12.2 Built Environment and Health

The built environment shapes our health in profound ways. From urban design to transportation systems, our surroundings impact how we move, live, and thrive. This section explores how city planning and infrastructure choices can promote physical activity, reduce pollution, and foster community well-being.

Housing and community spaces also play a crucial role in public health. We'll examine strategies for creating affordable, safe housing and equitable neighborhoods. These approaches aim to address environmental injustices and build healthier communities for all residents.

Urban Design and Walkability

Designing Cities for Pedestrian Accessibility

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• Built environment encompasses all physical aspects of where people live and work (buildings, streets, parks) that influence health behaviors and outcomes
• Urban planning involves designing and managing the built environment to promote livability, sustainability, and public health through land use, transportation, and infrastructure decisions
• Walkability measures how conducive an area is to walking based on factors like pedestrian infrastructure (sidewalks, crosswalks), safety (lighting, traffic), and proximity to destinations (shops, services)
• Improving walkability through urban design strategies (mixed-use development, pedestrian-friendly streets) can increase physical activity levels and reduce obesity and chronic disease risks

Incorporating Nature into Urban Environments

• Green spaces are areas of vegetation (parks, gardens, forests) incorporated into urban environments that provide physical and mental health benefits
• Access to green spaces is associated with increased physical activity, reduced stress and depression, improved air quality, and lower rates of cardiovascular disease and all-cause mortality
• Urban planning can prioritize the creation and preservation of green spaces through land use policies (zoning for parks), development incentives (density bonuses for including green space), and community engagement (participatory planning processes)
• Examples of integrating nature into cities include linear parks (High Line in New York City), urban forests (Tijuca National Park in Rio de Janeiro), and green roofs (Chicago City Hall)

Transportation and Housing

Developing Efficient and Equitable Transportation Networks

• Transportation systems include the infrastructure (roads, rail lines, bike lanes) and services (public transit, ride-sharing) that enable people to move around their communities
• Access to reliable and affordable transportation is a key determinant of health, affecting access to healthcare, healthy food, education, and employment opportunities
• Transportation planning can prioritize active transportation modes (walking, cycling) and public transit over car-centric development to reduce air pollution, increase physical activity, and improve health equity
• Examples of innovative transportation solutions include bus rapid transit (TransMilenio in Bogotá), bike-sharing programs (Vélib' in Paris), and congestion pricing (London's Ultra Low Emission Zone)

Ensuring Access to Safe and Affordable Housing

• Housing quality refers to the physical condition and safety of residential buildings, which can impact health through exposure to hazards (lead, mold, pests) and stress
• Affordable housing is housing that costs no more than 30% of a household's income, allowing residents to meet other essential needs (food, healthcare, education)
• Land use policies can promote the development of affordable housing through inclusionary zoning (requiring a percentage of units to be affordable), density bonuses (allowing higher density in exchange for affordable units), and public-private partnerships (subsidizing development costs)
• Examples of initiatives to improve housing quality and affordability include housing trust funds (Seattle's Housing Levy), community land trusts (Dudley Street Neighborhood Initiative in Boston), and home repair programs (Philadelphia's Basic Systems Repair Program)

Community Health and Equity

Addressing Environmental Injustices

• Environmental justice is the fair treatment and meaningful involvement of all people in environmental decision-making, regardless of race, color, national origin, or income
• Low-income communities and communities of color are disproportionately exposed to environmental hazards (polluting industries, toxic waste sites) and have less access to environmental benefits (green spaces, healthy food)
• Strategies to promote environmental justice include community-based participatory research (identifying local environmental health concerns), policy advocacy (strengthening environmental regulations), and green jobs training (preparing residents for employment in sustainable industries)
• Examples of environmental justice victories include the cleanup of the Dudley Triangle in Boston and the closure of the Fisk and Crawford coal plants in Chicago

Building Healthy and Equitable Communities

• Healthy communities are places that promote the physical, mental, and social well-being of all residents through access to healthcare, healthy environments, and social support networks
• Zoning laws are local regulations that govern land use, density, and building types, which can impact community health by shaping access to resources (healthcare facilities, grocery stores) and exposure to hazards (polluting industries, fast food outlets)
• Health impact assessments are tools used to evaluate the potential health effects of policies, plans, and projects and make recommendations to maximize health benefits and minimize harms
• Examples of initiatives to build healthy communities include the Healthy Neighborhoods Equity Fund in Massachusetts, the Fresh Food Financing Initiative in Pennsylvania, and the Village of Euclid v. Ambler Realty Co. Supreme Court case that established the constitutionality of zoning for public health