Design principles in housing for people with complex physical and cognitive disability: towards an integrated framework for practice

To develop a research-based environmental framework to guide the design and construction of suitable residential dwellings for individuals with complex disability. An environmental approach to housing design and development recognises that there are physical, psychological and social components relating to housing design, dwelling location and the neighbourhood context, and that these elements interact to affect the physical, psychological, and social wellness of individuals. Following theoretical review and synthesis, a comprehensive set of design features that are conducive to residents’ wellness and quality of life are described. It is clear that housing design and development for people with complex disability ought to consider the physical, social, natural, symbolic, and care environment in relation to housing design, dwelling location, and the neighbourhood context for improved housing outcomes. An integrated housing design and development framework is presented. It is hoped this practical matrix/evaluative tool will inform future inclusive housing design and development decisions in Australia and internationally. The application of this framework is especially relevant to political climates striving to achieve design innovation to increase housing choice for people with complex disability

Migration and geographical inequalities in health in the Netherlands: An investigation of age patterns.

Objectives This paper estimates, for six different age groups, whether and how migration influences inequalities in health between deprived and non-deprived neighbourhoods in the Netherlands. Methods Data were accessed from the Netherlands Housing Survey 2006. Using multi-level logistic regression analyses, we compared the health of migrants with that of nonmigrants in the area of origin and assessed the role of demographic and socioeconomic characteristics. Next, we assessed the magnitude of health differences between deprived versus non-deprived areas among migrants and non-migrants. Results For many age groups, migrants into non-deprived areas were healthier and migrants into deprived areas had similar levels of health compared with non-migrant populations in the area of origin. These differences in health were not explained by demographic and socio-economic characteristics. For all ages and for people aged 25–34 years we found smaller area inequalities in health among migrants compared with non-migrants. For most other age groups, about equally large differences were observed. Conclusions For most age groups, the results do not provide empirical support to the expectation that migration would enlarge health differences between deprived and non-deprived neighbourhoods. Keywords: The Netherlands, Health inequalities, Selective migration, Age patterns, Socioeconomic factors, Morbidit

Change in neighborhood traffic safety: Does it matter in terms of physical activity?

Background There is limited evidence on the causality of previously observed associations between neighborhood traffic safety and physical activity (PA). This study aims to contribute to this evidence by assessing the extent to which changes over time in neighborhood traffic safety were associated with PA. Methods Data were accessed from the national survey Netherlands Housing Research for 2006 and 2009. The two samples of in total 57,092 Dutch residents aged 18–84 years lived in 320 neighbourhoods. Using multi-level hurdle models, the authors assessed whether the odds of being physically active and the mean hours of PA among active people (in 2009) were related to the levels of neighborhood traffic safety (in 2006) and changes in the levels of neighborhood traffic safety (between 2006 and 2009). Next, we examined if these associations varied according to gender, age, and employment status. Results Higher levels of neighborhood traffic safety were associated with higher odds of being active (OR 1.080 (1.025–1.139)). An increase in levels of neighborhood traffic safety was associated with increased odds of being active (OR 1.060 (1.006–1.119)). This association was stronger among women, people aged 35 to 59, and those who were gainfully employed. Neither levels of traffic safety nor changes in these levels were associated with the mean hours of PA among people who were physically active (OR 0.997 (0.975–1.020); OR 1.001 (0.978–1.025), respectively). Conclusion Not only levels of neighborhood traffic safety, but also increases in neighborhood traffic safety were related to increased odds of being active. This relationship supports claims for a causal relationship between neighborhood traffic safety and PA

Impact of a Dutch urban regeneration programme on mental health trends: A quasi-experimental study.

Background This paper aims to assess the mental health impact of an urban regeneration programme implemented from 2008 onwards in the 40 most deprived districts in the Netherlands. Interventions varied from improvements in the built environment to activities promoting social cohesion. Methods We accessed repeated cross-sectional data from the annual Health Interview Survey, for the period 2004–2011 among adults (n target districts=1445, n rest of the Netherlands=44 795). We used multilevel logistic regression models to compare the development of mental health in the target districts with the rest of the Netherlands and with comparably deprived districts. Results were presented as ‘slope estimates’ with corresponding 95% CIs. Finally, we analysed the trends by gender and by the intensity of the programme. Results The trend change in mental health between the intervention and preintervention period was approximately the same in the target districts as in broadly comparably deprived control districts (Δ slope 0.06 (−0.08 to 0.20)). However, among women, a tendency was found towards more positive trend changes in the target districts compared with control districts (Δ slope 0.17 (−0.01 to 0.34)). Those districts that implemented an intensive programme experienced an improvement in mental health, while residents of the comparably deprived control districts experienced a deterioration, resulting in a statistically significantly more positive trend change between the preintervention and intervention period in those target districts (Δ slope 0.19 (0.01 to 0.38)). Conclusions Implementing an urban regeneration programme with a wide range of intensive interventions may be effective in promoting good mental health. Further research is required to examine which mix of interventions is needed for the programme to be effective