2021 / Built environment + Urban design, COVID

COVID-19, the Built Environment, and Health

Citation

Frumkin, H. (2021). COVID-19, the built environment, and health. Environmental Health Perspectives, 129(7), 075001. doi.org/10.1289/EHP8888

Link to file

An air quality meterBackground

Ever since people started building cities, the places where people live and work have shaped how diseases spread. Those same places have changed in response to outbreaks. COVID-19 is a clear example of both patterns. The pandemic created an opportunity to build health and disease prevention into many parts of the built environment.

Objectives

This commentary looks at two things: features of the built environment that raised the risk of COVID-19, and ways the pandemic response could reshape the built environment and public health for the long term.

Discussion

In the built environment, risk factors that made COVID-19 spread more easily include crowding, poverty, and racism (especially as they show up in housing and neighborhood conditions), poor indoor air flow, and outdoor air pollution. Looking ahead, COVID-19 could change the built environment in lasting ways through:

  • New building designs
  • More remote work
  • Redesigned streets
  • Shifts in how people travel
  • More parks and green space
  • People moving away from dense city centers

It is still too early to know which of these changes will stick. But tracking them can help health professionals, architects, urban planners, policymakers, and the public build healthier places — during the recovery and beyond.

Abstract

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.