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How can placemakers help to reduce loneliness?

How can placemakers help to reduce loneliness?

Helen Ashby-Ridgway 21 Jun 2019
Last week was Loneliness Awareness Week, a week established by the Marmalade Trust to raise awareness of loneliness and social isolation, to reduce the stigma of loneliness and to help people connect. This will be its third year and the movement is growing. This isn’t surprising when studies have shown that in the UK more than 9 million people always or often feel lonely[1]. The Costa Book Award winning novel Eleanor Oliphant is Completely Fine was written by its author Gail Honeyman after she had read an article on the subject of loneliness which reported on an interview with a young lady who said she would come home from work on a Friday and then wouldn’t speak to anyone again until Monday morning. Such a situation seems incredibly sad but worse yet, extensive research shows that loneliness poses a number of risks to physical and mental health, including: Increased risk of developing coronary heart disease and stroke (Valtorta et al, 2016), Increased risk of high blood pressure (Hawkley et al, 2010) Greater risk of cognitive decline (James et al, 2011) Higher risk of the onset of disability (Lund et al, 2010) More prone to depression (Cacioppo et al, 2006) (Green et al, 1992) Predictive of suicide in older age (O’Connell et al, 2004); and, One study concludes that lonely people have a 64% increased chance of developing clinical dementia (Holwerda et al, 2012). Some of the studies are more worrying. Not long ago a stark headline was being carried by a number of newspapers. A meta study (a study of studies) of some 3.4 million people by Professor of Psychology Julianne Holt-Lunstad and her research team[2] had concluded that weak social connection has the same risk of death as smoking 15 cigarettes a day. Moreover, according the findings it doesn’t matter whether the loneliness is perceived or actual the risk to health remains the same[3].The NHS ‘Behind the Headlines’ critique of this particular study concluded that the research ‘provided some evidence that the isolation was causing ill health, rather than the other way round, but we can't be certain[4]’. Whether or not this particular headline is as troubling as it appears the remaining evidence that suggests that loneliness and social isolation can have adverse impacts upon our health and well-being and upon the UK economy. Research reported by the Co-op suggests that loneliness costs UK employers £2.5 billion per year. Causes of loneliness The causes of loneliness are not surprising. They include but are not limited to: Changes in day-to-day routines (such as retirement), A lack of or loss of friends (such as through bereavement or divorce), Restricted mobility, cognitive and sensory impairment or other causes of poor physical health (which then create a vicious circle), Financial limitations (limiting ability to participate in activities), Personal characteristics (such as age, stage in life, ethnicity, sexual orientation); and, Neighbourhood characteristics (such as a lack of amenity, layout of streets, crime). Loneliness is not only restricted to those who are alone or are of a particular age group.  “Young or old, loneliness does not discriminate” said the late Jo Cox MP who, with her colleague Seema Kennedy MP, set up a cross-party Loneliness Commission in 2016. Source: ONS analysis of Community Life Survey August 2016 – March 2017 Creating spaces that reduce social isolation National and many local planning policies seek to ensure that developments create healthy and safe communities. Many of the recent call to action publications by a variety of respected organisations, charities and commissions focus on a wide range of measures to improve loneliness and to reduce social isolation. However, not as much has been written in these documents about how the built environment can contribute to tackling its causes. As place makers we can help to create places that encourage social connection and to create spaces that people want to use and are able to use that are safe and secure and that are accessible to all.  These are just a selection of ways that creating spaces and places can help to increase both formal and informal social interaction which may in turn help to reduce loneliness: Making dementia-friendly spaces that are designed to encourage people out of their homes, with connections and routes that are accessible and safe (The RTPI has published practice advice on this); Ensuring that amenities and facilities are in walking distance and the routes to these places are safe, legible and encourage more people to use them; Delivering a range of places for leisure activities and where people can meet - from community halls to bowling greens, and from public squares to public footpaths; Including facilities for physical activity such as formal parks and informal open spaces, playgrounds for children where parents can mingle, as well as allotments for all ages; Ensuring that the spaces to meet are safe, with excellent natural surveillance through active frontages and well-considered layouts; Creating jobs and educational opportunities with further enhancements by creating dedicated indoor and outdoor spaces for people to meet during lunch breaks (rather than eating a sandwich at a desk); and, Places for cultural activities through formal and informal spaces such as heritage assets, coastal paths and outdoor theatres. Understanding why places and spaces are important in helping to combat loneliness is a good starting point. Indeed, many of the measures are integral to high quality urban design decisions but can be easily missed although our experience, from working on health impact assessments for a number of projects, is that the measures can be simple and often not costly. Whilst we cannot solve the factors causing loneliness entirely, placemakers can be part of a range of measures that help.  [1] https://www.gov.uk/government/news/pm-commits-to-government-wide-drive-to-tackle-loneliness [2] https://www.aging.senate.gov/imo/media/doc/SCA_Holt_04_27_17.pdf [3] https://www.ahsw.org.uk/userfiles/Research/Perspectives%20on%20Psychological%20Science-2015-Holt-Lunstad-227-37.pdf [4] https://www.nhs.uk/news/mental-health/loneliness-increases-risk-of-premature-death/  

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Planning for an ageing population: is co-housing the solution?
It is no secret that the UK’s population is ageing. Between 2016 and 2030, the population of over 60s in the UK is estimated to rise from 15 million to 20 million, and currently (for the first time ever), there are more people aged 65+ than there are children aged 15 or under[1]. Older population growth leads to household growth, and inevitably the housing needs of the UK will change alongside this shifting demographic. Lichfields’ Insight Focus explores this issue within the context of South West England. So, what is the planning system doing to address the changing demographic? I first turn to England’s ‘planning bible’, the National Planning Policy Framework (2019), which amongst other things aims to significantly boost the supply of homes. Within this context it requires the size, type and tenure of housing needed for specific groups in the community to be assessed and reflected in planning policies, including housing for older people (para. 61). While there is clear policy support for certain types of housing, such as Starter Homes and Build to Rent, there is no specific policy support or Government initiative to promote the delivery of housing for older people. The undersupply of adequate retirement housing has all too often been overlooked at national planning level. In London, the London Plan (2016) has adopted ‘Lifetime Homes’ as a requirement in new housing developments. Although this is a positive step towards creating inclusive and adaptable homes, it mainly focuses on physical accessibility of older people, and doesn’t address the need to provide accommodation with an element of care to support those with physical or mental needs, often affecting the older population. The draft London Plan, which is currently undergoing Examination in Public, has a specific policy relating to specialist older persons housing. Draft Policy H15 requires Boroughs to ‘work positively and collaboratively with providers’ to identify sites appropriate for such homes. The draft policy is a step in the right direction and in response to local need sets targets for the number of specialist accommodation units to be delivered annually in each London borough (until 2029). Draft London Plan Policy H15 should help to ensure that a quantum of housing for older people is delivered across all London Boroughs. However, we are aware that providers of housing for older people struggle to compete with more standard housing providers when acquiring sites, which makes delivery of housing for older people more difficult. There are several potential planning mechanisms that could assist delivery for this housing type, such as introducing policies that explicitly support provision of specialist accommodation in boroughs where there is an identified unmet need. Planning conditions attached to permissions can also secure occupancy for older people in perpetuity. There is increasing interest in senior co-housing schemes to help address the needs of our ageing population which is considered below. Co-housing: a potential solution to a growing problem Co-housing schemes are usually arranged as a cluster of private homes around a shared communal space (including a ‘common house’, guest room for visitors, garden(s) and laundry rooms), which is designed and managed by its residents. Community groups comprising retirees only are creating their own senior co-housing schemes which aim to encourage independent living with shared facilities while helping to reduce loneliness. Other pull factors include the sociable nature (limiting isolation), increased security (with more ‘eyes on the street’), and the sense of community it creates. Furthermore, senior co-housing developments enable older people to downsize, thus freeing up larger family homes. Co-housing is an established concept in Scandinavia and the Netherlands, while the UK plays catch up. There are currently over 60 groups in the UK in the process of developing their own co-housing projects, and the Government is making £163m available across England for such projects (up to 2021), through the Community Housing Fund. Sadiq Khan also launched the Homes for Londoners Community Housing Hub in 2017 to support community groups (not specifically for older co-housing communities) and individuals wanting to build their own homes by offering advice - including how to access funding and unlock land, and providing technical support for projects. Below is an exemplary senior co-housing scheme in Barnet, London: New Ground, Barnet -  Older Women’s Co-housing  (OWCH): This senior development comprising 25 homes was built in 2016 for a group of women over 50. Eight are let for social rent through the housing association Housing for Women; the others are leaseholds. OWCH faced local opposition, but eventually managed to obtain planning permission in early 2013 with help from the Director of Adult Social Care who agreed that senior co-housing communities can reduce pressure on health and social care services. Sourced imagery: OWCH It is not fair to suggest that there is only one housing solution for such a diverse demographic group, but senior co-housing schemes could be a positive option for older people to live independently, while also having a community close-by. Increasing the number of these communities can reduce pressures on health and care services, and allow older people to be independent within a close network that helps in reducing loneliness and isolation. It is of course important to note that senior co-housing communities would only be appropriate for older people without specialist mental and physical health care needs. Additionally, community-led housing projects such as senior co-housing schemes come with a lengthy process of finding an appropriate site, securing funding, and successfully negotiating with a registered provider/developer partner. For OWCH, the whole process took around 16 years! To assist the delivery of senior co-housing schemes, local authorities could remove some of the planning barriers by offering free pre-application advice or implementing a nil CIL rate for such schemes. Local authorities could also impose planning conditions to ensure these developments can only be occupied by older people in the long term. Furthermore, planning authorities should ensure community-led development policies are included in their Local Plans, and produce SPDs on community-led housing to set a clear approach for delivery. They could also allocate Council-owned sites for such developments or obtain outline planning permission for senior co-housing development to speed up the process for co-housing groups. The bottom line is that more attractive options need to be available for retirees (particularly the ‘young-old’ generation) to enable them to take a leap from their family homes and start afresh. This would free up larger homes for other people that need them. With the post-war baby-boomers reaching retirement age, built environment professionals must seek ways to provide high quality housing for them…and pronto!   [1] UK Census 2011, ONS

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