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Vitamin P: Tapping the Power of Place to Keep Us All Healthy

 

Union Square Market in New York City, NY.  Photo by Project for Public Spaces

One number stands above all others as the best indicator of good health. It’s not your blood pressure, cholesterol level, average daily calories or even the age at which your grandparents die.  It’s your zip code.

This fact has sent shockwaves across the county. The chief aspiration of American democracy is that everyone deserves an equal opportunity for life, liberty and the pursuit of happiness. Yet medical evidence shows that people living in disadvantaged neighborhoods face greater health and mortality risks.

“That should not be…. All communities should have a right to a safe, sustainable, healthy, just, walkable community,” says Robert Bullard, the father of the environmental justice movement and a professor of Urban Planning and Environmental Policy at Texas Southern University.

“Health disparities don’t just happen by accident,” he declared at the 2nd National Walking Summit, accentuating his point with a series of maps showing that high levels of diabetes, hypertension, heart disease and obesity correlate strongly with low-income neighborhoods and those with a history of racial segregation.

Dr. Anthony Iton, former health commissioner in Alameda County, California, (which includes inner city Oakland and wealthy suburbs) notes: “we have areas where people live shorter lives, substantially shorter — 20 years shorter than in other areas.”

The Case for Healthy Places[link] report just released by Project for Public Spaces (with support from Kaiser Permanente and Anne T. and Robert M. Bass) chronicles this stark contrast in health outcomes across the nation.

“Numerous studies have explored how differences in the design and function of low and high-income neighborhoods contribute to health disparities,” the report states. “Research shows that low-income groups and racial and ethnic minorities have more limited access to well-maintained parks or safe recreational facilities …These areas are also significantly more likely to lack access to supermarkets and places to obtain healthy, fresh food.”

Placemaking and the Importance of Public Spaces

The good news here is that we can do something about this problem.

“If you have parks, playgrounds, community gardens, and wide sidewalks, you have good health outcomes,” explains Ron Simms, a neighborhood activist in Seattle’s African-American community and former Deputy Secretary of  HUD, who commissioned some of the first research identifying zip codes as a critical determinant of good health as chief executive of King County, Washington.

This is the central message of The Case for Healthy Places, which maps out a common sense solution known as placemaking. It’s collaborative blueprint for improving health in all communities by strengthening and reimagining the public realm —those gathering spots, local institutions and other places where we come together as neighbors, friends and citizens.

“Placemaking is one of the most powerful things we can do to address physical and mental health as well as revitalize democracy and add more conviviality to our lives,” explains Tyler Norris, Vice President of Total Health Partnerships at Kaiser Permanente. “It supplies us with a sense of belonging, which creates resilience and well-being, according to scientific evidence.”

“Heightened bliss is what happens in a public space,” adds Fred Kent, president of Project for Public Spaces. “We seek them out —even if it’s just an interesting street corner — because we know it’s good for us. It calms and relaxes you, like meditation. You can feel your blood pressure go down.”

Just 10 to 20 percent of a person’s health condition is attributable to the access and quality of health care services. More than 40 percent is due to social and economic factors in our lives and community, 30 percent to individual behaviors shaped in part by the neighborhoods we inhabit, and 10 percent to the physical environment around us, according to a 2016 study by the University of Wisconsin Population Health Institute.

What Makes a Healthy Community?

The Case for Healthy Communities details the accumulating medical knowledge about the importance of place on our health and offers well-proven strategies, practical steps and real-world success stories in these five target areas:

1. Social Support and Interaction

Harvard sociologist Robert Putnam popularized the concept of social capital in his book Bowling Alone, which documented how the social and economic health of a community depends on people working together in organizations, volunteer projects and other personal networks (symbolized by bowling leagues). High levels of social capital also correlate with lower mortality rates, according to research by the Harvard School of Public Health. A Harvard study shows that socially disconnected people are two to five times more likely to die from a variety of causes than those with strong ties to family, friends and neighbors.

In light of this evidence, it’s disturbing that only 20 percent of Americans regularly spend time with their neighbors and that the number of Americans who report having no one to turn to in times of crisis tripled between 1985 and 2004.

The value of public spaces to boost physical and mental health as well as reduce stress has been well-documented. A study in Miami’s East Little Havana neighborhood found that architectural features such as front porches that stimulate social interaction reduces levels of psychological distress while features that inhibit interaction, such as parking on the ground floor, instill feelings of isolation and unease in subjects.

Public space restoration projects in three lower- or middle-income Portland neighborhoods resulted in statistically significant improvements in social capital and lower incidences of depression.

2. Play and Active Recreation

Parks, playgrounds and ballfields are literal common ground — places where people of all socio-economic backgrounds and personal beliefs can meet, interact, and get to know each other better. It is hard to fear, hate, dismiss or ignore people you’ve scrimmaged in basketball, crossed paths with on a bike trail or watched your kids swoosh down a slide together.