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Built Environment and Public Health: More Than 20 Years of Progress
FIGURE 1— Built Environment and Health Articles Indexed by Four Databases, 2003–2022 Fall 2023 marked 20 years since the AJPH “Built Environment and Health” (BEH) special issue.1 The issue highlighted the reengagement of health and design professions and growing interest in the built environment’s potential to improve health. Public health and urban planning linkages were not new. Late 19th- and early 20th-century efforts to improve air, water, food, and housing quality; sanitation; and workplace safety contributed to better quality of life and increased life expectancy. The sectors became isolated over time, with little collaboration until recent decades. The anniversary of the special issue offers an opportunity to inventory progress in BEH: combined perspectives from public health, urban planning, architecture, transportation, and related fields on how the physical components of where we live, work, learn, and play influence health. The following sections contain an overview of BEH progress in research, practice, education, and policy, as well as current context and future priorities.
Read moreMaking Healthy Places: Designing and Building for Well-Being, Equity, and Sustainability
In Making Healthy Places, Second Edition: Designing and Building for Well-Being, Equity, and Sustainability, planning and public health experts Nisha D. Botchwey, Andrew L. Dannenberg, and Howard Frumkin bring together scholars and practitioners from across the globe in fields ranging from public health, planning, and urban design, to sustainability, social work, and public policy. This updated and expanded edition explains how to design and build places that are beneficial to the physical, mental, and emotional health of humans, while also considering the health of the planet. This edition expands the treatment of some topics that received less attention a decade ago, such as the relationship of the built environment to equity and health disparities, climate change, resilience, new technology developments, and the evolving impacts of the COVID-19 pandemic. Drawing on the latest research, Making Healthy Places, Second Edition imparts a wealth of practical information on the role of the built environment in advancing major societal goals, such as health and well-being, equity, sustainability, and resilience. This update of a classic is a must-read for students and practicing professionals in public health, planning, architecture, civil engineering, transportation, and related fields.
Read moreWhat Next? Expanding our View of City Planning and Global Health, and Implementing and Monitoring Evidence-Informed Policy
Figure 1. The pathways through which urban and transport planning decisions affect health This Series on urban design, transport, and health aimed to facilitate development of a global system of health-related policy and spatial indicators to assess achievements and deficiencies in urban and transport policies and features. This final paper in the Series summarises key findings, considers what to do next, and outlines urgent key actions. Our study of 25 cities in 19 countries found that, despite many well intentioned policies, few cities had measurable standards and policy targets to achieve healthy and sustainable cities. Available standards and targets were often insufficient to promote health and wellbeing, and health-supportive urban design and transport features were often inadequate or inequitably distributed. City planning decisions affect human and planetary health and amplify city vulnerabilities, as the COVID-19 pandemic has highlighted. Hence, we offer an expanded framework of pathways through which city planning affects health, incorporating 11 integrated urban system policies and 11 integrated urban and transport interventions addressing current and emerging issues. Our call to action recommends widespread uptake and further development of our methods and open-source tools to create upstream policy and spatial indicators to benchmark and track progress; unmask spatial inequities; inform interventions and investments; and accelerate transitions to net zero, healthy, and sustainable cities.
Read moreBuilding Healthy Community Environments: A Public Health Approach
A framework for improving community health through better environment decision making. The current state presents baseline health and defines built environmental challenges. The desired state presents public health and environmental goals for a healthy community. The core components of the public health approach are shown indicating the path toward the desired state. Adapted from the World Health Organization. Bulleted items may differ for various communities and applications. Environmental quality has a profound effect on health and the burden of disease. In the United States, the environment-related burden of disease is increasingly dominated by chronic diseases. At the local level, public health practitioners realize that many policy decisions affecting environmental quality and health transcend the authorities of traditional health department programs. Healthy decisions about the built environment, including housing, transportation, and energy, require broad collaborative efforts. Environmental health professionals have an opportunity to address the shift in public health burden toward chronic diseases and play an important role in the design of healthy communities by bringing data and tools to decision makers. This article provides a guide for community leaders to consider the public health effects of decisions about the built environment. We present a conceptual framework that represents a shift from compartmentalized solutions toward an inclusive systems approach that encourages partnership across disciplines and sectors. We discuss practical tools to assist with environmental decision making, such as Health Impact Assessments, environmental public health tracking, and cumulative risk assessment. We also identify priorities in research, practice, and education to advance the role of public health in decision making to improve health, such as the Health Impact Assessment, as a core competency for environmental health practitioners. We encourage cross-disciplinary communication, research, and education that bring the fields of planning, transportation, and energy in closer collaboration with public health to jointly advance the systems approach to today’s environmental challenges.
Read moreCOVID-19, the Built Environment, and Health
Figure 1. Milan’s lazaretto, built just outside the city’s walls in the late 15th and early 16th centuries to house plague victims. Having outlived its usefulness, it was demolished about 400 y later. This part of Milan, Porta Venezia, is now a vibrant neighborhood of galleries and ethnic restaurants—or it was until COVID-19 struck. Source: Wikimedia Background Since the dawn of cities, the built environment has both affected infectious disease transmission and evolved in response to infectious diseases. COVID-19 illustrates both dynamics. The pandemic presented an opportunity to implement health promotion and disease prevention strategies in numerous elements of the built environment. Objectives This commentary aims to identify features of the built environment that affect the risk of COVID-19 as well as to identify elements of the pandemic response with implications for the built environment (and, therefore, for long-term public health). Discussion Built environment risk factors for COVID-19 transmission include crowding, poverty, and racism (as they manifest in housing and neighborhood features), poor indoor air circulation, and ambient air pollution. Potential long-term implications of COVID-19 for the built environment include changes in building design, increased teleworking, reconfigured streets, changing modes of travel, provision of parks and greenspace, and population shifts out of urban centers. Although it is too early to predict with confidence which of these responses may persist, identifying and monitoring them can help health professionals, architects, urban planners, and decision makers, as well as members of the public, optimize healthy built environments during and after recovery from the pandemic.
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