options of exercising needed, even
in demographics with some common core characteristics. A wide range of interests
amongst the adults and the children were exhibited, along with an expressed
appreciation of community models such as the Police Citizens and Youth Clubs
(PCYCs) in other suburbs that families had accessed previously. They claimed that
these clubs hosted a range of activities for children to keep them active and healthy
210
after school in a safe environment, and were affordable. Mothers wanted to be able to
do aerobics, but could not afford childcare or gym memberships, while older people
were interesting in Tai Chi and social walking groups. Some younger people were
not interested in social walking groups, but rather games such as netball and football,
and individual fitness activities, such as jogging. A community level response to
increasing physical activity in a poorer neighbourhood would have to offer a broad
range of recreational pursuits to accommodate diverse interests, abilities, and time
constraints.
8.6 Implications for Urban Design: What Neighbourhood Traits
Work Well for Vulnerable Demographics?
From an urban design perspective, the blog, interviews and community focus group
provided rich feedback on how the Kelvin Grove Urban Village design is working
for the Brisbane Housing Company apartment dwellers. It must be remembered that
the blog provided data on specific aspects of the neighbourhood that have been
shown in previous studies to be important for improving physical activity and health,
while the interviews allowed the aspects of the neighbourhood that were most salient
to BHC dwellers to emerge in conversation. Thus, while design features such as
pathways, bikeways, and green spaces were discussed in a positive light when
participants were asked about them, they did not emerge naturally in the interviews
as being an important part of the neighbourhood affecting health and well-being. Far
more important to the BHC dwellers were building aesthetics and functionality,
stigma, geographic location, and neighbourhood relationships. That is, these key
psychological, social, and cultural aspects of the neighbourhood were at the forefront
of participants’ consciousness about where they lived, who lived there, and how it is
perceived by the broader public. These factors were key in shaping how satisfied
they were living there, how safe they felt, and how likely they were to want to
‘move-on’ again. In terms of vulnerable populations who are usually highly transient,
this mobility is a major social challenge, as support and health services cannot keep
reliable records or provide a continuity of care to the people most in need of it. Thus,
design plays a vital role in potentially providing peace, stability, and relief to social
groups who tend to struggle from neighbourhood to neighbourhood. It is vital that
future design and health literature targets and questions demographics most at risk in
211
research concerned with changing trends in health inequalities by altering aspects of
context that sustain them. Without mining the contexts of lower socioeconomic
demographic in ways that assist in understanding their experiences in
neighbourhoods and with health services and information, neither urban design nor
health interventions are likely to be accurate or truly responsive. Table 1 summarise
the key aspects of design that emerged as important for residents, and their insights
regarding their experiences with these dimensions of their living contexts.
212
Table 8.1 Aspects of Urban Design important for Healthy Living
Feature of Urban
Design
Participant Insights Future Recommendations
Mixed-land use Positive response to a diverse
range of desirable locations
within walking distance
Social and health services
needed as well as retail
outlets and public spaces
Having a number of locations that are useful,
desirable, and accessible for the local
demographic is important for enabling walking
to local destinations and engaging with the
people and resources in the neighbourhood.
Health-Related
Resources
Well-used and add to sense
of safety
Not necessarily viewed as
relating to health or physical
activity
Increased daily walking
Increased leaving the house
and social interaction
Parks, wide, even pathways and bikeways all
contribute positively to aesthetic, feelings of
safety, wanting to share the neighbourhood
with friends and visitors, and increased
walking. Excellent for improving PA levels of
demographics that walk for transport and
logistics, ie A to B, not necessarily exercise.
Aesthetics and
Functionality of
Housing Design
Appearance of apartments
important for sense of self
and identity
No elevators – stair dangers
Too noisy
No room for children
No parking
No public telephones
Government supportive housing needs to be
non-distinguishable from other buildings in the
neighbourhood, have a pleasing aesthetic, and
be built in ways that accommodate the
demographic group it is housing. Apartment
blocks not suitable for families unless park
area and play facilities surround building, or in
close proximity to supportive social and health
services.
Geographic
Location
Close to CBD and other
facilities very positive
Close to public transport that
is regular and reliable very
positive
Close to university and
theatre very positive
Positive responses by participants who were
glad not to be stuck in ‘dumps’ or in the
‘middle of nowhere’. Location idea for those
who have no transport, or with limited cash
flow. Some issues raised with proximity to city
and West End being too close to drug dealers
and networks. Positive media image greatly
enhanced positive feelings about living there.
Mixed-Tenure
Arrangements
Problematic for all residents If BHC is to continue to use apartment blocks
to house low-income groups this cannot be
done successfully without linking to relevant
services or the implementation of support
networks and facilities close-by.
Security Low sense of security near
BHC apartments due to
violence, crime, and needle
use.
Without supportive health and community
services, including access to resource support
(food vouchers, clothing, etc) and financial
counselling, theft and conflict likely to remain
problematic. Police response may reinforce
images of high crime already associated with
blocks such as Grey Gums.
213
From an urban design perspective, such new urbanist planned communities are likely
to be successful in so far as they decrease dependence on automobiles, and increase
people’s access to – and hence propensity to walk to – local shops and services.
Having access to affordable food outlets is a vital resource for all residents, but
especially for low-income families who often have to wait until they can afford taxis
to go grocery shopping. Having the reputation of the place elevated via proximity to
more esteemed establishments, such at a University, also seemed to detract from the
stigma poorer residents are used to living with and within.
However, there were also many pitfalls inherent in this particular design. The idea of
heterogeneity was largely theoretical in this Village. True heterogeneity either comes
from a long, historical build up of eclectic and diverse populations choosing to live in
close proximity to one another, or else needs to be planned in a more authentic way.
That is, affordable housing needs to be integrated far more subtly into these
communities, instead of being built up as easily identifiable apartment blocks where
poverty is condensed. In this case, the stigma of poverty may not perforate through
the entire Village, but is certainly attributed to the affordable housing apartments.
Typically, and as has been shown time and again in the past, placing people with
similar social and economic problems in close proximity to one another acts to
exacerbate the challenges they already face, primarily through fear of, and conflict
with, one another. This study highlighted in particular how these apartments acted as
unwanted mirrors of their pasts and aspects of their lives they would have preferred
to leave behind. A community design that dilutes stigma and provides healthy, green,
and spacious resources for families to be active within are recommended.
8.7 Implications for Health Inequalities Research: What Do We
Know About the People, Place, and Health Relationship That We
Did Not Know Before?
The key contribution from the methodology and findings in this study stem from the
re-conceptualisation of ‘area effects on health’ from being a set of linear, catalytic,
causal relationships between a number of set variables within a place, to a notion of
socioeconomic living contexts being social, dynamic, cultural, and organic. That is,
poor health is a trait of poor living contexts in the same way that a low income, or a
214
low education level are defining elements here, but there are a number of ongoing
everyday material struggles and psychological barriers that continuously prevent
lifestyle changes from occurring that could improve both wealth and health. Health-
related behaviours themselves are entrenched in the norms and circumstances of poor
environments in ways that reduce people’s chances of improving their financial
prospects, as well as their health and well-being. This creates powerful cyclic effects
in that the poor stay both poor and unhealthy, and pass these contextual effects on to
their children and grandchildren in rapid succession due to early child-bearing.
Further research is needed into the psychological, social, and cultural processes that
prevent poorer demographics from making important changes that would improve
their life quality and chances overall. Further, the importance of diluting these potent
contextual effects by preventing a ‘ghettoisation’ of the poor in urban areas, or an
increased integration of those who are struggling on a number of levels into
communities that are rich in resources, education, social support, and healthier
lifestyles is yet to be fully explored and evaluated.
This thesis makes the case that contexts do not exist because they are called into
being by the drawing of a geographical boundary, or defined by socio-demographics
or particular physical components of an area. These measurable qualities are merely
the infrastructure of a social space. Further, while such contextual elements or
features are as tangible as the health behaviours and health outcomes that can be
located there, these things do not exist in causal relationships with one another.
Instead, they are the artefacts and ‘by-products’ of a particular setting, in the same
way that coffee consumption, conversation and chairs can be found to cluster in
cafés, along with similar variable congregations such as kneeling, praying and the
presence of steeples in church buildings. Once we understand context to be
meaningful, socially constructed, and subjectively perceived and responded to, then
neighbourhoods can be conceptualised more clearly as contexts that ‘produce’ health
or health-behavioural profiles. To explore neighbourhoods or other socioeconomic
contexts such as occupations or households as social and meaningful, a point of
departure needs to be made from an epidemiological imagining of these settings.
Once we have established that socioeconomic context matters from a health
perspective, a competent framework for thinking about how contexts work needs to
be applied to this phenomenon, and studied with appropriate or matching
215
methodologies that are sensitive enough to shed light on how poorer health
behaviours cluster in poorer areas.
There are a number of useful theoretical and conceptualisations of context available,
but health inequalities researchers will need to cross over and explore other
disciplines if they are to locate the philosophical and methodological frameworks
that suit research questions regarding why and how health-risk behaviours prevail at
higher rates in lower socioeconomic contexts. These methodologies are not in
competition with, nor are they incompatible with, epidemiological approaches; they
are simply different tools for different research questions on a particular topic. That
is, epidemiological methods are needed to track and locate where problems are most
prominent, and the nature of these difficulties from a health perspective. For
example, there are areas that seem to suffer from high levels of depression and
mental illness, while others exhibit higher levels of other types of illness, disease,
and even injury. It is vital to know the types of health challenges facing particular
areas before bringing in the research lens for a closer look at the micro-processes
contributing to these effects. Further, these research methods could be applied to an
extensive range of demographic, geographic, behavioural, and health variables that
stand out as significant or problematic, including health patterns in workplaces,
occupations, suburbs, or ethnic groups. It is vital to examine the everyday, social
processes, norms, and ‘sharing’ of ideas and behaviours to gain a more competent
idea of why health patterns cluster in particular areas. To do this, theoretical
frameworks and qualitative methodologies that suit the nature of the problems
identified in epidemiological studies are required.
To sum up the key contributions of this study to the fields of health inequalities and
health and place research, the following points have been outlined below:
• The importance of conceptualising and studying neighbourhoods and
households in a holistic, contextual sense was highlighted via the insights
retrieved in this study as to why physical activity is less likely to get done in
poorer living environments.
• The value of tracking stories and ‘real life’ processes over time was
demonstrated in this investigation through revelations about the interactive
216
and compounding influences of both migration and area on health-related
behaviours and, in particular, on physical activity.
• A number of contextual factors – psychological, behavioural, social, and
economic – were found to be operating together over time in iterative and
collective ways to create barriers to healthier lifestyles; with these effects
gaining exponential powers in relation to health when in close proximity to
one another.
• Some of the key contextual factors in poorer living environments likely to be
impinging on more active and healthy lifestyles include disadvantaged
childhoods, high levels of fear based on childhoods and previous poor
neighbourhoods, increased chances of having children in teen years, having
large caring responsibilities in combination with low incomes, boredom,
depression, feeling trapped, lack of hope for something better, fear of
neighbours, inclination to abuse drugs and alcohol, having family members in
jail, lack of sufficient space for safe interaction and recreation, concerns
about body weight/image, smoking habits, and other household-level
constraints and influences, such as partners who are unemployed and not
interested in pursuing physical activity.
• These contextual factors require intervention on a number of fronts, as it is
not one variable or factor – be it social or economic – causing or shaping
entire lifestyles or steering people away from health. Health promotion
experts, health communicators, community workers, urban designers, and
economic and social policy makers need to work collaboratively to better
understand the nature of lower socioeconomic contexts as they pertain to
poorer health, and to respond in a more sensitised and informed way.
8.8 Using the Theoretical Knowledge Built in this Thesis to Develop
Effective Research and Policy About the Relationship Between
Poverty and Physical Activity.
The knowledge generated in this thesis lies in its exploration of the properties and the
processes within poorer living contexts that collectively create strong and reliable
barriers to healthier living. Within these contexts, individuals constantly manage risk
217
in order to alleviate harm and increase their quality of life. However, this quality is
relative, in the sense that their responses ensure some kind of survival, but are not
conducive to improving their circumstances. Ironically, in many cases, their
responses – which are restricted by a diminished range of choices in most scenarios –
actually lead to a worsened set of living conditions, which they in turn respond to as
a means to survive, and so on and so forth. It is insights into these conditions, the
consequences for the humans in them, and the choices made within them that make it
clearer as to how these contexts yield such powerful, and apparently deterministic,
forces over lifestyle and health.
Importantly, and as is discussed in the papers published in this thesis, the opening up
of these contexts to understand the factors and processes within them that lead to the
unravelling of particular styles of life on particular social, economic, and geographic
landscapes, allows us to see more clearly how health promotion ‘bounces’ off these
demographics, and how the best of intentions in urban planning and design do not
elicit the types of responses one would ordinarily expect or hope to achieve. What is
clear from the analysis, is the cyclic and catalytic effects that disadvantaged
childhoods in poor households and neighbourhoods can have on individuals that
ensure that their sense of place – social, economic, or geographic – does little in the
way of shifting upwards during their lives, and how health remains firmly locked
outside of these contexts. The core category of identity management identifies the
constant daily psychological, emotional, and behavioural responses of people who
occupy hostile living environments, and how these responses, in these complex and
often paradoxical situations, both ensure survival and preclude health.
Future policy-making in the area of reducing the obesity epidemic needs to
acknowledge that, firstly, this is a socioeconomic issue as much as it is a health issue
and, secondly, that so long as class differences exist, then gaps in health will follow
suit. The problematic and paradoxical relationships between poverty and being
overweight are not issues that are openly and publicly discussed or addressed, and
the findings in this thesis point to the importance of studying the relationships in
depth to make the case that poverty affects identity, and this in turn affects health-
related behaviours. The findings in this study also revealed that it is unlikely that
these relationships are linear, uni-directional, or causal; it is however, highly
218
catalytic, with the various properties of poor contexts – such as abuse, violence,
neglect – eliciting a chain of events and behaviours that appear to keep people both
poor and unhealthy.
What is needed is research to further investigate the characteristics within poorer
living contexts that are at work to increase the chances of poor children growing up
with no real hope of finding a pathway to higher education, training, income
generation, housing security, or health. In the context of their lives, physical activity,
fitness, and ideal exercise regimes and body images become associated with people
in ‘other worlds’, such as celebrities, and the rich and the famous. What is needed are
policies and interventions that are able to protect children who are at risk, provide
them with respite from hostile living contexts, and simultaneously offer feasible
pathways along which they can grow and live without fear and insecurity. Further,
health promotion needs to be pitched as something within the reach of vulnerable or
struggling demographics, and accompanied by the provision of low-cost community-
based options for sport and recreational physical activity. Change needs to occur on a
broad front with open, direct, and robust discussions on how differences in
socioeconomic status affect people’s sense of place, sense of self, and ultimately
their health.
8.9 Critical Reflections: Limitations of the Methodology and Future
Considerations
On critical reflection of the conceptual theory introduced in this thesis, and the social
constructionist approach that followed, a recommendation for future research using
this framework is that both the context and the health-related behaviour of interest be
very specifically defined or characterised. To effectively employ the Berger and
Luckman (1966) idea that behaviours or artefacts within a human context come to
hold specific meanings as they are socially negotiated over time, then the process of
theoretical sampling is of paramount importance in ensuring that you are analysing a
context that is theoretically representative of the people and relationships you wish to
study. This approach would arguably be more suited to studying smaller, or more
specific, contexts with less discrepancy in the characteristics of the people or the
places under investigation. This way, a deeper and more convincing focus could be
219
placed on the social pathways connecting particular groups to particular patterns of
consumption or lifestyles. For example, I suggest that this approach be used to study
particular health-behaviour patterns found to be evident in specific occupations or
workplaces. To this end, this type of methodological approach may indeed be useful
for exploring potential social processes underpinning ‘clusters’ in risk-taking
behaviour, or in illnesses caused by lifestyle. These clusters could be studied using
this methodology in many and various social groups, including teenagers in schools,
online communities, courses within universities, and specific social or religious
groups.
Although the difficulty associated with locating relationships between households,
neighbourhoods and patterns in health-related behaviours has been addressed with an
arguable degree of success within this thesis, there is room for extending the
possibilities of philosophies and conceptual frameworks that may indeed be better
suited to studying people’s relationships with their places of residence in more detail.
Methodologies from the urban design literature, and the work of philosophers such as
Lefebvre, Lacan, and Foucault hold much potential for further unearthing the
powerful relationships between where one lives, and how healthy one is likely to be.
Further, it is proposed that the work of Bourdieu – and in particular his work in
Distinction (1984) – be applied to further studies on the strength of the association
between socioeconomic position and patterns in consumption and behaviour.
Although Bourdieu was not concerned with health or geography, his philosophical
paradigm, which demonstrates rigorous ways of studying and understanding how
class and consumption are linked, hold great potential for health inequalities studies
generally.
Finally, although the survey data in this thesis was not successful overall, it is
strongly recommended that mixed-methods approaches to understanding and
redressing health inequalities be used in future. This way, an evidence-base to
locating a target group can precede any contextual investigation to unearth the social
processes determining the patterns evident in the epidemiological data. An
interdisciplinary approach that brings together epidemiological approaches with
sophisticated philosophical paradigms and well-suited qualitative methodologies
would go some way to shedding light on how best to think about, discuss, and
220
redress the relationships between the context of social class and health.
8.10 Conclusion
This thesis makes a contribution to the ways in which socioeconomic contexts are
studied for their propensity to produce particular lifestyles in relation to health. It has
highlighted key aspects of the experiences of those who occupy poorer living
contexts that detract from the pursuit of active and healthy lifestyles. The
methodological, theoretical and substantive contributions are highlighted in the
published papers of this thesis, but its core contribution is the in-depth insights it
brings to the evidence repeatedly showing that inequalities in a population’s social
and economic circumstance generate inequalities in a population’s health. It
highlights the associated properties of lower socioeconomic position within living
contexts as a range of lived experiences that force ‘health’ or ‘healthy living’ down
the list of priorities in the lives of those who occupy them. These experiences have
been thematically organised and theorised in the published papers in this thesis, and
identify many key areas for future intervention. Early childhood interventions were
located as vital in stemming the rapid cyclic manner in which unhealthy patterns are
produced and propagated from generation to generation. Housing options and
neighbourhood designs that allow children from poorer families opportunities to
engage in activities that are safe, affordable, and local are recommended. Respite for
these children from their harsh household lives would go some way to preventing
early homelessness and a repeating of the difficulties encountered by their parents
and carers.
Further, health promotion efforts amongst the adults in these families that allow them
respite from their caring duties and an opportunity to pursue healthier and more
active living in safe, sensitive, and affordable spaces is vital. The promotion of
physical activity in poorer neighbourhoods needs to be accompanied with social
support and an approach that accounts for the various barriers to health faced by all
ages in these settings. The provision of parks, bikeways, and pathways alone is an
insufficient response in light of the aspects of these people’s experiences preventing
exercise in public from being a straight-forward or achievable goal. Further, the high
costs associated with gym memberships or hobbies for children that allow them to be
221
active are likely to continue to act as barriers to healthier living for low-income
families. Physical activity programs in schools also leave out the children in these
neighbourhoods, as many do not attend school regularly, or change schools too often
for this to be effective or sustainable. Specially designed community intervention
targeted at the provision of physically active recreational pursuits for people living in
these contexts is needed. Ideally, government provision of activities such as
swimming, tennis, martial arts, performing arts, and sports need to be made available
locally in all neighbourhoods, with costs subject to income levels.
Finally, this thesis advocates the importance of increased collaborative efforts
between quantitative and qualitative researchers in the health inequalities research
area. Further, a more interdisciplinary approach between health inequalities, housing,
education, health promotion, sociology, and urban design would create a more
effective case for macro-policy changes in relation to the many aspects of life that
affect human health. The qualitative research in this thesis highlights the many
aspects of context that were identified as salient by the participants as affecting their
ability to lead active and healthy lives: as such, their stories make the case for a
broad intervention front, and an understanding of the complex and varied barriers
that ‘poor living’ creates in relation to better health.
222
APPENDIX A
QUT Ethics and KGUV Research Committee Approval
223
APPENDIX B
Information and Consent Forms
224
Participant Information Sheet
Project Title: Kelvin Grove Urban Village Study on the Ecological Processes
Contributing to Patterns of Physical Activity among Different Residential Groups.
Researcher One:
Julie-Anne Carroll
Telephone: 07 3719 5640
Email: [email protected]
Researcher Two: Researcher Three
Dr Barbara Adkins Dr Elizabeth Parker
Telephone: 0419 6500 90 Telephone: 07 3864 3371
Email: [email protected] Email: [email protected]
Description
This project is being undertaken as part of a PhD thesis for Julie-Anne Carroll at The
Centre for Social Change Research (CSCR) at the Queensland University of
Technology (QUT). The purpose of this project is to determine the extent to which
urban design and social diversity contribute to the likelihood of residents engaging in
physical activity. The specific purpose of this study is to understand the ways in
which physical activity gets done in your everyday life, and how this particular
behaviour is linked to your perception and experience of where you live.
The research team requests your assistance to participate in an online discussion or
225
‘blog’ that will contain photographs of different aspects of KGUV urban design,
including housing, pathways, parks, and cultural and educational facilities, as well as
questions for you to think about and answer in relation to how these characteristics
affect the amount of physical activity you do. A ‘blog’ is a webpage set up
specifically for discussions and forums around a topic of interest. In this case, the
topic will be KGUV as a case-study and the relationship between people, place and
physical activity more broadly. The blog will stay open to participants for a fortnight,
during which time you will be required to respond to the questions and photographs
posted there on every second day. If you do not have access to a computer or the
Internet, QUT will provide these resources to you for the purpose and the duration of
the study only.
The information accumulated on the blog over the fortnight period will be analysed
to gain an understanding of the processes and daily practices that link people, place,
and health.
Participation
Your participation will involve logging on to the blog address from your computer
every second day for a fortnight (ie 14 days). This means that you will be required to
give as little or as much information you like in response to a photograph or question
that is posted on the blog every second day, providing us with 7 entries in total. You
will be able to respond to other entries posted by other participants, or write in your
own unrelated entry.
You will NOT be contacted for further participation following the completion of the
entries over the fortnight.
Expected benefits
It is expected that this project may benefit you in terms of gaining an insight into the way you
relate to your living environment, as well as why you do or do not use your neighbourhood for
physical activity. It may also provide you with access to a computer and the Internet which you
may not have otherwise had. Additionally, you may acquire computing skills that you did not have
prior to the data collection, as any assistance or training you need will be provided by the
researchers. It will be of benefit to the researchers in terms of data collection for this study, but
226
also to the wider, international academic community interested in understanding the processes
that connect people, place and health, who are then able to pass this data on to policy makers in
the area of urban design and health.
Risks
There are no additional risks associated with your participation in this project.
Confidentiality
All comments and responses are anonymous and will be treated confidentially. The names of
individual persons are not required in any of the responses.
Voluntary participation
Your participation in this project is voluntary. If you do agree to participate, you can withdraw from
participation at any time during the project without comment or penalty. Your decision to
participate will in no way impact upon your current or future relationship with QUT.
Questions / further information
Please contact the researchers if you require further information about the project, or to have any
questions answered.
Concerns / complaints
Please contact the Research Ethics Officer on 3864 2340 or [email protected] if you have
any concerns or complaints about the ethical conduct of the project.
227
QUT Letterhead
Participant Information Sheet
Project Title: Kelvin Grove Urban Village Study on the Ecological Processes
Contributing to Patterns of Physical Activity among Different Residential Groups.
Researcher One:
Julie-Anne Carroll
Telephone: 07 3719 5640
Email: [email protected]
Researcher Two: Researcher Three
Dr Barbara Adkins Dr Elizabeth Parker
Telephone: 0419 6500 90 Telephone: 07 3864 3371
Email: [email protected] Email: [email protected]
Statement of consent
By signing below, you are indicating that you:
• have read and understood the information sheet about this project;
• have had any questions answered to your satisfaction;
228
• understand that if you have any additional questions you can contact the research
team;
• understand that you are free to withdraw at any time, without comment or penalty;
• understand that you can contact the research team if you have any questions about
the project, or the Research Ethics Officer on 3864 2340 or [email protected] if you
have concerns about the ethical conduct of the project;
• agree to participate in the project.
Name
Signature
Date
229
Participant Information Sheet
Project Title: Kelvin Grove Urban Village Study on the Ecological Processes
Contributing to Patterns of Physical Activity among Different Residential Groups.
Researcher One:
Julie-Anne Carroll
Telephone: 07 3719 5640
Email: [email protected]
Researcher Two: Researcher Three
Dr Barbara Adkins Dr Elizabeth Parker
Telephone: 0419 6500 90 Telephone: 07 3864 3371
Email: [email protected] Email: [email protected]
Description
This project is being undertaken as part of a PhD thesis for Julie-Anne Carroll at The
Centre for Social Change Research (CSCR) at the Queensland University of
Technology (QUT). The purpose of this project is to determine the extent to which
urban design and social diversity contribute to the likelihood of residents engaging in
physical activity. The specific purpose of this study is to understand the ways in
which physical activity gets done in your everyday life, and how this particular
behaviour is linked to your perception and experience of where you live.
230
The research team requests your assistance to participate in an online discussion or
‘blog’ that will contain photographs of different aspects of KGUV urban design,
including housing, pathways, parks, and cultural and educational facilities, as well as
questions for you to think about and answer in relation to how these characteristics
affect the amount of physical activity you do. A ‘blog’ is a webpage set up
specifically for discussions and forums around a topic of interest. In this case, the
topic will be KGUV as a case-study and the relationship between people, place and
physical activity more broadly. The blog will stay open to participants for a fortnight,
during which time you will be required to respond to the questions and photographs
posted there on every second day. If you do not have access to a computer or the
Internet, QUT will provide these resources to you for the purpose and the duration of
the study only.
The information accumulated on the blog over the fortnight period will be analysed
to gain an understanding of the processes and daily practices that link people, place,
and health.
Participation
Your participation will involve logging on to the blog address from your computer
every second day for a fortnight (ie 14 days). This means that you will be required to
give as little or as much information you like in response to a photograph or question
that is posted on the blog every second day, providing us with 7 entries in total. You
will be able to respond to other entries posted by other participants, or write in your
own unrelated entry.
You will NOT be contacted for further participation following the completion of the
entries over the fortnight.
Expected benefits
It is expected that this project may benefit you in terms of gaining an insight into the way you
relate to your living environment, as well as why you do or do not use your neighbourhood for
physical activity. It may also provide you with access to a computer and the Internet which you
may not have otherwise had. Additionally, you may acquire computing skills that you did not have
prior to the data collection, as any assistance or training you need will be provided by the
231
researchers. It will be of benefit to the researchers in terms of data collection for this study, but
also to the wider, international academic community interested in understanding the processes
that connect people, place and health, who are then able to pass this data on to policy makers in
the area of urban design and health.
Risks
There are no additional risks associated with your participation in this project.
Confidentiality
All comments and responses are anonymous and will be treated confidentially. The names of
individual persons are not required in any of the responses.
Voluntary participation
Your participation in this project is voluntary. If you do agree to participate, you can withdraw from
participation at any time during the project without comment or penalty. Your decision to
participate will in no way impact upon your current or future relationship with QUT.
Questions / further information
Please contact the researchers if you require further information about the project, or to have any
questions answered.
Concerns / complaints
Please contact the Research Ethics Officer on 3864 2340 or [email protected] if you have
any concerns or complaints about the ethical conduct of the project.
232
QUT Letterhead
Participant Information Sheet
Project Title: Kelvin Grove Urban Village Study on the Ecological Processes
Contributing to Patterns of Physical Activity among Different Residential Groups.
Researcher One:
Julie-Anne Carroll
Telephone: 07 3719 5640
Email: [email protected]
Researcher Two: Researcher Three
Dr Barbara Adkins Dr Elizabeth Parker
Telephone: 0419 6500 90 Telephone: 07 3864 3371
Email: [email protected] Email: [email protected]
Statement of consent
By signing below, you are indicating that you:
• have read and understood the information sheet about this project;
• have had any questions answered to your satisfaction;
• understand that if you have any additional questions you can contact the research
233
team;
• understand that you are free to withdraw at any time, without comment or penalty;
• understand that you can contact the research team if you have any questions about
the project, or the Research Ethics Officer on 3864 2340 or [email protected] if you
have concerns about the ethical conduct of the project;
• agree to participate in the project.
Name
Signature
Date
234
APPENDIX C
The Physical Activity Survey
Kelvin Grove Urban Village
A Survey on Physical Activity Patterns in the Urban Environment
For further information please contact:
Julie-Anne Carroll07 3719 5640
Instructions for filling out this Survey
The questions in this survey are about the physical activities in your everyday life before and after moving into Kelvin Grove Urban Village (KGUV).
Think about your everyday life and the activities that you do on usual days during the week when you are answering the questions in this survey. By ‘everyday life and activities’ we mean all the different ways that physical activity happens or gets done in your daily life - for example, walking to get places, doing housework, hard labour, or gardening - not just when you are exercising.
Please tick the box next to each question that you feel most applies to you.
Note: The questions about the use of health-related resources at KGUV refer to the following geographical area only. Specifically, they refer to the parks, walkways, bikeways, and green meeting spaces in and directly adjacent to KGUV.
The Kelvin Grove Urban Village
1
Section One – Your Life before Moving into KGUV
Note: Section One is about your everyday life before moving to KGUV
The first two questions in this section are about the amount of brisk walking you did for any reason on a usual day before moving to KGUV.
1. On a usual day before you moved into KGUV, did you do more than 30 minutes of brisk walking for any reason?
Always Often Sometimes Rarely Never
2. On a usual day before you moved into KGUV, did you do more than 10 minutes of continuous brisk walking for any reason?
Always Often Sometimes Rarely Never
3. On a usual day before moving to KGUV, did you walk to get to and from places instead of taking a car, taxi, bus etc? (You can include walking to a train station, bus, or ferry if it is far away enough to potentially drive or take another mode of transport there.)
Yes No (Go to Q 4)
If you ticked ‘yes’, please list the main places that you walked to and from, your main reasons for walking, and the estimated total time spent walking.
3.1 Please list the main places you walked to and from (e.g. from home to school, shops, work, ferry etc):
3.2 Please list main reasons that you walked to and from places rather than using another form of transport (eg to lose weight, lower stress levels, to avoid parking fees, no car available, etc):
2
3.3 Please tick the estimated total amount of time in minutes that you walked to get to and from places on a usual day:
0-5 6-10 11-15 16-20 21-25 26-30 30 minutes
4. On a usual day before moving to KGUV, did you do any brisk walking within and around a particular place, such as your home, workplace, university campus, shopping centres that was not done as a means of transport or exercise?
Yes No (Go to Q 5)
If you ticked ‘yes’ please list the main places where this walking occurred, the main reasons this walking occurred, and the estimated total time spent walking.
4.1 Please list the main places where the brisk walking occurred (e.g around the house, to get around a uni campus, between wards in a hospital, between shops, along local streets, etc)
4.2 Please list the main reasons for walking briskly (e.g housework and childcare duties, to get to class, to get to work meetings, boredom, as part of your job, etc)
4.3 Please tick the estimated total amount of time in minutes this walking took on usual day?
0-5 6-10 11-15 16-20 21-25 26-30 > 30 minutes
The next questions are about the amounts of vigorous and moderate physical activities you did before moving into KGUV. They are NOT related to activities that are part of your paid work, volunteer work, or work around your house and garden. You may wish to include any sexual activity you did if you feel it fits these categories.
5. Before living at KGUV, did you do any vigorous exercise or physical activity at least once a week for 20 minutes or more? (Vigorous physical activity makes you sweat or breathe hard, e.g. cycling, football, swimming, jogging, netball etc)
Yes No (Go to Q. 6)
3
6. Please list up to four types of vigorous activity that you did regularly in a usual week, the number of times per week that you did them, and the total amount of time in hours and minutes you spent in each session.
Eg Jogging 4 45 minutesActivity Frequency per week Time spent in each
session
7. Before living in KGUV, did you do any moderate physical activity at least once a week for 30 minutes or more? (Moderate physical activity causes a moderate increase in heart rate and makes it a bit difficult to talk, e.g. walking for exercise, yoga, pilates, bowls, golf, etc)
Yes No (Go to Q.8)
8. Please list up to four main types of moderate physical activity that you did regularly in a usual week, the number of times per week that you did them, and the total amount of time in hours and minutes you spent in each session.
Eg Yoga 3 1 hour 30 minutesActivity Frequency per week Time spent in each
session
The next two questions are about the physical activity you did in your paid work, volunteer work, or house and gardening work immediately prior to moving to KGUV.
9. Before living in KGUV, did you undertake jobs or tasks during a usual week that made you sweat or breathe hard (eg bricklaying, moving furniture, tree chopping, industrial cleaning, etc?)
Yes No (Go to Q 11)
10. Briefly describe this work and how long you would spend doing these tasks in hours and minutes:
11. Before living in KGUV, did you undertake jobs or tasks during a usual week that caused a moderate increase in heart rate and made it difficult to talk (eg wheeling equipment, delivering goods, caring for a sick/elderly relative, repairs and paint jobs, gardening etc)
Yes No (Go to Q 13)
4
12. Briefly describe this work and how long you would spend doing these tasks in hours and minutes:
The last questions in this section are about how you view your lifestyle and yourself as a person (in terms of the amount of physical activity you did) immediately prior to moving to KGUV.
13. When you think about your daily life before moving to KGUV, which category do you think best describes yourself? You can tick more than one box to describe your previous lifestyle.
A person who exercises
A person who avoids exercise where possible
A person who is active in their daily life and tasks
A person who is inactive in their daily life and tasks
14. If you ticked ‘active in their daily life and tasks’, please explain why you chose this option (e.g. ‘I was looking after a toddler and didn’t get to sit down much’, or ‘I had multiple tasks to complete in one day and did a lot of running around’, or ‘I did hard labour as part of paid work’)
15. If you ticked ‘inactive in their daily life and tasks’, please explain why you chose this option (e.g. ‘I spent a lot of time indoors watching TV’, I had a desk-job’, or ‘I drove a cab for a living’)
16.Before moving to KGUV, did you have any health problems that limited the amount of physical activity you were able to do?
None of time Little of the time Some of time Most of time All of time
5
Section Two- Your Life in KGUV
Note: The questions in this section are about your everyday life in KGUV
The first two questions in this section are about the amount of brisk walking you do for any reason on a usual day since moving to KGUV.
1. On a usual day since moving to KGUV, do you do more than 30 minutes of brisk walking for any reason?
Always Often Sometimes Rarely Never
2. On a usual day since moving to KGUV, do you do more than 10 minutes of continuous brisk walking for any reason?
Always Often Sometimes Rarely Never
3. On a usual day since moving to KGUV, do you walk to get to and from places insteadof taking a car, taxi, bus etc? (You can include walking to a train station, bus, or ferry if it is far away enough to potentially drive or take another mode of transport there.)
Yes No (Go to Q 4)
If you ticked ‘yes’, please list the main places that you walk to and from, your main reasons for walking, and the estimated total time spent walking.
3.1 Please list the main places you walk to and from (e.g. from home to school, shops, work, ferry etc):
3.2 Please list main reasons that you walk to and from places rather than using another form of transport (eg to lose weight, lower stress levels, to avoid parking fees, no car available, etc):
6
3.3 Please tick the estimated total amount of time in minutes that you walked to get to and from places on a usual day:
0-5 6-10 11-15 16-20 21-25 26-30 30 minutes
4. On a usual day since moving to KGUV do you do any brisk walking within and around a particular place, such as your home, workplace, university campus, shopping centres that is not done as a means of transport or exercise?
Yes No (Go to Q 5)
If you ticked ‘yes’ please list the main places where this walking occurred, the main reasons this walking occurred, and the estimated total time spent walking.
4.1 Please list the main places where the walking occurs (e.g around the house, to get around a uni campus, between wards in a hospital, between shops, along local streets, etc)
4.2 Please list the main reasons for walking briskly (e.g housework and childcare duties, to get to class, to get to work meetings, boredom, as part of your job, etc)
4.3 Please tick the total estimated amount of time in minutes this brisk walking takes on usual day?
0-5 6-10 11-15 16-20 21-25 26-30 > 30 minutes
The next questions are about the amounts of vigorous and moderate physical activities you do since moving to KGUV. They are NOT related to activities that are part of your paid work, volunteer work, or work around your house and garden. You may wish to include any sexual activity you did if you feel it fits these categories.
5. Since moving to KGUV, do you do any vigorous exercise or physical activity at least once a week for 20 minutes or more? (Vigorous physical activity makes you sweat or breathe hard, e.g. cycling, football, swimming, jogging, netball etc)
Yes No (Go to Q. 6)
7
6. Please list up to four types of vigorous activity that you do regularly in a usual week, the number of times per week that you do them, and the total amount of time in hours and minutes you spend in each session.
Eg Jogging 4 45 minutesActivity Frequency per week Time spent in each
session
7. Since moving to KGUV, do you do any moderate physical activity at least once a week for 30 minutes or more? (Moderate physical activity causes a moderate increase in heart rate and makes it a bit difficult to talk, e.g. walking for exercise, yoga, pilates, bowls, golf, etc)
Yes No (Go to Q.9)
8. Please list up to four main types of moderate physical activity that you do regularly in a usual week, the number of times per week that you do them, and the total amount of time in hours and minutes you spend in each session.
Eg Yoga 3 1 hour 30 minutesActivity Frequency per week Time spent in each
session
The next two questions are about the physical activity you do in your paid work, volunteer work, or house and gardening work since moving to KGUV.
9. Since moving to KGUV, do you undertake jobs or tasks during a usual week that make you sweat or breathe hard (eg bricklaying, moving furniture, tree chopping, industrial cleaning, etc?)
Yes No (Go to Q 11)
10. Briefly describe this work and how long you spend doing these tasks in hours and minutes:
11. Since moving to KGUV, do you undertake jobs or tasks during a usual week that cause a moderate increase in heart rate and made it difficult to talk (eg wheeling equipment, delivering goods, caring for a sick/elderly relative, repairs and paint jobs, gardening etc)
Yes No (Go to Q 13)
8
12. Briefly describe this work and how long you spend doing these tasks in hours and minutes:
The last questions in this section are about how you view your lifestyle and yourself as a person (in terms of the amount of physical activity you did) since moving to KGUV.
13. When you think about your daily life in KGUV, which category do you think best describes yourself? You can tick more than one box to describe your current lifestyle.
A person who exercises
A person who avoids exercise where possible
A person who is active in their daily life and tasks
A person who is inactive in their daily life and tasks
14. If you ticked ‘active in their daily life and tasks’, please explain why you chose this option (e.g. ‘I look after a toddler and don’t get to sit down much’, or ‘I have multiple tasks to complete in one day and do a lot of running around’, or ‘I do hard labour as part of paid work’)
15. If you ticked ‘inactive in their daily life and tasks’, please explain why you chose this option (e.g. ‘I spend a lot of time indoors watching TV’, I have a desk-job’, or ‘I drive a cab for a living’)
16. Living in KGUV now, do you have any health problems that limit the amount of physical activity you are able to do?
None of time Little of the time Some of time Most of time All of time
9
Section Three – Your Use of the Urban Environment
The next questions are about how you use the resources that have been built for residents at KGUV.
The questions only refer to the resources that fall within area on the map provided with the survey instructions.
Next to each of the KGUV resources listed below, please tick the box if you use it for any reason. Then name up to four reasons that you use them, and how many hours per week on average this occurs.
For Example:
1. Parks (in and adjacent to KGUV) Yes No
Four main reasons for using this resource Amt of hours spent per week (average)
Jogging 2 hoursMeeting up with friends 4 hoursPlaying with children 6 hoursTo take a short-cut 1 hour
1. Parks (in and adjacent to KGUV) Yes No
Four reasons for using this resource Amt of hours spent per week (average)
______________________________ ___________________
______________________________ ___________________
______________________________ ___________________
______________________________ ___________________
If you did not tick the box to indicate use of this resource, please state briefly why you do not use it:
2. Pathways/Walkways Yes No
Four reasons for using this resource? Amt of hours spent per week (average)
______________________________ ___________________
______________________________ ___________________
______________________________ ___________________
______________________________ ___________________
10
If you did not tick the box to indicate use of this resource, please state briefly why you do not use it:
3. Bikeways Yes No
Four reasons for using this resource? Amt of hours spent per week (average)
______________________________ ___________________
______________________________ ___________________
______________________________ ___________________
______________________________ ___________________
If you did not tick the box to indicate use of this resource, please state briefly why you do not use it:
4. Green meeting places, eg BBQ areas Yes No
All reasons for using this resource? Amt of hours spent per week (average)
______________________________ ___________________
______________________________ ___________________
______________________________ ___________________
______________________________ ___________________
If you did not tick the box to indicate use of this resource, please state briefly why you do not use it:
11
Section Four - Your Social and Cultural Neighbourhood
The questions in this section are about the social and cultural environment in which you live. Specifically, they refer to your perceptions of your neighbourhood, your tastes and preferences in terms of where you live, and your feelings about where you stand in society at this time in your life.
1. How often do you see people walking for exercise, jogging, or playing sport in the KGUV neighbourhood on a usual day?
Always Often Sometimes Rarely Never
2. What do you think when you see people in your neighbourhood doing jogging or exercise? List some brief thoughts and feelings.
3. How comfortable would you feel jogging or exercising in the KGUV neighbourhood?
Very comfortable Comfortable Uncomfortable Very uncomfortable
Q. 4 For each of the statements below, please tick the box that best describes the extent to which the following neighbourhood qualities appeal to you, and are important to you when deciding where to live. These questions are NOT about where you have lived before, or where you live now, they are about the type of place you would ideally like to live in.
Very im
portan
t quality
Som
ewhat im
portan
t
Unim
portan
t
I don’t valu
e this q
uality
A neighbourhood where people often out and about keeping fit
A quiet neighbourhood where people keep to themselves
A neighbourhood where people are not seen out and about in the streets much
A neighbourhood where you can call on your neighbour for a hand
A neighbourhood with residents who are similar to you in their tastes and preferences
A neighbourhood that will tolerate a certain amount of noise, eg parties, children etc
A neighbourhood where other people keep their houses/units well-presented
A neighbourhood where there are lots of specialty shops close together in the streets
A neighbourhood that is close to a big shopping centre
A neighbourhood that has lots of parks and green open spaces
A neighbourhood that contains one of the major take-away food stores, eg ‘McDonalds’
A neighbourhood with international food available to purchase, eg sushi, Thai, Chinese etc
A neighbourhood with a gym or venue where you are able to exercise
A neighbourhood that has easy access to public transport
A neighbourhood that has a lot of greenery, overgrowth, and Australian wildlife
A neighbourhood with neatly mowed lawns and trimmed greenery in the gardens
A neighbourhood with wide open pathways or pavements for walking
A neighbourhood where the houses look very different from one another
12
Q. 5 The following questions are about how you feel about your social living environment at KGUV.
When you think about the accommodation you live in and your immediate neighbours (e.g. your building and the people in it), please tick the box that best describes the extent to which you agree or disagree with the following statements:
Note: The words ‘this group’ refer to all the people living in your building.
Stro
ngly A
gree
Agree
Undecid
ed
Disag
ree
Stro
ngly D
isagree
When someone criticises this group it feels like a personal insult
I don’t act like the typical person of this group
I’m very interested in what others think about this group
The limitations associated with this group apply to me also
When I talk about this group I usually say ‘we’ rather than ‘they’
I have a number of qualities typical of members of this group
The group’s successes are my successes
If a story in the media criticized this group I would feel embarrassed
When someone praises this group, it feels like a personal compliment
I act like a person of this group to a great extent
When you think about the KGUV neighbourhood as a whole, including all of the other residents, please tick the box that best describes the extent to which you agree or disagree with the following statements:
Note: The words ‘this group’ now refer to KGUV as a whole
Stro
ngly A
gree
Agree
Undecid
ed
Disag
ree
Stro
ngly D
isagree
When someone criticises this group it feels like a personal insult
I don’t act like the typical person of this group
I’m very interested in what others think about this group
The limitations associated with this group apply to me also
When I talk about this group I usually say ‘we’ rather than ‘they’
I have a number of qualities typical of members of this group
The group’s successes are my successes
If a story in the media criticized this group I would feel embarrassed
When someone praises this group, it feels like a personal compliment
I act like a person of this group to a great extent
13
The following two questions refer to how you feel about your own standing in society at this time.
Think of this ladder as representing where people stand in Australia. At the top of the ladder are the people who are best off – those who have the most money, the most education, and the most respected jobs. At the bottom are the people who are worst off – have the least money, the least education, and the least respected jobs or no job. The higher you are on the ladder, the closer you are to the people at the very top; the lower you are, the closer you are to the people at the very bottom.
Where would you place yourself on this ladder? Please place a large X on the rung where you think you stand at this time in your life, relative to other people in Australia.
At the top of this ladder are the people who have the highest standing in the KGUV community. At the bottom are the people who have the lowest standing in the KGUV community. Please place a large X on the rung where you think you stand at this time in your life relative to other people living at KGUV.
14
Section Five
Socio-demographic Information
1.Please state your date of birth
__________________________
2. Sex Male Female
3. Do you identify as Aboriginal or Torres Strait Islander? Yes No
4. Do you identify as a person with a disability? Yes No
5. If yes, what is the nature of the disability?
6. Do you currently hold a Healthcare card? Yes No
7. Do you currently hold a pensioner card? Yes No
8. Do you have private medical cover? Yes No
9. Do you have daily access to a car? Yes No
10. Which of the following best describes the highest level of education you have completed? Please tick.
No schooling
Completed primary school
Completed junior school (to Grade 10)
Completed senior school (to Grade 12)
Trade, technical certificate or diploma
University or college bachelor/undergraduate degree
Postgraduate qualifications
Other _________________
11. Which of these best describes your current employment status? Please tick all the boxes that apply to you.
Employed full-time
Employed part-time or casual
Self-employed
Home duties
Unemployed
15
Full-time student
Part-time student
Retired
Permanently ill/unable to work
12. Before tax is taken out, which of the following ranges best describes your household’s approximate income, from all sources, over the last 12 months? Less than $25,000
$25,001-$50,000
$50,001-$100,000
Over $100,000
13. Please tick the category that best describes the home in which you currently live. Public Housing (rental)
Private Housing (rental)
Privately owned (paying mortgage)
Privately owned (fully purchased)
Student accommodation
Retirement accommodation
14. Which of the following best describes your living situation? Single living alone
Single with flatmate/s
Single with child/ren
Couple on their own
Couple with flatmate/s
Couple with children
15. What was the name and postal code of your previous residential suburb/town?
Finally – please tick this box if you would be willing to be contacted for a follow-up interview where we will ask you about your answers in further detail. (It is unlikely that you will be selected due to the small number we plan to follow-up, however, we are very grateful for your willingness to chat to us further!)
Yes you can ask me a few more questions in a few months time Ph:_____________
No I do not wish to be contacted further
Thank you for your time today!
235
APPENDIX D
The Blog
Note: Some of the comments made on the site were removed by
the principle researcher, as the participants had accidentally
pasted their answers in twice, thus resulting in a duplication of
data. However, no data has been omitted from the blog.
236
The Effects of a New Urban Context on Health
Friday, October 13, 2006
Self, Health and Space: What Moves You?
This is an extra post to provide space for thinking and writing about how you interact
with your living environment and how this affects your lifestyle and your health. You
can write a story, comment, opinion or perspective on where you live and how active
you are able to be here and why. You can use this online SPACE for any of the
following reasons:
1. To talk about a social interaction or event/incident that affected how you felt about
living in the KGUV neighbourhood.
2. To suggest activities and get others together to pursue activities eg, birdwatching,
walking groups, games in the park (perhaps for mums with young children) , theatre
outings, coffee or book clubs or a swimming team... anything that interests you!
3. To give feedback on stories and ideas of others, to swap email addresses and
phone numbers, to get in touch, and to get socially connected and physically active.
posted by Julie-Anne @ 7:08 PM 13 comments
Sunday, September 17, 2006
Social and Psychological Aspects of Physical Activity
237
This is the last post for questions about the Kelvin Grove Urban Village and the
amount of physical activity you do. Please write as much as you can...
1. Would you say that, in a general sense, you are aware of how much physical
activity or exercise you achieve during the day, and do you worry about it, or try to
increase the amount? Do you ever consider taking more exercise, or are you content
with how active you are?
2. If you see an ad on the TV telling people to do more physical activity, or hear a
health promotion message about it on the radio does this make you want to become
fitter? Do you ever act on these messages, or do you forget about them soon after
hearing them?
3. What types of thoughts do you have that would make you want to increase your
physical activity levels? What kinds of things play on your mind or which life events
might suddenly make you motivated to exercise?
4. If you see people out and about exercising, does this inspire you to become more
active? Do you compare yourself to others' bodyweights in and around the area that
you live? How does this make you feel?
5. How interested would you be in being part of a social group that organised group
walks, or bicycle rides, or games in the local park? Why/why not? And would you
like to hear about such events online, by mobile/home phone, texting, or pamphlet in
the mailbox?
posted by Julie-Anne @ 8:32 PM 73 comments
238
Depth of Engagement with Neighbourhood Resources for Physical Activity
For this post, I am interested in finding out the degree to which you are aware of
what is available in your neighbourhood, and which resources you are most
interested in using or accessing for physical activity.
Q1. Are you aware of the public transport options available to you from the Village,
and do you use them? If so, which ones to you use and why?
Q2. Do you ever use the parks or BBQ areas to socialise, rest, play sport, care for
children, exercise or any other reason? If so, how often? What is your opinion of the
local KGUV parks and green spaces? How could they be improved to make you use
them more?
Q3. Do you use any of the pathways or bikeways? If so, what do you use them for,
and do you find that they help you to walk or exercise more than you could where
you were living previously?
Q.4 Are you aware of any other health-related resources that are near to the Village
or that will be available to you soon, eg health clinic, GP, gymnasium, pool etc. Do
you think you are likely to use these kinds of resources? WHy/why not?
Q5. Overall, would you say that KGUV is a place that promotes or allows physical
activity for residents? If so, in what ways does it achiev this or not achieve this?
posted by Julie-Anne @ 6:47 PM 80 comments
239
Thursday, August 10, 2006
Moving into a New Urban Environment...
For this first post, I am interested in how much choice you had in deciding to move
into your current accommodation; what your expectations were before moving in;
and whether you feel that your everyday routine and lifestyle have changed
significantly since moving to KGUV. Importantly, I would like to know whether you
intended to become more PHYSICALLY ACTIVE once you moved in - or whether
you did not expect much change in lifestyle and physical activities to occur. Please
answer the following questions.
1. What brought you to KGUV? What persuaded you to choose this accommodation
option over any other? How much choice do you feel you had in moving here?
2. How much did you know about KGUV prior to moving in? What types of
expectations or images of the housing, resources, and neighbours did you have in
mind before you came here?
240
3. What kind of lifestyle did you hope to lead once you were here? Did you have any
expectations that your daily activities would be more interesting, or that you would
more become more physically active once you moved in?
Please click on the COMMENTS link below and number your answers 1,2 and 3. Be
as open and honest as you like, and feel free to respond to other comments that you
see - whether you agree or disagree. Please write as much as you can.
posted by Julie-Anne @ 3:46 AM 48 comments
Saturday, June 03, 2006
The Effects of a New Urban Context on Health
This is a site for conducting qualitative research into understanding the processes
connecting people, place, and physical activity in a new urban village in Brisbane,
Australia. The name of the case-study under investigation is the Kelvin Grove Urban
Village (KGUV). I am interested in finding out about how urban design and social
diversity contribute to lifestyle patterns and communicative processes that influence
health behaviours. Digital photography of the place, and comments and opinions of
residents from different housing options will be posted. An analysis of the digital
stories that emerge will provide an opportunity to build theories and interprative
frameworks for understanding the empirical relationship between people, place, and
health in the future.
posted by Julie-Anne @ 8:04 PM 2 comments
241
About Me
Name: Julie-Anne Carroll
Location: Queensland University of Technology, Brisbane, Queensland,
Australia
View my complete profile
Links
• Centre for Social Change Research
• Health and Place
• IPAQ
• PLACE, UQ
• VicLanes Study
• RESIDE - Uni of WA
• SEID - Uni of WA
• GOLD
• RAW
• Health Behaviour News Services
Previous Posts
• Self, Health and Space: What Moves You?
• Social and Psychological Aspects of Physical Activ...
• Depth of Engagement with Neighbourhood Resources f...
• Moving into a New Urban Environment...
• The Effects of a New Urban Context on Health
Archives
• June 2006
• August 2006
• September 2006
• October 2006
242
BLOG POSTS AND COMMENTS
Post a Comment On: The Effects of a New Urban Context on Health
"Self, Health and Space: What Moves You?"
13 Comments - Show Original Post Collapse comments
participant 1 said...
1.Personally, I absolutely love living in the KGUV. The neighbourhood is
friendly and the people are approachable. Since most of the shops are now
open, the convenience is wonderful. I will definitely be shopping locally.
6:16 PM
participant 1 said...
2. As I don't normally find a great deal of spare time, organised events during
the week do not necessarily suit, but I was thinking whether perhaps a
weekend market may be of interest.
6:19 PM
participant seven said...
The difference in living in a university area at the Kelvin Grove Urban
Village is the educational value for one of my age group (aged) I have already
been to Sharing Stories which was so interesting and am off to the Human
Rights Lecture by Dr. Carmel lawrence The mature age students who live in
the complex are so kind and give us lots of information on all social activities
that are on at the village .I love the shopping complex and am looking
forward to the community hub opening soon to enjoy the company of
243
different age groups .
2:13 PM
participant seven said...
2.I have lots of interest outside the village and have lots of physical exercise
but maybe a card night for people that can not exercise due to ill health would
be a good idea .I think once the village gets under way the community hub
would be great for people to interact with others to organise some activities .
Ballroom dancing classes come to mind as well and music soothes the soul ...
2:22 PM
participant seven said...
3.Parks are wonderful places for exercise and there are some great ones
around the village so maybe an evening class of Tai Chi ?? or very gentle
exercises for families with a B.B.Q afterwards would be an idea for getting to
know the residents .
2:37 PM
participant 1 said...
3. The idea of having Tai Chi classes would be perfect and also to continue
the yoga. Unfortunately, I haven't been able to go because it has been
conducted on a week day so perhaps a Saturday morning class would be
good. I would also really enjoy the idea of ballroom dancing as well.
6:16 PM
participant seven said...
1.during the week I enjoyed having a birthday morning tea with residents
from Ramsgate Street and was so thrilled that these people who I have only
244
known for a short time would do this for me .
I know Anne has so much to do but she went out of her way to have the
morning tea at her lovely unit .
This is why I love the atmosphere of the village as although we have other
interests outside people are very caring of others
and it goes to show how a community like this can succeed .
At present the shops here are still not up and running but the future looks very
bright for the residents because of the convenience and locality here.
9:01 PM
Julie-Anne Carroll said...
Yoga in the park
The Kelvin Grove Urban Village has a comprehensive community
development program in place for new and surrounding residents, as well as
students, staff and others who work in or visit the Village.
The program includes a series of free low impact yoga classes on the Parer
Place lawn, led by Yoga Chi Gung teacher Geraldine Carty. Classes are
designed to respond to the needs of beginners through to intermediate
participants, and are suitable for a broad range of age groups.
Classes are being held on Tuesdays from 7am to 8am until 28 November.
Free entry, no booking necessary.
9:41 PM
Anonymous said...
Participants Eleven
1. Living in Kelvin Grove Urban Village is convenience not only its location,
5 minute walking distance to KG campus but the facilities available around it
these including supermarket, flight centers, wet market, restaurants and many
245
more. Every evening I can sit in the garden next to my apartment and at the
same time watching children with their parents walking and playing which
remind me about my home back in Brunei. The most interesting to me is that
I can push the supermarket trolley straight to my kitchen which I never
experience in my whole life. The first two weeks living in KG Urban Village
I can access to the University off Campus wireless which is very convenience
to me. I can communicate with my children and wife via msn chat box and
webcam which make me feel like we are closed. I don’t do much exercise but
walking up hill going to the campus is sufficient for me at this age.
8:54 PM
Participant Thirteen said...
A community BBQ would be a great idea - and we could all put in, sit down,
meet people, and get to know each other.
5:16 PM
Participant Fourteen said...
Our neighbour next door - you couldn't wish to meet a nicer couple. And the
lass with the baby she is fine now that the baby has a cot - but before she was
crying alot. The smokers drive us mad, because they are chain smokers. And
we had to call the police because a man was throwing shoes at our louvres at
4am in the morning.Most of our neighbours are good, but we need to get rid
of some of the rubbish, but BHC dont seemto listen to us when we complain.
We're not whinging, but we just want to live peacefully.
6:06 PM
Participant Fifteen said...
Someone started a fire in our refuge. Someone smelt the smoke and saw the
burnt paper. But we dont think anyone will help us stop these kinds of
problems
246
6:11 PM
participant 16 said...
1. I have so far enjoyed living in the area and i have made many new friends,
my neighbours are some of the most wonderful and interseting people you
will ever meet. There are no worries what age you are as we all get along
very well. I would be very interested if there was a weekend market of some
sort and everyone loves a bargain. I enjoy talking to people to hear their
stories and think it is great that we are not finding it too difficult to mix with
others older or younger than ourselves. The shops all have lovely and kind
people working in them and most would do anything for you, very helpful.
7:09 PM
7:08 PM Post a Comment On: The Effects of a New Urban Context
on Health
"Social and Psychological Aspects of Physical Activity"
73 Comments - Show Original Post Collapse comments
test user said...
this is a test
8:12 PM
Study participant number eight said...
1. Constantly trying to do more activity. I know that more walking will be
good for me.
7:44 PM
Study participant number eight said...
2. I take it on onboard but I am generally aware of my own health needs from
247
use more reliable sources.
7:45 PM
Study participant number eight said...
3. When I worry about my weight or other risks to my health, such as the risk
of diabetes.
7:48 PM
Study participant number eight said...
4. Don't worry about others too much.
7:48 PM
Study participant number eight said...
5. Yes I would be interested in organised walks including, for example,
birdwatching. Pamphlets in the post are best.
7:51 PM
study participant seven said...
1.i don't worry about how much exercise I do but try to be as active as
possible with a social tennis game weekly and linedancing twice weekly and
now the summer is here I intend to do more swimming .
2.No. T.V
does not sell me on anything .I think there is too much said about diets and
exercise and I think it is only up to one,s own self to participate in looking
after your own body .
5:10 AM
study participant seven said...
248
3.My thoughts on physical exercise is in a group session maybe aqua aerobics
or a walking club in the village .Weight is always a problem especially after
winter when one tends to hibernate for the winter months
4.I do get motivated by older people exercising and try and do as much as
possible .I have arthritis in both knees and find movement is restricted at
times but feel better after exercise.
5:39 AM
study participant seven said...
5.Very interested in a social group with walks etc. E-mail is fine for more
information or pamplets in the mail.
5:44 AM
participant two said...
Yes I am aware that I do little physical exercise other than around the home
or wheeling Ted when going around shops etc., as I am unable to leave Ted
unattended even to take a quick walk around our pathways. We go when I
wheel him to QUT!s coffee shop, and it is a slightly uphill pathway therefore
I am exercising muscles, though not as good as straight walking. With
community centre offering e.g Tai Chi or gym with light exercises, we could
be together there. I am unable to leave Ted unattended at home, nor am I able
to leave anyone other than a nurse should I have to leave Ted.Yes we would
definitely love to have more regular exercise which we really believe we all
need for healthier living.
9:22 PM
participant two said...
I am not usually prone to just accept because TV or papers tell me this or that
will benefit my health wise or physically, e.g. I would not go ahead and
purchase equipment that TV has told me is !for me!. I would take in an
249
exercise that I could readily do at home if I could see it would benefit.
Overall I know myself that I do need physical exercise and mental
stimulation if I wish to live a healthy life and I would do all I could to achieve
this should facilites be close to home that would enable to enhance my life
and again this refers to diet.
9:28 PM
Comment deleted
This post has been removed by the blog administrator.
9:28 PM
Comment deleted
This post has been removed by the blog administrator.
9:28 PM
Comment deleted
This post has been removed by the blog administrator.
9:28 PM
paparticipant two said...
I don!t really as I am a good weight I do the exercises I am able at home,
being that I would love to be able to get out, to do more. I am sensible in not
letting myself become overweight, am aware of what consequences could
develop. So no I am aware I must always try to keep as fit as possible for me.
9:40 PM
participant two said...
Whilst I would love to do my share to help in these activities, with my Ted
250
totally wheelchair bound I would not be able to share in the organising of
these unless the folk participating would be happy to be led by myself and my
darling precious wheelchair bound husband who is my priority. Perhaps on
reflection this could be one fun activity in itself!
9:45 PM
participant four said...
1. Yes, and recently yes, I have been taking steps to excercise more.
1:02 AM
participant four said...
2. Sometimes, if I feel like I haven't done much during the day.
1:03 AM
participant four said...
3. Feeling weak or easily exhausted is my major kick start.
1:04 AM
participant four said...
4. Yes, and no.
1:06 AM
participant four said...
5. Not sure, I feel I best excercise by myself and am not much of a socializer,
yes I would be interested in a pamphlet.
1:08 AM
participant nine said...
251
1. I have some heart problems, but most days I do exercises because I want to
stay healhty. I walk around the place with my neighbours or myself.
6:58 PM
participant nine said...
3. If you do things that make you feel good your life improves and if you
interact with people and get going in activities you start to feel better. So I
know to do this.
7:04 PM
participant nine said...
4. When I was younger I did compare myself to others, but I dont think that
matters to me anymore. When you are young you worry about how you look,
but when you get older you dont worry.
7:06 PM
participant nine said...
5. I would be keen to do something like that but I worry about the effects
about my accident... would you I be able to do it? I would need to tell people
about my accident. But it would be a great idea to do. By phone or pamphlet
would be the best way to tell me about it.
7:10 PM
participant nine said...
5. I would be keen to do something like that but I worry about the effects
about my accident... would you I be able to do it? I would need to tell people
about my accident. But it would be a great idea to do. By phone or pamphlet
would be the best way to tell me about it.
7:10 PM
252
Anonymous said...
1. I am quite aware of the exercise I do and do not worry about the extent
because it varies according to how much time I have. I definitely would
increase my physical activity if I had the time to do so.
6:26 PM
participant one said...
2. I never act on advertising and am not influenced by other people's
comments regarding becoming "fitter". I feel quite confident regarding my
own judgement of how fit I am and will only increase my activity if I wish to.
6:30 PM
participant one said...
3. As I said previously, I chose when to exercise according to the availability
of time. Most exercise consists of getting from A to B. No particular thoughts
influence me to increase my activity expect if I'm running late for an
appointment or something similar.
6:35 PM
participant one said...
4. I never compare myself to others as everyone has different body shapes
and each can decide for themselves whether they need to increase their fitness
levels. I chose not to be influenced by others.
6:38 PM
participant one said...
5. I generally prefer to exercise alone except for Thai Chi which is pleasant to
do as a group. I generally find out about any available exercise groups
myself. I do not like having what I can consider junk mail.
253
6:42 PM
Participant Six said...
1. I think so. I always time myself doing physical activity, I want to put more
exercise into my day. I would exercise at night, but at night time I am too
scared of what will happen to me out walking by myself. So I walk to work
and to the shops, but the fear hinders me at night to put more exercise into my
day. Walking from the city is OK because of all the lights, but I feel brave if I
do it. But exercise by myself is just too scary in the night - the news always
says that old ladies are being attacked, so I don't go out.
6:04 PM
Participant Six said...
2. If you hear anything to promote your health then you can know more about
what to do. You need to become fitter if health promotion says to become
fitter. I don't forget the messages, I listen to them and acquire the knowledge
about what to do. I never ignore that I need to become healthier.
6:06 PM
Participant Six said...
4. You have to organise people around your area to do some more activity
that makes you feel happy among the group and this will be a good increase
in your personality and of your health. If there are ads inviting you to attend
some kind of activity then it is nice for you to join, because it involves your
physical body. Encouragement from other people who are doing exercise
inspires me so much to become more active. I always think why they can do
it and why can I not do it? So if I see people I think that is lovely and it is
inspiration for others.
6:09 PM
Participant Six said...
254
5. I am very much interested to join if there are people who can organise this
kind of activity. Games in the park would be great. But I wonder if they will
invite me, but I am always available. You go with the flow with what the
groups are doing otherwise you isolate yourself. A phone call would be the
best way to get me. If you don't come and talk face to face or verbally with us
then we won't go, but a home visit is much more important - person to person
to talk about these things and organise activities is better.
6:13 PM
study participant three said...
1. i am not really aware of how much physical activity i do, except that it is
not enough and i should be doing alot more! i only walk and would love to be
running and playing a sport. i have been getting healthier, quitting smoking,
and as a result am recently motivated and have been running sometimes, to
get back into cross country and track that i did when i was younger.
4:12 PM
study participant three said...
2. if i see an ad for physical activity i feel guilty for sitting in front of the tv
and want to do excercise, but soon forget or get too lazy.
4:13 PM
study participant three said...
3. my weight is a huge factor in my wanting to excercise, having illness cause
me to put on 25 kilos and quit track. i would love to get back into it when i
feel better, and when my treatment is goin well i generally do more excercise.
also, if i feel bad about my weight or my fitness, this motivates me to
excercise, for example if someone makes a comment negatively on my looks
of my fitness, or if i feel generally run down and unfit.
4:16 PM
255
study participant three said...
4. if other people excercise i feel bad, as they are fitter and better looking than
i am and i feel if people see me excercising i will just look fat and stupid, so it
quietly motivates me to better myself but makes me feel bad.
4:17 PM
study participant three said...
5. i think i would be interested in like an indoor netball team or social soccer
team or something, but not just a social walking group. i am not really
motivated unless i take what i am doing quite seriously and need the
motivation right now to improve my fitness.
4:20 PM
Comment deleted
This post has been removed by the blog administrator.
7:37 PM
Comment deleted
This post has been removed by the blog administrator.
7:38 PM
Comment deleted
This post has been removed by the blog administrator.
7:50 PM
Comment deleted
This post has been removed by the blog administrator.
256
7:52 PM
Anonymous said...
Participants Eleven
2. As I mention earlier I don’t do much exercise but walking up hill going to
the campus is sufficient for me at this age. In the evening I preferred sitting
outside in the garden in front of my apartment. Sometimes I meet my
Bruneian friends who are also studying at QUT. Living away from home with
entirely different environment and cultures sometime it make me feel lonely.
But KG Urban Village is so different though I hardly know my neighbor; I
feel this is the best place I ever experience for the last 4 semester living in
Brisbane.
8:54 PM
Participant Twelve said...
1. It does not really worry me that I don't always do the amount of exercise I
need to do or that other people say I need to do. If some one is big it does not
necessarily mean they are unfit.
7:19 PM
Particcpant Twe.ve said...
2, Seeing ads about exercise or other things like that does not really motivate
me as I do as nuch as I can cope with at a certain time. There are some times
when I am more active than others and sometimes my body tells me to veg
out.
7:21 PM
Participant Twelve said...
3. I have been told by the doctor to watch my weight mainly because of pre
diabetes and when I think carefully about what I put in my mouth and do
257
moderate exercise I do lose weight. I mainly want to be fit to care for my
husband and I was a carer for my mother before him so when I got
overweight once when looking after her I lost 20kg.
7:25 PM
Participant Twelve said...
4. Some people can be inspirational but in general you have to be happy with
yourself and if YOU want to lose weight or be active you have to do it for
yourself. I don't really look at body image as sometimes this can put people
down and not give them any self confidence. Start off being happy with who
you are and then you can go where you want to go.
7:28 PM
Participant Twelve said...
5. I already go with the walking group but if there were activities in the park
that I enjoyed doing and I had the time I would probably join in. I do see the
Hub newsletter in my mailbox and things are posted up as well.
7:30 PM
10 said...
1.10 I have physical limitations. I can do moderate exercise until I reach a
pain threshold which is quite low as I have pinched nerves in my neck and
other disabilities.
7:41 PM
10 said...
3.10 Nothing
7:44 PM
258
10 said...
4.10 I don't compare myself. Seeing people exercising makes me feel sore.
7:46 PM
10 said...
5.10 Because of my medical condition I would be limited in what I could do.
7:47 PM
Participant Thirteen said...
1. I have a pedometer that I got from a friend of mine. You can get them from
health stores or chemists - it tells you how many steps you have taken and
how many kilometres you've walked. I dont reset it, I just see how much I've
added on to my last count to see how much I have walked during the day. I
just love walking and exercise, although I smoke, and it keeps me healthy
from my perspective. I have done martial arts since I was 5, and bike riding
since I was 10 - I worked in a bike shop and that is how I got into bike riding.
I was 19 or 20 when I started smoking.
5:01 PM
Participant Thirteen said...
2. No, I already have my own fitness and do so much walking so I am happy
and content with that. I can eat as much as like and I don't put on weight.
5:04 PM
Participant Three said...
3. I am just high on life and that motivates me to move and walk. I feel like I
am moving, meeting people, out and about seeing things, smelling the roses,
and it beats sitting at home. I walk at the New Farm Neighbourhood Centre
right across from the park, so I walk there.
259
5:07 PM
Participant Thirteen said...
4. I already have my own thoughts about what my fitness is, and I already
like walking. Once I get a bike you won't see me for dust! There is a bike
event from Toowoomba to Maryborough over a few days, and that is ideal for
me. I might just volunteer this year, but I can do up to a 100k per day.
5:10 PM
Participant Thirteen said...
5. Yes I would - Tai Chi, Kung Fu - or anything like that. I got trained in
Samurai. Martial arts or yoga would be great. I am flexible in that way.
5:12 PM
Participant Fourteen said...
1. No I am not happy with my current activity levels. I would like to work
and could do light activities or tasks like cleaning. But I need to find out
where I can get work.
5:44 PM
Participant fifteen said...
1. I'd like to get out in the garden and get active, but I can't here. They were
going to let me go down and do volunteer gardening at Northey Street in
Windsor, but this hasn't eventuated yet.
5:47 PM
Participant Fourteen said...
2. Yeah we do listen to them and try to take notice of them, but they aren't
effective in getting me to change behaviour
260
5:49 PM
Participant Fiffteen said...
2. Not really no. I walk every day, so I'm happy with that.
5:50 PM
Participant Fourteen said...
4. I have had thyroid cancer in 1975 and my weight went up since all the
treatment, and they blasted my metabolism. I am not influence by what others
are doing.
5:52 PM
Participant Fourteen said...
4. I have had thyroid cancer in 1975 and my weight went up since all the
treatment, and they blasted my metabolism. I am not influence by what others
are doing.
5:52 PM
Participant Fifteen said...
4. No this has no effect on me.
5:53 PM
Particiipant Fourteen said...
5. I would be interested. We go into concerts in the city hall and I am
interested in things like that. We went to the concert at the Con and it was
very good. I would like to hear about activities through a pamphlett in the
mail.
5:56 PM
261
Participant Fifteen said...
5. Gardening would be great. Pamphlet would be great because we don't have
a computer.
5:59 PM
participant 16 said...
I am currently very aware of how much exercise i do as i'm on the tony
furguson diet and i am trying to lose the excess weight. I go walking, running,
riding and do pilates and tae kwon do.
6:50 PM
participant 16 said...
2. I do not listen to anything that i hear on the radio or t.v as i believe it is just
some money making scheme or ploy to get people to spend money on stuff
that probably dosen't work anyway. I am also aware of my bodys needs and
do not need t.v to tell me what i need.
6:54 PM
participant 16 said...
3. I exercise everyday, i do pilates at home and i have an exercise bike, a gym
ball, a skipping rope and i practice my Tae kwon do at home as well as
running and walking and if the pool is ever ready i will swim too. I also do
weights once a week at my boyfriends.
6:56 PM
participant 16 said...
4. Invite friends to exercise with me sometimes but others do not interest me
much.
262
6:57 PM
participant 16 said...
5. used to do Tae kwon do at club, but when moved here tried BTC down the
road and did not like the "you are invisible" approach by staff members. Also
did not enjoy the environment there and now prefer to exercise alone or in the
company of friends. Group situations no longer interest me.
7:00 PM
8:32 PM
Post a Comment On: The Effects of a New Urban Context on
Health
"Depth of Engagement with Neighbourhood Resources for Physical
Activity"
80 Comments - Show Original Post Collapse comments
test user said...
test
8:11 PM
Study particpant number 8 said...
1. Yes. I use the northern busway, pensioner's taxi and buses on Kelvin Grove
Road.
7:29 PM
Study participant number eight said...
2. I use the BBQ facilties in the BHC complex. I have taken my
granddaughter for walks in the parks. More shade is needed, especially near
the BBQ areas.
263
7:35 PM
Study participant number eight said...
3. I use the pathways for walking. They are better than the walkways I
previously had access to, which was a hilly area.
7:39 PM
Study participant number eight said...
4. Looking forward to the medical centre starting up. Yes I will use some or
all them becuase they are nearby.
7:40 PM
Study participant number eight said...
5. Hard to tell just yet but I hope so.
7:42 PM
study participant seven said...
1.Yes public transport is very convenient here being close to Kelvin Grove
Road .I go to the city quite often now as I have joined the city library and find
shopping very easy .Also walking to the bus stop easy as it is all on one level
(no hills)South bank and the lyric theatre are only 15 mins away for all the
activities one enjoys and buses are available every 10 mins.
2:21 AM
study participant seven said...
2.I have used the parks to play with my Grandson and enjoy the walks on the
pathways as it is very safe and secure .The B.B.Q. in the Ramsgate complex
is often used as it is very convenient and a nice way to engage in a meal and
conversation with the other residents. I usually show visitors around the parks
264
and often relax as the seating is excellent around the pathways and parks
.maybe more shade in the B.B.Q in the parks during summer
2:38 AM
Studyn participant seven said...
3.My thoughts on Physical activity is in a group maybe walking for pleasure
and ball room dancing or line dancing (anything that gets the body moving)
!!!!Swimming is great 1n Summer and aqua aerobics is fun in a group .A
walking club in the shopping centre when finished would be a great way to
meet people and also be great for the heart rate.
3:49 AM
study participant seven said...
4.Sorry Julie I messed these questions up so hope you can follow !!!!
yes Human resources is a good place to go for exercise in the gym if needed
.I would be interested in using all the facilities .I have my own doctor but
would use a medical centre if close by .
5:08 AM
study participant seven said...
5.I think in time KGUV will promote physical activity as it is a new concept
in living so I am looking forward to new ideas and maybe a swimming pool
in the future for the residents as the walking paths are great and the parks are
well estabished for all sorts of fun and games.
5:19 AM
participant two said...
We realise there is a great bus service within easy reach however as Ted is
totally wheelchair dependent we are limited to maxi-cab transport. This is not
265
as satisfactory as we could hope, as the maxi cabs are short we believe in
supply and we have had more than hours waitin unpleasant weather at times.
8:07 PM
participant two said...
2. We believe these are great, however with Ted in wheelchair we are limited
in our use. The paths are not so easy to push the w.chair. We do have good
neighbours to help at times, I have a frozen shoulder, and do not at the same
time wish to impose. The Ramsgate Residences do have a wonderful
barbecue set-up which we use with our neighbours and family.
8:25 PM
participant two said...
3. Yes we use the pathways again with help of neighbours to push my special
husband in wheelchair, going to QUT!s coffee shop where they provide
excellent morn.,afternoon teas and lunches. Again it is much better accessed
for us than previously in that we could not get Ted out in wheelchair at all to
walk and QUT coffee shop provides me with gluten free foods as I am coeliac
and they are so anxious to please. This we could not do at either of our 3
previous addresses.
8:32 PM
participant two said...
We are aware that a medical practice is to open in the new shopping complex
which would be a bonus being on our doorstep. Also a swimming pool may
be a help for Ted together with help which may be available through our
Allied Health services which have been wonderful for us in assisting with
physio for each of us and may extend to help for Ted who would need their
assistance. A community centre with its facilites e.g. card games, exercise
programmes such as tai chi perhaps, just mingling socially perhaps. We
266
would use these and it would greatly benefit Ted in that he does not have
these social outings presently. A library would benefit us also, both of us are
great lovers of books.
8:40 PM
participant two said...
We hope with facilites offering to us such as community centre!s facilities,
swimming pool, walking paths,
QUT!s coffee shop and maybe library with its computer access and maybe
any learning programmes such as writing we all will grow and at the same
time learn and also help others. We feel privileged to have all these wonderful
people ready and so kindly willing to help us to live a more gracious and
healthy lifestyle. We are most grateful for this.
8:48 PM
participant four said...
1. Yes, I use the buses and taxi's. I prefer them to buying a car and the costs
associated with running it.
12:51 AM
participant four said...
2. Yes, more often recently, as I have tried to increase my physical actvity
outside the house. I find the green areas outside the KGUV complex to be
good but small. I would prefer them to be bigger, since there are many roads
and hills in this area and it's hard to find a place for a quiet walk or ride.
12:55 AM
participant four said...
3. Yes, I use them for walking and riding, and no, I find them to be simply a
267
requirement of a small urban area and not specifically built as a walkway for
excercising or riding.
12:57 AM
participant four said...
4. No, and yes, for relaxation and enjoyment.
12:59 AM
participant four said...
5. It's hard to say at this point, since I don't believe that KGUV has been fully
finished but I imagine it would promote more physical activity.
1:00 AM
participant nine said...
1. Yes and I think it is a very good connection here actually... the buses are
great, I use the ones on Kelvin Grove to go shopping. But sometimes I walk
to the shops. I go to the City for something to do. I catch the bus there to look
around.
6:42 PM
participant nine said...
I use the BBQ area to socialise with my neighbours. I love the Victoria park,
if you walk there at night is it wonderful sightseeing, you can see the
beautiful city. It is nice to look at, if you don't get disturbed by a golf ball!
6:45 PM
participant nine said...
It is a bit too hilly,but i can cope with it, it is no problem. The surrounding
268
areas are very nice to look at and you can meet the students and talk to them.
The international students have come to visit us.
6:47 PM
participant nine said...
I am not sure if they are still building the health building... so I am doubtful at
this stage about the health resources available.I would use a gym if it was
made available. I couldn't swim after my accident.... no muscles.
6:50 PM
participant nine said...
5. It will be good for physical activity especially walking and jogging and
going sight-seeing is good exercise. And going to the shops.
6:51 PM
participant one said...
1. I do not have a car so rely heavily upon public transport. I use the bus
services, usually the Northern Busway, and mostly the shuttle bus services
between the Uni campuses.
6:46 PM
participant one said...
2. I rarely use the parks or BBQ areas because I tend not to have the time.
The green spaces in KGUV seem to be adequate but am worried they will not
accomodate the influx of people once the construction of all the units are
completed. It is unlikely that I will be using them until I can access more time
to do so.
6:50 PM
269
participant one said...
3. I use the paths and bikeways to get from A to B and find them very useful.
Lighting along the bikeways could be improved though. Again I tend to walk
more because I do not possess a car.
6:53 PM
participant one said...
4. My daughter and I will be using the pool on a daily basis, if possible,
depending on time available. To have a health clinic close will be an extra
benefit.
6:55 PM
participant one said...
5. The lack of car spaces and parking tends to force people into choosing
alternatives to private transport which I see can have it's benefits except for
those who depend upon private transport to access either their work or family.
KGUV appears to promote a healthier lifestyle through its advertising
promotions.
7:00 PM
Study Participant Six said...
1. I was very much aware of the public transport because I always choose
accommodation that has good public transport, this is a priority for me. I use
the buses because they go to the city all the time. I always walk to the bustop.
5:43 PM
Participant Six said...
2. I do not use the BBQ areas yet because I cannot do that because I am
alone. I like the parks surrounding the area because they are so gorgeous and
270
I feel comfortable and satisfied with the air. I just walk around and sit down
and with the other people resting there. I want to have more people coming
over and being here because of the beauty. One of my friends said the place is
beautiful because of all the green spaces, and it is pleasing to visitors. I hope
there will be no more buildings infront of us, because we cannot see the green
beauty of the gardens around us then. It does need more flower though, I
wanted to donate some flowers to make it prettier with additional lovely
flowers.
5:47 PM
Participant Six said...
3. Although I dont have my bike, I do use them for walking. It is convenient
and very suitable. Absolutely I walk more here, I didnt have parks or
pathways where I was before, which was a new suburb. I walk more here,
because that has been my life - walking.
5:50 PM
Participant Six said...
4. I would use the medical centre. I dont swim, but I like to go and watch
others swimming. I want to see others involved in recreation. I feel very
happy and good just looking at others using these kinds of things. I would go
and watch a swimming contest or something like that.
5:53 PM
Participant Six said...
5. This is a good example for all people who are fond of physical activity, and
this is the right place for them to do it. You will live longer because a good
environment and a clean one makes you live longer! Anywhere you go the
environment and the behaviour of the people living there - if they have self-
discipline - then this is healthier. They need to have good morals. If people
271
are making trouble and people are making you stressed then this makes your
health unfit for your physical body. Otherwise there will be no happiness and
harmony among the people living here. I have only had one problem with
people throwing water and rubbish out of their apartments and we have
complained. This is not healthy. Otherwise it has been pretty good.
5:59 PM
study participant three said...
1. I am aware of the northern busway as well as buses going down kelvin
grove road, along with the student bus that goes direct to the city QUT. i use
the buses from the busway and kelvin grove road as i dont have a car and rely
solely on public transport. i find it efficient means of travel and catch the 390
or 345 mostly, and connect to where i need to go from the city if that is not
my destination. i find they come frequently enough, and are usually very
efficient.
3:56 PM
study participant three said...
2. I use the parks to play around and do some physical activity, but not to
really socialise. Usually the parks are just to pass through on the way to the
bus. I feel i would use them more when the contruction is finished, as i will
be feeling safer in the area then.
3:58 PM
study participant three said...
3. I use the pathways to get to the red hill shops and find i am walking more
than previously, although i used to have a car but dont anymore. I have also
been motivated to go for a run in the area, which i havent done for years due
to illness, and have found the pathways useful for this as they are broad.
4:01 PM
272
study participant three said...
4. i am hoping there will be a GP, gym and chemist, and plan on using them. i
am hoping to use the gym if i have enough money, which is a new thing for
me as i am not into excercise, but the convenience would be great and
motivating. i may or may not use the gp as i have a great gp at red hill
already, but would consider it due to convenience.
4:05 PM
study participant three said...
5. i think KGUV does promote health and wellbeing. the parks are
encouraging to have a fun activity, while the pathways are great for a run and
if there is a gym, more serious fitness activities. i think it will also promote
social activities and be a very active area.
4:07 PM
Anonymous said...
Participants eleven
The location of KGUV, facilities offered surround it really well for the
residents.
8:16 PM
Anonymous said...
Participants Eleven
3. I regularly, used the QUT shuttle bus not because of it free fare but this the
only bus that know where it drop me when I go to the city and pick me up
back to the KG UV. To this day I do feel KGUV is the better place for student
from abroad. Apart from it distance to KG campus but also the facilities it
offer.
273
8:55 PM
Comment deleted
This post has been removed by the author.
6:54 PM
Comment deleted
This post has been removed by the author.
6:57 PM
Comment deleted
This post has been removed by the author.
7:01 PM
Comment deleted
This post has been removed by the author.
7:04 PM
10 said...
1. 10. Yes we use the northern bus way mainly as it is shorter by one stage to
CBD. My wife pushes me in the wheelchair as the length of walk is
sometimes more than i can cope with.
7:05 PM
Comment deleted
This post has been removed by the author.
7:06 PM
274
10 said...
2. 10. We generally do small walks as this is all I am up to these day.
Whenever we have visitors we walk the around the parks in the area. At these
times I usually use the wheelchair. In future we will use the BBQ facilities.
7:13 PM
10 said...
3.10. The pathways are good quality and especially as one gets out of the area
does one notice how much better they are than the general walkways around.
I find the inserts very interesting and they are among the features we point
out to visitors.
7:19 PM
10 said...
4. 10. I am aware of those facilities but I probably will not use them very
much as my health problem will not allow it. However my wife is very much
looking forward to the pool in particular. The medical centre will be of great
interest to me.
7:27 PM
10 said...
5.10. I think this is a fine concept it is fine in its promotion of walking and
cycling I really hope others will use it . If my health allowed I certainly
would be greatly benefited.
7:32 PM
Participant Twelve said...
1. Yes, we knew we could use buses in the village. We picked up timetable
but it took us a while to work them out and where to get back on in the City. I
275
push my husband in the wheelchair through QUT to the busway and we catch
the bus into the City to go to the Public Library. We have also caught the bus
from Kelvin Grove Road. When we lived in Strathpine we used to catch the
train into the City and use the ticket for bus or ferry and we do the same now.
4:42 AM
Participant Twelve said...
2. On one of our walks we visited all the parks in the area and I saw that Grey
Guns park would be ideal when small children of my friends and family come
to visit as we can take them for a walk up there and let them kick a ball
around and we can sit and talk. I will be going to the movie in Kulgun Park
and I have sat there with friends who have visited us and I have shown them
around.
4:45 AM
Participant Twelve said...
3. Yes, as I said before we use them to walk and to get to the bus stops.
Where we were renting before it was newish and there were good pathways
we used to use; the only thing here is that there are more pleasant pathways
which encourage you to use them more.
4:47 AM
Participant Twelve said...
4. Our neighbours go to the doctor in QUT but as they are sometimes not
there and my husband needs to see the doctor every month we decided to go
elsewhere. We do use the Chemist. I am also very much looking forward to
the swimming pool being completed in the commercial retail building next
year. In the meantime I have a lady I know going to the Centenary pools and
because I know the walking track there now I am gong to walk and meet her
there thisw Friday for a start and see how I go and maybe do that weekly.
276
4:50 AM
Participant Twelve said...
5. I think the village is trying hard to promote the use of the pathways, parks
etc. Information is given out and we do have a community meeting once a
month. One suggestion at the meeting was to use the park for a market once a
month. I'm sure more input will be given as time goes on.
4:52 AM
Participant Thirteen said...
1. Yes I do. Buses and trains. It all depends where I am going to.
4:47 PM
Participant Thirteen said...
2. No not a great deal. It is great, its nice to have nice parks, it is wonderful in
that way. It's a good thing for the community to get together and
communicate in that way.
4:48 PM
Comment deleted
This post has been removed by the author.
4:51 PM
Participant Thirteen said...
4. Theres a Red Cross getting built, a pool is coming soon too. I know about
the doctors and the chemist. I will definitely use the gym and the pool. I know
there is a gym up at QUT. I 'm looking forward to things getting developed
alot more so I can use the facilities.
277
4:54 PM
Comment deleted
This post has been removed by the author.
4:56 PM
Participant Thirteen said...
3. I love the pathways because I cycle, I do Tour de France type of cycling. I
do Flatland cycling too where they do tricks etc. I only have that kind bike at
the moment. A car hit me on my bike years ago in 1994.
4:14 PM
Participant Thirteen said...
5. I do, derinitely. Like with the parks, a couple of the hills give great
exercise. It's good in the walking sense, even walking to the buses and there
are so many bus services here - you can get to the Bulimba ferry, Valley, city -
so it's easy to walk to those things.
4:15 PM
Participant Fourteen said...
1. I use the buses all the time, three four times a week.
5:18 PM
Participant Fifteen said...
1. I use the buses to go to my RSL meetings down at Gaythorne.
5:18 PM
Participant Fourteen said...
278
2. No we never use them. We have no BBQ at Kundu Park. We have tables
there, but no swings for the children. But we don't use the parks. If they had
something at Kundu Park I woudl take my grand-daughter down.
5:20 PM
Participant Fifteen said...
2. The green spaces are important - we overlook the city in our apartment and
we overlook Kundu Park and that is great. They reckon the view from the
fourth floor is beautiful, but that is full of homeless people - and this is a
problem. People out of jail are in there. We're on teh ground floor wiht good
neighbours - so that is good, but some of the neighbours are terrible. We have
nowhere to hang our washing here - I have to dry my sheets in the shower,
and I need a clothes hoist.
5:25 PM
Participant Fifteen said...
3. I use the bikeways and pathways. Some parts are too rocky and to thin, but
the rest are fine, and I go on the community walks - we go along Herston
Road - there are three walks and we have done two of them.
5:28 PM
Participant Fourteen said...
3. I will walk around the shopping centre and to the bus and around town. I
spend alot of time with my grandchildren and children.
5:29 PM
Participant Fourteen said...
4. We go to the QUT optometry and the health clinic, the doctors up there.
5:31 PM
279
Participant Fifteen said...
4. We are waiting for the pool and I reckon I will get alot of use from that. We
can walk around to Centenary Pool, but when the one is in here that will
better.
5:32 PM
Participant Fifteen said...
5. Could be better. The walking club there was nine of us at first, then seven
and last week only two, so what we are going to do is kick off at 4pm and do
an hours walking. That is my neighbour and I. The walks start too late
otherwise because when it gets dark the pathways are narrow and a bit
dangerous. And there have been rapes on the news.
5:36 PM
Participant Fourteen said...
5. Not really. I think things have to be cleaned up and changed in Hartop
Lane because of retired people who want to live a peaceful life and this is
difficult because there is no communication with the manager at Rental
Express. This is all about people in the unit and no-hopers.
5:38 PM
participant 16 said...
1. New about buses and busway and where they go because a friend lives and
works close by and told and showed me where to find all the public transport
that i needed.
6:34 PM
participant 16 said...
2. New about the parks as i use these for exercise or just sitting in the sun on
280
a cool day. Have not used the BBQ's as i do not know how often they are
clean if at all and needs more seats as it will only accomodate a small group.
6:36 PM
participant 16 said...
3. The Paths and bike way are good for going running or riding. have only
used these a few times but it seems fairly good. The paths are clean and tidy
and luckily are not in need of repair like others i have used before moving
here. It is also good as it means there is no excuse for walking on the road.
6:39 PM
participant 16 said...
4. Not currently aware of any GP's in the immediate area, need to travel to
newmarket for this and when not well, catching the bus sucks. Looking
forward to getting one soon.
6:41 PM
participant 16 said...
5. fairly friendly in that there are walkways, bikeways and parks for physical
activity, i have used these already.
6:42 PM
6:47 PM Post a Comment On: The Effects of a New Urban Context
on Health
"Moving into a New Urban Environment..."
48 Comments - Show Original Post Collapse comments
study participant one said...
281
1. this is a test
6:34 PM
study participant one said...
this is a second test
1:08 AM
study participant seven said...
1.Because of financial restraints I has no choice about living in low cost
housing .Brisbane Housing appealed to me because of location and having
parks theatre and transport near by .Also the village will be a great concept
when finished so shopping will be in walking distance.
I read about the village about 2 years ago so kept in touch with Brisbane
Housing so I was prepared to move as soon as a unit was available and I am
not sorry I moved .The only problem is all my friends and family live in
suburbia so I have furthur to visit and as petrol is so expensive these days
vists are not as frequent.I was concerned about living in an environment with
so many different ages and so many units but because of good management,
problems that have arrived have been dealt with in a polite and professial
way.
9:01 PM
study participant seven said...
2.I was interested in the urban village for a few years so kept an eye out for
advertising on the site.The housing commission was very hard to access
accomadation so the only alternative was look elsewhere and Brisbane
Housing contacted me and offered me a one bedroom unit so I thought go for
it I can always leave if it does not work out !!!Also young people keep you
young and I have met some really interesting people here and have had a
great social experience as well .
282
9:23 PM
study participant seven said...
3.When I inspected my unit I was very impressed because of the gardens and
the decor of the building so did not hesitate in signing a lease .Rent is a bit
higher than i anticipated but the concept of the whole enviroment appealed to
me .I have always been into exercise and find the walks here very peaceful
and as the building progressed very interesting to see.
The Q.U.T provides fitness tests for all ages and I have already had one
meeting at the Human Recources and found the students very helpful in their
field.
My lifestyle has not changed a great deal as I have had lots of interests in
linedancing ,tennis and swimming so continued those interests since I came
to live in the Village .
9:47 PM
Study particpant number eight said...
I had temporary accomodation and needed a permananent alternatve. I was
listed with the Housing Commission and after 18 months waiting was given
an opportnuity through BHC to join KGUV. KGUV is close to transport and
is an attractive place to live. While my choices for accommodation were
somelimited, the KGUV met all my requirements.
6:59 PM
Study participant number eight said...
2 Until BHC approached me, I had heard nothing of KGUV. Given the
information BHC provided, I expected people living there to be of various
ages and backgrounds. I expected the village would have many amentities
and that I would be able to be involvled in activities through the QUT.
7:18 PM
283
Study particant number eight said...
3. I hoped there would be many people to get to know, which has eventuated.
I had hoped the gym would be useful although in reality it is not sutiable. I
have increased the amount of walking I do on a regular basis, largely as a
result of the assistance I obtained from the QUT podiatry clinic.
7:26 PM
study participant one said...
1. I felt I had full control over my accomodation choices and chose Brisbane
housing because it suited me best. Financially, I am better off living in low
cost housing and am more than satified with the accomodation. I don't
possess a car so needed to be close to transport. My daughter attends the local
school which is only a short walk away. I thoroughly enjoy living in this
environment.
5:31 PM
Anonymous said...
2. I discovered information about KGUV through the website when looking
for suitable accomodation close to the University and was very interested in
the concept presented. I was impressed by the concept of mixed housing and
the close association with the Uni. I am usually extremely busy studying,
being a single parent and working part-time to truly get to know the other
residents but I feel very comfortable and secure with my neighbours.
5:38 PM
Anonymous said...
3. It has been necessary for me to become more physically active because of
the lack of private transport. I thoroughly enjoy walking so this has become
an added bonus more than intentional. When the complex opens that houses
the indoor pool, myself and my daughter plan to be using the facilities
284
regularly.
5:43 PM
participant two said...
1. I was at my lowest stage stress wise having my husband slowly recovering
from heart surgery, strokes, hip & prostate surgery. Also I myself had angina,
other health problems & then had fallen whilst Ted in rehab, shattered right
upper arm & taken shoulder blade out & unable have surgery then fallen
broken left hip December 2005. Private rentals had become too costly as well
as we had relocated from Melbourne 1998 due to my really serious ill-health.
We had to move from our unit after Ted!s heart etc problems with his
inability to use stairs, the next unit was too costly, I had to purchase all white
goods, furniture really everything and with no help as no family here. We had
a granny flat and again had to move when house occupants were
moving.Stress wise I was at a low stage having Ted in & out of hospital &
had to move quickly.Again our owner died,, we had our names with Qld
Housing & needed better affordable housing and help.
6:38 PM
participant two said...
2. Brisbane Housing had asked us if diversity of culture would be a problem..
we had no worries, looking forward to learning new cultures maybe helping
anyone with problems. Ted is unable to walk and the unit is designed totally
wheel-chair friendly, no carpets, no steps. The Village was designed with
great foresight, we had no idea that all the medical services and all health
services would be so readily available.
7:48 PM
participant two said...
3. We had hoped our lifestyle, once we were settled and stresses lifted
285
gradually, that we would be able to perhaps enjoy outings to e.g. Southbank,
Museum, Roma Street Gardens as we now were living within easy access of
these wonderful facilities.Also we hoped we could take walks, of course I
would be wheeling Ted and in this regard hoped level paths would be
available, perhaps a walk to university coffee shop and knew when the new
shopping complex was ready in some months time, we would have much
easier access as it would be within walking distance. We looked forward to
use of facilites at new community centre to be built. Yes we definitely looked
forward to a less sressful and healthier lifestyle.
7:58 PM
participant four said...
1. We moved into KGUV because of time and money restraints, the unit we
had lined up was lost because of a Real Estate error, so we had to find new
accomidation quickly.
12:43 AM
participant four said...
2. We knew where the KGUV would be and we knew what it looked like due
to the presentation given to use by the Brisbane Housing staff, apart from that
we didn't have many expectations due to us having to move so quickly.
12:45 AM
participant four said...
3. I expected to have the same amount of physical activity before moving in.
And expected my lifestyle would change little.
12:47 AM
participant nine said...
286
I was waiting on the housing commissison list and they said I would have to
wait for seven years then I went looking in the private market but they said
my income was too small. I couldn't find a place to stay. So I got here
because I was listed as emergency housing and the BHC units came up.
6:35 PM
participant nine said...
I was just happy to have a place to live and had no expectations. I really was
just glad to have a place to live.
6:37 PM
participant nine said...
I didn't imagine my life would change much.. I was curious about what the
new housing would be like, but had no expectations of what it would offer. I
had no job when I came here, and I was welcomed greatly by my neighbours
and thought that was a great sign.
6:40 PM
Study participant six said...
1. I had no other choice but to take the one that they offered me. I was living
with my daughter for two and a half years and I wanted to have freedom of
my own in my own place and a friend introduced me to this housing option,
and when I saw the unit I wanted it. Then I went to the QlD Housing
Commission to apply for a bond and it was approved. And I really love the
place.
5:46 PM
Participant Six said...
2. I was expecting that is really good for me and even if I have to pay the
287
price I wanted the freedom with having my own place and all the things I can
do by myself. I expected to have lovely neighbours who could help me,
especially the Australian people who are really accommodating and helpful in
any undertaking that I have encountered.
5:51 PM
Participant Six said...
3. I was so excited and happy to have the area that I got. It is so convenient
for me to go to the city and do sight seeing and see places I haven't seen
before. I wanted to improve myself and my knowledge and how I can solve
my own problems. I was going to be transfered to near my work, so I was
happy and my friends were happy for me. And I get to walk to work and that
makes me healthy and I enjoy walking to the school. Walking is my life. I
dont care if I dont if I dont have a car, I just love to walk anywhere. I am still
healthy so I don't need a car. And here I can work to work, the city. I walk to
the school to clean and I start walking at 4 o clock in the morning, then we
have a conversation before we start cleaning! I have been in Australia 22
years.
5:59 PM
study participant three said...
1. I did not have alot of accomodation choices available, having a real estate
error leave me one week away from not having a home. Taking a chance on a
referral i had received form the Department of Housing, i called Brisbane
Housing Company to discuss my options. They had two units available to us
and we chose to rent with Brisbane Housing company due to an inability to
get another rental and financial restraints. We chose KGUV over the other
rental in Red Hill because of the plan for the area, e.g. the shopping centre,
proximity to university, parks etc. I feel, although we had limited time and
resources, we had a choice in moving to KGUV and we made our decision
based on the unit being new and the features of the urban village.
288
3:40 PM
study participant three said...
2. I didnt know a great deal about the urban village before moving in, and
only really know now what i am observing happening around me. We were
told about our unit and the area by the Housing Company, and were told it
was an exciting new development, close to the city and uni's, with shops to be
built and a number of other facilities. It sounded great to us as young people
and when we checked out the unit we found the accomodation exceeded our
expectations. It was alot nicer and more modern than we thought it would be.
It has been a bit annoying to be here with the construction still continuing- it
has made my allergies really bad and the noise is awful, especially of the pie
van. These were things we had not anticipated, as well as never having lived
in public housing before we had no idea what to expect of our neighbours. the
first few weeks were difficult in this respect, but the real estate dealt with
issues swiftly and efficiently. I also thought the facilities would be finished
earlier and available to us earlier, and this has been a bit dissapointing.
3:49 PM
study participant three said...
3. I thought once i moved in that my daily activities would be more active,
though i have been very ill, and that i would start feeling better, and be more
active in social activities as well as physically. i was being quite optimistic
about this, but felt the area may bring out the best in me. I also thought things
would be much more interesting, being close to a uni and a central 'hub' of
activity.
3:51 PM
Anonymous said...
Participants Eleven
4. Honestly, speaking I don’t expected much. But its location closed to KG
289
campus, really motivate me to choose KGUV.
8:56 PM
Participant Ten said...
1. this is a test
6:20 PM
10 said...
1. 10 .We unfortunately have to live on disability pension as I have a
deteriorating bone/joint condition and at least four different types of arthritis.
Hence low cost housing is a necessity for us. This accommodation is very
suitable and in fact lets me get out more especially via public transport
6:35 PM
Anonymous said...
1. We have had our name down on Queensland Housing since June 2003. A
couple of years ago Brisbane Housing Company contacted us to enroll for
affordable housing within Brisbane. We did this and a couple of times we
were offered housing but it was only bedsit or one bedroom and because of
my husbands medical condition we were eligable for a 2 bed room unit. We
were offered this in September 2006.
6:43 PM
Ju said...
2. We picked up a Brisbane Magazine and there was a page of information on
KGUV and the opening in October 2006. We were interested in going along
and while reading the information saw the it had public housing as well. I
commented to my husband wouldn't it be funny if we were offered something
there. The fact that the village was sustainable appealed as well. Being new
290
we thought that any neighbours we had would appreciate that as well. We
ourselves had a complete interview and we expected everyone else to as well
but since moving in we see that not all tenants are responsible and some have
had to be removed and others are in the process.
6:47 PM
10 said...
2. 10. I did not expect a whole lot as I have seen a number of low cost
housing schemes in 3 different countries and they have all been of fairly low
standard.
We did entertain some hope of at least some greater quality accommodation
as we had read a favourable write up about Brisbane Housing here at Kelvin
Grove Urban Housing Project.
6:49 PM
Ju said...
3.I do like to be active but I do have some injuries from my youth that play
up as I get older. However, the Hub has community meetings and we have
formed a walking group which I enjoy very much and one of the walks we
have done I did on my own again. The access pathways are great and if I push
my husband in the wheelchair he enjoys the area as well. Sometimes when h
e is up to it he walks a little himself.
6:50 PM
10. said...
3. 10. I never had any problems with making new friends so this was not a
issue with me. And it has worked our well as we socially seem to fit in and
are getting to know others quite easily and am able to participate in some of
291
the social events being organized. I were a little worried as most of my life I
have lived on the country but it worked out fine as we overlook a park now.
6:58 PM
Participant Eleven said...
1. Honestly, speaking I don’t expected much. But its location closed to KG
campus, really motivate me to choose KGUV.
9:41 PM
Participant Thirteen said...
1. I went through Heart 4000 - an emergency housing place - I had only been
out of jail for three months and then this house came up. On the 23rd of
November 2006 I got my forms approved and moved in on the 24th.
4:42 PM
Ju said...
2. I just basically expected a place. I was actually overwhelmed because the
place was brand new and I was the first person to live there.
4:43 PM
Ju said...
3. Not really, no. I am what I am and that has never changed. I know what my
lifestyle is, and I know my boundaries. Every good man should know his
boundaries and limitations.
4:45 PM
Participant Fourteen said...
292
1. Not much really. Our lease was up at the unit on the North Coast, and for
health reasons for my husband, we wanted to come to Brisbane near the
hospital.
4:57 PM
Participant Fifteen said...
1. I came here to be near Prince Charles, and for an operation at Royal
Brisbane in urology. I have had three mild heart attacks and I am a diabetic,
and they were silent heart attacks so I didnt know I had had them. Just some
pain and we found out at Nambour General Hospital. So it's easier to be the
hospitals.
5:00 PM
Participant Fifteen said...
2. We knew nothing about this, and we weren't introduced to any neighbours.
They took us through and showed us the single room units, but that is no
good to say. So now were in an adaptable unit. We were paying 240 per week
and they were going to raise the rent so were were pretty desperate to get a
place.
5:03 PM
Participant Fourteen said...
2. We dont need a car here as we're near the busway and its a wonderful
service. But we didnt know about all of this before we came. We didnt really
know what was going to be available.
5:05 PM
Participant Fourteen said...
3. I miss my garden and I have some pot plants, but I had to leave alot
293
behind, so that is something I can't do anymore. I would love to work, but am
not sure what I could do. I get so bored. I have always been a very active
person. I am not as active as I should be, though.
5:12 PM
Participant Fifteen said...
3. It's been harder coz I have come out of doing shift work all my life, so I get
up very early out of habit and do word puzzles. I miss gardening here. I do
walk around here - and I can do the walks here. There is a garden here but we
aren't allowed to touch it for legal reasons.
5:15 PM
Anonymous said...
study participant seven
I have been here for 16 months now at the village and enjoy the lifestyle .I
have made some really lovely friends and we get together to play cards and
have dinners together .We also participate with the Q.U.T reserchers and find
the information very interesting and educational .There is always a mixture of
entertainment at the Block ,the theatre and meetings at the Hub so we are all
very involved with different people so find our life very interesting. I still
enjoy outside interests with family and friends but usually invite people over
for lunch or dinner so they can experience the life here .
4:39 PM
participant 16 said...
1. Moved to kelvin grove because i was looking for a place away from my
parents, my mums cooking sucked and my dads snoring and bad mood was
kind of annoying. My own space was so i can do as i please without having to
answer to anyone but myself. I am one of eleven children and sharing a room
with 4 sisters and decieded that at the age of 25 i needed my own bedroom.
294
6:22 PM
participant 16 said...
2. Hoping that there were lots of shops, the possibility of part time work and a
place to meet friends. Was also hoping for parks to picnic in and lots of
friendly people to make friends with. Was excited but nervous about moving
to a place i had never been to before. was hoping for it to be a place that was
clean, friendly and fun to live in.
6:26 PM
participant 16 said...
3. Look forward to cooking really tasty food, mixing with people, doing angel
card readings, reiki and other new age stuff for other people in the area. was
looking for part time work to bring in the dollars until i can start my own
business. Losing weight? who dosen't want to? walking, running or tae kwon
do for fitness.
6:30 PM
295
APPENDIX E
Interview Schedules and Transcripts
296
Interview Schedule for BHC Participant Interviews
Individual Level Questions
Key themes: Socio-historical influences; Attitudes and beliefs about PA;
Presence/absence of PA and health as daily goals; Agency/motivation; Real and
Perceived Barriers to PA and health; Meaning of PA and identity
1. When you were growing up, how important was a healthy lifestyle in the family
that you came from, or the household you grew up in? Did your parents or carers
encourage you stay fit and healthy, or was it not really talked about that much?
� What kinds of advice did they give?
� What were the family/household attitudes like – what was
important as life-goals?
� What were the family/household norms – did you play sport,
go the beach, play in parks etc?
2. What is your own personal opinion about physical activity?
� Is it important?
� What are some of the benefits you might get from doing
physical activity?
� How much do you think you need to do each day or week to
get the benefits?
3. In your every-day life, how much would you say you think about doing things that
might make you healthier?
• Do you ever think about making changes to your lifestyle?
• Do you think about health when you are out walking, or
preparing food, or deciding what to do or eat or drink?
• Is health important to you?
297
• Do you think you can get healthy or sick by things that you do
in your everyday life?
4. If you had no barriers or constraints to the amount of exercise you were able to do
– any kind, any place, with any equipment you needed – what kinds of things would
you be interested in doing? If any?
• What would you enjoy being involved in?
• What do you think you would get out of being able to do that?
• What are the main things that prevent you from being able to
be as active as you would like?
• Is PA/exercise something that you would like to do, and your
‘life’ wont let you, or are other things more
important/appealing to you?
REPEAT QUESTION NUMBER FOUR AROUND GOALS FOR THEIR
CHILDREN.
5. What types of images or people come to mind when you think of physical activity
or exercise? Do you associate yourself, or how you see yourself now in your life with
being a person who is physically fit/active? What kinds of things are different/same
between people who are really fit and active, and how you see yourself? When you
see images of people doing healthy things, ie eating fruit, or jogging or playing sport,
can you see yourself doing that? Why/why not?
6. If someone was trying to get a message out to people to get them to do more
physical activity, or lead a healthier lifestyle – and make all the changes that go with
that to their lives – what kinds of things would they have to say to convince you to
make these changes?
� Do scare tactics work?
� Does seeing people who are fit and health in gym gear work?
� Does motivating music/images on TV work?
� Radio health information?
298
� Pamphlets in Drs rooms?
� The internet?
� What kinds of things would need to change or would you need
help with to allow you to do the kinds of PA health promotion
recommends you do?
299
Household Level Questions
Key themes: Daily routines and habits; barriers to lifestyle change – people,
money, resources; Social and structural barriers to increasing PA coming from
family members.
1. Describe a typical day
2. Describe a typical weekend
3. Who does any PA in the family?
4. Is there anyone in the household who would like to do more PA? Who prefers
not to move too much?
5. What kinds of things stop the people in the house who want to be more active
from doing so?
6. Is it hard to organize to do PA altogether? Why?
7. Is there anything about your housing type/style or neighbourhood that makes
it harder or easier to do more exercise?
8. When you seem pictures or images of families doing things together like
playing in a park, or running on a beach, or doing sport, can you see the
family you are in now doing things like that? Why/not?
9. If someone suggested putting some exercise into the families daily routine,
what do you think the reaction would be from other family members?
10. Does your family ever talk about getting fitter, or losing weight, or changing
your lifestyles to become healthier? Who initiates this talk/what is the
response?
300
Interview One.
For the first question, if you had to think about some of the places you lived in
the past five to ten years, which ones come to mind as places that make you feel
good or healthy, either mentally, physically or emotionally?
Here. (laughs)
Here? Really?
Yeah.
So if you think about the other places you have lived over this time, and I guess
for you that was raising your children…
Yep.
Where… was there anywhere that made you feel particularly fantastic or
healthy or good?
Here and in Maryborough, in Clayton Street, where we used to live. The routine was
really good.
OK, in what ways?
Oh, the kids were better controlled, and I had ‘em doin’ better.
Was there anything about the actual place that was good, there at Clayton
Street?
Yeah, it was right in town, whenever we tried to get into town we were right there,
just a walk.
So it was really central?
Yeah.
Anything else good about it?
Yeah. Close to the schools, close to the parks, and big back yards.
301
And you mentioned here as being good?
Yeah well this is much better, cause we’ve got more to do here. Like for the children,
‘n it’s not so stressful on me and James (laughs).
So in what ways?
Well I took ‘em to the park, and High Five was on, and I take ‘em to that, and the
shops are closer here, really closer here, and we don’t got to worry about walking,
just got to jump across the paddock (laughs). Yes, the kids are more settled here, in
Brisbane (pauses). They can go to libraries n that here and a park just up the road.
What other things do they do, have they been to GOMA or anything like that?
To the art galleries or anything like that?
Yeah, we’ve took ‘em to the museum.
Oh great. Cool.
And um…
And so you were talking about your stress levels…it makes is easier for you
how?
We’ll if they’re bored, we just take ‘em, take ‘em out, instead of stuck here at home,
and that stops me from being a bit stressed. And that’s even better.
And do you feel that you are being more active?
Yeah, more so here. Cause in Maryborough we weren’t that active. No, we were
always stuck at home cause it was too far to go… but here is not too far, see we just
take ‘em to South Bank… run around Southbank all day, it’s good there.
That’s terrific.
We ended up just finding out the new water fountain bit? That was brilliant. Really
good.
And in the summer too, I guess?
Well them lot (points outside to her four children) are going out in the winter time
302
too! (laughs).
So, on the other hand, have there been places that made you feel less good, or
not so great? And why? What was it about the place that made you go ‘Don’t
feel so great here?’
That was probably Ipswich. When we used to live there, cause we couldn’t take the
kids anywhere cause of the needle use everywhere.
Needles?
Yeah, yeah, couldn’t take ‘em to the park cause there was needles everywhere, and
that was the stress bit for me.
So, too dangerous?
Yeah, yeah.
So what about the feel of the place?
Yeah, not so good.
So if you think about KGUV and where you live now, in this unit, how would
you describe it and how does the place make you feel?
I feel good actually. This is the best place we’ve ever had really. The other places
we’ve had like bit of a dump, you know?
When you say this place, do you mean the unit you are living in?
Yeah! Well the whole place, the whole little village kind of thing, it’s great for all of
us, actually.
If you had to describe the place to someone how would you do that?
It’s beautiful (laughs) It is. It’s lovely. Nice and peaceful.
OK. How does it make you feel about yourself and your family?
It makes us feel really good. It makes us feel poshy for once, you know?
It makes you feel poshy?
303
Cause we’ve had dumps all the time, and we haven’t been in anything like this
before.
And does this reflect on you?
It does, it does. You feel down, you feel like you’re nothing, but now here we feel
like we’re something, you know, cause we’re in something nice. It makes us feel
good.
What are the bits that are doing that for you? Is it the way the unit is designed?
Is it what’s in the Village, who’s in the Village?
I think it’s the way that they’ve got it all set up, so I can set it all up into a nice little
home. The kids can go out and we’re not worried about ‘em, in the last places we had
to go out check what they’re doing every five seconds, cause there are too many bad
people around. Well, over in West End, before we come here, we used to see people
trying to shoot up in the main street, and here you’re not really worrying about it,
cause you are not really seeing anything like that. Me and the girls walked into the
toilet and seen someone in the toilets shooting up, and that really shocked me cause I
didn’t think I was going to see something like that, and I ended up seein’ it.
And this place?
No. no. And it’s nice and clean here. It’s just got a clean feel. It’s not like over there
where the streets are dirty.
And that affects how you feel about yourself?
Yeah, yeah.
And does it affect what you feel like doing during the day?
Yeah well it perks you up a bit, you don’t feel like laying around doing nothing.
Ok, now this question is going back in time. When you were growing up, how
important was a healthy lifestyle in the family you grew up in? Were your
parents or carers encouraging you to be fit and healthy or was it not really
talked about that much.
Not really talked about. We used to bring ourselves up. My mother was a real, you
know. She wasn’t a very nice person. We brung ourselves up and looked out for each
304
other.
So you had a lot of other things to worry about, besides health?
Yeah, well my mum used to get flogged up somethin’ fierce, so.
Can you tell me what you mean by that?
She used to get, what’s it called? Like, domestic violence.
Oh, your mum was beaten up? By your dad?
Yeah, by my stepfathers. Not my real father, cause I didn’t know who my real father
was until I was 18. I’ve never met my father.
So you grew up in quite a violent situation?
Yeah I left when I was thirteen. Me and James’s been together since I was about
thirteen. James is the one that’s brought me up
So he’s been your mentor
Yeah yeah
So in this quite violent beginning, how do you think it affected you in later life…
your goals or what you wanted out of life?
Yeah it sort of did, cause I ended up having children really young, so I was fifteen
when I had Christian and that ended up stopping a lot of things. I used to be a
champion athlete when I was at school… but that ended up stopping it, cause I ended
up falling pregnant. I was a runner.
So where did you live, when you were 13 but still at school and being a runner?
I lived with James. They let me run for a couple more months, but then I ended up
getting bigger and they said it would be too stressful
In year 9?
Yeah, going into Year 10. I ended up getting out of school in year 10. Halfway
through it. I did a lot of things, I did childcare and hairdressing…
305
So you trained in various areas?
Yeah yeah
Then you had your other three babies?
Yeah we just done it by ourselves. My mum was a bit there to help me a little bit, she
used to teach mea little bit what I didn’t know, but I told her back off, if I need help
I’ll ask for it, you know?
So in this that you’re telling me the thing that has stood out as being obviously
about physical activity, is that you were this athlete.. do you think it will
influence how you encourage your children? Will you want them to be athletic,
or will you want to go back to it one day yourself?
I have thought of doing it again. Once the kids are older n that. And I can see my kids
doin’ it… I can see they’re pretty fast at the moment (laughs). I keep them trying to
do something, like Christian is a real little gymnast, he can do the splits and
everything.
Does he go to training?
Nah, nah. Up in Maryborough he went to the Police Youth Club. And he used to go
there and meet other kids and do gym. And through school n that. Athletics at school.
With anything they do I make sure they push it along, it doesn’t matter what it is,
they have to see it through. Even if they’re colouring in or something, you don’t just
leave it and do something else, they gotta finish something what they’re doing. Or I
make sure they go to the parks, and that they are doing something properly.
OK, and what do you think about physical activity? Is it important, and if you
think it’s important, what do you think the benefits are?
You feel nice and relaxed and you’re not so grumpy. You feel good. Well. You’re
healthier with your weight. Cause James has weight trouble there, and we try to push
as much exercise as we can. And the kids, if we go and do lots of exercise, the kids
sleep really well. We take them swimming all day, and then when we come home
they’re not, they just want to sit down and watch TV, not running a muck. And that is
what we need for ours because they are so full on (laughs).
306
Fair enough. Thanks. Now, in your every day life, how much would you say you
think about doing things that make you healthier?
Sometimes we don’t think healthy, but sometimes we do. We always make sure there
is something healthy for them to eat. And during the day I make sure the children
don’t eat heaps of junk food.
So if you are thinking healthy, in terms of food, what kinds of foods do you
think need to be put in it, for you to consider it healthy?
A lot of fruit and veggies is the main thing. Cause Shakira won’t eat meat, so we
make sure she has fruit and things like that, but the other two will eat anything, so we
make sure there isn’t junk food around, cause if they see it they will want it.
What about other things? Do you worry about alcohol or smoking?
Well I don’t drink. I have never drunk alcohol, I can’t stand the stuff.
Is there a reason for that?
I just don’t like it, I cant stand it. Hubby will, once in a blue moon, but he will ask
me first (laughs). We smoke, but not a lot.
Do you worry about that in terms of your health?
We should worry about it heaps. We’ve tried to quit heaps. I can’t take the patches,
they make me sick. I can’t take codeine either. The ambulance won’t get here quick
enough. I gotta watch out what medication I take, and sometimes I just have to ride it
out, cause most medicines have codeine in them. It’s really hard when I am sick.
OK. If you had no barriers or constraints to the amount of exercise you were
able to do… any kind, any place, any equipment, what are the sorts of things
you would be interested in doing? This is a wish list.
I do exercise all the time. If I’m not runnin’ I’m walkin’. Swimming would be great.
Just to have the time to relax and swim, cause you don’t get that with the kids, you’re
always worried about them. When I take them I never get any time for myself to be
in there, just gotta be running around making sure they’re alright. You don’t get time
to have a relaxing swim.
307
So, going back to here, to The Village, if you could say ‘oh I would really love if
they put in this’ – what would that be?
A gym.
Yeah?
Yeah, cause James would too and so would Christian. Something outdoors would be
good too. Something to do, more to do in the park.
I think they are putting in a gym and a pool.
Oh they are, are they?
Yeah
Well something else to do in the park during the day would be good too.
What else would you and the family be interested in doing?
Well Christian wants to do Karate. Martial Arts. Cause I was a brown belt in Karate.
And Christian wants to do this, but I think they need to get self-control first, before
they try and do that kind of thing. They cant just do it when they want.
But if they set up something like that here locally would that be good?
Yeah karate, or gym would be good. Yeah and not too far away.
OK, I have another question, what types of images or people come to mind when
you think about physical activity or exercise? And do you see yourself as being
really fit and active?
Yeah well we’re really not a fit type like other people you see running and that
(laughs). We’re not really like that at the moment (laughs again).
So what do you think about those people and those activities?
We would like to make them be in our life a little bit more, its just really hard to get
to them kind of places to do that sort of stuff.
So what are the main barriers?
Transport. And money can be the biggest problem too, sometimes.
308
OK when you see pictures of people doing healthy things, say in an ad, eating
fruit or jogging or something like that, do you relate to that? Do you see yourself
being a bit like that?
Not at all, not at all. Um we wish we were like that. Like a bit healthier and that
sometimes. Sometimes we are, but sometimes we get a bit lazy and don’t want to do
any exercise, but then the next day we will be running around non-stop.
What makes it vary, do you think? What is it about the days that make you stay
in – is it about feeling, money, or…
Money, it’s about the money. When we’ve got it we will get out a bit more, and when
we haven’t got it we will just sit around and we wont do big things, unless we find
out it’s free. When we have money we might travel somewhere – if it is far away we
can travel to do something.
If someone was trying to get a message out to people to do more physical
activity, or lead a healthier lifestyle, what kinds of things would they have to say
to convince you to make these changes? Scare tactics, or images of people who
are fit and healthy… Is any of this convincing?
Yeah some of it. Usually the smoking ads sometimes. And the way they’ve stopped
smoking in the park has really pulled us up. And mostly the cancer, the one that says
it causes cancer, cause James has got cancer, it makes me sit down and think well
should I stop, you know?
So did he go for tests?
Yeah he has to go for an operation to see what it is – it’s bowel.
So what about health pamphlets, say in the doctors’ surgery – do you read
those?
Sometimes. Getting five minutes to sit still and read something like that is pretty
rare.
What about seeing images of people doing exercise or ads to tell you to be active
309
or get your children to get fit?
Yeah that does sometimes, with the kids a lot more, if they tell us to do more for the
children then we usually push it to go and do activities with them. Better get up and
do it, you know?
What kinds of things would need to change in your world or in your life to allow
you to do the amount of physical activity that would improve your health, make
you feel fit and healthy and feeling fantastic? What would need to happen or
change?
Like something for the kids, more for the kids to do, instead of just a park and them
playing on the slippery slide and they get bored just swinging on swings. We try to
take balls usually, but still they need something that is going to be fun. And
somewhere where I can take them to do something where I can sit down and relax.
Yeah and the money situation, the transport to get them to these places.
310
INTERVIEW TWO
If you think about the places that you have lived in the past five or ten years, or
in your life, what places come to mind as places that made you feel good or
healthy or positive?
The Gap.
The Gap? And why?
Surroundings? It’s ten minutes from the city, but it’s the whole rain forest feel. All
the bush and the trees. And no-one bothers you out there.
Oh, OK?
Yeah, you know what I mean? From my past it’s a bit of an upheaval in my past, but
out there you feel safe and secure and yeah no one bothers you and you can change
your lifestyle.
So how would you describe your lifestyle out there at the Gap?
Good, yeah, there were horses out the back. This is a bit different, living here, but it’s
turning out alright.
Yeah alright, because I am going to ask you about here in a minute, but you said
the Gap is somewhere that made you feel good, what about the places that made
you feel less good, and why was that?
Nowhere is really less good, it’s just lifestyle wise, the people you associate with.
The city, you know, is closer for them. I suppose…it was a pretty bad lifestyle I used
to live, so the elements of those people follow with that, like in Spring Hill or the
Valley and that. It has in way, but it hasn’t rotated back to that. My lifestyle has
changed heaps, but those people and those elements still live around you, you know
what I mean?
But the Gap made you feel?
As soon as you say The Gap, they go nah I’m not going out there it’s too far. And it’s
311
like, OK then, that’s good.
These are the people that you didn’t want to associate with.
Yeah. And all the bushland is all there. And it’s just yeah good.
So it removed you from a lifestyle you weren’t happy with?
Yep.
So this place now. KGUV, how would you describe it, how does it make you feel?
This place, we’ve had a few hiccups along the way, we’ve had a man come in and it’s
the wrong house… with a gun. So that’s why we’ve got the dog here. But um,
someone came in with a gun, and they came into the wrong place, so…it was a bit
full on. It’s a bit like the Bronx here at the moment.
Is it?
Yeah. We’ve had someone get burnt by hot water by her boyfriend, and the police
rock up here like every day. I think it’s calming down a bit now, but it’s become like
pretty full on, like that all comes with the people who are being moved here as well,
like yeah, we’re all from the same lifestyle but some of us have changed and some of
us are still there. So its difficult in that way, where they have tried to put all lower
class people in one building, where some people have moved on and some people
haven’t.
How does it affect the people who have moved on?
It’s been quite difficult. I’m not coping at the moment.
OK?
Not because of things that I’ve done, but things that have been brought to me
because of moving here, I’m just not coping. A lot of elements are being opened up,
like I think it’s picking up a bit now, so it’s my mind set I have to change now, and
get back into that positive, ‘it’s gunna be good’….
So what about in relation to the Village itself, and what’s there, is it a good
312
place? Despite the troubles here, say?
Well, the children are going to move to Kelvin Grove State School, so it’s gunna be
good. (child interrupts, and mum lights cigarette). You’re moving next term mate,
I’m sorry (to child). Child says – but I like my Chinese lessons at the Gap. The
mother says: I’ll get you private ones.
So she’s at the Gap?
Yeah she’s in Grade Four, and it’s the perfect school out there but it’s just too
difficult to get her there. We’re doing quite well and getting her there in the mornings
lately.
So your partner’s here as well?
No, he’s my ex as of yesterday, and he’s in jail.
And are these all your children?
No the boy’s not mine, only the girl is mine. But the three boys were living with us
when we moved here, and we needed somewhere cause we were living in hotels.
Hotels?
Yeah, they’re expensive.
OK, now we are gong back in time to when you were growing up.
[Interruption here where her daughter tells her that foster parents have arrived
for one of the other girls living there, and the interviewee says ‘that’s fine I
wanted her to move anyway’. This situation wasn’t explored further or clarified,
and the couple left with the young girl]
Sorry – when you were growing up, how important was a healthy lifestyle in the
family that you came from? Or the household that you grew up in? Did your
parents encourage you to be fit and healthy, or was it not talked about much?
It was only my mum for most of it and she was a workaholic. She’s an accountant
now, and she was an acupuncturist, but she always worked.
313
And how did that affect you?
Well nothing seems to have changed so far. I cooked for mum, I did all the cooking.
[NOTE: There is a gap in the interview here where the interview failed to record in a
way that was audible for transcription]
If you could get involved now with any kind of physical activity, with everything
you needed to do it, what kinds of things would you be interested in doing?
The aerobics is a big one for me. I used to go at um, trying to remember what it’s
called now, we used to go twice a day, I mean after work and before I dropped my
daughter at school I would go again. And it’s the one just at Chermside at the back,
you know in the back streets of Rodie Rode there. Used to be Tai Bo and High
Impact and that, so…
And for your kids, your daughter, if you could get her involved in any kind of
sport or activity, what do you think she would like?
She loves Ju Jitsu. She did that at the um, YMCA. Oh no, PCYC sorry. There at
Arana Hills, they had a really good. She’s not doing activities at the moment. She
was doing Street Funk at Madhouse of Dance. [daughter interrupts ‘why don’t I go
there anymore’ and the mother responds ‘you have to turn up to classes for me to pay
for that’]
On the topic of physical activity, what kinds of images or people come to mind
when you think of physical activity or exercise? Your idea of physical activity
Healthy people (laughs).
And how far away do you see yourself as being from these images or these types
of people now?
No. A couple of years or twelve months working on it, then yeah. I need to eat
regular meals, and getting the motivation to get those endorphins working where you
actually go ‘ok this is what I want to do this morning’
[Daughter interrupts – ‘we need a work list’ and mother replies ‘well go on then, you
start it, go on, write it up’ – they both laugh]
314
When see images of people doing healthy things like eating fruit or playing
sport, do you see yourself as being like that, or is that another world, or is that
your world in 12 months time?
Probably another world at the moment. But just a good week of starting at it, and it
would just become habit.
And is this a good place to allow you to do that, where you’re living now?
Yeah I think so, now that it’s being fixed a bit. But with those elements that got
moved in here it’s hard to change your mindset into ‘oh it’s positive’.
When you say it affects your mindset, what do you mean about that being
affected?
It just lapses you back, you know, and I get stressed and my health has gone down
hill something severe, so yep, it really, it’s ten years of my life being thrown back in
my face in one, you know what I mean? Um it sort of brought my mindset back to I
haven’t advanced as much as what I thought I had? But even though it wasn’t me
slipping, it still sort of just delusionalised me, well maybe I am still at that stage.
Does that make sense?
Yeah, so the associations here made you feel like you were still a part of
something that you wanted to feel you had moved on from?
Yeah it’s funny, I’m a big addiction person, and um its even like associating in the
same complex as those people then it goes OK, it’s really nice and everything, but
you haven’t moved on, it’s still housing commission. Yeah…
Ah, OK. And what about being in the Village, with it being all different people,
like some being housing commission, some people have bought units, you’ve got
all these different groups, does that affect how you think about things?
Yeah – even just being at the front of the complex instead of the back has made a
huge difference, because it was mainly the back that had different elements and you
know, at the front people seem more like they are going places, you know, here. It
seems to make a difference in this place, well to me anyway, if you’re at the front or
the back… I think I would have gone more back if I had been back there… you
315
know?
Yeah I guess I can kind of understand that. So anyway, if someone was trying to
get a message out to people to change their lifestyles to be healthier, what kinds
of things would they need to say to convince you of that, or what would they
need to show you, like the scare tactics in the smoking ads?
See those smoking ads, they just make me go, ‘oh I haven’t had a cigarette in a
while’…silly things like that, like as a scare tactic… yeah and um with those ads
they don’t seem to… like that drink driving ad with the baby crying that’s amazing.
But does it affect you and make you feel that you would never drink drive?
No because I would never drink and drive, but with an ad like that, that has a
powerful message, it doesn’t matter who I’m speaking to, they all get affected by that
ad.
OK, so that’s a good one. What about when you are say at a doctors’ surgery or
community center and you see health pamphlets? Do you ever use anything like
that to find out about health?
Sometimes, but I have never found anything more effective than that one particular
baby ad for drink driving, it’s the most powerful thing. I’ve been watching that
smoking ad where he says he feels like he’s been hit by a truck? You seen that one?
It’s the new one out, where they have someone who is like me, who says once I’ve
been hit by a truck then I will give up smoking, and the person who is actually dying
of smoking, or like, cancer, they say they feel like they have been hit by a truck, and
they are the exact same age sort of thing, but he’s sick and the other one’s not?
And how does that make you feel?
Yeah it’s starting to get a bit more real. I’m trying to give up now.
So what kinds of things would you need to have now do you think, to help you to
lead a really active, say to get that aerobics going again, what kinds of things to
get that off the ground? Is it an inside thing or an outside thing?
It’s a bit of both. Cause you have to be in that sort of mindset to do it, for one. And I
316
suppose if you see a lot of people doing it, and it’s not a hassle to get to, then it’s like
OK, and usually it’s financial. The gym is expensive and things like that. Money
would make a difference with a lot of things, but then I have just gone through 10
000 dollars in three months and it hasn’t made me happy, it doesn’t make you happy,
it makes you more depressed because more people rob you.
So you’re saying you’ve been through a lot of money in a short amount of time
and it hasn’t made you happy?
No it hasn’t. And that is why I am not coping at the moment, because people make
out to be your friends and they’re not. Yeah, people just being surreal to you. The
money comes through proceeds, and we needed to use it because of low income, you
know, and his friends, who basically aren’t his friends all took tabs at the money. And
it doesn’t make you happy. It makes you less stressed in that you can go ‘well we’ve
got money there and we don’t have to worry about how are we gunna pay for that’
we just pay it. So $5000 has been stolen from me. I feel totally ripped off.
Are these people from your past, or from around here?
Pretty much both, yeah.
317
INTERVIEW THREE
So we’ll start with questions about place, and places you’ve lived in, if you had
to think about places you’d lived in the past 5 to 10 years or even before, which
ones come to mind as places that made you feel good or healthy or happy and
what was it about those places that did that?
No idea really. No they’ve all been pretty much the same. It’s a roof over your head
and you keep to yourself. I don’t really make use of parks, although this one is so
close I really should make use of it but I haven’t bothered. Most of the time I haven’t
had to have public transport close by sometimes I have needed that.
What about relationships with neighbours? Has there been a place where the
community felt good?
Well I’ve always been someone who tried to keep to myself, cause once you get
involved, the neighbours know your business, and then fights break out, so I try to
steer away from that.
Is there a place you can remember that you felt particularly bad about?
Just mainly the neighbours, it would have been the neighbours. Lived in Sydney,
there was a place in the South West called Airds?? And it was near townhouses and I
hated that place. I hated going out after dark ‘cause it was pretty scary, with a high
unemployment level. Just um walking down the road, they knew you would have a
few dollars on ya, so they’d roll ya for the money for grog or smokes.
So if you think then about KGUV and where you live now, how would you
describe it and how does it make you feel?
Because it has a lot of people living in the same spot it reminds me of that, so after
dark you don’t go out by yourself.
So similar issues?
Yeah and a lot of these people don’t work here either. Like you’re meant to live in
peace and harmony, but as far as that goes it went out the window pretty much
318
straight away. Like living right next to each other, and any amount of noise you make
that person next to you will straight away snap you up for making too much noise…
I notice sitting here how close you are to your neighbours here, just sitting here I
can see straight into their units and their verandahs
That’s right. And with the lights on I always feel ‘oh god I hope no-ones looking in’
and it’s just a feeling I get that I’m not comfortable with, probably cause I have lived
in houses for ten, fifteen years, individual houses, you know… you can hear
footsteps and you think ‘god I hope that roofs solid’ (laughs). The only conversations
we hear are on the balconies, unless they’re screaming and fighting, but on the
balconies you can hear, so I’m not out here much. I very rarely venture out onto the
balcony. Brooke will come out here for fresh air to have her cigarettes. When you’re
out here, who knows who’s watching you and from where. It’s all open. The front
has a better design with their brickwork with the little holes in them and they have
some privacy.
Can you think of any specific examples that have made you feel that this is a bit
intense, living here?
Everything. Like the police have been here, like, in the first week we were living
here, like a half a dozen times. Yeah just through people fighting and bitching and
things. And other domestic violence incidents’s like 6 o clock in the morning there
were people having domestics downstairs…
Which you can hear?
Yeah, and most of the people living in here do have children, so when they want to
have their rowdiness they’ve gotta, they haven’t stopped to think about the families
living in here. Which is nearly everyone.
OK, now this question is going back in time and talking about lifestyle and
health, really, and back when you were growing up, as a kid, how important was
a healthy lifestyle in the family you came from and grew up? Did your parents
and carers encourage you stay fit and healthy, or was that not really talked
about?
It was important because there was no, uh, it was expensive when you went to the Dr
319
or pharmacy, so um, so it’s better to health. And I was fairly sickly, and fairly sick
when I had flu’s and things and had to have two weeks off school. Um, I tried to stay
as healthy as possible. Always had veggies every night, you know. Pretty much a
health diet.
OK.
But I was pretty much an only child until I was fourteen.
Oh, OK?
Um, yeah. Didn’t like to go the doctor’s too often, but when you had to, you had to.
Did you play sport ever, or…?
Yeah there were always some sports I would have a go at, but some I was no good at,
so I would stay clear (laughs). Generally we attended the sports carnivals.
Did you have any of your own particular interests or hobbies?
What, sports?
Yeah well, any kind really…
Sewing, all sorts of stuff like that.
What kinds of things were important as goals in the family? What kinds of
advice did your parents give? Did they tell you to stay fit and healthy?
All of the above. Good money values were taught strongly. Budgeting, saving, things
like that.
So what is your opinion now about physical activity, do you think it’s important,
and if you do, what kinds of benefits do you think you get from it?
Yeah well being active as in I prefer to walk than drive any day. You don’t even
realize that you’re exercising when you just walk to the shop. If you exercise then
you don’t feel so headachy and lethargic. So just general exercise, you don’t need to
go to aerobics every day.
And do you see yourself as being active like this?
320
I feel I am active, but I don’t get out and about a lot. I am more active in terms of
housework and cleaning up messes, all every day errands. I haven’t lied down in the
lounge room all day now for many years now (laughs). You don’t much rest anyway,
someone always has to do the dinner or the washing, or whatever. I see students
running up those stairs, there are two women who run up and down those stairs every
morning… I haven’t used that park yet. I don’t know why, really, but when I am
sitting on my veranda I see those people doing exercise.
[Dughter interrupts: Hey I help out a lot and mum replies ‘shoosh you get your turn
in minute]
In your every day life, how often would you say you think about doing things
that are healthy, say when you make a meal?
I try to have all me veggies, potatoe, punkin, and your mixed veggies, greens and
peas and all that, I try to.
What about smoking or anything else… do you worry about those sorts of
things?
I’ve quit smoking now for ten years. Not only that it doesn’t make you feel very
well, and your mouth feels like an ashtray, and the expense of it, but I just stopped.
But I still sit and see everyone else smoking and think I may as well smoke too. I
have to tell people that I’m not a boring person, cause everyone thinks I’m boring,
like a goody-goody two shoes, and I would have fun, it’s all you lot (points to
daughter) that makes me not have fun.
What about alchohol?
I’ve just given up alcohol recently because um, I just don’t drink at the moment. Just
a few issues that I felt, I gave up with someone else.
Do you go to get support for that?
No, not at this stage, it’s only been a week (laughs). But I’m not a heavy drinker, if
nobody else is drinking then I wont have a drink, it’s more a social thing, so if that
person won’t drink, I wont even think about it, I can do without it.
321
What sort of issues was it raising for you? Was it monetary, emotional?
Everythink. Alcohol raises a lot of stuff, and you name it, it was coming up. I was
watching on the local news last night at the local pub, the Normanby there was a bit
of drama there. I guy was pinned down and they smashed a bottle in his face and cut
his eyelid. It always involves alcohol.
If there were no barriers or constraints in terms of to the amount of exercise you
could do… any time, any place, any equipment what kinds of things would you
be interested in doing?
Oh probably just about everything. I haven’t had a massage in ages! That’s just
indulgences, but I am interesting in everything.
So you would like to be able to spend more time relaxing or more time on
yourself?
Yeah but that’s not exercising
No that doesn’t matter, I am also interested in other lifestyle activities.
I have joined a gym a couple of times over my lifetime, but I just couldn’t be
bothered. Nah. I joined with a group of people. I always join cause they are doing
specials and someone gets me to join to get them something.
Is there a kind of gym that would appeal to you?
Nah. I really used to like bike riding when I was younger. I haven’t had the time or
opportunity… we used to have a bike lying around, but no-one wanted to ride it.
Mainly cause it had a flat tyre (laughs). Also time is a big issue, we drive the car
because we have to get to places and rush around.
What kinds of images or ideas come to mind when you see people doing physical
activity? Do you associate yourself with those sorts of images?
I am pretty fit and healthy too, however, it wouldn’t hurt me to do something else. I
used to watch Aus Aerobics on TV and think I am not like them…
Oh yes, I remember them, they used to be up at the crack of dawn in white
322
leotards! (laughs)
Yeah men mainly perve on them and we don’t do that, we can’t do what they are
doing. I think it was male oriented. But you can get exercise videos.
OK, so if someone was trying to get a message out to people about health, as I
am sure you have seen them do, to tell them to lead a healthier lifestyle, what
kinds of things, like when you think of the smoking ads and the pictures…
It probably works for me. Probably the baby one. The premature baby on life
support. It says like smoking can harm your unborn baby, and the baby is like skinny,
small.
What about things like health pamphlets in doctors rooms or information about
health.
Most of the time, I get interested in a pamphlet and the minute I’ve left the doctor’s
surgery I’ve forgotten about it. I go, I really must remember to look into that and then
something else, and it’s gone, and the next time you see it, you go, oh yeah I was
meant to look into that..
What about TV ads telling you do more exercise?
I don’t know, you can get that just walking down the street. I can do it walking up
and down the stairs, and if we are emptying the car, that can be up and down three
times, once for missy, then if there’s something else to carry, lots of carrying we do
between the two of us (Referring to herself and eldest daughter). Like, when first
moved in we couldn’t do the full set of stairs, we had to stop half way for a break.
OK, getting back to the place here, has this changed your lifestyle, or your..?
Everything, yeah everything. Cause I come from houses, and that was private rental,
and very expensive that was, I mean this is meant to be affordable renting, but it’s
not? Like that other woman over there, she was asking me, cause I was downstairs
cause any noise and I’m like ‘huh!’ and I sleep with one eye open. Just a few
experiences I have had since moving in, like I thought I was moving in to a normal
place, although these days what is normal (laughs). But we were here and people
were yelling out any time, doesn’t matter if its midnight, three o clock on the
323
morning, or whatever, and screaming, barnying, over whatever…
How does it affect you?
Sighs. Pause. Well I don’t want to stay here much longer, I am going in my head ‘it’s
only temporary, it’s only temporary’. So yeah it’s, she was out there just hanging her
washing out and I was out there on the little steps and I am thinking ‘Shit, what is
with all these people that live here?’ And she goes ‘Hi’ and so I go ‘Hi’ cause I had
spoken to her in the stairwell one of the nights the police were here and we weren’t
allowed to like go anywhere sort of thing, like a lock in, and we had a big chat about
it all. It was an age group thing, she also has older children and she was saying ‘God
how much are you paying here?’ And I said a lot, and we talked about the cost and
then we all agreed that we paid the same amount.
So you’ve been a bit shocked and disappointed?
Yes.
And so maybe there are people in the buildings that could relate to each other,
it’s just that some others are making it problematic?
But I am still not into the socializing thing, in the units. As the years have gone by I
have just learnt to keep to myself. It’s nothing personal, as soon as you socialize, you
accidentally say too much sometimes and then your problems are spilled all over the
block. I’m sure they have their own skeletons and that, that they’ve let out, but I
think it should be ‘hello, goodbye’ if you have to say that. Just not to, you know, get
involved. And the kids don’t like that about me, and I say well cause over there, a
couple of years ago, they go and spill everything and then a few weeks later that’s
not their best friend anymore and they have blabbed it all over to their other friends
and they are fighting about it, you know? It’s just (pauses) they will learn that
eventually.
324
INTERVIEW FOUR
What I am going to do, is start with a couple of questions about places where
you’ve lived in the past, and how those places have made you feel. So if you
think about the places you’ve lived in your life, which ones come to mind as
places that make you feel good, either mentally, physically or emotionally?
This is the very first place that has made me feel really good. Yes.
OK, tell me why.
Before I was living in Fortitude Valley, and it was very unsafe there. I could go to
places, but not at night time. As soon as it starts getting dark, it’s time to stay in.
OK, and what were the dangers?
People robbing you of money, and stalking you.
So the Fortitude Valley you felt was a dangerous place, so what about this place,
you said this place makes you feel really good, what is it about this place that
does that?
It makes me feel good, because I am like around a university, and the people round
here, I’ve sort of noticed, it’s sort of like a respectful place. And it makes me feel
younger (laughs). And even sometimes you know I would like to get to learn what I
could. Because I had a disability from my brain hemorrhage and I used to have to
learn to walk again, talk again. I had to relearn everything. I used to be computer
whiz, crossword whiz, everything, and I just can’t do it anymore.
And so you see the University as a place where…
Yeah I see the University as a start, although you get scared to start at my age.
It’s scary to start at any age (both laugh). And what else do you like about the
place?
It beautiful, it’s not unsafe, everybody’s friendly, even outside of the block, on the
university campus, in the village.
325
How do you think it affects your wellbeing?
Well it makes me feel younger and that makes me feel good.
I guess we talked about the Fortitude Valley as being a place that is not so good
in terms of how you felt, can you think of other places where you think ‘oh I
didn’t feel good there?’
In Woodridge. Same thing, people would be looking for money, you know like bums,
you turn your back and they’re gonna get you, if they see you walking along.
Kingston also no good.
All pretty much for the same reasons?
Yeah. All pretty much for the same reasons. Like mainly where the low income
earners are, like this is different cause it’s a mixture. Not all low income earners but
it’s a mixture of the good, the bad…
So it’s diverse and that it’s a good thing?
Yeah it’s a good thing. Since I’ve been here I have come across some really nice
people. Yeah because after my bad experiences I refuse to talk to anybody, but when
you come her it’s different.
You feel safer?
Yeah.
And would you say it affects how you feel about yourself?
Yes! Um, it makes me feel more positive about myself and gives me a lot more
confidence. Yeah.
And does this affect your lifestyle?
I found that I am more myself more young and doing a lot more things, and not be
hidden indoors like I was before.
So you can come out and be part of it all.
Yeah, I can. It’s not just one low income earners…
326
So what about the block of units? Here?
The block of units still needs a little bit more attention to it, but that is something we
will discuss in our meeting tomorrow. A community meeting. If we do have problems
they… we come out and settle it.
That’s good.
Yeah it’s good.
And what about the design of these units?
Yeah I am happy with the design, it’s very nice.
Alright, this is going back in time now. This is about health and lifestyle. When
you were growing up, how important was a healthy lifestyle in the family you
came from?
Um. No, no, I had a hard time with my parents because my parents were alcoholics.
Yeah and like my mother had children, and my father had children and they came
together and had us. And me and my brother always felt like we came last. Because
they paid more attention to them than they did us.
So it was a tough childhood?
Very tough.
And with the alcoholism, that obviously comes with a lot of problems.
A lot of problems. A very lot of problems. Cause with alcoholism, I got molested by
an uncle and I felt the best thing to do was to tell my mother? And I remember the
guy saying, you can tell you and she’s not going to believe you, and I told my mum
and she would not believe me and I was really just hurt in the heart. I ran away. That
was it, you know. She didn’t believe me. Although before she died, before she died
she knew that I was telling her the truth.
How old were you when this happened?
Eight years old.
327
Eight? And you ran away?
Eight. And I kept on running away and running away.
Where did you live?
Friends houses, wherever.
Did you get an education?
Til year nine. Only til year nine.
That’s still impressive, considering…
Yeah but I wish I went back to school
Yeah that’s a tough childhood. (Pause). And now obviously you have since met
your husband and had your own children…
Yeah it must be good cause I have been here for 25 years
You’ve been married 25 years?
Yes I have. My eldest son in 34. The others are 32, 29, 24, and 25 years old.
You have five children?
Yes.
And did you find you encouraged things in your children, or did things
differently, given the difficulties you faced in the past, did it make it hard for
you as a parent?
It didn’t make it hard, I always find, that the more parents work, that is where the
problems come from for the children and not enough time spent with them. So while
my daughters were growing up with us, I was very open and anything you could tell
me, anything, even if it was going to hurt me, I would rather know. I found a lot of
their friends had troubles and a lot of the reasons why were because the parents were
working.
What about health, now, in terms of your own children, do you emphasise
health as a goal?
328
Yes.
In what ways.
Exercising, even if it’s just walking, or swimming and going out and doing
something.
So just being active in life?
Yeah just in every day life.
In every day life, how often would you say you think about doing things that
make you healthier… do you think ‘oh I’ll walk to the shops’… or anything?
Yeah I think about a lot of vegetables, and I discourage donuts and things like that,
sweet things, even Coke, you know, I don’t like Coke. I put my teeth inside a cup and
show the kids, and say ‘You can, you can drink Coke, but this is what is going to
happen to your teeth’ (laughs).
And do you ever think about making changes to your lifestyle, do you think ‘I’m
sort of healthy, but I could be healthier?’
Yes. I would like to work with troubled teenagers. I still have that agoraphobia, and I
really don’t get out in the public, and because of my past experience and because of
what I have heard about so many people, so many children having those kinds of
experiences and not being able to go to their parents…
So you would like to look for more work…
Yeah to help children.
If you had no barriers or constraints to the amount of exercise or physical
activity you were able to do every day, if you could do any kind, any place, with
any equipment what kinds of things would you be interested in doing?
Exercising? Swimming. I love swimming (laughs).
You know they are building a pool here?
Yeah (laughs)
329
So you are going to use that?
Yeah. Swimming and meditating. I was interested in doing Tai Chi but I never got
around to it… a lot of things like that I would find simple, and soothing…
If they did or held activities like that in the Village, would you go?
Yeah, yeah.
OK, what type of images or people come to mind when you think about people
who exercise.
I don’t mean to be like that, but Asian. Asian people are more free to do the exercise
or the Tai Chi. I see them out doing their exercising.
That’s really interesting. Do you associate yourself with that, or can you imagine
yourself being a part of a lifestyle like that?
Yeah.
So you don’t see a big gap between your lifestyle now and people who are living
a fit and healthy lifestyle?
There’s probably people a lot more people are more fit than I am. I am getting there
though, cause I haven’t been out and about, but since I moved here I am going for
these walks four, five times a day.
So this place has affected the amount of walking you do?
Yeah, and before if I did, I could never walk alone…
So here you feel…
I feel really good because we have the park right up here, so I get up and take my
grandson right up here and sometimes I go up to New Farm. Now that’s a distance…
Yeah that’s far. But you walk all the time here?
Yeah
330
And this is good for physical activity?
Yeah, yeah and I’m not scared, seee that’s the main thing, I’m not scared when I am
walking around here, and it makes a big difference.
OK, so I am sure you have seen ads on TV and around the place encouraging
people to live a healthier lifestyle or do more physical activity…
Yeah
What kinds of approaches do you think work? If any? Or do you think
pamphlets and TV ads don’t do much?
Nup. I don’t think they.. pamphlets I don’t mind, pamphlets I don’t mind…
But what do they need to say for you to say ‘ah! I’m interested in that, or
interested in that lifestyle?’
The one that I see on the TV, if it’s meditating or Tai Chi, that’s the kind of thing
where you go ‘yeah I’d be interested in that’.
Ah OK, cool. And what about things like scare tactics where they say if you
drink too much or smoke too much, all these kinds of things, you know all the
scare tactics, do they work do you think?
It should work, I reckon it should and does work on children now because my sons
grew up and they hate cigarettes because you know mum did and dad did, so it does
make a difference. When we were growing up they didn’t tell you nothing.
So you smoke?
Yeah I do.
So what kinds of things do you think would need to change or be in place to
allow you to do more physical activity? Availability of it? Or other things.
Availability is important. If things are not around, then I feel bored and have nothing
to do, um the expense if it, if it costs too much, then no good.
So joining a gym, no good?
331
No, no. Joining a gym is alright, but it’s a lot of money too as well. If you could just
pay as you go then it might be OK?
Pay by class?
Yeah, yeah.
And what about distance? Is it important for it to be local.
Yes, it’s important for it to be local cause I don’t drive.
332
Interview Five
OK, firstly we’ll talk about place, think of some of the places you’ve lived in the
past five or ten years, or even further back, I don’t mind, which ones come to
mind as places that made you feel good or healthy, either mentally, physically or
emotionally?
Ah the closest I can see where I enjoyed it and where I wanted to go out was when
we were living in Harvey Bay
So what was good about Harvey Bay?
Everything was close. You had the beach a five, maybe six minute walk away, you
actually were happy to get up and walk out cause you knew at the end of the road the
kids were going to have fun, you were going to be able to sit and relax and don’t
worry about nothing. The weather was always beautiful… not like here where it’s
cold then hot.
So, nice even temperatures?
Yeah and they had like a really big park and stuff like that. Like nothing like what
you see here.
And that made your life easiers?
In Harvey Bay, they’ve got the Esplanade, which is just one really long road down
the beach which went forever, I think it was about 10 ks, and just the whole thing
was there was a place where you could get on push bikes and it looked like a car with
three in the back and two in the front, but everyone’s gotta cycle, and they can go up
and down the footpaths…
Wow.
And it was just like non-stop parks for the kids, and eight to ten BBQs and we
walked three steps and were right at the beach
333
And how did all this make you feel?
Energetic. Like, we used to walk from where we were right down to the big fishing
pier and that was 3ks exactly from where we were, we’d go there, we’d fish until 4, 5
o’clock at night and then walk home and we’d cook the fish. Never put on weight. As
soon I left, I started putting on weight.
You think that was to do with the place, like just not being able to…
Yeah cause there’s nothing to do, you don’t want to do anything. I mean the most
you’ve got here is the city, there’s no beaches, the parks aren’t fun enough to amuse
the kids for longer than five minutes, the BBQs are always ruined ‘cause non-one
wants to clean up after theirselves. And in Harvey Bay, people with pets constantly
cleaned up so you never had to worry about any pet mess anywhere. It was
constantly clean.
That sounds really really good. Was there anywhere that was really bad?
Yeah we come from Mt Druit (sp?) that’s down in New South Wales.
So that had some bad stuff?
Everythink. You can’t even walk out your backdoor…
For fear of?
For fear of the kids, they can’t ride their pushbikes ‘cause they will get bashed and
robbed for ‘em. If you’re out, after a certain time you will get rolled for shoes, your
money, your wallet, different things like that. It was just… a lot of the areas aren’t
safe no more. I mean, people used to say this area used to be like this 20 years ago,
and it’s nothing like it, and that’s when I say, if I could come back and live in any
time, it would be back when you could always leave your front door unlocked or
window open if it’s hot, whereas now you’ve got to lock up everythink and you don’t
know if you’re gunna wake up in the morning and your TVs still there…
Yeah I understand. So OK, that was a rotten place, Harvey Bay was good,
what’s here like?
Hectic.
334
Is it?
Yes
In what ways?
Instead of people if they don’t like each other not talking to each other, they are in
conflict.
You’re talking about here in the units?
Yes. So that’s why I keep to myself. The only time I go out is when I have to go out.
Like I said, the park’s no good here.
What about outside these units, cause you’ve got quite a mix in the population,
you’ve got the uni, people who have bought their own units, how do you feel
about the broader Village even if you don’t like School Street so much?
I think, down the shopping centre they could do with a few more things. I find that
the shopping centre is very dear.
The IGA too?
Yes, compared with Woolworths or something like that, yes it is. And its hard also
cause to get it home you have to get a taxi, and then what’s worse, if you live in these
units, if you’ve got a big shop you’ve got to leave half of it down, run up, to run back
up, to run down, and by the time you’ve done those stairs twice you’re absolutely
beat and that’s where you lose your energy, and you think I’ve done my exercise,
I’ve just walked up all that.
Fair enough. OK, question is going back in time now to when you were growing
up, how important was a healthy lifestyle in the family that you came from?
Well growing up, my uncle owned a farm so like we always had a healthy life. I was
in dancing from the age of four through til when I had the kids, and my brother well
he had horse-riding. It wasn’t until teenage years that the family started laying back
as the kids got older…
So do you think that had an effect on your health in terms of being less healthy
during teenage years?
335
Yeah well I moved out of home soon after my first son was born, and that was at 15,
so… In the last 12 months my father had a heart bypass, my mother is due to go in
and have one…
Was this due to their lifestyle?
In the last ten to fifteen years I would say yes.
What do you think contributed to that?
Smoking. And then they couldn’t be bothered… with us being older and their
grandchildren not nearby they don’t get out like they used to, not like when we were
younger and used to go camping and different things like that… no more.
And do you smoke?
Yes I do. I gave it up for eight weeks and then I went down to Sydney and with the
stress of dad being ill and mum going off her head twenty four seven I started
smoking again. I told my boys though that I am going to quit again cause for that
eight weeks that I did quit, I could walk. Walking around I didn’t get the chest pains
and I didn’t always get puffed out, like I could walk up a hill and I was alright. But
with smoking again, even just here at Kelvin Grove walking to the shops and back,
by the time I get back I am just so puffed my back hurts, and my legs start to
cramp…
Amazing what a difference it makes…
And I find that I get to sleep a lot easier when I am not smoking, whereas now I am
back to it being one, two o clock in the morning before I get back to sleep.
So your whole lifestyle is healthier when you’re not smoking?
Well I smoked from age fifteen right through, I gave up for both pregnancies and
started again, and when I gave up recently that was the first time I had quit without
being pregnant and oh, I could tell the difference. And the zits stopped too.
In your every day life, how often would you say you think about doing things
that make you healthier? Obviously you have mentioned the smoking but do
336
you think about it when you are making a meal or something like that?
Yes, but we have been talking as a family and we’re going to get a weights system
done and we’re all going to start eating healthier and we’ve already sat down and
talked about how with the kids lollies and chocolates and stuff will no longer be in
the cupboards. Because he’s twelve, he’s actually at an age where he wants to start
getting muscles…. So I said let’s do it. With me, going from a size eight to a size
fourteen to sixteen in less than twelve months is like, I cant handle it anymore. When
I go into the bathroom now I don’t even want to put makeup on because I just don’t
see the point.
So it’s really affected how you feel? And you feel that weight loss will…
Yeah, cause I’ve always been size eight except for in the pregnancies, and so for me
being five foot one and people say you’re only 70 kilos, but for me that’s big, I’m
used to being 49 to 50 kilos and I had an eight pound and nine pound baby…
And do you see that weight loss goal as being achievable?
Yes, because what I weigh now is what I was at nine months pregnant with him.
Yeah I can relate to that, my weight went up greatly after my third pregnancy…
Well I’ve put on weight once after the boys were born, but that was when I was on
the injections from falling pregnant, they’ve got injections that you get every three
months and I put on weight with the very first one, so I never went back. Well I put
on like 10 kilos, so when I stopped I went back to my normal size, and I’ve never
been a big girl.
So if you had no barriers to the kind of physical activity you were able to do,
any kind, any place, any equipment, what kinds of things would you pursue?
Oh God. (sighs). Yeah. Um, I’d like to, if I had the money to be able to afford to get
to a gym to get taught how to do anything properly. I don’t want to end up with big
arms and thin legs or anything – like toned and normal, like still look like a female,
and I don’t want to be one of these females that you see that look more muscly than
the men. I’d just like to be happy in myself. But even when I am small, I still have a
baby belly.
337
So a gym would be good?
Yeah. Swimming I’m no good at ‘cause I get asthma again. Me and swimming pools
don’t seem to get along (laughs).
So what kinds of images or people come to mind when you think of physical
activity?
As soon as I think of exercise, I think of models.
So for you it’s mainly about body image and appearance?
I think that that’s the time we live in now, the bigger you are, the more down you get
put. Everything is about image. Once upon a time it was about brains, or what you
could give to somebody, but now it’s about how you look first, and how you present
yourself first, before mind or what you can do comes into it. I mean I don’t
remember it being like that when I was a kid. But nothing everything, you can’t
watch TV without, even ads like for awareness of anything, they’ve got a nude
model.
So you feel it puts a lot of pressure on women…
Men too. And men too. Like if a man is not a certain structure, people don’t look at
them in the way they do if they look good. So it’s for both, it’s not all one sided. But
I believe that is the way the world is.
If someone was trying to get a message out there to do more physical activity or
lead a healthier lifestyle, what kind of things do you think they would need to
say to convince you, or are you not really affected by things like the media or
pamphlets?
The only message that I like looking at is The Biggest Loser. Like, when you see
them going from such a big person to such a small person, and even if they don’t
win, they can look at how much weight they have lost and go on and live their lives
afterwards and still stay thin.. and it just shows people, whereas you get ads like
338
Jenny Craig before and after shots and its like ‘nobody can lost that amount of
weight and look that good in six weeks’ .You don’t think?
No.
But the Biggest Loser is better?
Yeah you can watch them week by week go from being these big people to these
small people, whereas Jenny Craig, or the ads where they are selling all these gym
products ‘You can look like this, just 20 minutes three times a day’ and that is just
like ‘Yeah right!’
So does the Biggest Loser motivate you?
It motivates me to lose weight. That’s why.
Would you seek other support while you were trying to work through a weight-
loss program, like a counselor or a doctor?
Nah. I would like to seek somebody who would like give me, but see like that is the
only problem is that it’s too hard. If you don’t have the money to find somebody, like
in The Biggest Loser, where a doctor or someone will sit there and check and tell you
your body is this, and you are this age group, and if you eat these sorts of food..
Like more individual attention?
Yeah I don’t want them to sit there and tell me you need to eat this on this day, and
this on this day, but if they could just write down a list of what the most healthiest
foods are, I could make my own list. But you cant get that just anywhere. Like I’ve
been to the doctor wanting to know how come I have put on so much weight in such
a short time, and they are just like ‘you are fat, you just need to lose weight’.
And that’s not helpful. What about things like diet groups?
339
Yeah
I was really interested in that bit at the end where you said it would be good for
doctors to be able to help you out with your diet…
The thing that hit me the most in terms of my weight gain was when I went to the
shopping centre just a couple of weeks ago, and I was putting on makeup because I
was going for interviews for a job and I was with my girlfriend at the time and I said
to her ‘Quick!’ cause she loves to try on all the make-up all the time, and I said
‘Quick! I gotta go to the toilet!’ and a lady turns around and says ‘Well that’s what
happens when you are expecting!’ And I was like ‘I’m not pregnant.’ And it just hit
me like a ton of bricks, so I felt so horrible, so I went to the doctor and I said look
I’ve put on all this weight gain and my feet have swollen and all the rest of it, and I
said I want to know what I can do, what tests there is, and she just turned around to
me and said ‘Lay up on the bed’ and she grabbed my stomach and said ‘You’re just
fat, you need to lose some weight, can you do that?’ It shouldn’t be like that.
340
INTERVIEW SIX
If you had to think about the places you’ve lived, in the past five or ten year, or
even throughout your life, which places come to mind as places that made you
feel healthy or good or made you feel that you really loved the place, and why?
Probably Sydney. I dunno it was just, I dunno, I love it…fresh air. It wasn’t so
suburbia as a lot of places I’ve lived in…
OK?
It was more spread out, and people kept to themselves.
And that’s a good thing?
For me, yes. I personally feel that I don’t like to get too involved in other people’s
business.
What’s good about keeping to yourself, for you?
That’s just a personal thing for myself because I’ve been involved and been friends
with neighbours and it doesn’t turn out a good thing.
Oh, OK?
For myself, it always turns out it always seems to be a bad thing, and I dunno
whether it’s the people I meet or whether it’s just myself, who knows? (Laughs)
But this place was good?
I just loved it. It was pretty far to walk to places too, which I liked cause I’m really
bad at exercise, so if I have to walk to childcare and it takes me 40 minutes, well then
I’ll do it. Yeah that was the best place.
And how old were you then?
Um that was only this year.
Oh, OK, so you were there just before here?
341
Yeah and that was probably the best place.
Thanks, now, on the downside, what about places that you hated, or just
thought ‘oh yuck, get me out of here?’
Um, well, this probably one of them, Kelvin Grove.
I am going to ask you about Kelvin Grove in a minute, is there anywhere else in
the past that you have not liked living in?
Probably Chatsworth. it’s in New South Wales it was really country it was too far to
travel, you’d have to go by bus and um you’d just sort of, I just felt really isolated
there myself. There was no shopping centres, so you’d have to catch a bus to go into
town and not really many people around and you just felt like you were stuck in on
an island
So it was really isolated?
Yes.
So getting back to Kelvin Grove Urban Village, I have a lot of questions here,
and am wondering about how you would describe it, and how does it make you
feel, and how does it make you feel about yourself and your family?
Um. I don’t like it here. Um community housing is probably the biggest downfall. I
have never lived in community housing before and um, so, just the people, the kinds
of people that are your neighbours. I have made one really good friend, out of it all,
but apart from that, I have been assaulted twice since I have lived here already. That
was pretty scarey. I’m not into drugs whatsoever, wheras the majority of people who
move into these houses are.
And so how does this make you feel, being surrounded, and being in close
proximity to these people?
Can’t stand it. I just think it’s disgusting. I mean, fair enough everyone’s got their
own lifestyle but when you are living in a box and you’re in the middle of it, and you
don’t fit in with the people who live here. I feel like I’m an outsider, especially
because they leave lots of needles lying around near the bins, so I don’t want my kids
342
even going outside. And if they do, I have to make sure they always wear shoes.
So did you get housing before this? Did you go through private rental?
Oh yes, just real estates and yeah, when I came to Brisbane, I ended up being
homeless so I was in a hostel for two weeks, which I have never been.
You and the two boys?
Yes and that’s when my family support worker said ‘Well they’ve got units going at
Kelvin Grove and you can get in’ and I thought anythings better than there…
Of-course.
And at the time I thought this would be really good, at least I could settle down and
get a roof over my head and you know and things would work out. But now I am
actually thinking that I am rather have stayed at the hostel than live here.
Wow, that’s really bad. What about the broader Village? I understand what
you’re saying about Grey Gums, but what about the broader Village?
I think, personally I am finding they are doing a lot of Department of Housing
developments everywhere and um, I just feel that um, I dunno. Look, I just don’t
want to live in a Department of Housing area. When you say Urban Village to
people, they just think of it as Department of Housing.
Really?
Yeah. They think ‘Oh you live at that community housing place’.
And do you think it reflects on you?
Oh it does. Yeah. I think well they think I’m a drug addict just like everyone else is
around here. And I feel like ‘I’m not one of them!’ And I don’t want to be
categorized into that. Just because I needed help with housing, doesn’t mean I am
here for that same reason, like that I’m poor, well OK, I was a little bit poor, but not
like some of these people who have ruined their own names and they can’t get
anywhere else, so they come here. I feel that this should be an opportunity for people
who do do the right thing, and do need some help. I mean, the IGA’s wonderful.
That’s probably the bonus about living here, cause it’s just around the corner.
343
Yeah, sure.
Um, but to me it feels like its more of a student thing. More for the Uni. I think it’s
meant for the uni students and not really for the Department of Housing people like
us.
Mmmm. I’m very interested in that answer, I have noticed that other people in
the interviews are saying similar things, and it does sound frustrating.
Oh look, it is really frustrating. We ring the real estate up, and it’s a ‘police matter’.
You ring the police up and they come over so many times that it gets ridiculous. And
it gets to the point where you just ignore it.
What do you think would be a better set-up? I actually haven’t asked anyone
this question before, but you’ve given me these really cool answers, and I would
like to hear from you, what kinds of alternatives do you think would work
better?
[door knock, child wanting to visit, participant returned the child to her mother in
neighbouring unit]
For someone like you, who genuinely needed the housing, and this is the
government response, do you think it would be better to have individual living
arrangements so people aren’t all so close together?
I think individually would be so much better. Like having one house in a street, and
that one house is Department of Housing. Um and not put a whole bunch of people
in one block of units who all have so many problems. Um I reckon, because I looked
at Sydney and I watched a documentary on MacQuarie Fields…
Oh, OK?
And that was Department of Housing and to me that just says it all. They’re wasting
their time. I mean, these were brand new units and you could imagine the majority
of them will be wrecked by the time people leave, and they probably wont get their
rent money. I mean you can just imagine. And even now, everyone’s calling these the
Drug Units. And they say the Real Estate is running the Drug Unit.
344
That is really interesting. Thanks for those answers. Now, this question is going
back in time a little. When you were growing up, how important was it in the
family you came from, or the household you grew up in to be healthy? Did your
parents or carers emphasise this as a goal, or was it not so important?
Um, I as a, well, growing up in my household, well there were lots of problems we
faced on a daily basis.
What kinds of problems?
My stepfather abused us, um, my mum ended up staying with him for twelve years,
which we in the end, just you know, got to the point where we were sick of it, cause
we had enough. And my mum ended up carrying on a few of his traits, and me and
mum clashed a lot, so…
Right…
I did have a weight problem when I was young, but I did something about it, I went
and joined Jenny Craig and you know, and started losing weight, and you know, I
dealt with it myself, because my mum used to call me horrible names about being
overweight and that didn’t help me. But then I moved out of home at fourteen
anyway, so…
So where did you go?
I ended up going into a homeless shelter and ruining my life, and then I ended up in
rehab.
So you got into some drug use and then rehabilitated.
Yup and haven’t been near it since I was 16. Nearly 10 years.
And then your boys came after that?
Yeah I was nineteen by then.
Great, thanks for that. Great answers. So thinking about now, do you think
about doing things that make you healthier on an every day basis, in terms of
you and the boys?
Um. (long pause). At the moment I’ve been really lazy, because of my pregnancy,
345
and I just don’t want to move. I like eating healthy with the kids especially. We don’t
have lots of sugary stuff. If we do, it’s just occasional. I mean we have a few bickies,
but I try to give them the cream ones and not the chocolate ones.
Oh, OK
And yeah, they don’t eat a lot of sugar, otherwise they just run around crazy all day. I
try and … I think it starts with healthy eating and if you’re going to overload with
sugar, you’re not going to motivate yourself to want to go for a walk, cause after half
an hour of running around crazy you just wanna go (pretends to collapse) and go
sleep.
Anything else you worry about? In terms of diets?
No, they’re pretty good. Jacob’s really bad when it comes to eating vegetables. I
don’t pressure him, or push him otherwise it’s just a big argument. And he doesn’t
like mash potato, so I substitute that with wholemeal pasta. They like their,
personally I think it starts with waking up early in the morning. Um yeah, I wake up
early, they wake up early. We get up at six and have breakfast and then go and do
something, even if it’s just a walk to the IGA and back, at least it’s something that
gets us out of the house. We walk up to the bus-stop too. I use public transport a lot
and the bus-stop isn’t that far away, so that is good. You can go up that hill, if you
can call it a hill, but it certainly feels like one.
So do you go to bed early?
Yes I do. I like my sleep, so I am usually in bed about nine.
That sounds like a good routine. Cool.
Yeah.
Ok, um in terms of this health aspect, is health important to you as a goal?
Um, when I’m pregnant, I don’t really have any… I like to eat healthy, but I can sort
of let myself go a little bit, cause I am getting bigger so it’s OK to put on that extra
five kilos, but when I’m not pregnant I’m really full-on about my health. I do lots of
exercise and keep healthy and um I do smoke cigarettes, which is probably a
bummer.
346
Yeah, yeah…
I don’t smoke as… I’ve cut down a lot. I just try and… I’m not a like a going to the
gym twenty four hours a day seven days a week kind of person, but I don’t really feel
that you need to go to a gym to get exercise and all you have to do is walk around the
block. If you keep doing that every day, just at least to keep, then at least you are
doing something. I like swimming, the kids love swimming, so we do that.
There’s a pool going in there soon
Oh wow
Yeah there is just across the road from IGA, a pool and a gym. It is an
improvement, so it probably is going to get a little bit better…
Wow.
So, just say, if you had no barriers to the amount or type of exercise you were
able to do, that you could do any time, any place, with any equipment you
needed, what would you be interested in doing?
(Long pause) Do you mean like, what, exercise?
Yeah, or any kind of active recreation.
I like doing pilates. I dunno, I like tennis, I like basketball, all kinds of sports. I mean
my biggest concern about going up there and using the park there is that there’s
needles. I know it sounds terrible, but I worry to take the kids up there and go for a
run around with the ball just incase they stand on them.
Oh my goodness. Yeah, I got you. So safety is a big issue here?
Safety is really huge around here in that there’s not a lot of it. I don’t feel safe at
night when I go to bed here.
Oh, OK that’s pretty bad. So an important part of how active you are able to be
where you live is about safety?
Yep
347
Your neighbours?
Yep
These are all important things?
For myself they are pretty huge, it seems. I would like to live in a community where I
could be safe and my kids, feel comfortable and safe too. I would like to just be able
to go off and do the normal things other people are able to do in a normal
environment. To me the community here isn’t classed as normal.
(Both laugh).
So what kinds of images or pictures come to mind when you think about
physical activity or exercise.
Um
When you see image of people jogging or keeping fit, do you think ‘yeah that’s
pretty similar to me and my lifestyle, or something I would like to be, or that’s
another world?’
I think, I would love to go for a jog or a run, but I dunno. I just prefer walking. I like
to walk. I think when I look at them that they’ve probably had liposuction and they
probably never really run (laughs). I mean that’s probably just me being in denial
(laughs again). No, yeah, I would love to be fit. I walk past gyms and see people, and
it really makes me think of going in, joining up, and using it.
Ah yeah, really?
But as soon as I walk past it, I think it’s just a dream.
Now if someone was trying to get a message out to people to do more physical
activity or lead a healthier lifestyle, what kind of things would they have to offer
you, or say for you to be convinced of that?
Dunno, really. I think what they are doing now is a good job. Just with all the
advertising. I think it does work. I notice with the heart foundation and those kinds of
ads that, and with the Skip, Jump, Run ad? They’re good. They motivate me and the
kids. Cause they look at it, and they go, ‘we can go running or we can go skipping’
348
and I go, ‘yeah we could’ (laughs). I think I find it um, with health and physical
activity, there’s too much in the magazines that really make women go ‘oh my gosh,
I wish I looked like that, but then it becomes a depressive thing. They just go away
and eat more!’
So you think it’s an unhealthy idea we have about weight?
Yeah. It’s unhealthy. Especially when you are looking at pictures of women, and you
know they have the money, and they have the cash to go and get plastic surgery and
you know they are not going out and jogging, and even if they are, they aren’t eating
a balanced healthy diet, and you cant expect to look like that. They are all either
undereating and exercising at the same time and look like they’re dying, or then they
stop exercise and they just pile it all on again, so it’s all a big yo-yo diet. And I think
its how it happens to us. I look at them and think ‘oh well, they do it’. I would go ‘I
wanna lose weight, I wanna lose weight’, and end up starving myself to the point
where I was going two weeks down the track, ‘oh my god I am so hungry’
Of-course
I need to eat, so I would eat, then get angry with myself for eating and I think it
stems from the magazines. We look at them, and want to be like them, but we don’t
want to eat actually eat the healthy food and do the exercise to get like that, we think
there must be an easier way.
I guess that’s a pretty unhealthy relationship to have with food? Not just
thinking about it as something we need to live?
Basically there was a program I watched called what you are is what you eat. And its
pretty much true. If you eat McDonalds five days a week, pretty much they look like
a big hamburger (laughs).
349
Interview Seven
So I guess I have spoken to you a little about what the study is about, it’s about
how place, or where you live, your neighbourhood affects your health…
Sometimes when I first moved in n that, it was really nice, but when the neighbours
at night n that are having big arguments, and a lot of the time they come and there’s
the police or the ambulance and you can see the lights when the ambulance comes,
and at times like that, I feel like I am in Once Were Warriors or something like that…
Oh really?
No, it’s just like, the apartments make me feel like, you know how you see it on TV
and in America in Harlem how they’ve got those units n stuff, and sometimes when
they’re all having their domestics and the cops are coming over all the time? That’s
what I’m thinking.
So it paints that image in your head?
Yeah, it paints that image in my head and then people are saying, um, we had that,
Vicky came that time, we had that talk downstairs for all the people in the units, and I
didn’t know all that stuff was going on and when she said all the neighbours had
been having a big scrap together… mainly the people at the back of the units, not the
front, then that’s what I had in my head ‘oh great, it’s like Harlem, all the units are
together and they’re all scrapping it out’. But most of the time I don’t think of it like
that, but when we had that meeting that day, that’s what I thought.
And how does that, I guess, do you feel part of that? And how does that make
you feel about you and your family and the situation?
I just think ‘ah no, that’s I’m keeping to myself’. That’s why. I mean I see the
neighbours and I am not rude and I say hi and stuff but I don’t really go over and
350
have a cup of tea with them and go over their house or anything and they wont come
to my house and the reason is, that after that meeting, I thought that it’s been the
same in other places I have lived… I mean you are friends with them one minute and
the next things are going missing out of your house, and that is why you can see how
I have set up this place; where I have put the cots and the beds and everything, and
where I set the TV up, so if we have any visitors or if people come through, like
Friday, the neighbour upstairs… the water was leaking through my bathroom and it
was just pouring down and she actually made me a coffee and brought it down to me
and yeah that was really nice of her. But I still have my things where they aren’t
seen, ‘cause I don’t know people.
So this is also influenced by previous experience?
Yeah by previous experience and by I think sometimes common sense, ‘cause you
don’t really know people. And you can know people, but not know people.
So you were saying, that sometimes it makes you feel you are in some kind of
America scene, and…
Yeah like when we were at the park that time, and that young boy said ‘Oh School
Street, that’s the bad place!’ and people say that kind of stuff to me, then I think I am
living in Harlem.
Yeah
But most of the time I feel ‘ah this is cool’ cause I am living right in the city, and
most people would be really happy to be living in my spot and yeah this is the place
where most people wanna be. I mean, I used to live in Ipswich, and everyone wanted
to live in the city. But ever since I came from New Zealand I have mostly lived in the
city. And city areas. Not in the suburbs.
So this is good, and what you need, there are just aspects that….
People make comments like when I tell them where I live, they say ‘oh there, that’s
351
got such a bad reputation’ and other people say that.
So would it make a big difference if the reputation changed, and the police visits
slowed down and it was more positive… would that affect you a lot?
I don’t think that it affects me. I think that maybe it does affect me, um where if I got
more of a good vibe from my neighbours, whereas in the back of my mind I am
thinking, cause I can hear them arguing at night and I can hear people abusing each
other and saying ‘you junkie blah blah’ and that is one reason why I don’t want to
know the neighbours, and you know which house it’s coming from cause you can
hear the yelling through the doors, and I’m thinking ‘I’m not going near that door or
that house’.
Sure, so you can tell who you want to socialize with and who to avoid?
One evening I had my window open and I could hear someone yelling ‘you junkie,
blah blah you junkie, you’ve left your kid with me for 11 and a half hours!’ and this
is like 11 at night, and this guy had just dropped off her kid and I could hear him
yelling, so I was thinking ‘I’m not going near that house.’ And the kid, the the little
boy was there, and I could hear him yelling ‘I brought your son back, ya blah blah’. I
could hear the guy yelling at the girl. I think you know them, they’re from that unit
over there
Oh, yeah, Ok
Well I know her son is about my son’s age and I was thinking ‘I don’t want my kids
to mix with you know, I don’t mean to sound mean, but I don’t want my kids mixing
with, I mean I do want them to meet kids that are there age, but not where that is the
other parents’ lifestyles.
So the problem is a big one here?
Yeah I think it is. It’s just that girl over there – you know her from the park.
352
Ah yeah.
Cause he was yelling at her and saying her name, so I know who it is. And he was
saying ‘you leave your son with me!’ and he was screaming his head off and saying
‘I’m going to scream even louder!’
So that must be a difficult context… although you say you are happy with a lot
of it, and we can talk more about the good stuff in a minute, but there are some
difficult things here as well, hey?
Yeah, when I am sleeping at night and then I hear some guy yelling that out, or the
time I said, when I was going out to hang out my washing, cause I usually do my
washing at night and then go out at around 10 to hang it out, I just like doing my
washing late, cause then the kids are asleep and I can get up and clean the house a bit
better and do the washing and hang it out, and so I am walking out to hang the
washing out and I hear some lady screaming ‘You stabbed me, you blah’ so I just
bring the washing back in and shut the door (laughs). I think ‘I’ll hang out the
washing tomorrow’ (laughs again).
That sounds pretty full-on. Now if we can talk about some of the positive aspects
of living here, not just in the units, the whole Village, what’s good about it? And
the whole Village too?
Um, I like where I am. I like this area that I am living in. I like that I am close to
Roma cause Roma is close to everything and you can get to anywhere from Roma.
And I like how the buses run every 15 minutes from the park. I like the shops, and
that they are just right there, and more stuff is being built all the time. I like how they
have a taxi rank right there at the park. Yeah so sometimes it’s perfect if I have to go
somewhere with all the kids, I can just jump in a taxi.
What about other things are good? Like, what is it like having the uni, or the La
Boite theatre right there?
I haven’t been to any of those, but I like the feel of having the uni students n them
353
going pastyou know when you see them going past you think oh wow cool things are
happening around here and people are um getting on with their lives n doing better
for themselves and it’s good when you see other people doing that. I did go to uni in
new Zealand n stuff and I got excited about that and you feel really good cause
you’re at university
What did you do at Uni?
I was doing a paper for pre-school, then I changed my mind. Yeah I did it for a year.
But when I was doing papers at varsity it was really exciting for me, and when I see
the students walking out the front here, I just remember that feeling of how exciting
it was, cause they have got so much to look forward to.
(phone interruption)
OK, now I would like to talk to you about lifestyle and health. Just generally.
And I will go back to when you were growing up, how important was a healthy
lifestyle in the family you came from, and what that a big deal or not so much of
a goal? Where did health kind of figure in your life when you were growing up?
Um, when my mum and together, my dad was the person who did everything. He
was the one who took care of the house, went to work and came home and did the
cooking and everything. Yeah like when I was sick he would open the windows up
and cover us up and put us on the couch. He would give us our medicine and make
our food, but he always had the windows and doors open. I would always think, man
I am freezing, but he’d always say it was to let the bad air out so you can let some
good air in, whereas my mum was the opposite. She would lock up the house, so
you’re sitting there with a cold and you’re sick and the whole place is stuffy. It’s just
common sense to let the bad air out.
So what about things like, would he encourage you to do sport or activity?
Ah yeah, well dad, he did, they got divorced when I was seven, yeah? I lived with
my mum’s family, my mum was too busy, but my mum’s parents raised us. My dad
354
had us for the second weekend, and he always took us everywhere. He always made
sure we had like fruit and veggies, we always had everything for school, he always
came and saw our principal. We were never without with our dad? And that’s funny,
our mum was the opposite of that. On the first day of school, my dad introduced
himself and us to the principal. If he couldn’t get us anything, like books or anything,
he would say to the principal, I will get this on this day. But usually he had
everything beforehand. He made sure we had lunches and everything. While mum
was totally the opposite (laughs). My mother wasn’t really children focused. For a
woman who had ten children she wasn’t very children focused. Everyone else looked
after her kids.
So where were you in the ten?
I am number five.
Cool. And do you think how your mum or dad were then influenced how you
lived or how you are now?
Yeah well, my dad always said make the best of what you’ve got. Not my mum, she
was always a poor me kind of attitude, like if it wasn’t for this, or if it wasn’t for that,
like negative all the time. But dad was always thinking. Like what can he do better,
how can he do more for his kids? And always helping other people. Every holidays
we went to the beach, to the zoo, we always did those kinds of things with my dad.
But the weekends he and his wife would cook dinner and we’d go to the park to eat
it, like not just stay home, you know? Whereas mum was busy with her own life. She
just had a life. A social life.
And so what did your dad do as his job?
Practically everything. He had some billiards that he owned. He would rent them to
the billiards room and get money back on that. His wife was working. He mainly
raffled things at the pub. He was always at the pub. My dad was a drinker, but he was
a good drinker. My dad always went to the pub and raffled seafoods and meats. And
most mornings of his raffling nights we would get up early and go down to the wharf
355
and my dad would get a sack of mussels, fish and mussel bottles and he raffled it. He
would go out fishing. He was always thinking of something.
And his drinking wasn’t a problem?
No he wasn’t a problem drinker. And plus he had six pool tables at home and it was
the kind you had to put money in so he had his mates come over and drink, they still
had to pay to use the pool table (laughs).
That’s great. Now in terms of now, do you think about or worry about healthy
living or eating, or not really, or…
Well only when it gets near pay day, then I have to think I had better make this last.
Then I am thinking like that, but most times I am not worried. Then I think, what
would dad do? My dad always bought fruit and vegetables, and my mum bought
eggs and bread. Dad was the cook.
(baby interruption)
So your dad had a positive attitude about what to do when things were low?
Yeah, and my dad was always into community stuff, so he was always doing stuff in
the community, so even if he ran low, there were people he had helped who would
help him. He was like always helping out, so if they saw him in need they helped him
out.
Gee that’s good. Is he still around?
Yeah he still lives in New Zealand with his wife. He doesn’t do as much now. His
wife still works, but he is on a pension. He has diabetes. He can’t do as much. But he
had a good life as a wharfie, and working at the meatworks, a lot of different stuff.
I just need to ask, in terms of physical activity and exercise? Is this an
important thing now for you in your life now, and for your kids?
356
Not really. Not since I have been here.
Does this place in anyway influence how active you are?
I think it makes me less active cause we are right in the city, and there isn’t much for
the little ones here. I think when it gets sunnier.
Are there facilities that you have seen that you think you might use when it does
warm up?
I haven’t really looked. Just mainly that park over there for them to play with.
How about the park at the park at the back of the building.
I actually haven’t been up there.
It looks beautiful.
Is it? I would take them to the park more if I had walked around to find it.
Sure, no worries. So would you say if you had no barriers to the amount of physical
activity you could do personally, what kinds of things would you like to do?
Yeah I would do it. I used to love going to the gym. But not right now iwht the kids
cause they are too young. I used to love the walking machine. I used to own one at
home, and I used to do that every day. If I had someone to look after the kids, I
would definitely go.
Yep, cool. What kinds of images come to mind when you think of physical
activity or exercise and do you associate yourself with some of those images?
No not really. I used to be a fitness fanatic in the past, but not now. It made me feel
good. I used to run to the pool, swim laps, then go to work, then go to the gym after
work. Before I had children. Even after my first son, but now all I do is push the
pram (laughs).
357
So if you see ads with people encouraging people to become fitter or do more
exercise or messages about improving your health, what do you think of them?
Well, if they had crèche facilities I would go to a gym. Free ones. If you didn’t have
to pay for childcare I would go. I would have to pay for each child and then myself? I
don’t think so. I am better off just pushing the pram around.
And at a household level, do you think who you live with influences how active
you are?
Yeah cause ……. Is really into rugby, so we go to games n stuff. Or take a ball to the
park.
And what about neighbours, or where you live? If you see people jogging or
doing activities does that influence you, in terms of how you live your life?
Not now. With the kids I am sweating before I leave the house (laughs). I buckle
them in the pram so they don’t mess up the house again while I have my shower and
get ready to leave!
Yeah, I use the TV to keep them still sometimes! And these are barriers to you
being fitter or pursuing more physical activity?
Yes! And I have four kids, who will look after them?
Well, that is kind of all I needed to know - thanks so much for that, I am really
grateful!
358
Interview Eight
Alrighty, we’ll start off with questions about place. If you think of the places you
have lived in over the last 5 or 10 years or so, which ones come to mind as being
places that made you feel great? Or even further back than that? And what was
it about those places that you liked?
Like suburb or house?
Both, either.
A place in Labrador I had a cottage-house. I liked that house.
What did you like about it?
It was homely and had a wall, and tiled, and it was nice. I haven’t really lived
anywhere other than that where I felt great or I was happy, so….
No? Alrighty. Fair enough. So what about these places? Why were they not so
good?
Um, Eagleby. It was the household members and the area. Just trouble. Beenleigh,
NSW, heaps of places are like that. Just negative. The people. Attitudes in just liers,
two-faced trouble-makers. Gossipers. And the area, there are other areas, and you
know, that is what I have experienced.
(visitor interrupts)
Ok then thinking about KGUV and where you live now, how do you feel about
the village and where you live now?
359
Well there are certain people that lived here that I didn’t get along with. This
apartment is alright. It’s meant to be one bedroom, but I don’t actually have a
bedroom door, so… I am not happy with it. And I have only met a couple of people,
and I stick to myself. As I said, I haven’t been out or associated with anyone, so I
cant really say.
And what is your feeling about the place in the broader sense?
It’s different.
Different how?
I don’t really know. Just different.
Do you like what’ s here?
There could be more. We need a Woollies. And there is no entertainment. They need
more retail. There’s so much food, but no retail. I understand there is a gym being
built. I am with Fitness First. That’s the gym I joined.
What about things for kids, do they need anything?
Yeah they need a community childcare and entertainment for children. More things
were children can go and play. And somewhere where the children can go and the
parents can have time-out. Um some kind of playgroup or something.
How do you think this place affects your lifestyle much? Does it affect what you
are able to do or not do?
Yeah because I, you gotta be weary you know. Living in units in general, you know,
people have their dramas, you know. When you want to live in peace, it doesn’t
always happen.
Is that because there are so many people living close together do you think?
360
And um people, how do I put this? You know what I mean. They should have
screened people before they let them in.
(Visitor interrupts).
Ok, so screening would have helped?
I don’t mean to be judgemental and nasty. But they should have thought about who
they selected and who they put together. It doesn’t work. Their ways, their attitudes –
some don’t go well together. I’ve had my clash in personality here. And people
thinking they can stand over you and standing over you with their big bad egos.
Especially with public community housing they have to be so careful with who they
put in.
In terms of when you were growing up, how important was a healty and active
lifestyle int eh family you came from, was it an important thing?
Yeah it was, but you know, I chose…. I drink heaps of coffee, and I only just joined a
gym. Dad did basic veggies and he did the casseroles. He raised us.
How many of you did he raise?
Three.
Does that influence how you live now, do you think? Your childhood and your
time with your dad?
Yeah, well I’ve chosen you know, like, it’s my own choice. It alls boil down to some
choose to be healthy and some don’t. I am a smoker.
And that’s a choice thing, yeah?
Yeah and I regret it now, cause I am trying to quit and I am having so much trouble.
361
You know the damage its doing and then you’re worried and paranoid and think I
wonder if cancer is developing. So… I sit there worrying about it – smoking and
worrying about it.
So you are fully aware of all the risks?
Yep. Circulation, everything. And when I don’t smoke I eat a lot. And I will just eat
whatever. If my mouth waters for chocolate, I will go for chocolate. And the ciggies
help control that. I have self-discipline problem. But having the kids and no childcare
doesn’t help.
So childcare is an issue in terms of health?
Yeah. And me self-discipline.
In your everyday life how often would you say you think about doing things that
are healthy… aside from the ciggie worry?
I worry about it everyday and all the time, and it’s just getting that motivation.
So it’s on your mind a lot?
Yeah.
And what about your kids – your little boy and your little girl – do you think
worry about their eating, or how much exercise they’ve had in a day or not that
much?
I do with me daughter, but that’s cause she is only just back in my care, she’s been
with her father for the last six months and everything. She does love her fruit, but
she’s hyperactive so I have to watch what I give her. I give her fruit, vegies,
mueslies…
What about activities, I know she’s still little…
362
She runs everwhere, so she never walks.
And do you use your urban environment, your neighbourhood, do you use that
for your activities, for you and your daughter, does it affect what you can do
with her, like the design of the place?
Yeah well its small, cramped, claustrophobic, no big yard, no swing set or anything -
so it does have an effect.
Ok, if you had no barriers or constraints to the amount of exercise you could do,
any kind any place with any kinds of equipment you needed, what kinds of
things would you be interested in doing?
Ah, I love dancing. I would love take dance classes. The funk classes are great.
So you really enjoy your exercise and your movement?
Yeah I do. Movement is an important thing, your body movement.
Does it affect how you feel emotionally?
It does, I do believe it does, cause it’s like energy build up, see? And releasing
energy, and it feels good.
What kinds of images or people come to mind when you think of physical
activity or exercise, and do you think of yourself as being like that.
I do visualise it, you know. It’s like you see your celebrities, them determined people,
focussed people, and think you can be like that too. It’s just mind over matter, that’s
all it boils down to.
By celebrities do you mean women, or…
363
No, just other people.
People in the media?
Yeah and people in general.
Is there any celebrity that you can think of in particular that you go, wow
about? For motivation?
Not really, it’s just seeing other people. Cause we’re all the same, you know, no-one
is better or worse but just everyday people…
Who are exercising?
Yeah, even just walking, dressed in Nike tracksuits, sort of just everyday people, and
you see ‘em happy, and you see how their bodies are and you know that energy, and
that is motivation and inspiration to me.
So, in a neighbourhood where people were doing a lot of exercise, that would
affect you psychologically? It would affect how you think?
Yeah cause you think well if they can do it, I can do it.
Thanks for that. If someone was trying to get a message out to people to do
more activity to lead a healthier lifestyle, what kinds of things would they have
to say to convince you to make changes in your life to achieve that?
Um, I would need to think that they knew what they were going on about, I would
need a 100% guarantee of that. You need a strong positive influence. It is about
personal power.
So it would need to be someone inspirational.
Yeah and someone wise who knows what they are talking about. Having the
364
knowledge. Without being pressuring and nasty in the process.
And for you to trust them?
I would need a 100% guarantee they knew their stuff.
What about scare tactics? Does that work? Does that work to get people to
change their behaviour or not?
In some ways. It depends, you know, what it is actually about, the way it’s
approached and what’s used, you know. Yeah it just depends.
Yeah great. Thanks for that, that’s terrific.
365
APPENDIX F
Community Focus Group Schedule and Transcript
366
COMMUNITY FOCUS GROUP
HELD AT LOCAL NEIGHBOURHOOD BBQ AREA
Six participants were present, but not all contributed to the
discussion about people, place and health.
I: What we might start off talking about, is how you feel about your current
living place – how do you feel about where you are living now?
P1: Um I think it’s not ideal for me, and not ideal for my children. I really wanted a
house, but had to move out of where I was living like straight-away.
I: OK –so was it a crisis situation?
P1: Yeah I was going through a crisis accommodation service and if it was up to me I
wouldn’t have moved here.
I: Right?
P1: If I had no children then I would have loved living here without children and that
would have been ideal for me..
I: OK
P1: I had to move out like right now and that was crisis accommodation and I had
applied for other places and I didn’t get them
I: So there are aspects of the place that are good, yeah?
P2: It would be great for single people, but not for me with my toddlers and my little
367
ones. The unit living is no good for my little ones, we need a yard and a fence and a
place where they can run under the trees. And we used to have a house like that, with
grass and trees and yeah, the units are great, but it is not what I would have preferred.
I: OK?
P3: It’s a great place, I really like it but…. Yeah I actually really like this area that
I’m in now I like the feel of it.
I: By ‘the feel of it, can you tell me what you mean?’
P3: Just living in Kelvin Grove, and the types of people here, and being near the uni
and everything, and the things that are happening are starting here. I like that buzz
about how people think about Kelvin Grove.
I: Can you tell me more about that?
P3: People I know all live in the suburbs – and they look at me and go ‘you’re right
in the city, right by the uni, right by everything’ like if I was still going to uni that
would have been great for me. But yeah, we still need yards and grass and trees.
I: What about the parks, like the one we are sitting in today?
P2: Well today the weather is crap, and it has been to cold to come out all the way
here.
P1: But since my car has been playing up I have been walking through here a lot.
I: Yeah? How does it make you feel to see other people out and about in the
parks?
P3: Yeah good. It feels family oriented. I see mainly the uni people walking past, and
you just see them walking past and doing their thing.
368
I: It’s nice that, yeah? And what about you Melissa – how are you feeling about
living here now?
P4: My kids love running over to the IGA all the time, and they run in the paddock.
We find good stuff and we find bargains.
I: Um Ok I might just ask – and I am not really following a structure here – but
I am thinking now about neighbours. How is that going? How are your
relationships with your neighbours? Do you have a relationship with your
neighbours?
P4: I don’t really talk to em. I might talk to em, but I don’t go into their houses or
anything like that. No. Well, most of them just stay inside all day. And you see em
coming out at night time.
I: They come out at night time?
P4: Yeah they go and do their thing at night time.
I: What work or…?
P4: Night time and the afternoons you see them coming out and doing their business.
P2: I have one friend and her sister and we are friends, and we just go backwards and
forwards through each other’s apartments all the time.
I: Did you know them from beforehand?
P2: Yeah we’ve known them from hostels. They’ve been in the hostel with us.
I: And what about you in terms of neighbours and your relationships?
P3: I usually see my neighbour at the side there and I say hello. I see them walking
out my door. It’s an old man and an old lady. I’ve been into one of the neighbours
369
houses yesterday. Cause the water was leaking down through my roof and I had to go
and say ‘Hello is your tap running, cause it’s leaking all through my roof!’ And we
had to turn off the electricity and everything…
I: And other than that?
P3: Before I moved here I had neighbours – one minute you are really good friends
and the next minute they are talking about you and having hassles with each others
kids. They are like ‘Your kids did this!’ and so we just like to keep to ourselves.
I: So it’s too stressful?
P3: Um, yeah, I just don’t want to feel uncomfortable around my neighbours . I’m
alright just us being us, I don’t need to have other people around me. I have already
had a full life – I don’t need to have people next to me, I don’t need to have friends
close to me all the time. I had old friends anyway, who I could ring and even though
we haven’t spoken in years we would be talking like we just saw each other a coupla
hours ago.
I: So you have your social networks already?
P3: Yep.
I: And where were these places before where you said you had trouble?
P3: Bowen Hills, Ann Street, and then I moved to Stafford. I had their child against
my child… and I used to have their child sleep over all the time and my child has
never been in trouble in his whole life and then the boy next door and him went to
old building sites. They were touching stuff and mucking around and now he’s got a
police record. And so she blamed my son for that. We thought that was funny cause
everyone in their family had a record and were very well known down at the police
station (laughs). And they are yelling going ‘our child never done nothing til your
child came along!’
370
I: So it was good to move I guess?
P3: Well the house we were living in was being torn down, so… they were building
apartment blocks, so…
I: So what things are important – when you have children – what is important
in a neighbourhood, what do you value?
P1: Well, we are just having troubles with people not using needles properly. And its’
all laying on the ground out the front…
P2: And I have seen them when I take my rubbish down.
P1: In the bins…
P2: And I have children, so I don’t want them seeing this.
P3: They are supposed to put them in those special bins.
Are there bins available?
P3: No, no. They just throw them in the wheelie bin and then it gets tipped over and
we can stand on them
P4: I have seen that in my apartments too.
P2: The landlady came and talked to us all about it.
P3: Yeah but it hasn’t changed.
That is a huge risk, yeah?
P4: Yeah. And the rubbish is bad too.
371
P3: I find the rubbish bad too. Sometimes I ask my son to take the rubbish down and
its full and he has actually stuck it in the bin, but when we went back someone threw
my rubbish out, and the bag had torn and my stuff was everywhere. They took it out
to put their rubbish in.
That’s horrible. Well – so would you say its fighting over space to put your
rubbish?
P4: Yeah well there isn’t much, there’s not really enough bins..
P1: I think not so much more bins, they should just collect twice a week.
P3: One big doesn’t last me one week. And once the bins fill that’s it, it all just goes
on the ground
P2: And I saw a man just throwing his alcohol bottles on the ground.
So how does this make you feel when you see stuff like this in your
neighbourhood?
P2: Pretty angry actually. There are small kids, and they just never think of the kids.
So overall what is the most important thing in your neighbourhood – the design,
the building, the people?
P3: The people who live there. And how they behave.
I: Do you think having the BHC units altogether is a good thing? Or should it be
broken up more? How is it with all the BHC units being in one spot?
P4: I don’t mind, it’s just the people who move into the units is all. We had a meeting
the other day and apparently one unit has already been completely trashed. They
trashed the whole unit. And all the apartments are great, but then the people do that
and it makes them really ugly and gives them a bad name. Like someone said to me,
372
‘Oh I have heard about that place and it’s really bad there’. I know it’s got a bad
reputation.
P2: Didn’t you have a man with a gun at your place or something?
P3: Yeah I heard that, and one of the ladies up stairs, I was about to go out and…
P4: Yeah she got stabbed in the arm with a key or something.
P3: I was just about to walked out and she said ‘you stabbed me you blah blah’ and
then the ambulance came and the police came, and I went back inside and shut the
door and went into my house and turned my TV up til it was all over.
P4: Yeah so there has been a lot of police visits and stuff.
P2: I think when I actually hear that stuff happening – and its always in the back
units – and when the landlady said there were troubles, it was all the back units. I
think seven apartments are fighting with each other.
Why is that? Why is it the back apartments do you think?
P4: It’s where it is – and where the bad people end up.
P2: They put all the bad people there.
P3: I have talked to some other people. There was, just this week, maybe Tuesday
night, my son walked down to take the rubbish down and this man walked and
followed him back and cause my son let the door shut slowly, the man followed him
back into our apartment. And he was like drunk and all he wanted was ‘Do you have
a cigarette? I really need a cigarette!’ and it was like nine o clock at night and he just
walked into the bathroom and I just saw this huge man – I was only up to his
underpits and he was like ‘do you have a cigarette?’ And I was like ‘Out out out my
house!’ I was so angry. If I had something in my hand I swear I would have wacked
him.
373
I: That’s pretty bad.
P3: He was huge and he could have knocked me out though.
P4: I don’t feel safe. I never feel safe.
I: So in terms of safety and your relationships with your neighbours, does the
place allow you to get out and about, and be physically active – getting out of
the house, doing things, going places?
P2: I have been getting out here a little. Well, being close to Roma Parklands and
being close to Southbank has made us want to get out more and do things.
P4: But it has to be warmer though.
And the parks here?
P2: Yeah, we even use the local school’s park and oval. We cheat like that.
P4: We used to just jump into the schools pools and go swimming. We loved doing
that. When it was all shut down. We jumped off the roofs.
P3: There is a pool being built here.
P2: Yeah but how much is that gunna cost?
P3: It’s free.
P2: Yeah?
P3: Yeah it’s free.
I: And what about the local health services, do you use them?
374
P3: No we use the one in West End.
P2: West End, yeah what’s it called?
P3: Kambu.
I: What’s Kambu?
P3: It’s the Aboriginal Medical Centre.
I: Is that far does it take you long to get there?
P3: No, they pick you up from your house.
P2: Yeah! They do that in Ipswich too. Do you know if they do this area?
P3: Yeah yeah they do.
P2: Can I have their number?
P3: Yeah yeah
P4: So what is this Kambu?
P3: It’s just a medical centre.
P2: I think its just Ipswich and this one.
P3: I had my pregnancy check-ups there.
I: Oh prenatal care? And are the doctors good there?
P3: Yeah yeah, no they are so good.
375
P2: You just gotta ring em up, make an appointment and they pick ya up
P3: And they drop you off. And you get your scans done on your medicare card
there. That is probably the only one that does that.
I: I remember having to pay for that.
P2: They wanted me to pay eleven dollars just to get one of these scan sheets
P3: And they just get you one for free
I: So you had you twenty week scans there?
P3: Yeah they don’t charge you.
I: And do they do counselling as well and other services?
P2: They do everything. You just book in even if you don’t have any money.
I: Gee that’s good.
P2: And I get my respite there for my son, he’s got ADHD.
[Interruption from children in the park]
P1: You know what we need here though is a public phone box. Not that one across
the road, it’s too freaky crossing here. Plus the one at the Red Rooster has the kids
there after school and you cant hear the person you are trying to talk to cause of the
traffic and the kids.
P2: And the kids beep you at the back of you saying ‘I need to call my mum, I need
to call my friend, someone’s gotta pick me up…’ And I am like, ‘you can just wait!’
376
I: Yeah you need a phone here.
P3: Yeah well I asked Vikki for a phone. I asked her for a latch on my door and she
said no cause it’s a fire hazard, and I was like yeah well it’s driving me crazy ‘cause
my kids can get out all the time.
P2: So does your latch turn easily at yours? Cause at mine my little ones can just
open it and get out.
P4: Yeah when you are inside they can just open the door and go out.
I: How far can they get?
P4: They get into the lift and go up to level five, and they play with the intercom and
get into trouble.
P2: If you want to get the kids to play you gotta take em right out, the apartments are
not kid-friendly.
P4: Nah.
P3: Plus you cant let your kids out by emselves cause you don’t know if strangers are
gunna take em.
I: Is there anything else before we end, that you want to tell me about, any
stories, suggestions, recommendations about where you live?
P2: Yeah well my partner was pulled up by the police last night… he was just getting
my mates keys out of her apartment and they thought he was breaking in (laughs),
but yeah no, it’s all good.
P1: I guess people are on the look out.
I: Do you have neighbourhood watch?
377
P3: No! No I hate neighbourhood watch.
I: Why don’t you like it?
P3: I dunno. My childrens dad was drinking one time on our balcony and um the
cops came over and asked me if we were number twelve or whatever number and
they said a number, like are you number blah blah, and someone had called the cops
cause there was an argument and someone was drinking and they saw him having a
drink on his balcony and automatically assumed it was him! (laughs). And he’s a big
Islander guy, and they were questioning him and he was upset about that.
P2: I was just having a smoke and the police asked me if it was me. I was just having
a smoke.
I: OK. Well we might end it there. Thanks everyone…
P3: Oh and don’t mail my IGA voucher to me someone will raid my mail and steal it,
can you drop it at my unit?
I: Sure.
378
REFERENCE LIST
Abdullah, M. & Saleh, E. (2004). Learning from tradition: the planning of residential
neighborhoods in a changing world. Habitat International, 28, 4, p. 625-639.
Abildso, C., Zizzi, S., Abildso, L., Steele, J., & Gordon, P. (2007). Built environment
and psychosocial factors associated with trail proximity and use. American Journal
of Health Behavior, 31, 374-383.
Al-Hathloul, S. & Aslam Mughal, M. (1999). Creating identity in new communities:
case studies from Saudi Arabia. Landscape and Urban Planning, 44, 4, p. 199-218.
Antaki, C & Widdicombe, S. Identities in Talk. SAGE: London.p. 15-34.
Antupit, A., Gray, B., Woods, S. (1996). Steps ahead: Making streets that work in
Seattle, Washington. Landscape and Urban Planning, 35, p. 107-122.
Antupit, A., Gray, B., Woods, S. (1996). Steps ahead: Making streets that work in
Seattle, Washington. Landscape and Urban Planning, 35, p. 107-122.
Bachnik, W., Szymczyk, S., Leszczynski, P., Podsiadlo, R., Rymszewicz, E., Kurylo,
L., Makowiec, D., Bykowska B. (2005) Quantitive and sociological analysis of blog
networks. Acta Physica Polonica B Vol. 36, No. 10 (2005) 2435-2446.
Badland, B. & Schofield.G. (2005) Transport, urban design, and physical activity: an
evidence-based update Transportation Research Part D: Transport and Environment,
10, 3, p. 177-196.
Badland, B. & Schofield.G. (2005) Transport, urban design, and physical activity: an
evidence-based update Transportation Research Part D: Transport and Environment,
10, 3, p. 177-196.
Bauman, A. (2005). Updating the evidence that physical activity is good for health:
an epidemiological review 2000-2003. Journal of Science and Medicine in Sport, 7,
1, 6-19.
379
Bedimo-Rung, A. Mowen, A. &.Cohen, A. (2005). The significance of parks to
physical activity and public health: A conceptual model. American Journal of
Preventive Medicine, 28, 2, p. 159-168.
Berger, P. & Luckman, T. (1966). The Social Construction of Reality: A treatise in
the sociology of knowledge, New York: Doubleday.
Bernstein, B. (1971). Class, Codes and Control: Theoretical studies towards a
sociology of language. London: Routledge & Kegan Paul.
Blaikie, N. (2000).Designing Social Research. Polity Press: MA:USA. p.35-227.
Bolam, B., Murphy, S. & Gleeson, K. (2004). Individualisation and inequalities in
health: a qualitative study of class identity and health. Social Science & Medicine,
59, 7, p.1355-1365..
Booth, M., Bauman, A., Owen, N., Gore, C. (1997). Physical activity preferences,
preferred sources of assistance, and perceived barriers to increased activity among
physically inactive Australians. Preventive Medicine, 26, 131-137.
Braubach, C., Daskalakis E. D., Shenassa, M., Frye, M. (2008), Routine stair
climbing in place of residence and body mass index: a pan-European population
based study, International Journal of Obesity, 32 (2):396
Brown, D., Balluz., L., Heath, G., Moriarty, D., Ford, E., Giles, W., Mokdad, A.
(2003). Associations between recommended levels of physical activity and health-
related quality of life: Findings from the 2001 Behavioural Risk Factor Surveillance
System survey. Preventive Medicine, 37, 520-528.
W.J. Brown, S.G., Trost, A., Bauman, K., Mummery, N Owen (2004). Test-retest
reliability of four physical activity measures used in population surveys, Journal of
Science and Medicine in Sport, 7, 2, June 2004, 205-215.
Buchecker, M., Hunziker, M. & Kienast, F (2003). Participatory landscape
development: overcoming social barriers to public involvement. Lanscape and
Urban Planning, 64, p.29-46.
380
Burke, P. (2002). Context in Context. In: Peace and Mind: Seriatim Symposium on
Dispute, Conflict, and Enmity Postcript on Method Duke University Press.
Bush, J., Moffatt, S. & Dunn, C. (2001). 'Even the birds round here cough': Stigma,
air pollution and health in Teesside. Health & Place, 7, 1, p. 47-56.
Carpiano, R., (2006) Neighborhood social capital and adult health: An empirical test
of a Bourdieu-based model, Health & Place13, 3, 639-655
Carpiano, R.M. (2006).Toward a neighborhood resource-based theory of social
capital for health: Can Bourdieu and sociology help? Social Science & Medicine, 62,
165-175.
Carver, A., Salmon, J., Campbell, K., Baur, L., Garnett, S. & Crawford, D. (2005)
How Do Perceptions of Local Neighborhood Relate to Adolescents' Walking and
Cycling?, American Journal of Health Promotion, 20, 2, 139-147.
Carver, Timperio & Crawford (2007) Neighborhood Road Environments and
Physical Activity Among Youth: The CLAN Study, Journal of Urban Health,
Volume 85, Number 4 / July, 2008, 1099-3460
Caspersen, C.J, Christenson, M.J, and Pollard, R.A (1986) Status of the 1990
physical fitness and exercise objectives--evidence from NHIS 1985, Public Health
Report 1986, 101(6), 587–592.
Castells, M. (2000). Materials for an exploratory theory of the network society. In
Hartley, J. & Pearson, R.E. (Eds.), American Cultural Studies: A reader. Oxford
Press: Oxford. P. 3-15.
Cattell, V.(2001). Poor people, poor places, and poor health: the mediating role of
social networks and social. Social Science & Medicine, 52, p. 1501-1516.
Caughy, M. O., O’Campo, P. J., & Patterson, J. (2001). A brief observational measure
for urban neighbourhoods. Health and Place, 7, 225-236.
Chan, C., Ryan, D., & Tudor-Locke, C (2004). Health benefits of a pedometer-based
381
physical activity intervention in sedentary workers. Preventive Medicine, 39, 1215-
1222.
Chandola, T. (2001). The fear of crime and area differences in health. Health &
Place, 7, 2, p. 105-116..
Charmaz, K. (1990). “Discovering” Chronic Illness: Using grounded theory. Social
Science and Medicine, 30, 1161-1172.
Charmaz, K. (1995). Grounded Theory: Rethinking methods in psychology. London:
Sage.
Charmaz, K. (2000). Grounded theory: Objectivist and constructivist methods. In N.
K. Denzin & Y. S. Lincoln (Eds.), Handbook of qualitative research (2nd ed.,
pp.509-535). Thousand Oaks, CA.: Sage.
Charmaz, K. (2006) Constructing Grounded Theory: A practical guide through
qualitative analysis. Pine Forge Press.
Charmaz, K. (2006). Meaning pursuits, marking self: Meaning construction in
chronic illness. International Journal of Qualitative Studies on Health and Well-
Being, 1, 27-37.
Coen, S. E., & Ross, N. A. (2006). Exploring the material basis for health:
Characteristics of parks in Montreal neighbourhoods with contrasting health
outcomes. Health and Place, 12, 361-371.
Crane, J., Quirk, K., & van der Straten, A. (2002). "Come back when you're dying:"
the commodification of AIDS among California's urban poor. Social Science &
Medicine, 55, 7, p. 1115-1127.
Creswell, J.W (1998). Qualitative Inquiry and Research Design: Choosing among
the five traditions. Sage: London.
Cummins, S., Curtis, S., Diez-Roux, A. V., & Macintyre, S. (2007). Understanding
and representing ‘place’ in health research: A relational approach. Social Science and
382
Medicine, 65, 1825-1838.
Cummins S, Curtis S, Diez-Roux A.V., Macintyre S. (2007)Understanding and
representing ‘place’ in health research: a relational approach. Social Science
Medicine (in press).
Cummins, S., Macintyre, S., Davidson, S. and Ellaway, A. (2005). Measuring
neighbourhood social and material context: generation and interpretation of
ecological data from routine and non-routine sources. Health & Place, 11, 3, p. 249-
260.
Dahler-Larsen, P. (2001). From Program Theory to Constructivism: On tragic, magic,
and competing programs. Evaluation, 7, 3, 331-349.
de Hollander, A. and Staatsen, B. (2003). Health, environment and quality of life: an
epidemiological perspective on urban development. Landscape and Urban Planning,
65, 1-2, p. 53-62.
Deutsch, R. (1998). How Early Childhood Interventions Can Reduce Inequality: An
overview of recent findings. Report for the American Development Bank.
Dick, B. (2007). Grounded Theory: A thumbnail sketch. Resource Papers in Action
Research. Online.
Diez Roux, A.V. (2007). Neighbourhoods and Health: We are we and where do we
go from here? Rev Epidemiol Sante Publique, 55(1), 13-21.
Diez Roux, A.V., Kiefe, C.I., Jacobs, D.R. Haan, M., Jackson, S.A., Nieto, F.J., Paton
C.C., & Schulz, R. (2000) Area Characteristics and Individual-Level Socioeconomic
Position Indicators in Three Population-Based Epidemiologic Studies. Annals of
Epidemiology, 11, 6, p. 395-405.
Dovey, K., Fitzgerald, J., & Choi, Y. (2001). Safety Becomes Danger: Dilemmas of
drug-use in public space. Health & Place, 7, 4, 319-331.
Drukker, M. Kaplan, C., Feron F. & van Os, J. (2003). Children's health-related
383
quality of life, neighbourhood socio-economic deprivation and social capital. A
contextual analysis. Social Science & Medicine, 57, 5, p. 825-841.
Ellaway, A. and Macintyre, S. (1998). Does housing tenure predict health in the UK
because it exposes people to different levels of housing related hazards in the home
or its surroundings? Health & Place, 4, 2, p. 141-150.
Feigelman, S., Howard, D.E., Li, X. & Cross, S.I. (2000). Psychosocial and
environmental correlates of violence perpetration among African-American urban
youth. Journal of Adolescent Health, 27, 3, p. 202-209.
Felonneau, M. (2004). Love and loathing of the city: Urbanophilia and ubanophobia,
topological identity and percieved incivities. Journal of Environmental Psychology,
24, p.43-52.
Ferguson, K. & Mindel, C. (2007). Modeling fear of crime in Dallas neighborhoods:
A test of social capital theory. Crime and Delinquency, 53(2), 322-349.
Finch, C.F., Boufous, S. (2008). Sport/leisure injury hospitalisation rates—
Evidence for an excess burden in remote areas, Journal of Science and Medicine
in Sport, In Press, Corrected Proof.
Finlay, S. & Faulkner, G. (2005). Physical activity promotion through mass media:
Inception, production, transmission and consumption. Preventive Medicine, 40, 121-
130.
Florida, R. (2002). The experiential life. In The rise of the creative class: And how
it's transforming work, leisure, community, and everyday life. Basic Books: New
York. P. 165-189.
Foo, T.S. (2001). Planning and design of Tampines, an award-winning high-rise,
high-density township in Singapore. Cities, 18, 1, 2001, p. 33-42.
Frohlich, K. L., Potvin, L., Chabot, P., & Corin, E. (2002). A theoretical and
empirical analysis of context: Neighbourhoods, smoking and youth. Social Science
and Medicine, 54, 1401-1417.
384
Gatrell, A.C., Popay, J. & Thomas, P. Mapping the determinants of health inequalities
in social space: can Bourdieu help us? Health & Place, 10, 3, 245-257.
Gergen, K. (1985). The Social Constructionist Movement in Modern Psychology.
American Psychologist, 40, 266-275.
Giddens, A. (1982). Profiles and Critiques in Social Theory. Berkeley, CA:
University of California Press
Giles-Corti, B. (2006) People or places: What should be the target? Journal of
Science and Medicine in Sport, 9, 5, 357-366.
Giles-Corti, B. & Donovan, R.J. (2002). Socioeconomic Status Differences in
Recreational Physical Activity Levels and Real and Perceived Access to a Supportive
Physical. Preventive Medicine, Volume 35, 6, p. 601-611.
Giles-Corti, B., Broomhall, M.H., Knuiman, M., Collins,C., Douglas, K., Ng, K.,
Lange, A. & Donovan, R.J. Increasing walking: How important is distance to,
attractiveness, and size of public open space? American Journal of Preventive
Medicine, 28, 2, p. 169-176.
Giles-Corti, B. Knuiman, M., Timperio, A., Van Niel, K., Pikora, T., Bull, F., Shilton,
T., & Bulsara, M., (2007). Development of a reliable measure of walking within and
outside the local neighborhood: RESIDE's Neighborhood Physical Activity
Questionnaire, Preventive Medicine, 42, 6, 455-459.
Glasgow, R., Eakin, E., Fisher, E., Bacak, S., Brownson, R. (2001). Physician advice
and support for physical activity: Results from a national health survey. Preventive
Medicine, 21, 3, 189-196
Gleeson, B. (2004). Deprogramming Planning: Collaboration and Inclusion in New
Urban Development. Urban Policy and Research, 22, 3, p. 315-322.
Goffman, E. (1963). Behaviour in Public Places. New York: Free Press.
Gregory, R., Slovic, P. and Flynn, J. (1996). Risk perceptions, stigma, and health
385
polic. Heath adults' participation in physical activity: A review. American Journal of
Preventive Medicine, 22, 3, p. 188-199.
Gregory, R., Slovic, P. and Flynn, J. (1996). Risk perceptions, stigma, and health
polic. Health & Place, 2, 4, p. 213-220.
Hallberg, L.R.M (2006). The “core-category” of grounded theory: Making constant
comparisons. International Journal of Qualitative Studies on Health and Well-Being,
1, 141-148.
Hawe, P. & Shiell, A. (2000). Social capital and health promotion: a review. Social
Science & Medicine, 51, 6, p. 871-885.
Hayes, L. J., Quine, S., Taylor, R., & Berry, G. (2002). Socio-economic mortality
differentials in Sydney over a quarter of a century. Australian and New Zealand
Journal of Public Health, 26(4), 311-317.
Hembree, C., Galea, S., Ahern, J., Tracy, M., MarkhamPiper, T., Miller, J., Vlahov,
D. & Tardiff K.J (2005). The urban built environment and overdose mortality in New
York City neighbourhoods, Health & Place, 11, 2, June 2005, p.147-156.
Hillsdon, M., Panter, J., Foster, C, and Jones, A. (2006) The relationship between
access and quality of urban green space with population physical activity Public
Health, 120, 12, December 2006, Pages 1127-1132
Hjalmarson, H.V., Straudmark, M., Klassbo, M. (2007). Healthy risk awareness
motivates fraction prevention behaviour: A grounded theory of women with
osteoporosis. International Journal of Qualitative Studies on Health and Well-Being,
2, 236-245.
Hoehner, C.M., Brennan Ramirez, L.K., Elliott, M.B., Handy, S.L & Brownson, R.C
(2005). Perceived and objective environmental measures and physical activity among
urban adults. American Journal of Preventive Medicine, 28, 2, p. 105-116.
Hou, F. & Myles, J. (2005). Neighbourhood inequality, neighbourhood affluence and
population health, Social Science & Medicine, 60, 7, 1557-1569.
386
Humpel, N., Owen, N. & Leslie, E. (2002). Environmental factors associated wiAl-
Hathloul, S. & Aslam Mughal, M. (1999). Creating identity in new communities:
case studies from Saudi Arabia. Landscape and Urban Planning, 44, 4, p. 199-218.
Hutton, T. (2004). The New Economy of the inner city. Cities, 21, 2, p.89-108.
Inagami , D . Cohen , B. Finch , S. Asch (2006) You Are Where You Shop: Grocery
Store Locations, Weight, and Neighborhoods American Journal of Preventive
Medicine, 31, 1, 10–17.
Ioannides, Y. M., & Zabel, J. E. (2007). Interactions, neighbourhood selection and
housing demand. Journal of Urban Economics,
Jackson, L. (2003) The relationship of urban design to human health and condition.
Landscape and Urban Planning, 64, 4, p.191-200.
Jacoby, E., Goldstein, J., Lopez, A. Nunex, E., Lopez, T. (2003). Social class, family,
and lifestyle factors associated with overweight and obesity among adults in
Peruvian cities. Preventive Medicine, 37, 396-405.
Jordens & Little (2004). ‘In this scenario, I do this, for these reasons’: narrative,
genre and ethical reasoning in the clinic. Social Science & Medicine, 58, 9, 1635-
1645
Kamphuis, C., van Lenthe, F., Giskes, K., Brug, J., Mackenbach, J. (2006). Perceived
environmental determinants of physical activity and fruit and vegetable consumption
among high and low socioeconomic groups in the Netherlands. Health & Place, 1-
11.
Karpati, A.M., Bassett, M.T., & McCord, C., (2006) Neighbourhood mortality
inequalities in New York City, 1989–1991 and 1999–2001, Journal of Epidemiology
and Community Health 2006; 60: 1060-1064.
Karvonen, S. & Rimpela, A. (1997). Urban small area variation in adolescents' health
behaviour. Social Science & Medicine. 45, 7, p.1089-1098.
387
Kavanagh, A., Goller, J. L., King, T., Jolley, D., Crawford, D., & Turrell, G. (2005).
Urban area disadvantage and physical activity: a multilevel study in Melbourne,
Australia. Journal of Epidemiology and Community Health, 59, 934-940.
Kawachi, I., & Subramanian, S. V. (2007). Neighbourhood influences on health:
Outstanding issues in the neighbourhood research agenda. Journal of Epidemiology
and Community Health, 61(1), 3-4.
Kelly, C., Hoehner, C., Baker, E., Ramirex, L., Brownson, R. (2006). Promoting
physical activity in communities: Approaches for successful evaluation of programs
and policies. Evaluation and Program Planning, 29, 280-292.
Kirtland, K.A., Porter, D.E., Addy, C.L., Neet, M.J., Williams, J.E., Sharpe, P.A.,
Neff, L.J., Dexter, C., Kimsey, J., & Ainsworth, B. (2003). Environmental measures
of physical activity supports: Perception versus reality. American Journal of
Preventive Medicine, 24, 4, p. 323-331.
Laitakari, J. & Miilunpalo, S. (1998). How can physical activity be changed – Basic
concepts and general principles in the promotion of physical activity. Patient
Education and Counseling, 33, 47-59.
LeClaire, J. (2001). Children's behaviour and the urban environment: an ecological
analysis. Social Science & Medicine., 53, p.277-292.
Lesch, E. & Kruger, L.M. (2005). Mothers, daughters, and sexual agency in one low-
income South African community. Social Science and Medicine, 61, 1072-1082.
Leslie, E., Saelens, B., Frank, L., Owen, N., Bauman, A., Coffee, N. & Hugo, G.
(2005). Residents' perceptions of walkability attributes in objectively different
neighbourhoods: a pilot study. Health & Place, 11, p.227-236.
Lindbladh, E., Lyttkens, C. H., Hanson, B. S., Ostergren, P., Isacsson, S.O. &
Lindgren, B. (1996). An Economic and Sociological Interpretation of Social
Differences in Health-Related Behaviour: An Encounter as a Guide to Social
Epidemiology, Social Science & Medicine, 43, 1817-1827.
388
Lindström, C., Lindström, M., Moghaddassi & Merlo, J. (2006) Health &
Place, vol. 12, 4, 479-489.
Lindström, M. (2004). Social capital, the miniaturisation of community and self-
reported global and psychological health. Social Science & Medicine, 59, 3, p. 595-
607.
Luymes, D. (1997). The fortification of suburbia: investigating the rise of enclave
communities.Landscape and Urban Planning, 39, 2-3, p. 187-203.
Macintyre, S. & Ellaway, A. (1998). Social and local variations in the use of urban
neighbourhoods: a case study in Glasgow. Health & Place, 4, 1, p. 91-94.
Macintyre, S., Ellaway, A., & Cummins, S. (2002). Place effects on health: how can
we conceptualise, operationalise and measure them? Social Science and Medicine,
55, 125-139.
Macintyre, S., McKay, L., & Ellaway, A. (2005). Are rich people or poor people
more likely to be ill? Lay perception, by social class and neighbourhood, of
inequalities in health. Social Science and Medicine, 60, 313-317.
M. Ahamed, Verma, S. Kumar, A. & Siddiqui, M.K.J. (2005). Environmental
exposure to lead and its correlation with biochemical indices in children. Science of
The Total Environment, 346, 1-3, 15 p. 48-55.
Marcus, B., Nigg, C., Riebe, D. (2000). Interactive Communication Strategies:
Implications for population-based physical activity promotion. Preventive Medicine,
19, 2, 121-126.
Markowitz, F.E. (2003). Socioeconomic disadvantage and violence: Recent research
on culture and neighborhood control as explanatory mechanisms. Aggression and
Violent Behavior, 8, 2, 145-154.
Marks, J.T., Campbell, M.K, Ward, D.S, Ribisi, K.M, Wildemuth, B.M, Symons, M.J
(2006). A comparison of web and print media for physical activity promotion among
adolescent girls. Journal of Adolescent Health, 39, 1, 96-104.
389
Marshall, A., Owen, N., Bauman, A. (2004). Mediated approaches for influencing
physical activity: Update of the evidence on mass media, print, telephone and
website delivery of interventions. Journal of Science and Medicine in Sport, 7, 1, 74-
80.
Maynard, D.W. & Clayman., S.E. (1991). The diversity of ethnomethodology. Annual
Review of Sociology, 17, p. 385-418.
McCann, E. (2002). The cultural policies of local economic development: meaning-
making, place-making, and the urban policy process. Geoforum, 33, p.385-398.
McCann, E. (2002). The cultural policies of local economic development: meaning-
making, place-making, and the urban policy process. Geoforum, 33, p.385-398.
McCormack, G., Giles-Corti, B., Bulsara, M & Pikora, T. (2006) Correlates of
distances travelled to use recreational facilities for physical activity behavior,
International Journal of Behavioral Nutrition and Physical Activity, 3, 18-28.
McCracken, K. (2001). Into a SEIFA SES cul-de-sac? Australian and New Zealand
Journal of Public Health, 25(4), 306-306.
McNeill, L.H., Kreuter, M., Subramanian, S. (2006). Social Environment and
Physical Activity: A Review of Concepts and Evidence, Social Science and
Medicine, 63(4), 1011-22.
Mills, J., Bonner, A. & Francis, K. (2006). The Development of Constructivist
Grounded Theory, International Journal of Qualitative Methods, 5, 1, 432-454.
Moghaddam, A. (2006) Coding issues in Grounded Theory, Issues in Educational
Research, 16 (1), 52-66.
Mokdad, A.H., Ford, E.S., Bowman, B.A., Dietz, W.H., Vinicor, F., Bales, V.S.,
Marks, J.S. (2003). Prevalence of Obesity, Diabetes, and Obesity-Related Health
Risk Factors. JAMA, 289, 1, 77-79.
Monden, C. W. S., Van Lenthe, F. J., & Mackenbach, J. P. (2006). A simultaneous
390
analysis of neighbourhood and childhood socio-economic environment with self-
assessed health and health-related behaviours. Health and Place, 12, 394-403.
Monden C.W., Van Lenthe F.J., & Mackenbach, J.P (2006) A simultaneous analysis
of neighbourhood and childhood socio-economic environment with self-assessed
health and health-related behaviours Health & Place, December 2006, 394-403.
Moyses, S. J., McCarthy, M. & Sheiham, A. (2004). Intra-urban differentials in child
dental trauma in relation to Healthy Cities policies in Curitiba, Brazil. Health &
Place. 3, 56-78.
Mummery, K. Shofield, G., Steele, R., Eakin, E. Brown, W. (2005). Occupational
sitting time and overweight and obesity in Australian workers. Preventive Medicine,
29, 2, 91-97.
Najman, J., Williams, G, & Room, R. (2007). Increasing Socioeconomic Inequalities
in Males Cirrhosis of the Liver Mortality: Australia 1981-2002. Alcohol and Drug
Review, 26, 273-278.
Oktay, D. (2002). The quest for urban identity in the changing context of the city:
Northern Cyprus. Cities, Volume 19, 4, p. 261-271.
O'Leary, Z. (2004). The Essential Guide to Doing Research. SAGE: London. p. 85-
102.
O'Loughlin, J., Paradis, G., Kishchuk, N., Barnett, T., & Renaud, L. (1999).
Prevalence and Correlates of Physical Activity Behaviors among Elementary
Schoolchildren in Multiethnic, Low Income, Inner-City Neighborhoods in Montreal,
Canada, Annals of Epidemiology, 9, 7, p. 397-407.
Owen, N., Humpel, N., Leslie, E., Bauman, A. & Sallis, J. (2004). Understanding
environmental influences on walking: Review and research agenda. American
Journal of Preventive Medicine, 27, 1, p. 67-76.
Parkes, A., & Kearns, A. (2006). The multi-dimensional neighbourhood and health: a
cross-sectional analysis of the Scottish Household Survey, 2001. Health and Place,
391
12, 1-18.
Parkes, A. & Kearns, A. (2006) The multi-dimensional neighbourhood and health,
Health and Place, Vol. 12/1, 1-18.
Penman, R. (1992). Good theory and good practice: An argument in progress.
Communication Theory, 2, 234-250.
Picket, K.E., Wakschlag, L.S., Rathouz, P.J., Leventhal, B.L, Abrams, B. (2002). The
working class context of pregnancy smoking. Health & Place, 3, 3, p. 167-175.
Pinson, D. (2004). Urban planning: an 'undiciplined' discipline? Futures, 36, p.503-
513.
Pinto, B., Friedman, R., Marcus, B., Kelley, H., Tennstedt, S., Gillman, M. (2002).
Effects of a computer-based, telephone counseling system on physical activity.
Preventive Medicine, 23, 2, 113-120.
Poland, B.D (2000). The 'considerate' smoker in public space: the micro-politics and
political economy of 'doing the right thing' Health & Place, 6, 1 p. 1-14.
Popay, J., Thomas, C., Williams, G., Bennett, S., Gatrell, A., & Bostock, L. (2003). A
proper place to live: health inequalities, agency and the normative dimensions of
space. Social Science & Medicine, 57, 1, p. 55-69.
Popke, E.J. & Ballard, J. (2004). Dislocating modernity: Identity, space and
representations of street trade in Durban, South Africa. Geoforum, Volume 35, 1, p.
99-110
Porta, S. (1999). The community and public spaces: ecological thinking, mobility
and social life in the open spaces of the city of the future. Futures, 31, p.437-456.
Rasool Azari and James B. Pick (2005). Technology and society: socioeconomic
influences on technological sectors for United States counties. International Journal
of Information Management, 25, 1, 21-37.
Reger, B., Cooper, L., Booth-Butterfield, E., Smith, H. (2002). Wheeling Walks: A
392
community campaign using paid media to encourage walking among sedentary older
adults. Preventive Medicine, 35, 285-292.
Reidpath, R. (2003). "Love thy neighbour" - it's good for your health: a study of
racial homogeneity, mortality and social cohesion in the United States. Social
Science & Medicine. 57. p.253-261.
Rhea, D.J. (1998). Physical Activity and Body Image of Female Adolescents:
Moving towards the 21st Century. The Journal of Physical Education, Recreation,
and Dance, 69, 134-146.
Romero, A. (2005). Low-income neighbourhood barriers and resources for
adolescents’ physical activity. Journal of Adolescent Health, 36, 253-259.
Rosenfeld, L.B., Richman, J.M., Bowen, G.L, & Wynns, S.L. (2006). In the Face of a
Dangerous Community: The effects of social support and neighborhood danger on
high school students' school outcomes, Southern Communication Journal, 71, 3 , 273
– 289
Rostad, B., Schei, B., & Krokstad. (2006) Socio-economic factors and health in two
generations of Norwegian women. Gender Medicine, 3(4), 328-340.
Rutt, C. & Coleman, K.J. (2004). Examining the relationships among built
environment, physical activity, and body mass index in El Paso, TX Preventive
Medicine, 40, 6, p. 831-841.
Sandstrom, U.G., Angelstam, P. & Khakee, A. (2005) Urban comprehensive planning
- identifying barriers for the maintenance of functional habitat networks. Landscape
and Urban Planning, In Press, Corrected Proof, Available online 13 March 2005.
Schwartz, M.B & Brownwell, K.D. (2004). Obesity and Body-Image. Body Image,
1,1, 43-56.
Scopellit, M. & Giuliani, M.V. (2004). Choosing restorative environments across the
lifespan: A matter of place experience. Journal of Environmental Psychology, 24, 4,
423-43.
393
Seik, F.T (2001). Planning and design of Tampines, an award-winning high-rise,
high-density township in Singapore. Cities, 18, 1, 33-42.
Shimanoff, S. (1980). Communication Rules: Theory and Research. Beverly Hills,
CA: Sage.
Siegrist, J. (2002). Effort-reward imbalance at work and health. Research in
Occupational Stress and Well Being, p. 261-291.
Slater, J., Ha, C., Malone, M., McGovern, P., Madigan, S., Finnegan, J., Casey-Paal,
A., Margolis, K. & Lurie, N. (1998). A Randomized Community Trial to Increase
Mammography Utilization among Low-Income Women Living in Public Housing.
Preventative Medicine, 27, p.862-870.
Slater, J., Ha, C., Malone, M., McGovern, P., Madigan, S., Finnegan, J., Casey-Paal,
A., Margolis, K. & Lurie, N. (1998). A Randomized Community Trial to Increase
Mammography Utilization among Low-Income Women Living in Public Housing.
Preventative Medicine, 27, p.862-870.
Sooman, A. & Macintyre, S. (2002). Health and perceptions of the local environment
in socially contrasting neighbourhoods in Glasgow. Health & Place, Volume 1, 1, p.
15-26.
Spencer, N. (2001). The life course, childhood housing conditions and adult health.
Journal of Epidemiology and Community Health, 55, 6.
Spinks, A., Macpherson, A., Bain, C., McClure, R (2006). Compliance with the
Australian physical activity guidelines for children: Relationship to overweight
status. Journal of Science and Medicine in Sport, 2-26.
Stafford, M., Cummins, S., Macintyre, S., Ellaway, A. & Marmot, M. (2005).Gender
differences in the associations between health and neighbourhood environment.
Social Science & Medicine, 60, 8, p. 1681-1692.
Steuteville, R. (2004). New Urban News – online, July edition.
394
Strauss, A. & Corbin, J. (1998). Basics of Qualitative Research: Techniques and
Procedures for Developing Grounded Theory. CA: Sage.
Teo, P. & Huang, S. (1996). A sense of place in public housing: A case study of Pasir
Ris, Singapore. Habitat International, 20, 2, p. 307-325..
Titze, S. Martin, B.W., Seiler, R., Stronegger, W. and Marti, B (2001). Effects of a
lifestyle physical activity intervention on stages of change and energy expenditure in
sedentary employees. Psychology of Sport and Exercise, 2, 2, p. 103-116.
Tivadar, B. & Luthar, B. (2005). Food, ethics and aesthetics, Appetite, 44, 215-233.
Troped, P.J., Saunders, R.P., Pate, R.R., Reininger, B., & Addy, C.L. (2003).
Correlates of recreational and transportation physical activity among adults in a New
England community. Preventive Medicine, 37, 4,p. 304-310..
Tucker, J., D'Amico, E., Wenzel, S., Golinelli, D., Elliot, M. & Williamson, S.
(2005). A prospective study of risk and protective factors for substance use among
impoverished women living in temporary shelter settings in Los Angeles County.
Drug and Alcohol Dependence, in press.
Türkoğlu, H.D (1997). Residents' satisfaction of housing environments: the case of
Istanbul, Turkey. Landscape and Urban Planning, 39, 1, p. 55-6.
Turrell, G., Kavanagh, A., & Subramanian, S.V. (2005). Area variation in mortality in
Tasmania (Australia): The contributions of socioeconomic disadvantage, social
capital and geographic remoteness, Health & Place, In Press, Corrected Proof,
Available online 22 January 2005.
Turrell, G., Kavanagh, A., Draper, G., & Subramanian, S. V. (2007). Do places affect
the probability of death in Australia? A multilevel study of area-level disadvantage,
individual-level socio-economic position and all-cause mortality, 1998-2000. Journal
of Epidemiology and Community Health, 61(1), 13-19.
Turrell, T. & Mengersen, K. (2000). Socioeconomic status and infant mortality in
Australia: a national study of small urban areas, 1985-89. Social Science & Medicine,
395
50, 9, p. 1209-1225.
Van den Dobbelsteen, A. de Wilde, S. (2004). Space use optimisation and
sustainability--environmental assessment of space use concepts. Journal of
Environmental Management, 73, 2, p. 81-8.
van Lenthe, F.J., Brug, J. & Mackenbach, J. (2005). Neighbourhood inequalities in
physical inactivity: the role of neighbourhood attractiveness, proximity to local
facilities and safety in the Netherlands. Social Science & Medicine, 60, 4, p. 763-775.
Veitch, J., Bagley, S., Ball, K. & Salmon, J. (2005). Where do children usually play?
A qualitative study of parents’ perceptions of influences on children's active free-
play. Health & Place, In Press, Corrected Proof, Available online 19 April 2005.
Vogt, C. and Marans, R.W. (2004). Natural resources and open space in the
residential decision process: a study of recent movers to fringe counties in southeast
Michigan. Landscape and Urban Planning, 69, 2-3, p. 255-269.
Wester-Herber, M.(2004). Underlying concerns in land-use conflicts--the role of
place-identity in risk perception. Environmental Science & Policy, 7, 2, p. 109-116.
Winkler, E., Turrell, G., & Patterson, C. (2005). Does living in a disadvantaged area
mean fewer opportunities to purchase fresh fruit and vegetables in the area? Findings
from the Brisbane food study Health & Place, In Press, Corrected Proof, Available
online 19 February 2005.
Wood, L., Shannon, T., Bulsara, M., Pikora, T., McCormack, G. & Giles-Corti, B.
2007, The anatomy of the safe and social suburb: An exploratory study of the built
environment, social capital and residents' perceptions of safety, Health & Place14,
pp. 15-31
Young, A.F., Russell, A. & J.R. Powers (2004). The sense of belonging to a
neighbourhood: can it be measured and iAbdullah, M. & Saleh, E. (2004). Learning
from tradition: the planning of residential neighborhoods in a changing world.
Habitat International, 28, 4, p. 625-639.
396
Zenk, S.N., Schulz, A.J., Mentz, G., House, J.S., Gravlee, Patricia C.G., Miranda, Y.,
Miller, P., Kannan, S., (2007) Inter-rater and test-retest reliability: Methods and
results for the neighborhood observational checklist Health & Place, 13, 2, 452-465.