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Table 3 CMO-Cs through which housing situation may affect health and wellbeing and potential contextual influences

From: Housing as a social determinant of health and wellbeing: developing an empirically-informed realist theoretical framework

CMO-C Contextual factors Mechanism Outcome
1 • Security of tenure
• Tenancy support
• Responsiveness of landlord to problems
• Expectations, situation and capacity of tenant
Positive tenancy experience reduces stress and provides tenants with autonomy and control Improved health and wellbeing
2 • Level of investment in property prior to tenancy Quality housing provides tenants with a comfortable space in which to relax and a sense of status Improved health and wellbeing
3 • Rent levels
• Income levels
• Benefits system (especially changes)
• Landlord responses to financial issues
Affordable housing reduces financial stress and frees up income for other expenditure Improved health and wellbeing
4 • Community development activities of landlord
• Opportunities for choice of neighbourhood
• Existing networks of tenants
• Tenancy support
Good neighbourhood environment and supportive social/community networks around housing location reduce stress and increase opportunities for socialisation Improved health and wellbeing