phil mason

The Effects of High‐Rise Living on Residential, Social and Health Indicators

and Outcomes in Glasgow:Results from the GoWell Programme

GoWell is a collaborative partnership between the Glasgow Centre for Population Health, the University of Glasgow and the MRC Social and Public Health Sciences Unit, sponsored by Glasgow Housing Association, the

Scottish Government, NHS Health Scotland and NHS Greater Glasgow & Clyde.

Phil Mason & Ade Kearns, University of GlasgowElise WhitelyCarol Tannahill, Glasgow Centre for Population Health

History of high‐rise dwellings in Glasgow

Glasgow City Council initiated ambitious building programme for social‐rented sector: “Build 'em high, build 'em quick”

Thousands of dwellings built from 1960s e.g. Red Road Estate

Response to post‐WW2 housing crisis – high‐density, poor sanitation and structure of Victorian housing stock

History of high‐rise dwellings in Glasgow

1960s – Initially popular with residents (white British families) and City Council

1970s – Problems begin to emerge – structural and social

1990s / 2000s– Change of inhabitants – students, homeless, significant proportion of asylum seekers & refugees

The future of Glasgow’s high‐rise flats

Glasgow City Council transferred 80,000 of its social‐rented houses from public to community ownership by Glasgow Housing Association (GHA)

£1.4 billion investment over 10 years

Variety of initiatives:demolitionnew buildneighbourhood renewal core housing refurbishment

Importance of service improvement and community empowerment

2000s – Plans to demolish multi‐storey flats and replace them with houses and low‐rise flats…

…or to undertake major refurbishment of existing tower blocks

The future of Glasgow’s high‐rise flats

Deprivation and high‐rise dwelling

Most of Glasgow’s high‐rise social‐rented accommodation is in areas of pronounced deprivation

Similarly deprived areas exist in the city, characterised by other housing types – low‐rise flats, tenements, four‐in‐a‐block houses, terrace/semi‐detached/detached houses

High‐rise dwellings still have an appeal to developers, the Council and residentse.g., private‐sector residences in the Glasgow Harbour development

Does living in high‐rise buildings in predominantly social‐renting neighbourhoods tend to exacerbate (or ameliorate) residents’circumstances, difficulties, health and wellbeing over and above what is due to prevailing high levels of deprivation existing in the city?

Deprivation and high‐rise dwelling

A 10‐year‐long (2006‐2016) programme exploiting Glasgow’s “natural experiment” in housing and community regeneration to investigate:

The effects of home and neighbourhood regeneration in Glasgow onindividuals’ health and wellbeing

The degree to which places are transformed across a range of dimensions through processes of regeneration and housing improvement

The processes that support the maintenance and development of cohesive and sustainable communities

GoWell Research and Learning Programme

Major quantitative component of GoWell involves repeat cross‐sectional/longitudinal surveys of residents from 14 areas in Glasgow

Provides wide‐ranging information about individuals, households, homes, neighbourhoods and communities

Looking at people who move out of (and back into) these areas as well as those who stay put

Four waves of surveys planned (2006 and 2008 completed)

Community Health and Wellbeing Survey

Community Health and Wellbeing Survey

Findings from 2006 baseline survey

Sample of 5,151 adult British citizen residents. Asylum seekers and refugees not included in the analyses presented here

Study areas split between those dominated by high‐rise dwellings and those featuring mainly other types of housing (houses, other flats, tenements)

Analysis compares responses of residents living in‐multi‐storey (5+) high‐rise flats [MFs]; 1,392 ‐ other flats (deck access, tenement) [FLs]; 1,907‐ houses [HSs]; 1,848

Respondent characteristics

Equal proportions of men and women in MFs, compared with 36 and 64% in FLs and HSs

MF residents generally younger (37% <40 years); HS residents more likely to be older (48% 55+ years)

Almost half of MF households were of adults, with 2 and 3 out of 10, respectively, being families and of older persons. Highest proportion of family (28%) and older‐person (35%) households lived in houses

Around 25% of respondents were in FT/PT work

70% of respondents had no difficulty meeting typical household costs (rent, bills, food, council tax, repairs)

Aspects of analysis

Findings concerning: Dwelling satisfactionNeighbourhood satisfactionSocial relations and sense of communityPhysical healthMental health and psychosocial wellbeingHealth behaviours

Adjusted for sex, age, household type, household tenure, employment status, household income and area deprivation

Area deprivation estimated as percentage income‐deprived relative to Glasgow average:

low: 1.0‐1.4% (48% of respondents)high: 1.6‐2.2% (52% of respondents)

Dwelling satisfaction

Raw percentages. Odds ratios relative to house, based on adjusted models

Gradient of dwelling dissatisfaction across housing types: house < other flat < high‐rise flat p<0.001, all comparisons

Same general trend when analysis restricted to high‐rise residents living on storeys 1 ‐ 5

Respondents expressing dissatisfaction with aspects of home

8.51.514.13.027.6External condition

8.51.716.02.927.6Internal condition

4.71.89.13.418.4Security

2.53.07.15.314.3Internal noise

9.81.415.22.325.6Internal space

5.11.911.32.918.4The home in general

PercentageOdds ratioPercentageOdds ratioPercentage

HouseOther flatHigh-rise flat

Aspect

Neighbourhood satisfaction

Flat dwellers more likely to be dissatisfied with area and to report high levels of ASB, but tend to rate and use amenities better than house dwellers (p≤0.001, except amenities p=0.05)

High‐rise residents on storeys 1‐5 more likely to be dissatisfied with area, have poor use of amenities and report high ASB rates than other flat dwellers

Respondents expressing dissatisfaction with aspects of neighbourhood

9.51.514.32.622.9Antisocial behaviour

13.90.68.90.912.0Amenity use

17.50.815.60.814.3Amenities

20.50.921.71.125.8Environment

7.31.612.71.813.2Neighbourhood in general



Aspect

Social relations and sense of community

17.01.118.01.824.2No social support

13.61.115.52.129.3Infrequent contact with neighbours

15.81.116.51.420.3No contact with family/friends

15.70.915.91.826.3Poor cohesion

15.41.115.81.318.3Feel unsafe after dark



Aspect

Respondents with poor social relations and rating of sense of community

Respondents in high‐rise flats more likely to rate aspects negatively (p<0.001, except safety after dark & family/friend contact p≤0.04)

House and other flat dwellers have similar experiences

Same general trend when analysis restricted to high-rise residents living on storeys 1 - 5

Physical health

Associations between self‐assessed components of adult physical health and housing type are generally weak

Only physical functioning and frequent GP visits are significant (p<0.01), largely due to the difference between house and other flat residents

Respondents reporting aspects of poor physical health

17.60.714.50.816.7Frequent GP visits

10.70.99.91.111.9Bodily pain (SF12)

10.70.89.91.013.1Role physical (SF12)

11.80.810.51.115.0Physical functioning (SF12)

18.30.917.91.121.8Recent health

7.90.98.01.111.0General health (SF12)



Aspect

Mental health and psychosocial wellbeing

Mental health outcomes are generally poorer among high‐rise residents, although only significantly for SF12 mental health measure (p=0.02)

Significant differences in psychosocial benefits of the home over the housing types: high‐rise flat < other flat < house (p<0.001)

Same general trend when analysis restricted to high-rise residents living on storeys 1 - 5

Respondents reporting poor mental health and psychosocial wellbeing

12.71.520.72.332.3Psychosocial benefits of home

12.91.011.50.910.1Vitality (SF12)

10.11.011.51.113.8Social functioning (SF12)

10.70.89.91.113.1Role emotional (SF12)

11.40.811.51.217.2Mental health (SF12)



Aspect

Health behaviours

Smoking, diet and exercise habits are poorest among high‐rise residents, although difference is only significant in the case of exercise (p<0.001)

Other flat residents are significantly more likely to be heavy drinkers than those from high‐rise flats and houses (p<0.001)

Same pattern for exercise when analysis restricted to high-rise residents living on storeys 1 - 5

11.20.88.71.617.5Amount of exercise

6.60.87.51.012.9Quality of diet

7.71.711.70.87.7Heavy drinker

39.91.249.11.152.0Current smoker



Aspect

Respondents reporting poor health behaviours

Conclusions

High‐rise living in areas where social renting is the predominant tenure is generally associated with more negative measures of residential and neighbourhood satisfaction, social relations and sense of community than can be accounted for by deprivation alone.

Poor physical and mental health and health behaviours are not soconsistently associated with high‐rise living

Much of the variation in all areas is due to personal characteristics and circumstances

Conclusions

Overall, these findings support the plans to demolish many of Glasgow’s existing tower blocks and replace them with houses and low‐rise flats.

Future waves of the survey will reveal whether the regeneration interventions deliver the intended improvements to individual health and wellbeing and strengthen communities

Later waves of the survey may determine whether major refurbishment is a viable alternative to demolition for residents

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