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Chaplin, Brian Douglas (2010) Health and Wellbeing in an Island Community Where Urban Style Deprivation and Traditional Rural Values Interact

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Chaplin, Brian Douglas (2010) Health and Wellbeing in an Island Community Where Urban Style Deprivation and Traditional Rural Values Interact Chaplin, Brian Douglas (2010) Health and wellbeing in an island community where urban style deprivation and traditional rural values interact. PhD thesis. http://theses.gla.ac.uk/1959/ Copyright and moral rights for this thesis are retained by the Author A copy can be downloaded for personal non-commercial research or study, without prior permission or charge This thesis cannot be reproduced or quoted extensively from without first obtaining permission in writing from the Author The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the Author When referring to this work, full bibliographic details including the author, title, awarding institution and date of the thesis must be given Glasgow Theses Service http://theses.gla.ac.uk/ [email protected] HEALTH AND WELLBEING IN AN ISLAND COMMUNITY WHERE URBAN STYLE DEPRIVATION AND TRADITIONAL RURAL VALUES INTERACT Brian Douglas Chaplin, BSc (Hons), MSc This thesis is submitted in fulfilment of the requirements for the Degree of Doctor of Philosophy Department of Urban Studies Faculty of Law, Business and Social Sciences University of Glasgow July 2010 ABSTRACT This thesis explored aspects of the urban-rural interface within a densely populated, deprived housing scheme located on a remote, rural island lying off the north west coast of Scotland. The thesis had two aims, the first related to heath, health inequality and aspects of neighbourhood and from this exploration a second aim emerged that focused in detail on the effects of rurality and religion as significant cultural influences that determined the nature of health and the social environment. The Cearns housing area of Stornoway on the Isle of Lewis is reminiscent of a mainland urban scheme in terms of housing design and layout with units spaced around a series of pedestrianised courts with little green space. Significantly, most tenants, both well-established and recent, have their origins in rural Lewis, bringing with them a number of rural beliefs and behaviours. An in-depth qualitative study was carried out through individual interviews (N=55) and Cattell‟s social network typology was applied to inform interpretation of the nature of the social infrastructure. The main findings demonstrated the existence of traditional, socially excluded and solidaristic networks from which a strong sense of island identity, described as „Hebridean‟, emerged. In marked contrast to many urban areas, crime and vandalism levels were low, the housing stock was well maintained and the area was described by residents as friendly and close-knit. Hebridean communities are rural in nature, the Cearns being an anomaly, yet it shared with neighbouring villages close familial and other connections as most residents either know, or know of, their neighbours. Rurality and remoteness reinforced a „can-do‟ self help culture where friendliness and co-operation is expected and this can be related to Freudenberg‟s notion of the „density of acquaintanceship‟. This study demonstrated that residents, irrespective of age or gender, have this view of the world, either from personal experience or through the rural upbringing of their parents and that either way a particular range of attitudes and behaviours has come with them to the Cearns. In addition to themes associated with rurality, findings from this thesis demonstrated the effect of religion at the level of the individual in terms of social support, as well as at community level in relation to social cohesion, identity and social control. Communities on the Isle of Lewis are distinctive and possibly unique within the UK in their continued adherence to the biblically strict Presbyterian religion, apparent through high levels of church attendance and strict Sabbath observance. Use of Social Identity Theory with its understanding of in-groups and out-groups provided a framework for an analysis of the interface of religion with social cohesion. The study concluded that these remote, close-knit, Gaelic-speaking, religious island communities are amongst the most distinctive in the UK and that the methodology and findings of this study would have relevance in studies of similar communities elsewhere, notably within the hitherto under-researched rural communities of the Western Isles. 1 TABLE OF CONTENTS Abstract 1 Acknowledgements and Author’s Declaration 8 Chapter 1: Scope of the thesis 9 1.1 Introduction 9 1.2 Context for the study 10 1.3 Aims of the study 18 1.4 Structure of the thesis 20 Chapter 2: Health, health inequalities, neighbourhoods 22 and social capital 2.1 Introduction 22 2.2 The concept of health 23 2.3 The meaning of the term wellbeing 27 2.4 Social determinants of health 30 2.5 The nature of health inequality 32 2.6 National government policies that address health 36 inequality, 1980 – 2008 2.7 An analysis of the dimensions of neighbourhood 41 2.8 Social capital and the nature of social infrastructure 46 2.9 Conclusion 49 Chapter 3: Rurality, health and culture 51 3.1 Introduction 51 3.2 The sociology of rurality 51 3.3 Rural communities and wellbeing: a good place to live? 59 3.4 Culture and the Gaelic language 69 3.5 Conclusion 76 Chapter 4: The impact of religion on individuals and 78 communities 4.1 Introduction 78 4.2 History of religious thought in Scotland 78 4.3 Protestant religion in the Western Isles, the current 84 situation 4.4 Theoretical frameworks for the sociology of religion 89 4.5 Secularization 92 4.6 Religion and modernity 95 2 4.7 Fundamentalism 101 4.8 Religion and health: the interface 103 4.9 Conclusion 109 Chapter 5: Methods 111 5.1 Introduction 111 5.2 Philosophical aspects 111 5.3 Applying case study methodology 115 5.4 The process of sampling 119 5.5 The nature of generalisation 121 5.6 Reliability and validity of qualitative research 124 5.7 Thesis aims and the development of sampling methodology 125 5.7.1 Stage 1: development of a methodology 127 5.7.1.1 Profile of respondents 130 5.7.2 Stage 2: evolution of a methodology 132 5.7.2.1 Profile of respondents 139 5.8 Data management 140 5.9 Conclusion 144 Chapter 6: The Cearns: its singular position within the 146 Western Isles 6.1 Introduction 146 6.2 The Western Isles: a demographic and socio-economic 146 overview 6.3 The Cearns: a Stornoway housing scheme 158 6.4 Health and wellbeing profiles: the Western Isles and the 176 Cearns 6.5 Conclusion 179 Chapter 7: The Cearns: starting to explore the residents’ 181 views of their health, built and social environment 7.1 Introduction 181 7.2 Starting to explore the residents‟ perception of health 181 and wellbeing 7.3 The built and outdoor environment 185 7.4 The close-knit nature of the community 191 7.5 Social networks and social support 195 7.6 The Cearns: areas of similarity and difference when 205 compared with mainland schemes 7.7 Conclusion 208 3 Chapter 8: Stage 2, findings 1: The impact of rurality on 210 the development of social infrastructure, community cohesion and identity 8.1 Introduction 210 8.2 The social neighbourhood: its extent, function and links to 210 aspects of rurality 8.3 Social networks and community involvement 222 8.4 Identity and belonging: the „Hebridean‟ 225 8.5 Conclusion 236 Chapter 9: Stage 2, findings 2: The mediating effect of 239 religion on social networks, social support and community cohesion 9.1 Introduction 239 9.2 Social networks, social support and religion involvement: 240 at the level of the individual 9.3 Social structure, social cohesion and religion: at the level of 250 the community 9.4 Conclusion 262 Chapter 10: Discussion 264 10.1 Aim 1 findings 264 10.1.1 How did residents‟ perceptions of health relate to 264 available routine data that demonstrated health and social inequality? 10.1.2 How were the main physical characteristics of the 265 Cearns‟ environment perceived? 10.1.3 How close-knit is the community and how did a feeling 266 of being close-knit relate to a typology of social networks? 10.1.4 What were the similarities and differences between 269 the Cearns and mainland housing schemes? 10.2 Aim 2 findings 270 10.2.1 How did the singular characteristics of rurality 270 influence the social environment? 10.2.2 How did the Hebridean identity interface with the 272 social environment? 10.2.3 What were the differences between rural and urban 274 culture? 10.2.4 How did Gaelic speakers view the Hebridean culture 275 and how different were their social network patterns? 10.2.5 How did religion interact with the social environment? 276 10.2.6 In what ways did religion interface with health? 280 10.2.7 How was the relationship with alcohol articulated? 280 10.2.8 How did the social networks of incomers manifest 282 themselves? 4 10.3 Strengths and weaknesses of the study 283 Chapter 11: Conclusion 287 11.1 Summary of key findings in relation to the two aims of the 287 thesis 11.2 Recommendations for further research and development 289 Afterword 292 List of Appendices Appendix 1: Approval from ethics committee 293 Appendix 2: Topic guide for interviews: stage 1 research 294 Appendix 3: Purposive sampling filter for potential interviewees, 295 distributed through ministers and elders Appendix 4: Purposive sampling filter for potential interviewees, 296 distributed through shop and community association Appendix 5: Topic guide for interviews: stage 2 research 297 Appendix 6: Press cuttings 298 References 304 List of Tables Table 1: The East London network typology: structural 44 characteristics Table 2: Percentage of residents by current religion, 86
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