Sorting Out the Connections Between the Built Environment and Health: A Conceptual Framework for Navigating Pathways and Planning Healthy Cities

Abstract

The overarching goal of this article is to make explicit the multiple pathways through which the built environment may potentially affect health and well-being. The loss of close collaboration between urban planning and public health professionals that characterized the post-World War II era has limited the design and implementation of effective interventions and policies that might translate into improved health for urban populations. First, we present a conceptual model that developed out of previous research called Social Determinants of Health and Environmental Health Promotion. Second, we review empirical research from both the urban planning and public health literature regarding the health effects of housing and housing interventions. And third, we wrestle with key challenges in conducting sound scientific research on connections between the built environment and health, namely: (1) the necessity of dealing with the possible health consequences of myriad public and private sector activities; (2) the lack of valid and reliable indicators of the built environment to monitor the health effects of urban planning and policy decisions, especially with regard to land use mix; and (3) the growth of the "megalopolis" or "super urban region" that requires analysis of health effects across state lines and in circumscribed areas within multiple states. We contend that to plan for healthy cities, we need to reinvigorate the historic link between urban planning and public health, and thereby conduct informed science to better guide effective public policy.

Noise Levels Associated with Urban Land Use

“…1 Indeed, more than half of the global population and over 80 % of North Americans now reside in urban areas. 2 The built environment is now attracting the attention of public and environmental health researchers, as its inherent quality, characteristics, and spatial orientation (i.e., urban sprawl) have been linked both positively (e.g., parks, trails) and negatively (obesity, injuries, stress) to a variety of health outcomes.…”

Complexity in Built Environment, Health, and Destination Walking: A Neighborhood-Scale Analysis

“…Health is related to how the built environment is perceived as walkable. 6,45 There are other pathways through which health and the built environment could be correlated, 13,41 such as availability of healthful foods, 44 air quality, 22,23 quality of housing stock, 36,47 and so on. However, these pathways, not being relevant to destination walking, are set aside for this present research.…”

Reuse Choice, Flood Risk and Resilience, and Characteristics of Counties with Brownfield Cleanups

“…Flood risk is buffered by natural spaces, including those created through green reuse of brownfields and where green conversion of brownfields near flood plains can create and connect green infrastructure, it can enlarge flood water storage for management and reduction of flooding, while restoring blighted areas [58][59][60]. As an environmentally preferable and more equitable alternative to sprawled development in flood plains and "greenfield" (or previously undeveloped) areas, the redevelopment of brownfields can be a sustainable development strategy for resilience [34,[60][61][62][63]]. …”

“…To accelerate and prioritize brownfield reuse, researchers and the EPA developed tools to inventory, map, and characterize sites for sustainability and economic impact [4,23,60,61,63]. It Neighborhood resources, as adopted in the model, represent the demographic, educational, employment, population characteristics, and economic strengths and social ties that mediate risk.…”

“…To accelerate and prioritize brownfield reuse, researchers and the EPA developed tools to inventory, map, and characterize sites for sustainability and economic impact [4,23,60,61,63]. It remains unclear how often practitioners use general vulnerability assessment or hazard planning tools in specific site or area-wide brownfield assessment and cleanup practices [34,44,51,52].…”