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Community severance and health: measuring community severance and examining its impact on the health of adults in Great Britain

Higgsmith, M; Stockton, J; Anciaes, Paulo; Scholes, S; Mindell, J; (2022) Community severance and health: measuring community severance and examining its impact on the health of adults in Great Britain. Journal of Transport and Health , 25 , Article 101368. 10.1016/j.jth.2022.101368. Green open access

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Abstract

BACKGROUND Aspects of community severance (the separation of people from goods, services, and each other by busy roads or other transport infrastructure) have been linked to poor health and wellbeing, but few studies have examined this relationship. We created a novel index for community severance and estimated its association with the self-rated health of adults in Great Britain. METHODS Data were collected from a nationally representative online panel survey of 4,111 participants, February-July 2016. To construct an index, polychoric factor analysis (suitable for ordinal variables), was conducted on four survey items related to the perceived impact of roads on ability to walk locally. Community severance index (CSI) scores were negatively skewed, so were categorised into four groups (lowest 40%, second, third, highest). We examined the association of community severance with self-rated health (‘good’ (very good/good) vs. ‘poor’ (fair/bad/very bad)) using logistic regression, adjusting for potential confounders (age, income, employment status). MAIN RESULTS Polychoric factor analysis confirmed that it was appropriate to combine the four survey items into a single index (Cronbach’s Alpha=0.86; Keiser-Meyer-Olkin measure of sampling adequacy= 0.76, factor loadings >0.74). After controlling for confounding factors, being in the highest CSI group was associated with higher odds of reporting poor self-rated health (Odds Ratio: 1.79, 95% Confidence Interval: 1.48-2.17) compared with the lowest CSI group. There was a dose-response gradient, with those in the second and third highest CSI groups having increased odds of reporting poor self-rated health, though of lower magnitude ((1.21, 1.01-1.45) and (1.41, 1.16-1.71) respectively). CONCLUSIONS We found an inverse association between CSI and self-rated health. This suggests that to improve health, local governments and road authorities should take steps to reduce community severance through traffic reduction and calming, pedestrian prioritisation, and the installation of well-designed crossing points.

Type: Article
Title: Community severance and health: measuring community severance and examining its impact on the health of adults in Great Britain
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jth.2022.101368
Publisher version: https://doi.org/10.1016/j.jth.2022.101368
Language: English
Additional information: © 2022 The Authors. Published by Elsevier Ltd under a Creative Commons license (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: Pedestrians, walking, community severance
UCL classification: UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Civil, Environ and Geomatic Eng
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
URI: https://discovery.ucl.ac.uk/id/eprint/10146404
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