16 C O N T E X T 1 1 9 : M A Y 2 0 1 1 activity. The internal design of buildings can make a difference, too. Giving prominence to stairs can encourage people to use stairs rather than lifts and benefit from the resulting physical activity. Physical activity is very important for children, who should be active for an hour a day. Providing good playspaces for children and young people can encourage them away from computer games on to more active pursuits. The environment can also affect mental health and general wellbeing. Often the same features that encourage physical activity and wellbeing can also promote mental wellbeing. It is intuitive that good quality, usable greenspace would encourage physical activity, and there is research evidence to back this up. There is also good evidence that experiencing greenspace can reduce stress and promote positive mental health. Similarly, playspaces not only increase physical activity but are also important to facilitate healthy development. Living in a poor environment with graffiti and litter can lead to chronic stress. Social support and social participation are important for mental and physical health. People who are socially isolated are more likely to suffer from mental health problems, including depression, and also to have poorer physical health. Neighbourhoods that encourage social interaction can increase social support. People living on busy roads have fewer social interactions with their neighbours than on quiet streets. This, known as community severance, suggests that designing neighbourhoods to reduce traffic may improve social interaction and therefore health. The traditional public health concerns such as air, water and housing quality are still relevant in the 21st century. Air pollution increases premature deaths, particularly from diseases of the heart and lungs. Around 30 per cent of the most significant pollutants for health are from road transport, and living near busy roads may cause poor health in some people. We are fortunate in the UK to have universal access to safe water and sanitation. But we still suffer from flooding events, which cause severe health – and other – impacts. Good drainage systems are essential to reduce the risk of flooding. Housing quality is another traditional concern. Every year there are over 2,000 excess deaths in winter in Scotland, which are partly due to cold stress in vulnerable groups such as older people. Research has shown that housing improvements that improve energy efficiency can significantly improve health outcomes. The UK continues to have significant inequalities in health. People in affluent communities have a life expectancy on average 10 years greater than those in deprived communities. For almost any health Photo: ©xendo
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