Health and wellbeing in Lambeth and Southwark: Insights from local communities

Our work with partners seeks to find new ways to support people to develop and maintain good health. While we focus our efforts on Lambeth and Southwark, we seek to generate evidence and learning that can benefit people in cities across the UK and around the world.

However, the data that exists on health at a hyper-local level is limited, in the boroughs where we work and beyond. We believe that more detailed data on the lives of residents – how they feel about where they live, their jobs, and their wellbeing – is key to designing better tailored interventions that have the potential to reduce inequalities in health.

We decided to do this study to better understand how the people in the places where we work feel about their health and the factors that affect it. Our ambition was to carry out the largest survey on health in Lambeth and Southwark to date, with respondents from every ward and representation from the many different communities that call these boroughs home.

We want to provide insight and inspiration for decision makers and community organisations alike, as they navigate some of the most pressing issues experienced in their neighbourhoods.

This report highlights key findings from the Health & Wellbeing Survey which reached over 5,000 people, as well as insights from Exploration Labs, which are focus groups that delve deeper into the lived experience of community members.

Living in Lambeth and Southwark

Residents in the study shared their perceptions of their local environment, on both physical aspects such as air quality, green spaces, and transportation, as well as emotional factors like feelings of safety and loneliness. While many respondents expressed satisfaction with public transportation and access to green areas, there are concerns about the levels of air pollution across both boroughs.

Air pollution:

Air pollution is more prevalent in urban areas. Its harmful effects are not felt equally and intersect with other systemic causes of ill health. Air pollution has a disproportionate effect on the health and wellbeing of those most susceptible to it. This includes children under 15 (including during pregnancy), older people and people with heart and lung conditions.

Our survey found that over two thirds of residents in Lambeth (68%) and Southwark (69%) are concerned about air pollution in their local area. The majority of respondents across all ages and ethnicities agree that air pollution in both boroughs is either ‘fairly’ or ‘very’ concerning. While younger respondents report the least concern, over 1 in 3 people aged 25-64, and responders over 75 report being ‘very’ concerned about air pollution in their local area.

Loneliness:

A large body of research has found that prolonged feelings of loneliness have an adverse effect on health. Research has shown loneliness increases the likelihood of early mortality and poor physical health; it has also been shown to put individuals at greater risk of poor mental health including depression.

Our study shed light on the prevalence of loneliness, which appeared to be more pronounced in Lambeth and Southwark compared to the national average. In Lambeth and Southwark, 33% of residents report feeling lonely ‘some of the time’ and ‘often or all of the time’ compared to 22% across England. There is also a gender difference, with 36% of women saying “often or always/ some of the time” compared to 31% of men.

Residents who identify as disabled are much more likely to frequently feel lonely compared to the average resident. Levels of loneliness are particularly high among those that have a mental health condition as well as those that have a physical or mobility condition.

Local services:

Overall, residents were positive about the services available to them, with public transport and green spaces receiving the highest ratings. Though sentiments on cycle lanes and sports facilities were generally positive, one in three believe cycle lanes are poor, and one in four feel the same about sports facilities. Improvements to make both more accessible to more residents who want to stay active has the potential to enable better health in the long term.

Homes are often a household’s highest financial outgoing, and where people spend a large part of their personal time, making housing one of the most important building blocks of health.

The stress caused by evictions and bankruptcy has direct and potentially long-lasting effects on health and is linked to increased risk factors for long term health conditions like high blood pressure and poor sleep. Living in a home in need of repairs, that is damp, difficult to heat or cool, or inappropriate in terms of accessibility also has a significant negative impact on health.

People already living with long term health conditions as well as those already affected by structural inequalities – including disabled people and people from minoritised communities – are more likely to experience issues with housing.

Our study found that home ownership was associated with better health outcomes, with 77% of homeowners reporting good health, compared to 61% of renters. However, this discrepancy is nuanced when considering different types of renters. Private renters, who constitute a significant proportion of younger people (60% below the age of 35), reported higher levels of health satisfaction (73%) compared to social renters that include local authority renters (54%) and housing association renters (48%).

“It does massively impact your mental health, having to deal with the constant back and forth with your landlords and playing with incompetent employees. As tenants communicating with landlords, you do see some levels of progress, only for there to be a standstill then you find out you have to do it all over again. People have other personal issues that they’re going through so this does take a mental toll.”

Concerns about housing conditions also vary across tenure types, with social renters expressing more worries about issues such as dampness and repairs (31% vs. 24% for private renters), while private renters are primarily concerned about affordability (47% for private renters vs. 35% for local authority renters).

“My son has breathing problems too. His room has so much mould and this is an old issue that has been (re-) occurring. At night, he can’t sleep because of the smell. On one occasion, when he woke up to go to school [he said] ‘Mum I can’t breathe’ and before I knew it, he collapsed. This has been an issue that keeps occurring. Anytime it is cold, it keeps happening…He has problems with his sinus, and I know it has made it worse.”

These concerns are further heightened for people with health conditions, who are more likely to worry about affording housing (47% vs. 35% of all residents), maintenance issues like dampness or mould (32% vs. 24%), heating and plumbing problems (31% vs. 22%), and maintaining a comfortable home temperature on hot days (32% vs. 24%).

This underscores the importance of comprehensive interventions addressing both housing conditions and socio-economic factors influencing health.

“Mental health – for you as a person, an individual, it [housing problems] can shape you. It can change who you are. You could become unrecognizable. And that’s what happened to me but when I moved… I laugh again, I have friends. My life just changed.”

Conclusions and next steps

When we began this work, our ambition was to conduct the largest survey on health in Lambeth and Southwark, with responses from residents in every ward. We wanted to better understand the detail of the factors that impact resident’s health and that contribute to overall inequalities in health.

The study’s detailed insights into residents’ experiences and feelings provide a granular understanding that cannot be observed through national and regional statistics. These findings highlight how and why some groups find it more difficult than others to maintain good health, and the particular issues faced by people living in cities, like air quality.

Our data demonstrates the layers of challenges faced by minoritised communities and people living on lower incomes when it comes to health:

• People from ethnically minoritised communities are more likely to suffer from chronic health conditions and exhibit lower levels of trust in healthcare services linked to previous experiences and systemic biases.
• Concerns about air pollution are prevalent among residents, disproportionately affecting children, elderly people, and those with long-term health conditions.
• Housing conditions and affordability also have a profound impact on health. Residents experiencing housing instability report higher stress levels and worse health, emphasising the critical role of housing quality and security in overall well-being.
• Access to healthcare services remains a significant barrier to good health and health equity, particularly for minoritised communities, younger residents, and residents living on lower incomes.
• Difficulties in accessing mental health support and GP services highlight where healthcare provision is lacking, making it harder for residents already experiencing or susceptible to ill-health to receive appropriate care.

We can see how again and again, people from minoritised communities experience more issues with their health. They are at greater risk of the health impacts of external factors like insecure housing and face significant challenges with accessing and trusting the healthcare system.

These layers of challenges intersect and make it difficult to maintain good health, which then affects people’s ability to progress – for example in their work, with their finances or education – forming a cycle of financial insecurity and ill-health that is hard to break.

Devising better ways to support good health requires an approach that centres community members and collaborates with local and national government, community organisations, funders, businesses, and healthcare services.

Impact on Urban Health’s work with our partners strives to enable these collaborations to improve health equity, and this study is a key element in increasing the local data we have on the factors at play to inform these collaborations. This research has also given us the opportunity to amplify the voices of Lambeth and Southwark residents, learn from them, and underline the importance of centring lived experience.

Our next ambition is to ensure that everyone working to improve health in both boroughs can use this data to develop strategies that are better tailored to the needs demonstrated across both boroughs. Ultimately, our hope is that this type of hyperlocal research developed with the community it seeks to support, is carried out in other London boroughs and beyond.