December 12th, 2017
In recent years, environmental health science has broadened the scope of its inquiries, expanding its investigations beyond the effects of single pollutants on individuals to incorporate the entire panorama of external factors that may affect people’s health. Consideration of the health impacts of the built environment—the human-modified places where we live, work, play, shop, and more—has been a key element in the ongoing evolution of the field of environmental health. Substantial scientific evidence gained in the past decade has shown that various aspects of the built environment can have profound, directly measurable effects on both physical and mental health outcomes, particularly adding to the burden of illness among ethnic minority populations and low-income communities. Lack of sidewalks, bike paths, and recreational areas in some communities discourages physical activity and contributes to obesity; in those low-income areas that do have such amenities, the threat of crime keeps many people inside. Income segregation—the practice of housing the poor in discrete areas of a city—has also been linked with obesity and adverse mental health outcomes. Lack of a supermarket in a neighborhood limits residents’ access to healthy foods. Dilapidated housing is associated with exposures to lead, asthma triggers (such as mold, moisture, dust mites, and rodents), and mental health stressors such as violence and social isolation. More recently, the field has begun to take an even wider-angle view, as investigators have begun using innovative new tools and approaches to explore the multifaceted interrelationships between the built environment and population-level health outcomes. It has become increasingly clear that the built environment not only directly impacts our health, but also factors in less direct, complex ways into the health of individuals residing in single-family homes, housing projects, blocks, neighborhoods, and entire cities. Low-income and/or ethnic minority communities—already burdened with greater rates of disease, limited access to health care, and other health disparities—are also the populations living with the worst built environment conditions. Studies have shown that negative aspects of the built environment tend to interact with and magnify health disparities, compounding already distressing conditions. Elucidating the associations between the built environment and health disparities has proven to be an enormous challenge to the scientific community, requiring the development of new research paradigms, hypotheses, and methodologies. Traditional studies have often lumped many important components of the built environment into a blanket socioeconomic status variable. But this approach makes it nearly impossible to tease out specific housing and community characteristics related to disease. So, although the traditional tools of environmental health science are still an important part of the mix, research endeavors in this area are now incorporating aspects of sociology, psychology, demography, urban planning, and architecture. Just as significantly, research efforts are reaching beyond the boundaries of the scientific community, embracing rapid translation of research into effective intervention and active collaboration with community members as central concepts in their research protocols.