Healthy Cities

Healthy Cities

Public Health through Urban Planning

Chinmoy Sarkar, Chris Webster and John Gallacher

Mounting scientific evidence generated over the past decade highlights the significant role of our cities’ built environments in shaping our health and well-being. In this book, the authors conceptualize the ‘urban health niche’ as a novel approach to public health and healthy-city planning that integrates the diverse and multi-level health determinants present in a city system.

Chapter 8: Does accessibility to health-promoting services affect self-perceived health and HADS anxiety and depression? Findings from a multi-level analysis of older men in Caerphilly

Chinmoy Sarkar, Chris Webster and John Gallacher

Subjects: environment, environmental geography, geography, cities, social policy and sociology, health policy and economics, urban and regional studies, cities, urban studies


As we have demonstrated in the previous chapters of this book, in the recent discourses on place effects on health several studies have established the facilitative role of accessibility in urban space in influencing individual behaviour and health (J. Pearce et al., 2006; Bernard et al., 2007). In one of the earliest studies of the impact of physical accessibility on individual behaviour, Horton and Reynolds (1971) conceptualized the notion of action spaces and stressed that the formation of individual action space is governed by socio-economic factors, travel preferences, home locations, cognitive image of the urban environment, duration of residence at a specific area, and the objective spatial configuration of the micro-level activity spaces and city as a whole, that is, a locus of all urban destinations perceived and visited by an individual as a result of day-to-day activities. In another study of four neighbourhoods of Glasgow differing in socio-economic profile, Macintyre et al. (2002) proposed that one of the key reasons for health inequalities originates as a result of differential accessibility to neighbourhood opportunity structures, expressed in terms of access to material and infrastructural resources, which included: (1) physical attributes of the environment to which residents of the area are exposed, such as quality of air, drinking water and so on; (2) the presence of health-promoting domestic and occupational environments; and (3) publicly or privately provided services to support daily lives.

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