Health and well-being in relation to high density living in Hong Kong

Abstract

The study which is presented here comprises an investigation of the biopsychic responses to high density living in the population of Hong Kong. It was carried out as a part of the Hong Kong Human Ecology Programme. A review of the relevant literature reveals that conditions of high denisty have a detrimental influence on health and social behaviour in animal populations. With respect to human beings, however, the evidence for deleterious effects is less clear-cut, and large gaps exist in our knowledge of the connecting processes between the experience of high density living and the biopsychic responses of human individuals. Information and impressions from Hong Kong suggest that the extraordinarily high levels of population density which exist in this city have remarkably little direct influence on biopsychic maladjustment or social disorder in the population. Some authors have commented on the likelihood that the ability of individuals in Hong Kong to cope successfully with their high density living conditions is in some way related to the cultural heritage and the traditional way of life of the Chinese people. The situation in Hong Kong prompted us to develop a conceptual model concerning the responses of human beings to high population density. This model forms the basis of the present study and it relates to the broader conceptual framework which underlies the Hong Kong Programme as a whole. It describes a sequence of states postulated to exist between high physical density in the total environment and the biopsychic state of individuals. This sequence can be described as follows. Individuals experience high physical density in the total environment to an extent which is dependent upon a series of 'filters' between the total environment and the personal environment. High density conditions in the personal environment may or may not be perceived in such a way as to produce in the individual a feeling of being 'crowded' - that is, a state of affective density. Under circumstances in which the individual cannot move away from the high density situation, a state of frustration is likely to develop which, if unresolved, may give rise to a state of stress. Stress, if excessive or prolonged, may ultimately give rise to a state of biopsychic maladjustment in the individual. Each stage in this pathway is subject to modification, so that maladjustment is not an inevitable outcome of the experience of high physical density, and considerably variability exists with respect to responses to high density living. Moreover, various stages in the sequence are susceptible to the intervention of adaptive processes. Field-work in Hong Kong involved carrying out a large-scale interview-questionnaire survey of the urban population - the Biosocial Survey. Almost 4,000 adults were interviewed, comprising a random sample of the population stratified by census district and by major housing type. The Survey aims broadly to contribute to our understanding of the situation by providing data for a description of the state of the population, and information for the study of interrelationships between environmental and life-style variables on the one hand, and state of health and well-being on the other. Several indices of biopsychic state are included in the Biosocial Survey, of which some are taken from previous investigations and some are specific to this study. They comprise measures of 'health' and 'enjoyment of life'. According to scores on these indices, there is, as might be anticipated, considerable variability in state of health and well-being in the population of Hong Kong. In general, we found less evidence of maladjustment than of enjoyment of life in the sample. According to the measures used, males are significantly more likely to be healthy and to enjoy life than are females. A comparison of results from Hong Kong and from studies using the same scales of biopsychic maladjustment in different parts of the world shows that the overall state of health and well-being of the population of Hong Kong is very similar to that of the populations in many modern Western cities. The degree of biopsychic maladjustment in individuals is found to relate to various aspects of the environment and the style of living. It is found, for example, that people of lower socio-economic status are relatively more likely to experience a poor state of health and well-being, and that the residents of resettlement estates are significantly more likely than people who live in any other type of housing to report signs of maladjustment and a lack of enjoyment in life. A comparison of the biopsychic state of the urban population with that of a sample of villagers from several 'isolated communities' in rural Hong Kong indicates that the latter group are more likely than the former to experience a state of wellbeing, as reflected in one of the scales used, and that they are much less likely to report symptoms of respiratory disorder. Results from the other indices of biopsychic state reveal little consistent difference between the urban and rural samples. The Biosocial Survey provided the opportunity to investigate the biopsychic responses to high density living in the population of Hong Kong. An assessment was made of levels of physical density in the respondents' personal environment, and questions were asked about the individuals' perception of high density conditions; thus it was possible to analyse the interrelationships between these parameters and state of health and well-being. The results obtained through the Biosocial Survey are consistent with and support the conceptual model relating to human responses to conditions of high population density. They indicate that high physical density is, indeed, associated with biopsychic maladjustment in the population of Hong Kong, although the relationship is a relatively weak one, and they highlight the important role of perception in responses to density. The results are also consistent with the suggestion that there are factors which interfere with or modify the postulated sequence of states from high density in the total environment to a state of biopsychic maladj ustment. The concept of density tolerance emerged during our study. It appears that there is wide variation in the population of Hong Kong with respect to tolerance of high density situations and, furthermore, that such tolerance is associated in individuals with a relatively good state of health and with an enjoyment of life. This finding supports our hypothesis that the perception of density in such a way as to produce feelings of being 'crowded' is associated with biopsychic maladjustment. Our data further suggest that the capacity for density tolerance is reinforced by a traditional Chinese way of life and is associated with relatively little formal education. The fact that this kind of socialisation is also associated with a lack of awareness or concern for world population problems, and with a relatively large family size poses a dilemma for the society. Although people may be able to tolerate, to some extent, conditions of extremely high density in their environment, this fact does not mean that these evodeviant conditions are without deleterious effect. The most effective adaptive response must ultimately be the reduction of population density through the control of population growth. Ideally, this will come about through the evolution of a social milieu which is conducive both to personal tolerance of high density and to concern, reflected in appropriate action, about the problems of over-population. Show more