Thearchitectureofmentalhealth:identifyingthe combinationofapartmentbuildingdesignrequirementsfor positivementalhealthoutcomes
PaulaHooper,a ∗ AlexandraKleeman,b NicoleEdwards,a JulianBolleter,a andSarahFosterbaAustralianUrbanDesignResearchCentre(AUDRC),SchoolofDesign,TheUniversityofWesternAustralia,Australia bCentreforUrbanResearch,SchoolofGlobal,UrbanandSocialStudies,RMITUniversity,Australia
Summary
Background Housingqualityisacrucialdeterminantofmentalhealth.Whiletheconstructionofhigh-risebuildings isapopularpolicystrategyforaccommodatingpopulationgrowthincities,thereisconsiderabledebateaboutthe healthconsequencesoflivinginpoorlydesignedapartments.DrawingonthreeAustralianstategovernment apartmentdesignpoliciesintroducedtoimproveapartmentdesignquality,thisstudyaimedtoidentifythe combinationofdesignrequirementsthatwereoptimallysupportiveofpositivementalhealth.
Methods K-meansclusteranalysesidentifiedgroupsofbuildings(n= 172)thatwerehomogenousintheirimplementationofamixof n =80measureddesignrequirements.Positivementalhealthwasmeasuredusingthe Warwick–EdinburghMentalWell-beingScale(WEMWBS).Linearmixed-effectsmodelscontrollingfordemographic characteristics,self-selectionfactorsandclusteringofparticipantswithinbuildingscomparedresidentsinthe differentclusters.
Findings Residentsinthe "highpolicyperformancebuildings", characterisedbyhavingagreaterimplementationof n= 29designrequirementsacrossninedesignelements,hadsignificantlyhigher(+1.96points)WEMWBSscores comparedwithresidentsinthe "lowpolicyperformancebuildings".
Interpretation Thisstudyisthe firsttoempiricallyidentifyamixofpolicy-specificarchitecturedesignrequirements thatareassociatedwithpositivementalhealthinapartmentresidents.These findingsprovidevitalempiricalevidence toinformnationalandinternationalapartmentandhigh-risehousingpolicies,anddesigninstrumentsandpractices toprotectpeople’shealthinapartmentdwellings.
Funding TheHighLifeprojectisfundedbyaHealthwayResearchInterventionProjectgrant(#31986)andan AustralianResearchCouncil(ARC),DiscoveryEarlyCareerResearcherAward(DECRA)(DE160100140).NEis supportedbyanAustralianResearchCouncil(ARC)LinkageProject(LP190100558).SFissupportedbyanAustralian ResearchCouncil(ARC)FutureFellowship(FT210100899).
Copyright ©2023TheAuthors.PublishedbyElsevierLtd.ThisisanopenaccessarticleundertheCCBYlicense (http://creativecommons.org/licenses/by/4.0/).
Keywords: Housing;Apartments;Highrise;Mentalhealth;Policy;Evaluation;Design;Architecture
Introduction
Substandardhousingisasignificantpublichealth issue.1 Thereisawell-developedinternationalevidence baselinkinginadequateindoorairquality,space,naturalventilation,sunlight,acousticandvisualprivacy, insulation,andthermalcomfortwithvariousphysical healthimpacts,includingasthma,hypertension,upper respiratorytractinfections,poorsleepquality,andinfectiousandchronicdiseases.2–5 Moreover,theeffectsof
prolongedexposuretopoorqualityhousingandassociatedphysicalillhealthcan,inturn,havenegative implicationsforthepsychologicalhealthofresidents.6
Anumberofcross-sectionalstudiesfromhighincomecountrieswithafocusonmentalhealthoutcomeshavefoundthatapartmentresidentshavepoorer mentalhealththanresidentsinotherhousingtypologies,2 6 andemergingevidenceindicatesthatapartment designmayplayaroleinthisassociation.Forexample,
*Correspondingauthor.AustralianUrbanDesignResearchCentre(AUDRC),SchoolofDesign,TheUniversityofWesternAustralia,35Stirling Highway,Crawley,6059,WesternAustralia
E-mailaddress: paula.hooper@uwa.edu.au (P.Hooper).
TheLancetRegional Health-WesternPacific 2023;37:100807
PublishedOnlinexxx https://doi.org/10. 1016/j.lanwpc.2023. 100807
Researchincontext
Evidencebeforethisstudy
Previousresearchhasshownthatapartmenthousingquality isacrucialdeterminantofmentalhealth.Whilethe constructionofhigh-risebuildingsisapopularpolicystrategy foraccommodatingpopulationgrowthincities,thereisstill muchdebateaboutthehealthconsequencesoflivinginhighriseapartments.Australiancitiesareexperiencingasignificant boominapartmentconstructionthatwillleavealegacyfor futuregenerations.Asignificantcritiqueofthecurrent evidencebaseisalackofpolicyanddesignspecificity;housing studieshavenotevaluateddesignoutcomesorhealth impactsofthepoliciesorlegislationthatunderpinthedesign anddeliveryofbuildings.Inaddition,studiestypicallydonot includedetailedassessmentsofapartmentdesignor adherencetopolicyanddesignstandards.Thereisalsoan emergingshiftinfocusfromhousingcharacteristicsthat preventdiscomfort,dissatisfaction,ordisease,tohowdesign cancreateconditionsthatfosterpositiveoutcomesand enhanceoccupants’ socialandemotionalwellbeing.
Addedvalueofthisstudy
Thisstudymakesacrucialcontributiontotheliterature.Itis the firststudytomeasureandexaminetheimplementation andcompositionofdesignrequirements(n =80)derived fromoperationalapartmentdesignpoliciesandtheir associationwithresidents’ positivementalhealthinalarge sampleofbuildingsandresidentsacrossthreecities.It providesempiricalevidenceofadose–responserelationship
insufficientspace,restrictivelayouts,lowlevelsofsunlightandnaturalventilation,andinabilitytocontrol environmentalstressors(e.g.,acousticandvisualprivacy)canadverselyimpactresidents’ qualityoflife,influencementalhealththroughincreasinganxietyand stress2,4,6,7 andhavebeenassociatedwithdepressive symptomsandmentalhealthissues.2 Higherdensity livingmayalsoimpactmentalhealththroughsocial mechanisms6 8 withstudiesreportingthathigh-riseoccupantsexperienceincreasedlonelinessorsocialisolation,negativelyinfluencingmentalwellbeing.8 A systematicreviewexploredthecollectiveevidenceonthe longitudinalimpactofhousingdisadvantagein12 temporallyorderedstudieswheretheexposureto housingdisadvantageprecededmentalhealthmeasures.Substandardhousingqualitywasshowntobe linkedtohigherstresslevels,anxietywashigherin rentersthanownersandovercrowdingwaslinkedtoa measureofmeandepressivesymptomsbutnota depressivedisorder.9 Anotherlongitudinalstudyalso reportedadecreaseindepressivesymptomsandthat improvementstothedwellingwererelatedtoimproved mentalhealth.10
betweenimplementingacombinationof n =29apartment policydesignrequirementsandpositivementalwellbeing. Theresultsprovideevidencetoinformfuturearchitectural anddesignpolicyandadvancepracticeforgoodapartment designandhigh-riselivingthatmaybenefitthementalhealth ofoccupants.
Implicationsofalltheavailableevidence
Ourresultshavepracticalimplicationsastheyidentifythe combinationofdesignrequirementsthatshouldbe prioritisedinbuildingdesignandapprovalprocessesto promoteoptimalresidentmentalhealthoutcomes.The findingsreiteratetheimportanceofarchitectureanddesign instrumentsthatfacilitatetheimplementationofminimum policystandardstoguidearchitecturalandurbandesign thinking,policy,andpracticeand,ultimately,thehealthof futurehigh-risehousingstock.Moreover,these findings providevitalempiricalevidencetoinformnationaland internationalapartmentandhigh-risehousingpolicyand designinstrumentsandpracticestoprotectthehealthof peoplelivinginapartments.Theresultscanbeusedto advocatefortheadoption(wherecurrentlymissing)or retention(wherepresentlyincluded)ofthespecificdesign featuresidentifiedinfuturedesignpolicies.Finally,thisstudy addressesasignificantgapintheliterature,providing empiricalevidencethatapartmentbuildingsthatadhereto Australianapartmentdesignpolicieshavethepotentialto promotethepositivementalwellbeingoftheinhabitants.
However,definiteconclusionscannotcurrentlybe drawnwiththeconflictingevidenceduetodifferencesin methodologicalapproachesandsubstantialheterogeneity inhowboththementalhealthoutcomevariableand housingqualitywasdefinedandmeasured.2 9 11 InternationallyandwithinAustralia,thereisgrowing emphasisoncompactcityplanningpoliciestohelp realiseurbansustainabilitygoals.Assuch,apartments arehousingarapidlyincreasingnumberofpeople. Nearlyone-third(30.9%)ofthealmostonemillionnew dwellingsacrossAustraliafrom2016to2021were apartments.12 Thisapartmentboomhasraisedconcerns aboutthepotentialnegativeimpactsofpoordesignon apartmentbuildingresidents,howeverfewstudieshave examinedapartmentdesignandhealthinAustralia.4 5 MoststudieshavebeenconductedinNorthAmerica andEurope,wherethepublicsectordevelopedmany high-riseresidentialbuildingsaftertheSecondWorld Warindeprivedareas.7 Thismaypartlyaccountforthe adversementalhealthoutcomesofapartmenthousing.2 4 7 Additionally,previousstudieshavecompared livinginhigh-risebuildingstootherhousingtypes,but havenotconsidereddifferencesindesignqualityor
characteristicsofvaryinghigh-risebuildingsand apartments.
Studiesexploringhigh-riselivingorapartment designandmentalhealthhavetypicallyreliedonmeasuresofnegativementalhealth,suchaspsychological distress,thatareindicativeofimpairedmentalhealth andmayreflectcommonmentaldisorders,like depressiveandanxietydisorders,6 butatalevelinsufficientforthediagnosisofadisorderorpsychiatric illness.11 However,thereisincreasinginternationalinterestinpositivementalhealththatreferstothepresenceofpositiveemotionsandgoodfunctioning,defined byTheWorldHealthOrganisationas "astateofwellbeing whichallowsindividualstorealisetheirabilities,copewith thenormalstressesoflife,workproductivelyandfruitfully, andmakeacontributiontotheircommunity",13 p.13).
Asignificantcritiqueofthecurrentevidencebaseis alackofpolicyanddesignspecificity.Studieshave rarelyevaluatedthedesignoutcomesofthepoliciesor legislationthatunderpinthedesignofthebuildings studiedandhavenotincludeddetailedordirectassessmentsofapartmentdesignoradherencetothese policyanddesignstandards.14 Barrosetal.,(2019)8 have calledforare-examinationofhousingpoliciesfroma multidisciplinaryperspectivethatconsiderspublic healthconcernstogetherwithmoreempiricalresearch toguideevidence-informeddesigndecisions.Moreover, thereisanemergingshiftinfocusfromhousingcharacteristicsthatpreventdiscomfortordisease,tohow designcancreateconditionsconducivetopositiveoutcomesthatenhanceoccupants’ physical,socialand emotionalwellbeing15 andananalysisofhowapartment designcancontributetopositivementalhealth.8
Thepolicyofapartmentdesign
TheboominapartmentconstructioninAustraliahas promptedtheintroductionofresidentialapartment designpoliciesbystategovernmentstoregulateand improvedesignoutcomesconducivetogoodamenity andwellbeing.16 Forexample,in2002,theNSWstate governmentintroducedtheStateEnvironmentalPlanningPolicy65(SEPP65)andApartmentDesignGuide.17 OtherAustralianstateshavesincefollowedsuit:the WesternAustraliangovernmentintroducedStatePlanningPolicy7.3(SPP7.3)ResidentialDesignCodes Volume2-Apartmentsin201918;andtheVictorianstate governmentintroducedtheBetterApartmentsDesign Standards(BADS)in2017.19 Allthreepolicies acknowledgeapartmentdesign’sroleinpromoting healthandwellbeingandincludeexplicitaimstoachievethis.Ourpreviousanalysisevaluatedhowwell contemporaryapartmentbuildingsconformedwiththe respectivestatepoliciesandidentifiedtheimportanceof acomprehensivedesignpolicytoachievingbetter apartmentdesignandamenity.3 However,empirical researchevaluatingwhethertheimplementationof theseapartmentdesignpoliciesisassociatedwith
residents’ healthisrare15 andthereislittleunderstandingofwhich combination ofapartmentpolicy designrequirementsareoptimalforpromotingpositive mentalhealthoutcomesforresidents.Previousstudies haveusedclusteranalysistechniquestorevealneighbourhood ’types’ withdifferentcombinationsofbuilt environmentcharacteristicsimportantforsupporting physicalactivitybehaviours.20 Inourstudycontext,this techniquecanbeappliedtocharacteriseapartment buildingtypesandexplorehowdifferentcombinations ofapartmentdesignfeaturesimpactresidents’ mental healthandwellbeing.
Thispaperaimedtoassesstheperformanceand impactofapartmentdesignpoliciesinthreeAustralian statesby(1)characterisingtheapartmentbuildings basedonthe ’mix’ orcombinationofpolicydesignrequirementsimplemented;and(2)exploringthecombinationofdesignrequirementsassociatedwiththe positivementalhealthofapartmentresidents.
Methods
TheHighLifeproject isacross-sectionalstudy14 evaluatingtheimplementationoftheSEPP65,SPP7.3and BADSapartmentdesignpolicyrequirementsinapartmentdevelopmentsinSydney,PerthandMelbourne andexploringtherelationshipbetweenapartment designandresidents’ healthandwellbeingoutcomes.14
Apartmentbuildingselectionandparticipant recruitment
Thebuildingselectionprocesshasbeendescribedin fullelsewhere.3 14 Thesamplecomprises172apartment buildingswith40ormoreapartments,threeormore storeysandbuiltbetween2006and2016,thatwere randomlyselectedfromthegreatermetropolitanareas ofSydney(n =57),Melbourne(n =46),andPerth (n =69).Buildingresidentscompletedaself-report surveyabouttheirapartmentandbuildingdesignand arangeofphysical,socialandmentalwellbeingoutcomesandsocio-demographics.14 Overatwo-yearperiod (2017–2019),10,560apartmenthouseholdswerecontactedviapostandinvitedtoparticipateinthestudy survey.Accountingfora5%rentalvacancyrate,the overallresponserateforthesurveywas13.2%.The analyticsampleforthisstudyafterexcludingparticipantswithmissingdatawas1135.TheHighLifeStudy wasapprovedbytheRMITUniversityDesignandSocial ContextCollegeHumanEthicsAdvisoryNetwork (CHEANB21146-10/17).
Measuringapartmentdesignrequirements
Eachstategovernmentpolicy,SEPP65(NSW),SPP7.3 (WA)andBADS(VIC),wasreviewedfordesignrequirementsthatcouldplausiblyimpactpositivehealth andwellbeingoutcomesacrosseightdesignthemes:(1) solaranddaylightaccess;(2)naturalventilation;(3)
acousticprivacy;(4)outlookandvisualprivacy;(5)indoorspace;(6)privateoutdoorspace;(7)communal outdoorspace;and(8)circulationspaces(i.e.,corridors andfoyers).Thesedesignelementswerederivedfrom priorresearchthatauditedapartmentdesignpoliciesfor theirpotentialtopromotehealth16 andwerebroadly consistentwiththegroupingsofdesignrequirementsin thethreepolicies.Designrequirementsthatimpacted theeaseandexperienceofapartmentlivingwerealso extracted:(9)bicycleandcarparking;and(10)apartmentmix.Designrequirementswereeligibleifthey includedastatedandpotentiallymeasurablecriterionor standardrelatingtothedesignoftheapartment,residential floors,orbuilding.21
Toassesstheimplementationofeachdesign requirementintheapartmentbuildings,tailoredmeasureswerecreatedusingarchitecturalordevelopment plans(including floorplatesforeachbuildingleveland elevationsforeachaspect)sourcedfromdevelopment applicationsfortheapartmentbuildings.14,21 Where buildingsweresitedwithinthesameapartmentcomplex,thecommunalspacemeasuresforthecomplex wereassignedtoallbuildingsinthatcomplex.Architecturallyqualifiedresearchassistantsextracteddatafor eachrequirement.Themeasuresweredevelopedwith guidancefromastakeholderpanelcomprisedofprofessionalarchitectsandurbandesignersfromthe DepartmentofPlanningLandsandHeritageandthe WesternAustralianOfficeoftheGovernmentArchitect. Datawereextractedandmeasurescomputedfor10,533 residentialapartmentsand1094residential floors withinthe172buildings.3 Forthisstudy,theimplementationoftherequirementswassummarisedatthe buildinglevel(e.g.,percentageofapartmentsinthe buildingwithoneaspect). Table1 outlinesthe n =80 designrequirementmeasuresexamined.Allbuildings wereassessedagainstthecompletepoolofdesignrequirementsderivedfromthethreepolicies,regardless ofwhethertherequirement/standardappliedinthe state.
Identifyingcluster-derivedbuildingtypesand combinationsofdesignfeatures
Clusteranalysisisanexploratorydataanalysistechnique fororganisingobserveddataintomeaningfulgroups basedoncombinationsofindependentvariables,which maximisesthesimilarityofcaseswithineachgroup whilemaximisingthedissimilaritybetweeninitially unknowngroups.22 First,aWard’shierarchicalcluster analysiswasemployedtohelpdeterminethenumberof clusters.Hierarchicalclusteringtypicallystartswith singleobjectswhicharecombinedtocreateclusters basedonsimilarity.Clustersarethencombineduntil onesingleclusterisachieved.Theappropriatenumber ofclustersisdeterminedusingthedistancemeasure betweenclusterformationsfromtheagglomeration schedule,wherealargejumpintheagglomeration
scheduleisindicativeoftheappropriatenumberof clusters.TheK-meansmethodisthemostcommonof the ’partitioning’ clusteringanalysesforsplittinga datasetintoasetof K groups.22 Aseriesof K-means clusteranalyseswererunonall n =80measureddesign requirementsforthe n =172buildingstoidentifyhomogeneousclustersofbuildingswithdifferingcombinationsofdesignrequirements.Allvariableswere standardised(i.e.,z-scores)sothateachdesign requirementisreflectedintheclusteranalysisonthe samescale.Differentclustersolutionswereobtained, andthewithin-clustervariancewasusedtodecideon theoptimalnumberofclusters(i.e.,thenumberat whichanyfurtherincreaseinclustersproducedonlya marginalreductioninthewithin-clustervariance).
Oncetheclustersweredetermined(n =2),T-tests wererunonthe n =80designrequirements(unstandardisedvariables)todeterminestatisticallysigni fi cant differencesbetweenapartmentandbuildingmeasures byclustertoassesshowstatisticallydistincttheclusters werefromoneanotherandidentifywhichclassifying variablesweresigni fi cantlydifferentbetweenthe clustergroupings(i.e.,whichofthepolicyderived designfeaturescontributedmosttothecluster solution).
WEMWBS – positivementalhealth
Residents’ positivementalhealthwasmeasuredusing theWarwick–EdinburghMentalWell-beingScale (WEMWBS).23 Thisscalewasdevelopedtomeasure mentalwellbeing,investigatedeterminantsofmental wellbeinginthegeneralpopulation,andevaluateprojects,programmesandpolicieswhichaimtoimprove mentalwellbeing.23 Participantsrespondedto14items ona1–5Likertscalerelatingtotheirmentalwellbeing (thoughtsandfeelings)intheprevioustwoweeks.The itemsarewordedpositivelytocoverbothfeelingand functioningaspectsofmentalwellbeingincluding optimism,perceptionofusefulness,con fidence,social interaction,energyandinterestinnewactivities.23 The continuousscalewasscoredbysummingtheresponses toeachitemanswered(range:14–70),withhigher scoresrepresentinghigherlevelsofpositivemental well-being.
Statisticalanalysis
AllanalyseswereconductedinSPSS® Statisticalpackage(version27).Allparticipantswereassignedthe clusternumberoftheapartmentbuildinginwhichthey lived.Participants’ sociodemographiccharacteristics,as wellasthemeanWEMWBSscoreofparticipantsinthe differentclusters,werecomparedusingPearson’schisquaredtests(χ2)forcategoricalvariablesandindependentsamplest-testsforcontinuousvariables.The differencesinWEMWBSscoresofparticipantsinthe twoclusterswasalsoestimatedusinglinearmixedeffectsmodelsthatcontrolledforsex,age,livingwith
1)Numberofresidentialbuildingswithinthe complex
2)Numberofstoreys/floors-countedfromthe ground floorandabove
3)Numberofapartmentswithinthebuilding
4)PlotRatio(theratioofthetotal
oorarea ofabuildingtotheareaofthesite)
5)%ofapartmentswith(only)1aspect
6)%ofapartmentswith2aspects
7)%ofapartmentswith3aspects
8)%ofapartmentswherethemainaspectgets ≥2hofdirectsunlighteveryday
9)%ofapartmentswithamainnortherly aspect
10)%ofapartmentswhereallhabitablerooms haveawindowinanexternalwall
11)%ofapartmentswitharatiooftheopenable livingroomwindowareatoopenplan
oor area ≥5%
12)%ofapartmentswitharatioofthelivingroom windowareatoopenplan floorarea
10%
13)%ofapartmentswithallbedrooms+living areaslocatedonanexternalface/wall
14)%ofapartmentswherethehabitableroom depthsare ≤2.5×ceilingheight(≤3for openplan)
15)%ofapartmentswithalivingareadepth
16)%ofapartmentswithatotaldepth
18m
17)%ofapartmentswiththeface/aspectonwhich thelivingareaoftheapartmentislocated is ≥12mfromthesiteboundary
18)%ofapartmentsthatarenaturallycross ventilatedwithwindowsontwoperpendicular walls
19)%ofapartmentswithacorrectbuildingstreet setbackdistance(3m)fromthefaceofthe buildingtotheroadcentreline
20)%ofapartmentswithprivatestorageexternal totheapartment
21)%ofapartmentswiththeareaofthemain/1st bedroom ≥10m2
22)%ofapartmentswiththeareaofthe2nd, 3rdor4thbedroom ≥9m2
23)%ofapartmentswiththewidth/depth dimensionsofthemain/1stbedroom ≥3m
24)%ofapartmentswiththewidth/depthofthe 2nd,3rdor4thbedroom ≥3m
25)%ofapartmentswithadedicatedstudyroom
26)%ofapartmentswithadedicatedlaundryroom
(Table1continuesonnextpage)
(Continuedfrompreviouspage)
27)%ofapartmentsmeetingtheminimum internal floorarea:Studio=35m2; 1-bed=50m2;2-bed=70m2; 3-bed=90m2 +5m2 2nd+bathrooms; 4-bed=102m2 +5m2 2nd+bathrooms
28)%ofapartmentsmeetingtheminimum internal floorareasize:Studio=37m2; 1-bed=47m2;2-bed&1-bath=67m2;3-bed &1-bath=90m2 (+3m2 for2nd/separate toilet,5m2 fora2ndbathroom,9m2 perextra bedroom)
29)%ofapartmentswithanyprivateopen (outdoor)space
30)%ofapartmentswithaprivateoutdoor courtyard
31)%ofapartmentswithaprivatebalcony
32)%ofapartmentswiththe1st/mainbalcony orcourtyardaccessiblefromthelivingarea
33)%ofapartmentswithabalconydepthless thanthewidth(i.e.,longsidefacingout)
34)%ofapartmentswithacourtyarddepthless thanthewidth(i.e.,longsidefacingout)
35)%ofapartmentsminimumprimarybalconysize (area)requirement:Studio ≥4m2; 1-bedroom ≥8m2;2-bedroom ≥10m2; 3-bedroom ≥12m2 (SEPP65/SPP7.3)
36)%ofapartmentsminimumprimarybalconysize (area)requirement:Studio,1-and2-bedroom ≥8m2;3+bedroomdwelling ≥12m2; Courtyards ≥25m2 (BADS)
37)%ofapartmentsthatmeettheminimum courtyardsize(area)requirement(15m2) (SEPP65/SPP7.3)
38)%ofapartmentsthatmeettheminimum primarybalconydepthrequirement:1-bedroom ≥2m;2-bedroom ≥2m;3-bedroom ≥2.4m (SEPP65/SPP7.3)
39)%ofapartmentsthatmeettheminimum primarybalconydepthrequirement:studioor 1-bedroom ≥1.8m;2-bedroomdwelling ≥2m; 3+bedroomdwelling ≥2.4m(BADS)
40)%ofapartmentsthatmeettheminimum courtyarddepthrequirementbasedonthe numberofbedroomsandbathrooms: 1-bedroom ≥2m;2-bedroom ≥2m; 3-bedroom ≥2.4m(SEPP65/SPP7.3)
(Table1continuesonnextpage)
(Continuedfrompreviouspage)
41)%ofapartmentsthatmeettheminimum courtyarddepthrequirementbasedonthe numberofbedroomsandbathrooms:Studio or1-bedroom ≥1.8m;2-bedroomdwelling ≥2m;3+bedroomdwelling ≥2.4m(BADS)
42)Length(m)ofthelongestsideofthe communaloutdoorspace
43)Minimumwidth(m)ofthecommunal outdoorspace
44)%ofthecommunalopenspaceperimeter thatisoverlookedbyapartmentbalconies
45)%ofthecomplexsiteareathatiscommunal openspace(standard ≥25%)
46)Areaofcommunaloutdoorspaceprovidedis 6m2 perapartment
47)Areaofcommunaloutdoorspaceis250m2 or 2.5m2 perapartment
48)%ofthecommunalopenspacethatisgrass
49)Area(m2)ofhardscaped(concrete,paving, decking)communalopenspaceperapartment
50)%ofcommunaloutdoorspaceareathatis hardscaped(concrete,paving,decking)
51)%ofapartmentslocatedona floorwith ≤8 units
52)%ofapartmentslocatedona
53)%ofapartmentslocatedona
units
54)%ofapartmentslocatedona floorwitha windowinthecommoncorridor
55)%ofapartmentslocatedona floorwhere thelengthofthelongeststraightrunofthe corridor(fromtheliftcore)is ≤ 12m
56)%ofapartmentslocatedona floorthatmeets theminimumcorridorwidth(1.5m) requirement
57)%ofapartmentswithbalconysetbacksof ≥6mfromadjacentsites
58)%ofapartmentswith ≤50%ofallbedrooms accessibledirectlyoffthelivingarea
59)%ofapartmentswhereonlyonebathroomis directlyaccessibleoffthelivingarea
60)%ofapartmentswherethelivingroomwindow doesnotopendirectlyintoexternalcommon circulationspaces
61)%ofapartmentswherethemainbedroom windowdoesnotopendirectlyintoexternal commoncirculationspaces
(Table1continuesonnextpage)
(Continuedfrompreviouspage)
62)%ofapartmentswherethelivingareais separatedfromexternalcirculationspacesby serviceareas UUU
63)%ofapartmentswherethemain/1stbedroom isseparatedfromexternalcirculationspacesby serviceareas
64)%ofapartmentswherethenumberofparty wallsislimitedto ≤2sideneighbours
65)%ofapartmentsinthebuildingthatwere assignedspecificcarparkingbay/s
66)Numberofvisitorparkingbays U
67)Numberofmotorbike/scooterparkingbays UU
68)Area(m2)ofbicycleparking UU
69)%oftwo-storeyapartments UU
70)%ofmezzanineapartments UUU
71)%ofcourtyardorterraceapartments UUU
72)%ofopenplan(living/dining/kitchenarea) apartments UUU
73)%ofstudioapartments UUU
74)%of1-bedroomapartments UUU
75)%of2-bedroomapartments UUU
76)%of3-bedroomapartments UUU
77)%of4-bedroomapartments UUU
78)%ofapartmenttypes(studio,1-bed,2-bed, 3-bed,4-bed)inthebuilding UU
79)Entropyscoreforamixofapartmenttypes (higherlevelsofentropy=highermixlevel) UU
80)%of floorswith ≥2apartmenttypes U
Table1: ApartmentbuildingdesignrequirementsfromtheSEPP65(NSW),SPP7.3(WA)andBADS(VIC)apartmentdesignpolicies.
apartner,childrenlivingathome,employmentstatus, householdincome,educationlevel,self-ratedgeneral healthstatus,24 lengthofresidence,city(Perth,Melbourne,Sydney),arealeveldisadvantageusingthe AustralianBureauofStatisticsSocio-EconomicIndexes forAreas(SEIFA)IndexofRelativeSocio-economic Disadvantage(IRSD)decilerankings(stratifiedinto threegroups:deciles1–4=highareadisadvantage; deciles5–7=midareadisadvantage;anddeciles 8–10=lowareadisadvantage),self-selectionfactorsand clusteringofparticipantswithinbuildings.Selfselectionfactorswerederivedfromsurveyquestions onthethreefactorsinfluencingtheirchoiceofapartment:(1)apartmentspaciousness,(2)naturallight,and (3)naturalventilationtotheapartment.25
Roleofthefundingsource
Theprojectfundershadnoroleinthestudydesign, datacollection,dataanalysis,interpretationorwriting ofthereport.TheDepartmentofPlanningLandsand Heritage(WA),Of fi ceoftheGovernmentArchitect (WA),GovernmentArchitectNSW(GANSW),PlanningInstituteofAustralia(PIA)andDevelopment WAwerestudycollaboratorswhoprovidedin-kind support.
Results
Table2 presentstheresultsoftheclusteranalysisand themeanvaluesforeachdesignrequirement(n=80)of thebuildingsinthetwoclusters.Thedistinguishing characteristics(i.e.,significantlydifferentdesignrequirements)ofthetwoidentifiedbuildingclustersare highlighted.
Cluster#1buildings(n= 89)werecharacterisedby havingastatisticallysignificantlygreaterimplementationof n =51ofthedesignrequirementsacrossnine designelementsandwerelabelledthe "highpolicyperformancebuildings". Forasmallnumberofthesedesign factors,alowervalueactuallydenotedmore ‘positive’ design(e.g.,abuildinghavingfewersingle-aspect apartments;orbuildingtypesthatweresmallerin scale,havingfewerapartments,fewerbuildingsper complex,fewer floors,andsmallerplotratios).Apartmentswerecharacterisedbyhigherlevelsofimplementationofthesolaranddaylightaccessand ventilationdesignfeatures(e.g.,higherproportionsof apartmentswithdualaspects,windowsbeingpresentin allhabitablerooms,andratiosofopenablelivingroom windowareastotheopenplan floorareabeingatleast 5%).Additionally,apartmentshadasignificantlyhigher implementationofdesignfeaturesforimproving acousticandvisualprivacy,includingbuildingseparationstandardsandseparationoflivingspacesandbedroomsfromcommonandexternalcirculationspaces. Cluster#1buildingsalsohadlargerapartments,witha
greaternumbermeetingtheminimumapartment, bedroomandprivateopenspacesizeanddimension standardsandhavingmoreprivatestorageareas externaltotheapartment.Further,thesebuildings providedlargercommunaloutdoorspaces(withhigher proportionsofthesespacesbeinggrassedareas)and hadmorecirculationspacesthatmetthecorridorwidth, length,andthenumberofapartmentrequirementsper floor.Finally,cluster#1buildingsprovidedhigherlevels ofresidentandvisitorcarparkingandagreatermixof apartmenttypes.
Afteraconservativemultiplicity(Bonferroni) correctiontoaccountforthenumberofT-tests, n =29 designrequirementsremainedsignificantlydifferent betweentheclustersatthep<0.0006alphalevel(i.e., 0.05alphalevel÷numberofvariables/T-tests),indicatinggreaterimplementationofthesedesignrequirementscomparedwiththesecondclustergroupof buildings.
Cluster#2buildings(n =83)werenamedthe "low policyperformancebuildings".Theywerecharacterisedby significantlylowerimplementationoftheapartment designpolicyrequirements,performingworsethan cluster#1buildingsacrossmostdesignelements.These buildingsalsohadmorebuildingswithineachdevelopment/complexandhigherplotratios(i.e.,larger complexes)andhadthehighestproportionsofsingleaspectapartments.
Table2 alsoindicatesthesourcepoliciesforeachof thesignificantlydifferentcluster-deriveddesignrequirements.Ofthe n =51significantdesignrequirements(p<0.05)fromthe “highpolicyperformance buildings” , n= 38wereincludedinSEPP65(NSW), n= 43inSPP7.3(WA)and n= 20inBADS(VIC).Using theconservativeBonferroniadjustedalphalevel (p<0.006),ofthe n =29significantdesignrequirements(p<0.0006), n =19wereincludedin SEPP65(NSW), n =25inSPP7.3(WA)and n =11in BADS(VIC).
Table3 presentsthecharacteristicsoftheHigh Lifeparticipantsample(n =1135).Theaverageageof participantswas42years;themajoritywerefemale (61%),half(52%)livedwithapartnerandthemajority(88%)hadnochildrenlivingathome,50%were owneroccupiersand51%rentedtheirapartment. Participantsinthe "highpolicyperformancebuildings" weresignificantlyolder(45yearsofage)thanthosein the "lowpolicyperformancebuildings" (40yearsofage) andweremorelikelytobeowneroccupiersthan renters.Further,Melbourne-basedresidentswere muchmorelikelytobein “lowpolicyperformance buildings” thanSydneyorPerth-basedresidents,as werebuildingresidentslocatedinneighbourhoodsof mid-levelareadisadvantage(comparedwiththose locatedinlowdisadvantageand,surprisingly,high disadvantageareas).Therewasalsoasignificant
differenceintheWEMWBSscoresofparticipantsin cluster#1buildings(51.8)versusthoseincluster#2 buildings(49.8)(Table3).Finally, Table4 presents theresultsoftheregressionanalysis.Residentsinthe
Number of apartments within the building Plot Ratio (the ratio of the total floor area of a building to the area of the site)
% of apartments with (only) 1 aspect
% of apartments with 2 aspects
% of apartments with 3 aspects
% of apartments with a ratio of the openable living room window area: open plan floor area ≥5%
% of apartments with a ratio of the openable living room window area: open plan floor area ≥10%
% of apartments with a correct building street setback distance (3m) from the face of the building to the road centreline
% of apartments with a dedicated laundry room
% of apartments with a dedicated laundry room
% of apartments with a private courtyard
% of apartments with a private balcony
% of apartments with a balcony depth less than the width (i.e., long side faces out)
% of apartments with a courtyard depth less than the width (i.e., long side faces out)
% of apartments that meet the minimum primary balcony size (area) requirement: Studio ≥4m2 ; 1-bedroom ≥8m2 ; 2-bedroom ≥10m2 ; 3-bedroom ≥12m2 (SEPP65 / SPP7.3)
% of apartments that meet the minimum primary balcony size (area) requirement: Studio, 1- and 2-bedroom ≥8m2 ; 3+ bedroom dwelling ≥12m2; Courtyards ≥25m2 (BADS)
"highpolicyperformancebuildings" hadsignificantly higher(+1.96points)WEMWBS(i.e.,positivemental wellbeing)scorescomparedwithresidentsinthe "low policyperformancebuildings".
(Table2continuesonnextpage)
(Continuedfrompreviouspage)
Denotesthebuildingclusterwithsignificantlygreaterimplementationofthedesignrequirement. DenotesthepolicycontainsthesignificantdesignrequirementafterBonferroniadjustment(p< 0.0006)fromthe “highpolicyperformancebuildings” Denotesthepolicycontainsthesignificantdesignrequirement(p<0.05)fromthe “highpolicyperformancebuildings” Denotesthepolicy containsthedesignrequirement. † Significantafteradjustingformultipletests(Bonferronicorrection:p<0.0006).
Table2: Cluster-derivedapartmentdevelopmenttypes.
Discussion
Unprecedentedglobalpopulationgrowthhashighlightedtheneedtoconsiderhowcitiesarebuilt,and peoplearehoused.Asaresult,Australiancitiesare experiencingapronouncedincreaseinapartmentconstruction.Theevidencetodatesuggeststhathousing designcanaffectthementalhealthofbuildingoccupants.Still,fewstudieshaveexploredhowtooptimise thedesignofhigh-densityhousingtopromoteresidents’ mentalwellbeing.26 Consequently,thereisaneed forempiricalevaluationofthedesignpoliciesrecently introducedinAustraliatoassesstheperformanceofthe
deliveredbuildings.Thiscanguideevidence-informed architecturalanddesignpolicyandadvancefuture practicesforgoodapartmentdesignandhigh-rise living.
Thisisthe firststudytoexamine:(1)theimplementationandcompositionofdesignrequirements derivedfromapartmentdesignpolicies;and(2)their associationwithresidents’ positivementalhealthbased onasubstantialsampleofresidentsandbuildings acrossmultiplecities.Theresultsrevealedastrong dose–responserelationshipbetweenpolicyimplementationandmentalwellbeing.Residentslivingin
Minimum width (m) of communal the outdoor space % of the communal outdoor space area that is hardscaped (concrete, paving, decking) % of apartments with an allocated car parking spaceCluster1:Highpolicy performancebuildings %(n)
Cluster2:Lowpolicy performancebuildings %(n)
%(n) 100(1135)37 8(429)62 2(706)
Sex
Male39 0(443)40 8(175)38 0(268)0 343
Female61 0(692)59 2(254)62 0(438)
Agea 42 1(15 7)45 6(17 0)40 0(14 4) <0 001
Livingwithpartner
Partner51 5(584)53 1(228)50 4(356)0 374 Nopartner48 5(551)46 9(201)49 6(350)
Childrenlivingathome
Yes12 1(137)14 2(61)10 8(76)0 083 No87 9(998)85 8(368)89 2(630)
Housingtenure
Publichousing3 3(37)2 3(10)3 8(27) <0 001
Privaterental47 3(536)37 1(159)53 4(377)
Ownoutrightormortgage49 5(561)60 5(259)42 8(302)
Education
Secondaryorless13 8(157)15 2(65)13 0(92)0 153 Trade/certificate19 3(219)21 4(92)18 0(127)
Bachelororhigher66 9(759)63 4(272)69 0(487)
Householdincome
$0–$60,00023 7(269)23 8(102)23 7(167)0 466
$60,001–$100,00024 4(277)21 9(94)25 9(183)
>$100,00148 2(547)50 3(216)46 9(331)
Notreported3 7(42)4 0(17)3 5(25)
Employmentstatus
Full-timeemployment63 3(719)59 9(257)65 4(462)0 164
Part-timeemployment16 4(186)16 6(71)16 3(115)
Notinpaidemployment19 6(222)22 8(98)17 6(124)
Notreported0 7(8)0 7(3)0 7(5)
Self-ratedgeneralhealth
Poor2 4(27)2 1(9)2 5(18)0 233
Fair9 7(110)7 9(34)10 8(76)
Good30 0(341)29 8(128)30 2(213)
Verygood43 9(498)47 6(204)41 6(294)
Excellent14 0(159)12 6(54)14 9(105)
Lengthofresidencea 2 2(2 3)2 2(1 5)2 3(2 5)0 558 City
Perth44 8(508)56 9(244)37 4(264) Melbourne33 4(379)2 6(11)52 1(368) <0 001 Sydney21 9(248)40 6(174)10 5(74)
Areadisadvantage
IRSDdecile1–4(Highdisadvantage)24 5(278)31 2(134)20 4(144)
IRSDdecile5–735 6(404)25 9(111)41 5(293) <0 001
IRSDdecile8–10(Lowdisadvantage)39 9(453)42 9(184)38 1(269)
Resident ’ dwellingpriorities/self-selectionfactorsa Apartmentspaciousness4
PcomparingdifferencesfromPearsonChi-Square(categoricalvariables)andindependentsamplest-test(continuousvariables).Bolddenotessignificantatp<0.05. aMean andstandarddeviation(SD)forcontinuousvariables.
Table3: CharacteristicsoftheHighLifeparticipantsample.
‘highpolicyperformancebuildings’,withgreaterimplementationofacombinationofdesignrequirements (n =29)forsolaranddaylightaccess,acousticandvisual privacy,privateopenspace,storage,communalcirculationspaces,carparkingandgreatermixesofapartments,hadsignificantlyhigherpositivemental wellbeing.
Thekeydesignrequirementsidentifiedinthisstudy aresupportedbypreviousstudiesonhousingdesign andhealth.Thebenefitsofnaturallightarewelldocumented,fromvitaminDproduction(alackofwhichhas beenassociatedwithdepressionandobesity)to enhancingsleeppatterns,mood,focusandproductivity.6 Inadequatedaylightingorpoorwindowviewshave beenfoundtoincreasetheprobabilityofdepressionby 60%and40%,respectively.3 6 Our findingsalsoalign withstudiesonindoorenvironmentsandtheimportanceofnaturalventilationandthermalcomforton occupants’ physicalhealthandcognitivefunction.3,6 Whilenoiseispervasiveinurbanenvironments,27 noisefromneighboursisperceivedasmoreannoying byapartmentresidentsandhasbeenlinkedtoarangeof non-auditoryhealtheffectsandadversehealthoutcomes,27 includingsleepdisturbance,cardiovascular diseaseandimpairmentofcognitiveperformancein children.28 Perceptionsofapartmentspaceandlayout, andcommunalareaqualityhavealsobeenindependentlyassociatedwithmentalwellbeing.3 8 Internalprivatespacetypicallyimpactswellbeingviacrowding,but qualitycommunalareasmayhelpminimisecrowding byprovidingexposuretogreenspaceandtheopportunitytointeractwithneighbours.8 Ananalysisofthe communaloutdoorspaceintheHighLifebuildings foundtheuseofoutdoorareaswaspositivelyassociated withneighbouring,whichprotectsagainstloneliness,29 andinturn,poormentalhealth.30 Importantly,our studyapproachedapartmentdesignholistically,testing awiderangeofrequirementsacrossmultipledesign elementstoidentifythecombinationofrequirements thatareassociatedwithmentalhealth,ratherthana siloedfocusonspecificdesignelements.
Ourstudyderivedmeasuresfromthreeoperational apartmentdesignpolicies,butnotablythesepolicies provideddifferentlevelsofdesignguidance,asevidencedbythedifferentnumberofdesignrequirements representedfromeachstatepolicy(Table2).For example,ofthe n =29designrequirementsinCluster #1thatwerepositivelyassociatedwithincreasedpositive mentalhealthscoresusingthemorestringentBonferronisignificancelevel, n =11(37.93%)arecurrently includedintheVictoriangovernmentdesignpolicy (BADS).Thissuggeststhatinitscurrentform,the policymaybeunabletobringaboutpositivemental healthbenefits.Conversely,theNSW(SEPP65)andWA (SPP7.3)policiescontained n =19(65.52%)and n =25 (86.21%)oftheidentifiedoptimalmixofdesignrequirements,respectively.Theseresultsprovideclear
Childrenlivingathome
Sydney
Areadisadvantage
IRSD8–10(lowdisadvantage)
Resident ’sdwellingpriorities/self-selectionfactorsb
Adjustedforsex,age,livingwithpartner,childrenlivingathome,householdincome,educationlevel, employmentstatus,self-ratedgeneralhealth,lengthofresidence,city,areadisadvantage,residents’ dwelling priorities/self-selectionfactors(apartmentspaciousness;naturallight;andnaturalventilationtotheapartment) andclusteringwithinbuilding.Bolddenotessignificantatp<0.05. aSE:standarderror. bContinuousvariable. Table4: Positivementalwellbeing(WEMWBS)estimatesbybuildingclustertype.
evidencetohelppolicymakersadvocatefortheadoption orinclusionofspecificrequirements(wherecurrently missing)ortheretentionofdesignrequirements(where
presentlyincluded)duringfuturepolicyreviewsanditerations.Indeed,severaldesignrequirementsthatwere includedintheoriginaldraftoftheVictorianstandards wererelaxedorremovedafterpubliccomment,16 highlightingtheimportanceofempiricalevidencetosupport ordefendkeystandardsandpolicydecisions.
Thisstudyhasseveralstrengthsthatuniquely contributetotheevidencebase.First,interdisciplinary collaborationsthatintegrate socialscientists,healthresearchers,urbandesignersandarchitectsarescarce. However,theyarevitaltofacilitatemeaningfulresearch exploringtherelationshipbetweenapartmentdesignand mentalhealthandisolatedesignfactors’ effectonmental health.6 Thisstudydirectlyaddressesthisgapthrougha uniquemultidisciplinaryandrigorousapproachthatprovidespolicymakers,architects,andurbandesignerswith empiricalevidenceonapartmentdesignpolicyimplementationanditsassociationwithmentalhealthinthree Australiancapitalcities.Second,anovelaspectoftheHigh Lifeprojectwasmeasuringtheon-grounddeliveryofthe apartmentdesignpoliciesinthebuildings(i.e.,the ’dose’ ofthepolicyinterventionthathadbeendelivered).The developmentanduseofpolicy-specificandarchitecturally groundedmeasuresofdesigninapartmentbuildingsis unique.Third,usingclusteranalysistocharacterisethe buildingsbasedonthecombinationofthedesignfeatures implementedisanovelapproachtoquantifythedesign performanceoftheapartmentbuildings.
Lastly,research(inadults)suggeststhattheWEMWBS coulddetectaclinicallymeaningfulchange.31,32 Areview of12priorstudiestestedwhetherWEMWBSwasableto detectachangeonmentalwellbeingatagrouplevel.31 Acrossallstudiesthestandardisedresponsemean (calculatedbydividingthemeanchangeinscorebythe standarddeviationofthechangescore)wasgreaterthan 0.5(rangingfrom 0.10,95%CI: 0.35,0.15to1.35,95% CI:1.06,1.64)whichcomparesfavourablytoothermental illnessandlifesatisfactionscales,generichealth-related qualityoflifescales,anddiseasespecificscalesandindicatesthatWEMWBSisresponsivetochangesinmental healthinterventionsindifferentpopulations31 Ourmean differenceinclustergroupsof2points(51.8 "highpolicy performancebuildings",49.8 "lowpolicyperformancebuildings")andaregressionestimateofa1.96higher WEMWBSscorein "highpolicyperformancebuildings" versus "lowpolicyperformancebuildings" indicatesasufficientlylargedifferencebetweentheclusterstobeofreal andmeaningfuldifferenceinmentalwellbeingofthetwo clusteredgroups.
Thethreedesignpoliciesevaluatedareperformancebased,thusdevelopersarenotrequiredtomeetallstandardsiftheyapplyinnovativesolutionsthatsatisfythe intentoftheobjectives.17 18 Indeed,ourpreviousanalysis foundthatbuildingsinSydney(NSW)hadonaverage implementedjust57%ofthemeasuredNSWpolicy designrequirements.3 Theresultsofthisstudyidentified thecombinationsofpolicydesignrequirementsthat
architectswereadopting.Notably,the findingsindicate thatwhenthiscombinationofselecteddesignrequirementsisimplementedtoasufficientlevel,thepolicy canbeaviableinterventiontopromotethepositivemental wellbeingofoccupants.
WhilethisstudyfocusedonAustralianapartment designpolicies,theresultsaredirectlyapplicableto otherinternationalpoliciesthatweresimilarlyintroducedtoregulatethestandardofhigh-risebuildings andapartmentdesignintheirrespective jurisdictions.33–35 These findingsprovideempiricalevidencefortheinclusionorretentionofspecificdesign featuresandarchitecturalsolutionsinfutureiterations ofthepoliciesforpromotingmentalwellbeing.
Thisstudymakesauniquecontributiontotheevidencebase.However,ithassomelimitations:(1)the cross-sectionaldesignmeanscausalitycannotbeinferred;(2)Thedesignrequirementstandardsarebased mainlyonindustry ’bestpractice’ andintuitionrather thanempiricalevidence,andtherehasbeenlittleevaluationofwhetherthesethresholdsareappropriate. Testingtheappropriatenessofthe(minimum)policy standardswasoutsidethescopeofthisstudybutisan importantareaforfutureresearch;(3)Buildingmeasures wereextractedfromthearchitecturalplansandelevations submittedinthedevelopmentapplicationprocess.Whilst itispossiblethatthe finalconstructedbuildingsdeviated fromtheapproveddevelopmentapplicationmaterials, ourmeasurementprocessscreenedthebuildingplans againstotherdatasources(e.g.,Stratatitleinformation, realestatelistings,marketingmaterials)andbuildings thatwerenoticeablydifferentfromtheapprovedplans wereexcludedfromthestudy3;(4)Ouranalysiscontrolled fornumeroussocio-demographicvariablesassociated withmentalhealth,however,weacceptthatmental healthmaybeimpactedbyother,unmeasuredconfounders,includingthelocationoftheapartmentbuilding,levelsofcrimeandviolenceintheneighbourhood andperceivedneighbourhooddisorder(e.g.,vandalism, lackoffacilities,vacanthousingandlitter)andair pollution.11 (5)Humanethicsapprovalforthestudy requiredthefocusofthesurveytobestatedonall recruitmentmaterials.Assuchparticipantsmayhave beenabletosurmisethestudyhypothesiswhichmay havesubconsciouslybiasedthemtorespondinaway theythinkisexpected.36
Conclusion
Thisstudyaddressesasignificantgapintheliterature, providingempiricalevidencethatapartmentbuildings developedinaccordancewithAustralianapartment designpolicyrequirementshavethepotentialtopromotethepositivementalwellbeingoftheinhabitants. Ourresultshavepracticalimplicationsastheyidentify thecombinationofdesignrequirementsthatshouldbe prioritisedinbuildingapprovalprocessestopromote optimalresidentmentalhealth.The findingsreiterate
theimportanceofarchitectureanddesigninstruments thatfacilitatetheimplementationofminimumpolicy standardstoguidearchitecturalandurbandesign thinking,policy,andpracticeand,ultimately,thehealth offuturehigh-risehousingstock.
Contributors
SFconceivedanddesignedthestudy.PHdevelopedthemeasureswith inputfromSF,NEandJB.AKconductedtheanalyses,andPHdrafted themanuscript.Allauthorscontributedtothemanuscriptdraftsand readandapprovedthe finalmanuscript.
Datasharingstatement
Datacollectedforthestudycanbemadeavailableonrequestfromthe authors.
Declarationofinterests
AllauthorshavecompletedtheICMJEuniformdisclosureformat www. icmje.org/coi_disclosure.pdf anddeclare:nodisclosures,exceptforSF whoreportspaymentorhonorariaby:Environment&Behaviorfor servicesasAssistantSeniorEditor;DepartmentofEnvironment,Land, WaterandPlanning(DELWP)forparticipationinapanel;Government ofWesternAustraliaforparticipationasamemberofStateDesign ReviewPanel;andtheConferenceoftheInternationalAssociationof People-EnvironmentStudiesforaconferencekeynotepresentation.
Acknowledgements
TheHighLifeStudywasfundedbyanAustralianResearchCouncil (ARC),DiscoveryEarlyCareerResearcherAward(DECRA, DE160100140)andtheWesternAustralian(WA)HealthPromotion Foundation(Healthway;#31986).PHwassupportedbyaWestern Australian(WA)HealthPromotionFoundation(Healthway)Research Fellowship(#32992)andtheAustralianUrbanDesignResearchCentre andSFissupportedbyanAustralianResearchCouncil(ARC)Future Fellowship(FT210100899).Studycollaboratorsprovidingin-kindsupportincludedtheDepartmentofPlanningLandsandHeritage(WA), OfficeoftheGovernmentArchitect(WA),GovernmentArchitectNSW (GANSW),PlanningInstituteofAustralia(PIA),Landcorpandthe HeartFoundation.Theassistanceofapartmentresidentsandresident associations,inthestudyisgratefullyacknowledged.
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