G McCartney1, W Hearty2, M Taulbut2, R Mitchell2, R Dryden2, C Collins3. 1. NHS Health Scotland, Glasgow, UK. Electronic address: gmccartney@nhs.net. 2. NHS Health Scotland, Glasgow, UK. 3. University of the West of Scotland, Glasgow, UK.
Abstract
OBJECTIVE: To identify and synthesise what is known about the impacts of regeneration on health, health inequalities and their socio-economic determinants. STUDY DESIGN: Rapid, structured literature review. METHODS: A rapid, structured approach was undertaken to identifying relevant studies involving a search of peer-reviewed literature databases, an Internet search to identify relevant grey literature, and a review of articles citing two key systematic reviews. The identified citations were screened, critically appraised according to the research design and narratively synthesised. RESULTS: Of the 1382 identified citations, 46 were screened as relevant to the review and included in the synthesis. Fifteen citations were reviews but most of the evidence identified or included within the reviews was of medium or low quality due to a lack of longitudinal follow-up, low response rates or attrition. The evidence base on the impacts of regeneration is generally not of high quality and is prone to bias. However, it is theorised as being an important means of addressing the socio-economic determinants of health. Housing refurbishment (generally, and for specific improvements) seems likely to lead to small improvements in health, whereas rehousing and mixed-tenure approaches have less clear impacts on health and carry risks of disruption to social networks and higher rents. Changes in the social composition of communities (gentrification) is a common outcome of regeneration and some 'partnership' approaches to regeneration have been shown to have caused difficulties within communities. CONCLUSIONS: The evidence base for regeneration activities is limited but they have substantial potential to contribute to improving population health. Better quality evidence is available for there being positive health impacts from housing-led regeneration programmes involving refurbishment and specific housing improvements. There is also some evidence of the potential harms of regeneration activities, including social stratification (gentrification and residualisation) and the destabilisation of existing community organisations. Broader labour market and housing policy approaches are also likely to be important as a context for understanding impacts. Regeneration programmes require careful design, implementation and evaluation if they are to contribute to improved health and reduced health inequalities.
OBJECTIVE: To identify and synthesise what is known about the impacts of regeneration on health, health inequalities and their socio-economic determinants. STUDY DESIGN: Rapid, structured literature review. METHODS: A rapid, structured approach was undertaken to identifying relevant studies involving a search of peer-reviewed literature databases, an Internet search to identify relevant grey literature, and a review of articles citing two key systematic reviews. The identified citations were screened, critically appraised according to the research design and narratively synthesised. RESULTS: Of the 1382 identified citations, 46 were screened as relevant to the review and included in the synthesis. Fifteen citations were reviews but most of the evidence identified or included within the reviews was of medium or low quality due to a lack of longitudinal follow-up, low response rates or attrition. The evidence base on the impacts of regeneration is generally not of high quality and is prone to bias. However, it is theorised as being an important means of addressing the socio-economic determinants of health. Housing refurbishment (generally, and for specific improvements) seems likely to lead to small improvements in health, whereas rehousing and mixed-tenure approaches have less clear impacts on health and carry risks of disruption to social networks and higher rents. Changes in the social composition of communities (gentrification) is a common outcome of regeneration and some 'partnership' approaches to regeneration have been shown to have caused difficulties within communities. CONCLUSIONS: The evidence base for regeneration activities is limited but they have substantial potential to contribute to improving population health. Better quality evidence is available for there being positive health impacts from housing-led regeneration programmes involving refurbishment and specific housing improvements. There is also some evidence of the potential harms of regeneration activities, including social stratification (gentrification and residualisation) and the destabilisation of existing community organisations. Broader labour market and housing policy approaches are also likely to be important as a context for understanding impacts. Regeneration programmes require careful design, implementation and evaluation if they are to contribute to improved health and reduced health inequalities.
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