Is empowerment a route to improving mental health and wellbeing in an urban regeneration (UR) context?

Camilla Baba

University of Glasgow, Scotland

http://usj.sagepub.com/content/early/2016/02/25/0042098016632435.abstract?rss=1 

Throughout the UK, large-scale urban regeneration (UR) interventions are increasingly recognised as Population Health Interventions (PHI). As complex, multi-sector programmes, UR programmes have the unique opportunity to ameliorate health inequalities. Indeed, there is an established evidence base on how population health improvements can be identified as potential outcomes of regeneration programmes. The research behind our recent paper in Urban Studies builds on previous evidence of a positive link between health and empowerment and applies this to the specific UR context.

The work presented is part of a wider, longitudinal research programme in Glasgow (http://www.gowellonline.com/) investigating the impact of UR on the health and wellbeing of affected individuals, families and communities. Central to this on-going city regeneration is the Scottish Government’s commitment to the empowerment for all communities, especially disadvantaged communities. It is envisaged that as empowerment has been positively linked to health within the other fields, investment in empowerment as part of UR programme delivery will improve residents’ overall wellbeing. However, currently there is a lack of evidence as to whether such investment could result in health gains.  Therefore, we sought to investigate this.

 We examined if feelings of empowerment were associated with;

• different personal/socio-demographic characteristics;
• different types of engagement activities;
• neighbourhood perceptions and resident interactions;
• physical and mental health and wellbeing outcomes.

Our analyses present a compelling argument for the inclusion of empowerment promoting activities within UR programmes. Sense of empowerment was shown to act as a positive predictor of both general and mental wellbeing, with householders reporting a stronger sense of empowerment also reporting better health.

However, our work also illustrates the need for changes to current stakeholder engagement practices. Long-term illness or disability was shown to impact negatively on feeling empowered and speaks to other research where financial difficulties and lack of peer interaction were influenced by long-term illness and disability. We suggest that stakeholders should pay particular attention to socially excluded individuals to prevent this growing sense of isolation and adopt other working practices for engagement.

More positively, higher satisfaction with housing /landlord services and a stronger sense of belonging to neighbourhood, were predictors for empowerment.  Householders who felt respected, had neighbourhood pride/ identity and felt they were given opportunity to contribute to local area decisions through feedback mechanisms also reported feeling empowered.

Our key message is that the delivery of empowerment promoting activities shows initial, very promising, links to health improvements and could ultimately prove to be a cost-effective pathway for such health benefits. However, a current lack of understanding over ‘what-works’ in sharing key decision-making processes with communities is preventing its progress. Thus, through examining what behaviours are linked with empowerment in an UR context, we argue that stakeholders wishing to promote empowerment must first examine residents’ PE, their capabilities/assets and how they work collectively. Such work future resource allocation in the pursuit of improved and more equitable health and wellbeing within and across communities.