SH6001 Urban Health : Solution Essays

Question:

Title: Assessment Component 1 – The Urban Health Profile

The Urban Health Profile requires you to focus on two aspects: the practical (observation and data collection) and the theoretical (informed by the wider literature) work on the urban health issue chosen for this Assessment.  You have to choose a relevant urban health issue, choose a local area (neighbourhood) to carry-out the study, and physically observe and collect data from the area for the Profile. You also have to look for scholarly literature published in relation to this urban health issue (this can be from the area and beyond). This literature will inform your analysis and theoretical discussion of the urban health issue and the area studied.

To prepare this Assessment Component 1, you have to take note of the following:

  1. Choose a relevant urban health issue for your Urban Health Profile. This could be the same or different to what you will look at for your Assessment Component 2 (extended urban health report).  Provide a clear rationale why this is an urban health issue and why you have chosen to study the issue in the selected area.  You have to provide clear and full description of the local area (neighbourhood) you have chosen to study.
  2. Present and give an account of the data and information you observed and collected from the local area (or neighbourhood) in relation to the urban health issue you are studying. This could include various aspects in relation to the area and the urban health issue such as size of the area, population, observation on related determinants (factors) that influence the urban health issue, physical facilities or amenities that are relevant to this issue as resources (e.g. parks; gyms; food outlets  – corner shops, supermarkets, fresh food markets, restaurants, fast food outlets, community centres, housing and accommodation) and health and social service points relevant to this issue. This part requires you to do a community inventory in relation to the urban health issue you have chosen. You can do this with the help of Google mapping.
  3. Provide an analysis and interpretation of data and information presented in this Profile, commenting on the implications of such data on the urban health issue and population health in the area. In this part, you should be scholarly enough by linking your analysis and interpretation of your local data with the wider literature on this urban health issue. Therefore, you should be able to suggest relevant recommendations and draw conclusions from your analysis and interpretation of the Profile data that are informed by the wider literature on this urban health issue.   
     
  4. The written Urban Health Profile should include: a title – reflecting the urban health issue and local area (neighbourhood) studied; an introduction – signposting the work and providing a description of the urban health issue and the area studied; a clear rationale  for the report to justify why this is an urban health issue and for choosing to study the issue in the chosen area; community profiling of the study area (local area), including any key issue/s observed or known about the area; observation data presentation and description of data and information collection about the urban health issue and the area, including all place-based characteristics that relate to the urban health issue being studied; discussion, analysis and interpretation of data and information from the Observation about the urban health issue and the area chosen (with strong scholarly reference to the widely published literature on this urban health issue, that is, the discussion should be underpinned by the wider literature on this urban health issue); and suggested relevant recommendations and conclusion that reflect the work covered in the report and the urban health issue and the area studied.

Urban Health Profile Report Outline / Structure

  1. Relevant Report Title – relevant urban health issue with a complete academic title, population group, the neighbourhood area of study
  2. Introduction – brief overview (introduction) of the urban health issue and clear signposting that shows how the work is organised
  3. Rationale of the Report – application of key theoretical concepts (UHF, sick city hypothesis, urban health penalty, urban health advantage) to explain and justify why the topic is an urban health issue and the relevance of the local (neighbourhood) area / place chosen to study this UH issue, use of relevant evidential ( epidemiological /statistical) data (of local area, London and /or England/ UK) that help to show the scale, depth and patterns of this urban health problem.
  4. Profiling and Description of the Local Area – use of secondary data/ information about the local area from relevant sources to provide spatial, demographic, socio-economic, key health data / information and details relevant to the UH issue and the area.
  5. The Observation Data – explanation of how the observation was done and presentation of quantitative and qualitative data observed in the area in relation to the UH issue and presented in tables, maps, graphs, pictures and photos; details of social determinants relevant to the UH issue.
  6. Analysis, Interpretation and Discussion of Observation Data Analysis – discussion of observation data and findings linked to relevant evidence in the up-to-date general academic literature on the UH issue. The discussion should be underpinned by relevant literature that relates to this urban health issue, e.g. with respect to its determinants, health implications, interventions and their impact.  
  7. Recommendations and Conclusion – recommendations tailored to specific stakeholders with interest in the UH issue in the area and conclusions that recap the key aspects of the report and the work presented about the urban health issue in the area studied.  References – a list of all resources used to prepare the work, in alphabetical order without numbering and in the Harvard style.  
 

Answer:

An Analysis Of The Mental Health Risk Facing Adult Population In The East London Borough Of Newham

Introduction

There are various risk factors or mental illness across the globe. This analysis delves into the mental health risk facing the Newham adult population given the prevailing socio-economic status of the borough. The housing situation in the area has led to homelessness, reliance on government council houses and assistance by the local charities in obtaining housing. This paints a grim picture on the fulfillment and possible mental health of the residents. Low income levels in the area and cases of unemployment could also contribute to mental stress since individuals may not be able to meet their needs adequately. Newham is ethnically diverse which sadly might lead to segregation which has been shown to cause depression. Observations were made in three areas of Newham and recommendations given after analysis of the situation on ground.

Rationale for the Report

A mental health needs assessment conducted by local government in Newham showed the need for action in dealing with mental illness.  This is due to the fact that the issue of mental illness is not widely discussed in the region. The report shows that there is an issue of under diagnosis with very few people coming forward to seek medical help.  Under-recording is also given as another plausible reason for the low levels of incidences recognized in the city (NHS, 2018). The data available on cases of mental illnesses is suspected to be insufficient given Newham’s socio-economic profile. This is derived from the fact that Newman faces many challenges that are prone to push people into depression. Looking at the incidence of mental illness in creating an urban health profile for the borough is, therefore, important as it will lead to the discovery of the true extent of the issue. This will influence policy making geared towards tackling the problem thereby promoting the mental and general health of Newham Residents.

The first socio-economic factor that might push Newham adult residents into depression is a high prevalence of homelessness. According to Walker (2018), a majority of homeless people suffer from mental illness in any area. An article by the Evening Standard (Tobin 2018), reported Newham to have the highest number of homeless people in the whole of London. Shelter London recorded the prevalence of homelessness to be 1 in every 24 people given the total of 16,411 people that are homeless in Newham. Trust for London collaborated this by giving the possibility of high rental rates in the city as contributing to the issue of homelessness (2017). Secondly, the low social and economic power of the majority of the population is a possible factor for mental illness.

Generally, urban areas are more densely populated especially among those with lower economic power (Gruebner, Rapp, Adli, Kluge, Galea & Heinz 2017). Newham has a population of 352, 005 according to 2018 estimates (ONS, 2018).  This coupled with an increase in population which is generally greater than the expansion of infrastructure in these areas increases the risk of poverty and compounds environmental adversities thereby increasing mental disorders among such populations (Srivastava 2009). Newham is one of the most overcrowded boroughs in the UK. A quarter of the 100,000 households in the borough live in a property that is too small for them (Caritas Anchor House, 2016).  Newman was ranked eighth in average level of deprivation with its income deprivation rank being 13 according to a summary conducted by the Corporate GIS AND Information team (2015). Income deprivation alludes to poverty and as discussed, poverty in the urban setting is a causative factor of depression.

 

Observation

The observation process for this health profile required sampling a few postal code areas and obtaining information in the areas from the local wards, census and other reports as well as by walking around and physically determining the state of the regions. The areas visited include: Newham Industrial Estate, Beckton Road and East Ham Industrial Estate.

Housing

The house type in the area are as below in table a. It shows that the more affluent area, New Ham Industrial Estate has the highest number of detached houses. East Ham Industrial Estate and Beckton Road, however, have high numbers of flats, terraced houses and residence in commercial housing.

Figure a. House Types

Housing Tenure in the five areas of study was as seen below (ONS 2017):

Type of Ownership

 

Newham Industrial Estate

East Ham Industrial Estate

Beckton Road

Owned Outright

81

16

10

Owned- Mortgaged

34

27

20

Shared Ownership

0

0

0

Rented from Council

0

11

48

Rented(charities and housing associations)

1

39

0

Private landlord

16

14

54

Rented other

2

5

2

Rent Free

3

2

1

Figure b. Housing Tenure

Housing occupancy varied in the observed area with some recording very high and others low numbers. The numbers from observation were compared to data from Aston-Mansfield (2017) and found to be similar as shown in figure c.

Figure c. House Occupancy

 

Ethnicity

In terms of ethnicity, Newham is an ethnically diverse area. Statistical records show that it does not have a single majority ethnic group but the Asian community has the highest population in the area (NHS 2018). The Black, Asian and Minority Ethnic Community is higher in Newham than in the rest of England as shown in figure d.

 

Figure d. BAME population in Newham against England

Figure e. Ethnic Composition of Newham (Newham, 2018).

Education Levels

A majority of Newhan area residents have low levels of education. The figure below gives the levels of education for residents of Beckton and East Ham areas according to the 2011 census figures (Aston-Mansfied 2017).

figure f & figure g.

 

Analysis, Interpretation and Discussion

The new Ham industrial area was seen to be the more affluent area of Newham having more detached homes with a high home ownership level compared to East Ham Industrial area and Beckton Road as shown in figures a and b. This same trend was also observed in the issue of overcrowding as the latter areas had more people living under one roof compared to the New Ham Industrial area as shown in figure c. Figure B suggests that many people are have a strained economic power and are thus relying on the government and charities for housing. This is definitely an indicator of possible stress and depression as the inability to afford own housing might trigger depression in some people. The process of acquiring council housing is also lengthy and complicated often requiring lengthy waiting periods. This means individuals may be homeless at some point and have definitely experienced declining mental health as a result.

 Beckton and East Ham industrial estate are high density areas with flats and terraced houses making a majority of the housing scene. The latter areas have low levels of education as shown in figures d and figure e. Housing statistics of the UK show that London has the highest number of rough sleepers with data from 2018 show that there were 4677 homeless people in London. Of these 50% are suffering from mental illness. 20% of these people have no access to mental health support (Public Health London 2018). A number of rough sleepers and beggars were seen on the streets of Newham implying that these statistics might be reflected in the borough.  According to statistics, 45% of homeless individuals recorded an incidence of mental illness which is higher than the 25% incidence of the general population in England (Public Health England, 2018). This shows a danger of mental illness

The recorded unemployment rates in Newham County governments are somewhat low but it is ranked high in London. According to the 2011 census data, 15 people were unemployed in East Ham Industrial Estate while Beckton Road recorded 20. Newham has the fifth highest unemployment rate in London standing at 6%. 41% of the population also lacks a level three certification which means that there is an issue of skill shortage. The number of people with corresponding level of education is as seen in figures f and g.  36% of the population is also low paid which gives it the highest rate in London. These statistics imply that a majority of Newham residents have low financial power thereby indicating the possibility of mental stress.

Immigration and ethnic isolation is the third socio-economic factor which makes Newham susceptible to the issue of mental illness. Newham is composed of various ethnic communities and is the most diverse burrow in the UK. Its composition is depicted in figure e. The discrimination and deprivation of a particular ethnic group can lead to increased levels of mental illness among that specific population. Having a background of migration in the urban context is in itself a risk factor for depression and psychosis according to Gruebbner, Rapp, Adli, Kluge, Galea and Heinz (2017). Newham has a high number of immigrants which means that it could pass as a segregated area. The isolation of immigrants in urban areas is also seen as a contributing factor to mental illness as a result of social isolation stress. This means that Newham is a risk area for mental illness thereby calling for intervention factors that will mitigate this health issue.

 

Recommendations and Conclusion

From the analysis above, it is evident that Newham has a very high risk of mental illness given its socio-economic status. There is, however, lack of data on the issue of mental health bringing into light the fact that the population may be under diagnosed or proper records not kept in hospitals. This calls for the development and implementation of a mental health policy which should be spearheaded by the local government in collaboration with medical practitioners in the borough. Recommendation is given to push legislatures, leaders and policy makers into recognize that mental health is an aspect of national importance. A tribunal/committee should thus be formed and supported by the local government to carry out an investigation of the extent to which Newman residents are affected by Mental illness. A campaign should also be conducted to encourage Newman Residents to seek medical advice in case they suspect mental illness. Hospitals and other medical centers should also be equipped with trained personnel and specifically community based healthcare providers in order to encourage diagnosis and proper record keeping.

 

References

Aston-Mansfield 2017, ‘Newhame key statitistics 2017: a detailed profile of key statistics about Newham by Aston-Mansfield community involvement unit’. Available at: https://www.aston-mansfield.org.uk/wp-content/themes/aston_mansfield/uploads/Newham_Statistics_2017.pdf [Accessed: 30 July 2019]

Caritas Anchor House n.d, ‘Homelessness in Newham’. Available at: https://www.caritasanchorhouse.org.uk/about-homelessness/homelessness-newham [Accessed: 30 July 2019]

Gruebner, O, Rapp, MA, Adli, M, Kluge, U, Galea, S & Heinz, A 2017, ‘Cities and mental health’, Deutsches Arzteblatt, vol. 114, no. 8, pp. 121-127.

Ministry of Housing, Communities and Local Government 2019, ‘Rough sleeping statistics autumn 2018, England revised’. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/781567/Rough_Sleeping_Statistics_2018_release.pdf [Accessed: 30 July 2019]

Newham London 2015,’Indices of deprivation: Borough summary’. Available at: https://newhamdata.wpengine.com/wp-content/uploads/2017/06/Demography-Bulletin-October-2015-IMD.pdf [Accessed: 30 July 2019]

Newham London 2015, ‘English indices of deprivation 2015’. Available at: https://www.newham.info/indices-of-deprivation-2015/ [Accessed: 30 July 2019]

NHS 2019, ‘Mental health needs assessment: 2016-2018’. Available at: https://www.newham.gov.uk/Documents/Health%20and%20social%20care/MentalHealthNeedsAssessment.pdf [Accessed: 30 July 2019]

Nooe, RM & Patterson, DA 2010, ‘The ecology of homelessness’, Journal of Human Behavior in the Social Environment, vol. 20, no. 2, pp. 105-152.

Office for National Statistics (ONS) 2019, ‘Population estimates for the UK, England and Wales, Scotland and Northern Ireland: Mid 2018’. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/bulletins/annualmidyearpopulationestimates/mid2018 [Accessed: 30 July 2019]

Office for National Statistics (ONS) 2019, ‘Housing tenure by borough’. Available at: < https://data.london.gov.uk/dataset/housing-tenure-borough> [Accessed: 30 July 2019]

Public Health England (PHS) 2019, ‘Health matters: rough sleeping’. Available at: https://app.box.com/s/kmtd250ykugkn1si8af6mmmrjh8wyubm/file/530939606282?sb=/details [Accessed: 30 July 2019]

Srivastava, K 2009, ‘Urbanization and mental health’, Industrial Psychiatry Journal, vol. 18, no. 2, pp. 75-76.

Stafford, A & Wood, L 2017, ‘Tackling health disparities for people who are homeless: start with social determinants’, International Journal of Environmental Research and Public Health, vol. 14, no. 12, pp. 1535.

The Center of Urban Design and Mental Health (UDMH) n.d, ‘How the city affects mental health’. Available at: https://www.urbandesignmentalhealth.com/how-the-city-affects-mental-health.html [Accessed: 30 July 2019]

Tobin, O 2018, ‘Revealed: the London boroughs with the highest rates of homelessness in England’. Available at: https://www.standard.co.uk/news/london/revealed-the-london-boroughs-with-the-highest-rates-of-homelessness-in-england-a3997391.html [Accessed: 30 July 2019]

Trust for London 2019, ‘Homelessness acceptances by borough’. Available at: https://www.trustforlondon.org.uk/data/homelessness-acceptances-borough/ [Accessed: 30 July 2019]

Trust for London 2019, ‘Temporary accommodation by borough’. Available at: https://www.trustforlondon.org.uk/data/temporary-accommodation-borough/ [Accessed: 30 July 2019]

Walker, ES 2018, ‘Evidence review: adults with complex needs, with a particular focus on street begging and street sleeping’. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/680010/evidence_review_adults_with_complex_needs.pdf  [Accessed: 30 July 2019]

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