Urban health

Personal perspectives on urban health and wellbeing

30 April 2017

Insights on the assets and risks of urban environment, diversity and deprivation

In brief

This report builds on existing research about urban health, to understand the wider determinants of health, how diversity affects the way in which services are accessed and how people often rely on informal networks to support health. It also investigates the cumulative effect of urban living, deprivation and high levels of diversity on people’s health. We do this in part by looking at the variance between Lambeth and Southwark and a selection of urban, diverse and deprived statistical neighbours: Haringey, Nottingham and Leicester.


Executive summary

Like much of London, the boroughs of Lambeth and Southwark are vibrant places to live and work. They’re changing all the time. They are densely populated (twice the average in the capital) and have a high level of population churn. There is also a complex ethnic and social mix, including large Black and LGBT+ communities and over 300 different languages spoken.

Like many London boroughs, affluence and poverty exists side by side. The health challenges facing the boroughs are complex and significant, and mirror many of the same challenges facing cities across the UK and around the world.

This research builds on a large body of work studying the impact of urban, diverse and deprived characteristics on people’s health, and confirms much of what the health sector already understands to be the best way to create place-based health strategies.

What is different about it is that it:

  • Looks explicitly at the cumulative impact of all three characteristics and how they interact with each other
  • Identifies variance between urban, diverse and deprived areas and therefore opportunities for place-based activity
  • Provides fresh insights into the lived experiences of people in Lambeth and Southwark, providing human context and behaviours around which interventions need to sit

If I lived anywhere other than London, I would be much less independent.

Isobel, 28

The research identified a set of themes which add valuable context and insight into the lived experience of health through an urban, diverse and deprived lens.

  1. The ability to navigate the city has a strong payoff for health
  2. High quality green space can improve people’s health and build community
  3. The fast pace, transient nature and density of the urban environment can negatively impact on physical and mental health
  4. Diversity influences health seeking behaviours and how people access health services
  5. Complex diversity within cities means many different cultural assumptions and attitudes to health exist in a relatively small geographical area
  6. Language barriers limit people’s understanding of what is available and dialogue about health with health professionals and employers
  7. There is often a reliance on ‘outside the system’ networks to support health
  8. Whilst social networks, individual resilience and mental wellbeing play a part in protecting health, living in a deprived area can still be detrimental to health
  9. The city is expensive and pressure to survive can be a strain on people’s health when managing on a small income
  10. If you are struggling to make ends meet on a low income, there isn’t the headspace or time available to consider exercise and diet

You need to know the process. Where to call to get attention. People can’t do that and they get lost in the system.

Kim, 62

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Read the 'Personal perspectives on urban health and wellbeing' report