Do the Determinants of Mental Wellbeing Vary by Housing Tenure Status? Secondary Analysis of a 2017 Cross-Sectional Residents Survey in Cornwall, South West England.

Housing is a social determinant of health, comprising multiple interrelated attributes; the current study was developed to examine whether differences in mental wellbeing across housing tenure types might relate to individual, living, or neighbourhood circumstances. To achieve this aim, an exploratory cross-sectional analysis was conducted using secondary data from a county-wide resident survey undertaken by Cornwall Council in 2017. The survey included questions about individual, living, or neighbourhood circumstances, as well as mental wellbeing (Short Warwick-Edinburgh Mental Wellbeing Scale). A random sample of 30,152 households in Cornwall were sent the survey, from whom 11,247 valid responses were received (38% response), but only 4085 (13.5%) provided complete data for this study. Stratified stepwise models were estimated to generate hypotheses about inequalities in mental wellbeing related to housing tenure. Health, life satisfaction, and social connectedness were found to be universal determinants of mental wellbeing, whereas issues related to living circumstances (quality of housing, fuel poverty) were only found to be related to wellbeing among residents of privately owned and rented properties. Sense of safety and belonging (neighbourhood circumstances) were also found to be related to wellbeing, which together suggests that whole system place-based home and people/community-centred approaches are needed to reduce inequalities.