"Built Environment" and Health Realities (Disparities)

Where you live determines, in large measure, how well and how long you will live.

Over the past decade or so, substantive, scientific research has tackled the relationship between health outcomes and health disparities and the various realities of "built environments."

Built environment is simply how things are arranged, constructed and included in the spaces where we live.

For example, the presence or absence of sidewalks, bike paths, recreational areas, and parks determines influential health factors such as physical activity and the prevalence of diabetes, obesity, asthma, hypertension and depression.

". . .in those low-income areas that do not have such amenities, the threat of crime keeps people inside. Income segregation--the practice of housing the poor in discrete areas of a city--has also been linked with obesity and adverse mental health outcomes" (from Ernie Hood, "Dwelling Disparities: How Poor Housing Leads to Poor Health," in Environmental Health Perspectives, Volume 113, Number 5, May 2005).

Most poor communities, especially in inner city areas, suffer (literally) for a want of supermarkets and access to healthy foods at affordable prices.

Instead, convenience stores encourage smoking, fast food restaurants feed obesity and diabetes, and liquor stores drive up teen drinking and addiction.

Add in low-quality, often dilapidated housing with the accompanying lead poisoning, asthma triggers and mental health stressors, including violence and social isolation, and you have a formula for disease well above the norm of the larger community.

Hood concludes in the introduction to his important and distressing essay, "Low-income and/or ethnic minority communities--already burdened with greater rates of disease, limited access to health care, and other health disparities--are also the populations living with the worst built environment conditions. Studies have shown that negative aspects of the built environment tend to interact with and magnify health disparities, compounding already distressing conditions."

Lots here to ponder, huh?

One thing seems very clear: we can reasonably expect that dollars invested properly, strategically and wisely in urban environments will pay off not only in terms of improved aesthetics, but also in concrete community health outcomes, and that over the long haul.