Influences of built environment and social conditions on physical activity and diet in a deprived community in Norfolk, England

Background: In 2008, nine towns in England received government funding to promote healthy lifestyles by increasing opportunities for residents to engage in physical activity and make healthier food choices. This qualitative research was undertaken in Thetford, a town in Norfolk with a population of about 22,000, high levels of deprivation and a large migrant community. It explores residents' perceptions of environmental and social influences on uptake of physical activity and dietary choices.

Methods: Six focus group discussions and a series of semi-structured interviews were undertaken with residents of disadvantaged neighbourhoods, young people and community workers. Discussions were recorded, transcribed and analysed using elements of framework analysis.

Results: Participants perceived aspects of the town's physical environment and infrastructure as limiting their ability to be active and to have a healthy diet. The geographical location of recreational facilities was cited as important in a situation where not all residents have a car or access to regular public transport. A transport infrastructure that encourages pedestrians and cyclists, with connectivity of routes between different areas, amenities and the town centre was regarded as central to individuals engaging in active travel. The social environment was seen as impacting on individual health behaviour and mental well-being. Issues raised included safety concerns, opportunities for interaction, community cohesion, limited training opportunities and unemployment. The results revealed a degree of scepticism about the likely benefits of short-term health promotion programmes. Participants emphasized the need for long-term urban planning, investment in facilities and social development to support healthy lifestyles.