Now Viewing: Built Environment and Health

Innovations from Abroad Are Keeping Seniors Socially Connected

Apr 13, 2017, 10:00 AM, Posted by Susan Mende

From a dementia village to the next AirBnB for seniors, global entrepreneurs are searching for ways to improve the lives of a rapidly aging population. Their lessons can inform efforts right here in the United States where the elderly population is expected to more than double by 2060.

Through the plate glass window of the café where I sipped my coffee, I watched an older gentleman bend to pick something off the ground. He did this repeatedly: down and up, down and up. I learned that he did this every day for hours, picking up fallen leaves.

The man had dementia and lived in Hogewey, a community outside Amsterdam where older people with advanced dementia lead largely autonomous lives in familiar, welcoming surroundings. This particular gentleman liked to pick up leaves—and why not? It did him no harm; in fact, it gave him a little exercise, and he probably found the activity relaxing.

Hogewey is unique—a gated, village-like community where those with dementia live in small-group homes that look and feel like real homes, with people of similar backgrounds and experiences. Caregiving and other staff support them in everyday activities and blend into the environment, serving as grocery store clerks, hairdressers, bartenders, and neighbors.

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6 Reasons Why Parks Matter for Health

Aug 22, 2016, 1:45 PM, Posted by Teresa Mozur

As the National Park Service celebrates its 100th anniversary of beauty, recreation, and conservation this summer, we asked six leaders why access to public land is vital to everyone's physical and mental health.

A couple looking at the mountains. Yosemite National Park

The National Park Service celebrates its centennial this week, and our national parks have never been more appreciated; visitors made a record-breaking 307.2 million visits to them in 2015. But what many park goers may not realize is that the access to natural scenery and park activities national parks provide play a role in improving health. In fact, research shows that using public parks—even tiny local ones in your neighborhood—contributes to health in a number of ways, from promoting physical activity to improving mental health and even having the potential to reduce health care costs.

To celebrate this milestone in American history, the Culture of Health blog's editorial team asked six leaders to give us their reasons why parks matter for health.

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At the Intersection of Urban Planning and Health in the New York Metro Region

Jul 12, 2016, 4:48 PM, Posted by Mandu Sen

Urban planning plays a role in addressing health challenges in America and can help give everyone the opportunity to live their healthiest lives possible. A new report shows us how.

More perhaps than any place in the world, the New York metropolitan region is known for its urban form—its physical layout and design. From the Manhattan skyline to the neon lights and tourist-packed streets of Times Square to the rolling hills and winding paths of Central Park, New York’s built and natural environment is part of what makes it such a vibrant, dynamic place to live. The distinctive form also has important health impacts. But, as discussed in a new report, State of the Region’s Health: How the New York Metropolitan Region’s Urban Systems Influence Health, these impacts are often poorly understood.

The report, written by the Regional Plan Association (RPA) with support from RWJF, provides an in-depth look at health in the New York metropolitan region, where 23 million people live in cities, suburbs, villages and rural communities stretching from New Haven, Connecticut to Ocean County, New Jersey. It finds that New York region residents live longer than U.S. residents overall, but they are not necessarily healthier.

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How Can Partnering with the Housing Sector Improve Health?

Jun 8, 2016, 11:00 AM, Posted by Pamela Russo, Rebecca Morley

Collaboration between public health and housing sectors can vastly improve the quality of life within communities across the nation.  

The house that Robert and Celeste Bridgeford bought in Curry County, Oregon over a decade ago wasn’t just old. It was dangerous. Water damage and thin walls wracked by decades of severe storms unleashed wide swaths of mold. The damaged floors put the whole family at risk of falling, especially Robert, disabled years ago by a work injury. “We had always planned to replace the house, but... then...life happened,” says Celeste.

The Bridgeford family—like a third of Curry County’s residents—lives in a prefab house that is manufactured in a factory and then transported to the site. About 40 percent of the prefab housing in Curry County is substandard. With little industry in the area, many families struggled to find work and couldn’t afford to fix or replace their homes.

This all started changing in 2013 when community groups, non-profits and public agencies joined to propose a pilot project for the state of Oregon. This project would, for the first time, provide low cost loans or other funds to help prefab home-owners repair or replace their homes.

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Why Every Street Should Be an Open Street

Mar 29, 2016, 11:00 AM, Posted by Sharon Roerty

How can streets get people moving and improve health? When they are open, with room for people of all ages to bike, walk, play, and build community.

Every street should be an open street—open to people with and without wheels, all abilities, all ages, all people. Streets belong to everyone. They connect us to each other and the places where we live, learn, work, and play—across neighborhoods, cultures, and economic status.

Streets are the vascular system of our cities and regions. They let us explore and experience our communities and all that they have to offer.

Most of the time, however, they are overrun by cars. At peak hours, traffic clogs the main arteries, automobile fumes foul the air, and blaring horns assault the eardrums.

What if one day a week we all left our cars at home and took to the streets on our own two feet? What would happen?

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Redesigning the Hospital as a Community Health Network

Sep 10, 2015, 3:35 PM, Posted by Shannon Kraus

Cleveland's MetroHealth Medical Center has reimagined itself to embrace community and build in thoughtful improvements to its programs and design that focus on everyday wellness and well-being.

Graphic of the MetroHealth Medical Center Image via HKS Architects

In a room filled with architects, acting Surgeon General Rear Admiral Boris D. Lushniak shook up the common definition of our profession by saying that “if you are an architect, you are a public health worker.

And many architects were already with him. We have been expanding our thinking beyond typical individual buildings to create healthy blocks, corridors and neighborhoods by shaping what they do within the property line so it’s responsive to what’s happening outside the property line. This in itself is not new, but doing so to improve health and wellness, while leveraging the resources of large civic-minded institutions, is a new approach to a traditional problem.

MetroHealth Medical Center in Cleveland, Ohio has taken on this mindful, responsive approach while morphing from an isolated hospital into an inclusive community health center. This process flips the paradigm of health delivery; instead of focusing on the hospital as the first line of defense in the care and wellbeing of a population, it is now the last stop.

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Community Development For and By the Community

Jul 13, 2015, 12:37 PM, Posted by Jasmine Hall Ratliff

Many families face rising rents they can’t afford. One local developer revamped an aging historic hotel into affordable housing to transform: "community development being done TO us.. to development done BY us."

Boyle Hotel before and after renovations. Before: The Boyle Hotel in disrepair. After: The Boyle Hotel-Cummings Block Apartments bring 51 new apartments to the neighborhood, all priced for people making between 30 to 50 percent of the area’s median income.

Ten years ago, Los Angeles’ Boyle Hotel was more than down on its luck. The grand old Victorian dame, built in 1889 by an Austrian immigrant and his Mexican wife, was uninhabitable. Over the years neglect had turned the stunning building with intricate period details into a ramshackle apartment house with shared bathrooms and communal kitchens. The wiring was faulty and the pipes leaked. Mold bloomed up walls. Rats scurried along the hallways. Absentee landlords racked up housing code violations, ignoring the residents’ repeated requests for basic protections of their safety and health.

Most of the tenants were older, single men: many of them mariachi musicians scraping by from gig to gig. They’d spend their weekends across the street in the plaza, as generations had going back to the 1930s, exchanging news and waiting for word of a quinceñeara or wedding where they might play. The musicians were a cultural anchor for the neighborhood, so much so that the residence was nicknamed the Mariachi Hotel.

The hotel sits at the peak of a steep hill, and if you look just beyond it you can see the full glory of downtown LA glinting in the sun. Maria Cabildo, Co-Founder and President Emeritus of the East LA Community Corporation (ELACC) and current Chief of Staff to the LA County Supervisor, saw the writing on the wall: The Boyle Hotel was bound to be snapped up by developers, and replaced by luxury rooms with a view if nobody attempted to save it. With plans for the LA Metro to extend its new light rail into the heart of the plaza, she knew that new development wouldn’t be far behind. What would the influx of business mean for the residents – mariachi musicians and families alike – who’d long called the neighborhood home?

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Crafting Win-Win Solutions with Health Impact Assessments

Jun 22, 2015, 3:01 PM, Posted by Pamela Russo

Health impact assessments are a powerful way to help communities think broadly about the health implications and equity aspects of policies and projects, so that a comprehensive approach to health becomes routine.

Prison Alternatives Boosted by Health Impact Assessment

Last week, almost 500 attendees arrived in the nation’s capital for the 2015 National Health Impact Meeting. The impressive turnout is a testament to the growing importance of health impact assessments (HIA) as a tool to improve community health outcomes.

As this year’s meeting attendees know, an HIA is a process that helps evaluate the potential health effects of a plan, project or policy outside of the traditional health arena. The findings from a completed HIA can provide valuable recommendations to help communities more effectively foster better and more equitable health among their citizens.

The use of HIAs has grown rapidly from just a few dozen in 2000 to more than 350 completed HIAs today. Dozens more are in the works. The earliest HIAs were mostly applied to the built environment, such as zoning, land use and transportation decisions. However, today the field has expanded to include such areas as energy policies, criminal justice and living wages.

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Building Healthier Places in Birmingham and Beyond

Jun 1, 2015, 11:46 AM, Posted by Susan Dentzer

How a section of Birmingham, Alabama is redeveloping and offering greater opportunities for people at multiple income levels. The secret? Engaging the community throughout the process.

With its elegant homes, pleasant park and bustling stores, the Woodlawn section of Birmingham, Alabama was described in a 1950 news article as “a really great section of Birmingham...typical of the fine things in life." Then came the racial unrest of the 1960s, disruption from urban renewal gone awry and white flight to Birmingham’s suburbs. Joblessness and poverty took root; the housing stock decayed. Today, median income in Woodlawn is just $21,000, less than half the level for Birmingham as a whole.

But now Woodlawn is in the midst of a turnaround, aiming to become not just a neighborhood that prospers economically, but also one where people live healthier lives.

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Clearing the Air in Louisville through Data and Design

May 13, 2015, 12:44 PM, Posted by Alonzo L. Plough

Louisville, Kentucky ranks among the poorest in air quality and highest in asthma rates among U.S. cities. A new art installation from Propeller Health shows residents real-time changes in the city's air quality, equipping them with the data to reach their goal of becoming one of the healthiest cities by 2020.

I stand in front of an intriguing art installation on a busy street corner in downtown Louisville, KY, and visualize the invisible. It’s a bright orange steel kiosk outfitted with an interactive touch screen that allows passersby to “see” how air pollution levels change around the city in real time while also learning how these pollutants impact the severity of asthma symptoms. Called AirBare, the installation project was funded by RWJF and represents a unique collaboration between visual artists, big data analysts and local health advocates. By “popping” virtual bubbles on the screen, users find out what causes air pollution and what it will take to reverse it. This is relevant information for residents of Louisville, a city that consistently ranks among the lowest in air quality in the nation and has one of the highest rates of asthma and other respiratory conditions.

My visit to the AirBare installation coincided with a conference held in Louisville in March that brought together economists, health policy folks, food experts and, remarkably, Charles, the Prince of Wales, to examine the issue of air quality and the larger concept of sustainability in this Ohio River Valley city. The Prince, a longtime advocate for environmental issues with connections in Louisville, added star power to the Harmony & Health conference, sponsored by the non-profit Institute of Health Air Water & Soil. But there is plenty else to be excited about in Louisville. Under the leadership of Mayor Greg Fischer, city agencies have collected reams of data on air quality, health outcomes, life expectancy, income inequality, and unemployment, among many other measures. What has emerged is a far better picture of the tough environmental and socioeconomic issues impacting the health and wellbeing of Louisville’s 600,000 residents, and a serious and concerted commitment to build a culture of health.

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