Table 2 Description of the main health-related results found in the cohousing projects

Altus and Mathews, 2002

To compare the satisfaction of rural senior housing cooperative and rental apartments members.

Cohousing country: USA

Age target: Elderly

Co-ownership: Yes

Quantitative

(cross-sectional with comparison group)

N: 39 cooperative residents; 48 rental apartments

Number of projects studied: 3

Quality of life measured by well-being index with 12 items related to safety, happiness, life satisfaction, friends, physical health, and psychological health.

QUALITY OF LIFE AND WELL-BEING

There are no significant differences between cohousing cooperative residents and rental apartment residents.

Bamford, 2005

To explore the physical structures and experiences of older people living in cohousing.

Cohousing country: Denmark and Netherlands

Age target: Elderly

Co-ownership: Yes

Qualitative (cross-sectional; in-depth interviews)

N: unknown

Number of projects studied: 2

Interview guide not provided.

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support:

Physical structures facilitate social relations and benefit the sense of security.

Different people go on outings together and in general “appreciate the social contact” and the possibility of “help or assistance” in time of need, but they remain keen to preserve their autonomy.

Choi and Paulsson, 2011

To evaluate the social support and quality of life in Swedish cohousing units.

Cohousing country: Sweden

Age target: Intergenerational

Co-ownership: No

Quantitative

(cross-sectional without comparison group)

N:241

Number of projects studied: 12

Life satisfaction with housing was measured by 6 items with Likert-scale of 3 points and 5 points.

QUALITY OF LIFE AND WELL-BEING

Increase life satisfaction among people living in cohousing compared to their own experience before and after moving.

Most respondents indicated high level of satisfaction and happiness with their lives in cohousing.

People over 60 thought they lived better than others of their age living in conventional housing.

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support: mutual support in cohousing communities is perceived greater than in conventional ones.

Cooper and Rodman, 1994

To assess how differences in physical design and the ability of residents to control the environment affect their quality of life.

Cohousing country: Canada

Age target: Intergenerational

Co-ownership: Yes

Mixed methods

Quantitative (cross-sectional without comparison group)

Qualitative (cross-sectional; in-depth interviews)

N:62 with disabilities; 241without disabilities

Number of projects studied: 16

Quantitative: Questionnaire conducted to gather data on levels of satisfaction, quality of life, participation, control, and social integration.

Qualitative: interview guide not provided.

QUALITY OF LIFE AND WELL-BEING

The social control perceived by residents over their residential environment was more important than their perceived physical control (accessibility) in explaining the perceived quality of life.

Fromm, 2000

To determine whether residents had achieved their stated goal of "creating a sense of community" through cohousing; and, if achieved, their satisfaction with it.

Cohousing country: USA

Age target: Intergenerational

Co-ownership: No

Mixed methods

Quantitative (cross-sectional without comparison group

Qualitative (cross-sectional; semi-structured interviews)

N:85 units

Number of projects studied: 3

Quantitative: information on the questions not provided

Qualitative: interview guide not provided.

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support: 100% of cohousing residents would feel comfortable asking neighbours to help with tasks or errands if they were ill, in their previous conventional housing only 40% reported the same possibility.

Sense of community: The residents have a much stronger sense of community within cohousing than in their previous neighbourhood.

Sense of security: There are feelings of security within the cohousing community.

Glass, 2009

To describe a resident-managed elder-only cohousing community focusing on mutual support and affordable housing.

Cohousing country: USA

Age target: Elderly

Co-ownership: No

Mixed method

Quantitative (longitudinal without comparison group)

Qualitative (longitudinal; in-depth interviews)

N:33

Number of projects studied: 1

Quantitative: Physical and mental health measured by self-perceived physical health and self-perceived mental health.

Qualitative: interview guide not provided.

SELF-PERCEIVED PHYSICAL AND MENTAL HEALTH

19% of project participants report improvements and 13% reported worsening in physical health compared to one year ago.

28% reported improvements in mental health and 3% reported worsening mental health.

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support: Residents count on their neighbours for help with household and personal care.

Sense of community: The sense of community and mutual support are perceived as important reasons for living in a cohousing.

Glass, 2012

To describe the health status of three elder-cohousing projects.

Cohousing country: USA

Age target: Elderly

Co-ownership: No

Mixed methods

Quantitative (longitudinal without comparison group)

Qualitative (longitudinal; in-depth interviews)

N:58

Number of projects studied: 3

Quantitative: General health was measured by self-perceived health.

Information on mental health scale used not provided.

Qualitative: interview guide not provided.

SELF-PERCEIVED PHYSICAL AND MENTAL HEALTH

The majority had good physical and mental health and it remained the same a year later living in the cohousing

Glass, 2013

To evaluate how cohousing projects, influence the ageing of older people.

Cohousing country: USA

Age target: Elderly

Co-ownership: No

Mixed methods

Quantitative (longitudinal without comparison group)

Qualitative (longitudinal without comparison group with interviews and participant observation)

N:43

Number of projects studied: 1

Quantitative: information on the questions not provided.

Qualitative: interview guide provided. Core questions related to the review:

Does living in this community affect how you think and feel about the aging process and any challenges that can come with that process? If so, how?

How is the mutual support working out? Have your expectations changed?

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support: Residents were willing to help others, ask for help when needed and accept help.

Sense of community:

Development and satisfaction of a sense of community and mutually supportive processes.

Bring prospective residents together regularly while the buildings are under construction to begin to build a sense of community and to discuss expectations about the community.

Glass, 2016

To determine if neighbourhoods, each based on the cohousing model promote development of social resources for their residents.

Cohousing country: USA

Age target: Elderly

Co-ownership: No

Quantitative

(cross-sectional without comparison group)

N:59

Number of projects studied: 3

Social networks measured by Lubben Social Network Scale.

Neighbouring support through four items.

Satisfaction with the neighbourhood community measured by seven items.

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support: The mutual support most frequently reported was sharing of knowledge to help someone (informational), lending/borrowing things (functional), and listening/supporting when someone had a personal problem (emotional).

Social isolation: Living in an intentional neighbourhood reduces social isolation by increasing social resources.

Sense of community: Participants were very dissatisfied with sense of community or feelings part of community.

Sense of security: 77,6% were very satisfied with security and safety from crime.

Glass and Vander Plaats, 2013

To assess life in co-housing and the beneficial results of living together in relation to ageing.

Cohousing country: USA

Age target: Elderly

Co-ownership: No

Mixed methods

Quantitative (cross-sectional without group) in 2012

Qualitative (cross-sectional; in-depth interviews) in 2009

N:31

Number of projects studied: 1

Quantitative: information on the questions not provided.

Qualitative: interview guide provided. Core questions related to the review: Why did you choose to move here? Why did you choose an elder-only community? How is the mutual support working out? Have your expectations changed?

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support:

An increase of mutual support, sense of safety and acceptance of aging was perceived.

Residents explained that they were prepared to help each other and learning to age well together.

The 89% say there is more mutual support in cohousing.

Social isolation

Over 90% of residents reported agreement or satisfaction on feeling safe, less worry and lessening of social isolation.

Sense of security

Residents showed feelings of security related to mutual support, socialising and companionship among residents.

All residents indicated that living in cohousing makes feeling safe.

Jolanki and Vilkko, 2015

To study what a “sense of community” meant to the residents and how a sense of community becomes visible in daily life.

Cohousing country: Finland

Age target: Elderly

Co-ownership: No

Mixed methods

Quantitative (cross-sectional without comparison group)

Qualitative (cross-sectional; semi-structured interviews and groups discussions)

N:6 discussants and 41surveyed

Number of projects studied: 1

Quantitative: information on the questions not provided.

Qualitative: Core questions related to the review: What kind of meanings are given to a “sense of community” by the residents of the co- housing community?

How does a “sense of community” become visible in the daily life of the community, according to the residents?

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support: Community as a source of social and practical support for residents.

Sense of community: Sense of community understood as a sense of togetherness, belonging and trust, created through community activities, doing things together, and have mutual support.

Sense of security: Trust in the community as a collective unit that supported its residents, trust in other residents, and always having someone to turn to create a sense of security and safety.

Kehl and Then, 2013

To assess the effects of multi- generation cohousing developments on the residents, health conditions and social support.

Cohousing country: Germany

Age target: Intergenerational

Co-ownership: No

Quantitative

(Cross-sectional with comparison group)

N: 313 program group; 428 control group

Number of projects studied: 4

General health was measured by self-perceived health

Care level was measured with scale from 0 points to 3 points.

Social support measured with scale from 0 points to 5 points.

SELF-PERCEIVED PHYSICAL AND MENTAL HEALTH

No significant differences in subjective health assessment.

13% of the programme group respondents are in need of care compared to 22% in the control group.

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support: Cohousing participants show more social support and social cohesion than the control group.

Labit, 2015

To explore the effects of cohousing on the quality of life of elderly people by focusing on personal autonomy and community solidarity.

Cohousing country: 2 Germany, 1 Sweden, 2 UK.

Age target: Intergenerational

Co-ownership: No

Qualitative

(cross-sectional; semi-structured interviews, participants observation and photographic record)

N: 30 with residents aged over 50

Number of projects studied: 5

Interview guide not provided.

QUALITY OF LIFE AND WELL-BEING

Cohousing is considered a good housing option for older people as it improves the quality of their lives by focusing on personal autonomy and community solidarity.

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support: Mutual assistance is often described as the result of affinity, although mutual assistance and solidarity between generations was also reported.

Sense of security: Solidarity and good neighbourly relations foster a sense of security, something that was most evident in senior participants.

Labit and Dubost, 2016

To learn about the experiences of residents living in a model of cohousing based on solidarity between elderly people and families in Germany.

Cohousing country: Germany

Age target: Intergenerational

Co-ownership: No

Qualitative (cross-sectional; semi-structured interviews)

N: 10 Cologne; 8 Berlin

Number of projects studied: 2

Interview guide not provided.

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support:

Creation of a strong attachment in mothers (single or not) because the community makes daily life easier

Intergenerational solidarity was not evident although seniors reported receiving help when they requested.

Older participants are discouraged by conflicts (budget management and maintenance of common areas)

Markle et al., 2015

To explore cohousing residents’ experience of social support in the USA.

Cohousing country: USA

Age target: Intergenerational

Co-ownership: Yes

Mixed method

Quantitative (cross-sectional with comparison group)

Qualitative (cross-sectional; semi-structured interview)

N: 60 living in cohousing; 65 not living in cohousing

N: 10 interviews

Number of projects studied: Unknown

Quantitative: Social support was measured with three scales: Social Provisions Scale (SPS), Social support given (SSG) and Social support received (SSR).

Qualitative: interview guide provided. Core questions related to the review: How do you give and/or receive support from other people in your cohousing community?

How has living in cohousing impacted or changed your life?

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support:

People who live in cohousing receive and give more social support than people who do not. Moreover, cohousing participants indicated that they felt more supported in cohousing compared to previous living situations.

Sense of community:

Elderly are aware that they can receive help from the community in their ageing and with their health problems.

The sense of community was a reason for joining cohousing.

Motevasel, 2006

To know the expectations and differences between residents in rental apartments and tenant-owned housing cooperative.

Cohousing country: Sweden

Age target: Elderly

Co-ownership: Yes (2/4)

Qualitative

(cross-sectional; in-depth interviews with comparison group)

N: 16 seniors in rental apartments; 12 seniors in cooperatives

Number of projects studied: 4

Interview guide provided. Core questions related to the review: Why have the residents chosen senior housing?

What are the differences between residents in rental apartments and tenant-owned housing cooperatives?

What advantages and disadvantages do the residents think that senior housing has?

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support: Socialisation, activities and community were perceived positive both, in the rental apartments and the cohousing cooperatives.

Social isolation: The architectural design forced socialisation and it was not always a positive experience. Nevertheless, it avoided the social isolation of the elderly who were sick and frail.

Sense of community: The informants did not think that they have chosen their present housing out of a desire for security or social community. However, they have come to appreciate that there is a community in the senior housing.

Nusbaum, 2010

To understand how creating and living in an elder co-housing community has impacted residents' sense of autonomy, a critical component of psychological well-being in old age.

Cohousing country: USA

Age target: Elderly

Co-ownership: No

Qualitative (cross-sectional; in-depth interviews)

N:10

Number of projects studied: 1

Interview guide provided. Core questions related to the review: Can you tell me about a typical day here at Capitol Court?

How is living at Capitol Court going for you?

How important is autonomy to you, or the meaning of deciding what you want in your life? Have you always been that way, or is that a quality that has become more important as you have gotten older?

QUALITY OF LIFE AND WELL-BEING

The participants deeply valued both their own autonomy and their fellow residents. Participants reported their autonomy was not compromised by functioning as a cohesive group, indeed various aspects of group life foster individual autonomy.

Living in an environment with a high degree of autonomy favours opportunities to participate and contribute, resulting in an improvement in different competences and skills.

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support: Participants cared greatly about the quality of their relationships with each other, and yet they also cared about quantity of time spent together.

Pedersen, 2015

To describe how the residents have adapted to the individual and collective challenges in a Danish senior cohousing

Cohousing country: Denmark

Age target: Elderly

Co-ownership: No

Mixed method

Quantitative (cross-sectional without group comparison)

Qualitative (cross-sectional; in-depth interviews)

N: 643 surveyed and unknown interviews)

Number of projects studied: Unknown

Quantitative: The questionnaire collected topics about the social interaction in the facilities and residents’ perceptions of the advantages and challenges of living in a senior co-housing community. Measures not provided.

Qualitative: Core questions related to the review: Why did the residents choose to spend their old age in a co-housing community?

Was it difficult to recruit new members for the board of residents?

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support: Social networks and satisfaction with housing increased compared to the previous housing situation.

Interviews indicated that social and practical activities played an important role in residents' lives and promoted closer friendships.

Sense of security: Most residents valued the sense of security they gained from living in an environment where people knew each other well.

Philippsen, 2014

To know the degree of social integration of the residents into their residential group and the mechanisms by which the integration takes place.

Cohousing country: Germany

Age target: 6 Intergenerational and 1 Senior

Co-ownership: Yes (1/7 projects)

Quantitative

(cross-sectional without comparison group)

N: 220 adults

Number of projects studied: 7

The questionnaire comprises three thematic blocks with 71 questions: 1) questions about life in the housing project, 2) questions about life situation and personal relationships and 3) general questions about the person.

Social support was assessed by the study of social networks and 10 questions based on the Fischer instrument and adapted to the special conditions in housing projects, covering instrumental and emotional support.

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support:

83-95% of residents have obtained instrumental or emotional support and 75-88% have given support.

93% of the inhabitants believe that it is possible to make close friendships in cohousing. Although, elderly residents have more friendships than younger ones.

Residents who regularly attend cohousing social gatherings are much more likely to be friends than residents who attend meetings only occasionally or never, the closer residents felt, the more likely they were to support each other, both emotionally and instrumentally.

Residents of all seven projects indicated more instrumental social support (help with cures, housework, etc.) than emotional support.

Rodríguez-Alonso and Argemir, 2017

To explore personal autonomy, organisation of physical space and collective self-management in the senior cohousing cooperative.

Cohousing country: Spain

Age target: Elderly

Co-ownership: No

Qualitative (cross-sectional; in-depth interviews, participant observation and a group discussion workshop)

N: 29

Number of projects studied: 1

Interview guide not provided.

Group discussion workshop focus on reasons for dismissing family and senior residence as primary options for care and how care is materialised in the cohousing.

QUALITY OF LIFE AND WELL-BEING

The ability to decide and manage the forms and timing of self-care promotes physical, emotional, and social well-being.

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support: Autonomy is only possible through collective support and social relations of solidarity. Physical spaces also allow for social interaction that leads to emotional bonds.

Ruiu, 2015

To assess whether cohousing communities (the case of Threshold Centre) might generate positive effects in terms of social housing.

Cohousing country: USA

Age target: Intergenerational

Co-ownership: Si

Qualitative

(cross-sectional; semi-structured interviews and cognitive maps)

N:18

Number of projects studied: 1

Interview guide not provided instead a list of topics was provide, topics related to the review were: Decision-making process; Physical layout and social life; Social dynamics and privacy (public and private spaces); Shared values and “ideologies” Relations with the outside; Safety.

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support: There is informal mutual support among residents and in the neighbourhood

Sense of community:

Participation in all stages of the process, in addition to self-management, contributes to a sense of community

Designing and managing common spaces helps to define community life and a collective perception

Sense of security: High sense of security thanks to the physical layout of the community.

Tchoukaleyska, 2011

To know how cohousing communities can reduce the risks associated with living in an urban context and are a desirable place to raise children.

Cohousing country: Canada

Age target: intergenerational

Co-ownership: Yes

Qualitative

(cross-sectional; semi-structured interviews)

N:5 residents (three family interviews)

Number of projects studied: 1

Interview guide not provided

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support: Cohousing encourage social relationship, social support among families and allows children to meet friends of different ages.

Many participants also reported the exchange of practical, pragmatic support within their community, involving sharing objects, borrowing cars, or offering rides, and caring for each other’s homes, plants, and pets while they were away

Sense of community: There is a sense of community and is a reason behind the selection of cohousing for their families, parents indicate.

Sense of security: There were a common desire to provide a family-oriented environment and emotionally and physically secure for children.

Tyvimaa, 2011

To discuss residents’ views of social and physical environments in a cohousing and in a senior housing setting in Finland.

Cohousing country: Finland

Age target: Elderly

Co-ownership: No

Mixed methods

Quantitative (cross-sectional with comparison group)

Qualitative (cross-sectional; in-depth interviews)

N: 34 group intervention; 64 group comparison

N:14 interviews

Number of projects studied: 2

Quantitative: information on the questions not provided.

Qualitative: interview guide not provided.

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support:

Well-designed common areas activate residents to socialise and organise activities. They use their common areas more actively than residents in conventional housing.

29% of cohousing residents and 14.9% of senior housing residents said they met with neighbours at least once.

Social networking is an integral component of happiness within the housing setting.

Social isolation: The residents had experienced loneliness or social isolation before moving into co-housing, after moving that sense disappears.

Sense of community:

The sense of community was a reason for choosing to live in cohousing.

Activities organised together connect the residents together and increase the feeling of sense of community

Wasylishyn and Johnson, 1998

To develop an understanding of the experiences of women living in a new housing co-operative built exclusively for unattached, low income women of middle age.

Cohousing country: Canada

Age target: Intergenerational

Co-ownership: Yes

Qualitative

(cross-sectional; in-depth interview; participants observation)

N:10 women

Number of projects studied: 1

Interview guide not included.

SELF-PERCEIVED PHYSICAL AND MENTAL HEALTH

A deterioration in physical and/or mental health was perceived after moving into the co-operative.

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support: The increased sense of control and social support inherent in community life were not immediately apparent.

Sense of community: Women perceived themselves as a diverse group without a common identity.

Sense of security: Less financial stress and more sense of safety.

Williams, 2005

To know how the physical design and management of a cohousing influences the social interaction of the residents.

Cohousing country: USA

Age target: Intergenerational

Co-ownership: No

Qualitative

(cross-sectional; activity diaries, in-depth interviews, and participants observation)

N:98

Number of projects studied: 2

Interview guide not provided

PSYCHOSOCIAL DETERMINANTS OF HEALTH

Social support:

The number and diversity of social activities organised in a community seem to affect levels of social interaction.

The management of indoor communal facilities was also shown to influence usage and social interaction.

Meetings could potentially provide the opportunity for more social interaction amongst residents.

Density (proximity) and layout, the division of public and private space and the quality, type and functionality of communal spaces appear to be the key design factors influencing social interaction in cohousing developments