Now Viewing: Built Environment and Health

Energy, Water and Broadband: Three Services Crucial To Health Equity

Sep 10, 2020, 10:00 AM, Posted by Pamela Russo

Imagine enduring the COVID-19 pandemic without running water, reliable internet or affordable gas and electricity. While many have faced this stark reality, communities around the nation are working to build health and equity into these services.

Power line at twilight.

As COVID-19 swept our nation this year, the important influence utility services have on our health became clearer than ever. Running water is essential for washing hands to prevent infection. Electricity keeps individuals and families comfortable while they follow recommendations to stay home. And internet access allows employees to work from home, children to learn remotely while schools remain closed, patients to access needed health check-ups, and all of us to stay connected.

Conveniently powering up our laptops, logging onto the internet and turning on the faucet are things many of us take for granted. But the COVID-19 pandemic has also revealed fault lines in America’s aging infrastructure. These inequities especially impact people of color, rural and tribal communities, and low-income households. For them, energy, water, and broadband are often unavailable, unaffordable, unreliable—and even unsafe.

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In West Baltimore, Physical Distancing Was a Way of Life Before COVID-19

Jun 1, 2020, 10:00 AM, Posted by Yolanda Ogbolu

Further physical distancing during COVID-19 has made us find creative and generous ways to strengthen connections.

Illustration of a family.

Imagine what it’s like to live on a block where elderly neighbors are bolted behind their front doors for fear of venturing out. Where parents worry daily about safety, so they resist letting children play in the neighborhood. Where more than half of the houses lie empty.

These images are not consequences of life under a pandemic. This was life pre-COVID-19 for the Baltimore neighborhood where I grew up and now work as a nurse researcher.  

For the past year, my research team at the University of Maryland, the Black Mental Health Alliance, the PATIENTS program, and B’more for Healthy Babies at Promise Heights, with support from the Robert Wood Johnson Foundation, has been listening to residents of two disadvantaged neighborhoods in West Baltimore. Residents told us they were “self-isolating” from family, neighbors and the community to cope with living in a neighborhood where they don’t feel supported, safe, or connected.

As one resident put it: “A lot of things scare us...it makes us not want to allow our kids to go to the recs that open because we fear that a drive by [shooting] or...standing in the doorway you can get shot.”

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Global Approaches to Curb the Health Impact of Climate Change

Mar 23, 2020, 8:45 AM, Posted by Sharon Roerty

Cities from around the world have a lot to teach us about improving our planet's health. Their efforts can inspire us to be resourceful, creative, and inclusive as we work to tackle climate change and its health impacts.

Global illustration.

In times of crisis, it becomes readily apparent how interconnected we are and that sharing learning around what works and what doesn’t is of utmost importance.

We are seeing this with COVID-19, as learning from Singapore, from Italy, from South Korea and from China is informing the efforts of other countries—including the U.S. response.

The same is true of climate change.

A recent survey found that the proportion of Americans who are concerned about climate change tripled over the last five years and is now at an all-time high. 

Whether it’s raging wildfires; stronger, bigger hurricanes and tornadoes; more extreme heat events; or worsening air pollution, people in cities across the United States and around the world are seeing, living and having to manage the impact.  

What’s worse is that damage caused by global climate change magnifies inequities, placing the most vulnerable communities and individuals at greatest risk. Historic and social factors, such as access to health care; where you live or work; your age; and your income can all impact how and how much climate change harms your health.

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Why Neighborhoods—and the Policies that Shape Them—Matter

Jan 23, 2020, 2:00 PM, Posted by Dolores Acevedo-Garcia

The Child Opportunity Index 2.0 uses contemporary data to measure and map inequities in all 72,000 neighborhoods in the United States. The tool helps researchers, city planners, community leaders and others identify and address inequities in their metros.  

Boys and girls run and play in the park. Image credit: iStock

The Tale of Two Boys Growing Up in Cleveland

Let’s ask two hypothetical 9-year-old boys a question: What is it like to grow up in Cleveland? 

Each boy attends school, and enjoys riding his bike and playing with Legos. Both live in Cleveland. Beyond these similarities, their life experiences are—and will continue to be—starkly different based on multiple, complex factors that lie within their neighborhoods.

Neighborhood A 

The boy living in Neighborhood A faces a host of obstacles to opportunity and well-being. 

Economic adversity is the norm. One in four families struggle with poverty, and nearly 83 percent of his peers in school need free or reduced-price lunch.

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How Bitter Melon Improved Housing in Providence, Rhode Island

Dec 9, 2019, 9:45 AM, Posted by Angela Bannerman Ankoma, Sharon Conard-Wells

Many housing projects focus exclusively on putting a roof over peoples’ heads. We sought a broader approach that integrates cultural values into kitchens, homes and neighborhoods.

Illustration of a neighborhood.

The literal translation of the word “sankofa,” from the Akan tribe in Ghana, means "go back and fetch it.” Figuratively, it captures an important belief in Akan culture: While the future brings new learning, knowledge from the past must not be forgotten.

This principle guided our efforts to transform 10 formerly blighted lots into a vibrant community of 50 modern “green” apartments in Providence, Rhode Island’s diverse West End community. The $13.5 million development is connected to 30,000 square feet of community garden space. Single fathers come with sons, pastors come with children and people sit under the garden’s pergola, which was built by local youth volunteers. It is, as one article put it, a “beehive of activity.”

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Home Is Where Our Health Is

Jul 22, 2019, 12:00 PM, Posted by Jessica Mark, Najaf Ahmad

Where we live affects how long and how well we live. Yet, affordable housing is out of reach for too many. RWJF is addressing housing stability, equity, and health through data and research.

Everyone should have the opportunity to live in a safe community.

There is growing evidence that safe and secure housing is a critical factor in achieving good health. Where we live can determine whether we’re connected to: safe places to play and be active; quality jobs and schools; and transportation to get us where we need to go. Yet millions of people in America live in substandard or overcrowded housing, temporary shelters, in cars, and on streets. Disadvantages also exist for the many living in residentially segregated neighborhoods isolated from opportunity. For them and others, the inability to access quality housing and neighborhoods deepens challenges and makes it much more difficult to be healthy and break out of poverty. 

Housing’s profound effect on health is often overlooked and misunderstood. This year, the Robert Wood Johnson Foundation (RWJF), led by President and CEO Richard Besser, MD, is shining a light on the link between housing and health. In his Annual Message, Besser discusses how safe and affordable housing supports positive outcomes across the lifespan—and how unsafe and insecure housing can deepen inequity and undermine a Culture of Health. 

He shares stories from housing initiatives across the country—from Boligee, Ala., to Chelsea, Mass., to San Antonio. These examples show that when we improve the quality and affordability of housing—health and lives also improve. Creating safe and affordable housing—as an essential part of comprehensive efforts to transform impoverished neighborhoods into places of opportunity—becomes a pathway to helping communities thrive.

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How Supportive Housing Uplifts Families in Crisis

Oct 15, 2018, 11:00 AM, Posted by Kerry Anne McGeary

Irma’s troubled life culminated in being thrown down the stairs when she was six months pregnant. Thanks to a program that’s addressing system-wide change, Irma and her family are now safe and secure with a new home and a brighter future. 

Supportive Housing program case worker, Melissa Rowe (right) with her client Irma and three of Irma's four children. Supportive Housing program case worker, Melissa Rowe (in white shirt) with her client Irma and three of Irma's four children: Joel, age 5, Delicia, age 3 and Julio, age 18 months.

Editor’s Note: Although foster care placement is sometimes necessary to ensure the safety and well-being of children, research indicates that keeping families together is generally better for children, parents, and the community. Working with the Corporation for Supportive Housing (CSH), the Robert Wood Johnson Foundation (RWJF) launched the Keeping Families Together (KFT) pilot in 2007 to explore whether supportive housing can help vulnerable families grow stronger, safer and healthier so that children—and their parents—may thrive. With the release of new findings from a federal demonstration project inspired by KFT, we are resurfacing this post.  

From too early an age, Irma faced a seemingly endless series of traumatic events that life threw at her as best she could—on her own.

But after a domestic crisis left her hospitalized, homeless, jobless, and in danger of losing her infant son, Irma finally received help from a supportive housing program that changed her life.

Keeping Families Together—the RWJF-supported model for the program that helped Irma turn her life around—has become my own personal touchstone for what building a Culture of Health should look like in the real world.

Irma’s story illustrates both the power of this model and the inner resilience that so many struggling families possess.

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Four Ways to Build Inclusive, Healthy Places for All

Jul 25, 2018, 11:00 AM, Posted by Sharon Roerty

Inclusive public spaces for all are a central part of healthy, resilient communities. A new framework can help ensure that processes for shaping these spaces lead to design decisions that promote equity.

Healthy Places Swing Set

It has been said that inspiration comes when you least expect it. My visit to Melbourne, Australia, inspired me to take an international look at place-making. I was standing in Federation Square, restlessly waiting for my daughter to finish her shift. I hadn’t seen her in nearly a year. I was wearing my mom hat, not my urban planner’s hat.

Nevertheless, as my eyes swept the Square, I had the sense of being in a very special place. And while I didn’t know it at the time, I was not surprised to later learn that Federation Square in the heart of Melbourne has been recognized as one of the best public squares in the world. Fed Square, built on top of a working railway, comprises sculpted and natural elements; it has small spaces like fire pits; and large and medium-size open spaces for planned and unplanned activity. There is a large TV screen that broadcasts international and national sporting events (it is not always on). The Square is open 24 hours a day; has free Wi-Fi for all; rest rooms; and no signs prohibiting activity or lingering. Restaurants open their doors to it; and transit lines and shops surround it.

I visited Fed Square daily for eight days, and what impressed me was how well it reflected Melbourne’s rich cultural diversity; how seamlessly it connected to the streets, buildings and facilities on its periphery; and how welcoming it always felt. It is a place for people—the well-heeled, the not-so lucky—and everyone in between. I should note, though, that Federation Square’s value as an open public space and cultural hub is currently being tested. Controversial changes to it are pushing forward sans public review and participation.

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How Housing Impacts the Health of People Living With HIV/AIDS

Apr 12, 2018, 3:00 PM, Posted by Safiya George

Inadequate housing is a tremendous barrier to achieving good health—especially when dealing with a chronic illness. A team of researchers is examining largely rural counties in West Alabama to assess the impact of stable housing on the well-being of people living with HIV/AIDS.

A row of homes on a tree-lined street.

We know that where we live, work, learn, and play greatly impacts our health. Especially important among these, and too often overlooked, is the impact of where we live. Housing is tied to health in powerful and inextricable ways. Think about the steps you take each morning to care for yourself, or each evening when you go to sleep. What would happen if you didn’t know where you would sleep that night, or weren’t sure how long you had until you were forced to find new shelter? Would you still take the time to go through your routines, if there was nothing routine about them? Would you set up relationships with health providers if you might not live in the same community next month—or even next week?

I faced homelessness twice and they were the most stressful experiences in my life. Lack of access to stable housing can feel like an insurmountable barrier to achieving good health and well-being—even more so when one is dealing with a chronic illness or other health challenges.

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What’s the Connection Between Residential Segregation and Health?

Apr 3, 2018, 4:00 PM, Posted by Donald F. Schwarz

Residential segregation is a fundamental cause of health disparities. We need to take steps that will reduce health risks caused by segregation and lead to more equitable, healthier communities. 

Graphic illustration depicting residential segregation

For some, perhaps the mere mention of segregation suggests the past, a shameful historic moment we have moved beyond. But the truth is, residential segregation, especially the separation of whites and blacks or Hispanics in the same community, continues to have lasting implications for the well-being of people of color and the health of a community.

In many U.S. counties and cities, neighborhoods with little diversity are the daily reality. When neighborhoods are segregated, so too are schools, public services, jobs and other kinds of opportunities that affect health. We know that in communities where there are more opportunities for everyone, there is better health.

The 2016 County Health Rankings released today provide a chance for every community to take a hard look at whether everyone living there has opportunity for health and well-being. The Rankings look at many interconnected factors that influence community health including education, jobs, smoking, physical inactivity and access to health care. This year, we added a new measure on residential segregation to help communities see where disparities may cluster because some neighborhoods or areas have been cut off from opportunities and investments that fuel good health. 

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