HEALTH AND THE BUILT ENVIRONMENT

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HEALTH AND THE BUILT ENVIRONMENT

• Diane Aranda, The California Endowment
• Elena Briones, The San Francisco Foundation

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Goals for Today

• Deepen understanding of the built environment and
  its connection to health
• Showcase how communities are working to improve
  the built environment and community health
• Share challenges and opportunities for funding in
  this arena

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The Built Environment

• All aspects of our surroundings that are
  constructed by people buildings, roads, parks
  and so on

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Buildings
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Roads and public transportation systems
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Parks and Green Space
Marin Co
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How we plan and design our cities
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and our neighborhoods
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Why does the Built Environment matter?

• The Built Environment directly and indirectly
  affects human health and the natural environment.
• The diseases of the 21st century will be chronic
  diseases, those that steal vitality and
  productivity, and consume time and money. These
  diseases-heart disease, diabetes, obesity,
  asthma, and depression-are diseases that can be
  moderated by how we design and build our human
  environment.
• -Richard J. Jackson, MD, MPH

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Cause of Death, California, 2003

• All Causes Percent of Total
  Deaths
• Diseases of heart 28.8
• Malignant neoplasms 22.7
• Cerebrovascular diseases 7.4
• Chronic lower respiratory diseases 5.6
• Accidents (unintentional injuries) 4.4
• Influenza and pneumonia 3.4
• Diabetes mellitus 3.0
• Alzheimers disease 2.8
• Chronic liver disease and cirrhosis 1.6
• Intentional self-harm (suicide) 1.4
• Source CDC/NCHS, National Vital Statistics System

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Leading vs Actual Causes of Death
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Diet and activity
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Actual Causes of Death

• are defined as lifestyle and behavioral factors
  such as smoking and physical inactivity that
  contribute to this nations leading killers
  including heart disease, cancer and stroke.

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Obesity Trends Among U.S. AdultsBRFSS, 1985
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
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Obesity Trends Among U.S. AdultsBRFSS, 1990
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
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Obesity Trends Among U.S. AdultsBRFSS, 1995
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
1519
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Obesity Trends Among U.S. AdultsBRFSS, 1996
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
1519
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Obesity Trends Among U.S. AdultsBRFSS, 1997
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
1519 20
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Obesity Trends Among U.S. AdultsBRFSS, 1998
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
1519 20
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Obesity Trends Among U.S. AdultsBRFSS, 1999
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
1519 20
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Obesity Trends Among U.S. AdultsBRFSS, 2000
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
1519 20
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Obesity Trends Among U.S. AdultsBRFSS, 2001
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. AdultsBRFSS, 2002
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. AdultsBRFSS, 2003
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. AdultsBRFSS, 2004
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. AdultsBRFSS, 2005
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
1519 2024 2529
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• It is unreasonable to expect that people will
  change their behavior easily when so many forces
  in the social, cultural and physical environment
  conspire against such change.
• -Institute of Medicine

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The role of the environment
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Access to Healthy Nutrition
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Other health issues related to the Built
Environment

• Asthma
• Childrens Health
• Injury
• Mental Health
• Elder Health
• Accessibility
• Social Capital

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Asthma

• During the 1996 Summer Olympics Games in Atlanta,
  researchers found that while peak morning traffic
  decreased 23 and peak ozone levels decreased
  28, emergency visits for asthma events in
  children decreased 42. During the same period,
  childrens emergency visits for causes other than
  asthma did not change.

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Crime and Violence

• In a 2001 study in one Chicago public housing
  development, there were dramatically fewer
  occurrences of crime against both people and
  property in apartment buildings surrounded by
  trees and greenery than in nearby identical
  apartments that were surrounded by barren land.

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Preventing injury among vulnerable populations

• African Americans residents of the Bay Area are
  more likely to suffer a pedestrian injury than
  white Bay Area residents
• Nationally, Latinos suffer twice as many
  pedestrian fatalities as whites

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Social Cohesion Strong Communities

• There is evidence to suggest that how we build
  and design our cities and neighborhoods can
  affect the degree to which neighbors know, care
  for and trust one another.
• See Heat Wave A Social Autopsy of Disaster in
  Chicago by Eric Klinenberg (or the review by
  Malcolm Gladwell in the August 12, 2002 edition
  of the New Yorker)

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