Skip to main content
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2005 Oct;59(10):893–897. doi: 10.1136/jech.2004.030353

Thinking inside the bubble: evidence for a new contextual unit in urban mental health

R Whitley 1, M Prince 1, M Cargo 1
PMCID: PMC1732909  PMID: 16166366

Abstract

Objective: Previous quantitative research has suggested that there is a link between housing, the urban environment, and mental health. However, methodological and design issues make it difficult to disentangle the relative influence of dwelling specific and wider urban environmental influences on individual mental health. The aim of this study was to explore the link between the dwelling, the immediate urban environment, and mental health to generate a new conceptual framework by which understanding of dwelling and urban environmental influences on mental health can be advanced.

Design and participants: Qualitative interviews and focus groups were conducted with 32 inner city residents. Participants, stratified by sex and mental health status, were randomly recruited from a wider quantitative survey. An almost equal number of men and women as well as people with or without mental health problems participated, allowing for comparison of experience. Data were analysed inductively to generate an appropriate theoretical framework regarding dwelling and urban environmental influences on mental health.

Setting: An inner city neighbourhood of about 6200 people in north west London. Most of that population live in public housing.

Main results: The principal study finding is that between the dwelling unit and the neighbourhood unit, evidence was found for another meaningful contextual unit of analysis, the "residential bubble" through which effects on mental health can be mediated. The residential bubble describes a limited area of three dimensional space that surrounds a dwelling, encompassing immediate neighbours (above, below, and adjacent) and shared public space bordering the dwelling. Positive events and processes within the bubble had a beneficial influence on mental health whereas negative ones tended to have a damaging influence. These seemed to disproportionately have an impact on people with pre-existing mental health problems.

Conclusion: The concept of the "residential bubble" may be a meaningful new contextual unit of analysis in urban mental health. This may have important implications with regards to interventions and measurement development.

Full Text

The Full Text of this article is available as a PDF (64.9 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Birtchnell J., Masters N., Deahl M. Depression and the physical environment. A study of young married women on a London housing estate. Br J Psychiatry. 1988 Jul;153:56–64. doi: 10.1192/bjp.153.1.56. [DOI] [PubMed] [Google Scholar]
  2. Dunn J. R., Hayes M. V. Social inequality, population health, and housing: a study of two Vancouver neighborhoods. Soc Sci Med. 2000 Aug;51(4):563–587. doi: 10.1016/s0277-9536(99)00496-7. [DOI] [PubMed] [Google Scholar]
  3. Evans Gary W. The built environment and mental health. J Urban Health. 2003 Dec;80(4):536–555. doi: 10.1093/jurban/jtg063. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Hopton J. L., Hunt S. M. Housing conditions and mental health in a disadvantaged area in Scotland. J Epidemiol Community Health. 1996 Feb;50(1):56–61. doi: 10.1136/jech.50.1.56. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Kawachi I., Berkman L. F. Social ties and mental health. J Urban Health. 2001 Sep;78(3):458–467. doi: 10.1093/jurban/78.3.458. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Krieger James, Higgins Donna L. Housing and health: time again for public health action. Am J Public Health. 2002 May;92(5):758–768. doi: 10.2105/ajph.92.5.758. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Matte T. D., Jacobs D. E. Housing and health--current issues and implications for research and programs. J Urban Health. 2000 Mar;77(1):7–25. doi: 10.1007/BF02350959. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Packer C. N., Stewart-Brown S., Fowle S. E. Damp housing and adult health: results from a lifestyle study in Worcester, England. J Epidemiol Community Health. 1994 Dec;48(6):555–559. doi: 10.1136/jech.48.6.555. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Pollack C. E., von dem Knesebeck O., Siegrist J. Housing and health in Germany. J Epidemiol Community Health. 2004 Mar;58(3):216–222. doi: 10.1136/jech.2003.012781. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Pope C., Mays N. Reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research. BMJ. 1995 Jul 1;311(6996):42–45. doi: 10.1136/bmj.311.6996.42. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Roberts R. E., Vernon S. W. The Center for Epidemiologic Studies Depression Scale: its use in a community sample. Am J Psychiatry. 1983 Jan;140(1):41–46. doi: 10.1176/ajp.140.1.41. [DOI] [PubMed] [Google Scholar]
  12. Sampson R. J., Raudenbush S. W., Earls F. Neighborhoods and violent crime: a multilevel study of collective efficacy. Science. 1997 Aug 15;277(5328):918–924. doi: 10.1126/science.277.5328.918. [DOI] [PubMed] [Google Scholar]
  13. Stewart Robert, Prince Martin, Harwood Rowan, Whitley Robert, Mann Anthony. Quality of accommodation and risk of depression in later life: an analysis of prospective data from the Gospel Oak Project. Int J Geriatr Psychiatry. 2002 Dec;17(12):1091–1098. doi: 10.1002/gps.749. [DOI] [PubMed] [Google Scholar]
  14. Wandersman A., Nation M. Urban neighborhoods and mental health. Psychological contributions to understanding toxicity, resilience, and interventions. Am Psychol. 1998 Jun;53(6):647–656. [PubMed] [Google Scholar]
  15. Weich Scott, Blanchard Martin, Prince Martin, Burton Elizabeth, Erens Bob, Sproston Kerry. Mental health and the built environment: cross-sectional survey of individual and contextual risk factors for depression. Br J Psychiatry. 2002 May;180:428–433. doi: 10.1192/bjp.180.5.428. [DOI] [PubMed] [Google Scholar]
  16. Whitley Rob, McKenzie Kwame. Social capital and psychiatry: review of the literature. Harv Rev Psychiatry. 2005 Mar-Apr;13(2):71–84. doi: 10.1080/10673220590956474. [DOI] [PubMed] [Google Scholar]
  17. Whitley Rob, Prince Martin. Is there a link between rates of common mental disorder and deficits in social capital in Gospel Oak, London? Results from a qualitative study. Health Place. 2005 Sep;11(3):237–248. doi: 10.1016/j.healthplace.2004.05.002. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES