When Better Health Care Isn’t the Answer: How to Promote Healthier Environments

July 7, 2018 / Author: Anna Walton

Sickness, even in its least severe form, lurks in each area we preside and cannot be eradicated. The inevitability of getting sick is what makes access to proper and affordable healthcare a human right; however, it can be argued that the best healthcare is that which prevents someone from visiting the doctor’s office to begin with.

If we want to see healthier populations, we must first understand a few of the root causes of illness and how to address them.

A poor built environment, or the setting in which someone’s life takes place, can negatively affect a person’s health by exposing him or her to pollutants and promoting a lifestyle that fosters obesity, asthma, and heart disease. Unfortunately, many of our cities and suburbs fall into this category.

The structural layouts of cities and suburbs are often incapable of supporting healthy and active lifestyles, which weighs down the well-being of these areas’ inhabitants. For instance, spread out cities and suburbs encourage automobile use, which both decreases the physical activity of drivers and contributes to citywide pollution that aggravates asthma– this was distinctly apparent in the 1996 Atlanta Olympic Games, when a reduction in traffic resulted in the fall of ozone concentrations by 27.9% and the number of emergency asthma events by 41.6%.

Many cities and suburbs also suffer from a scarcity of parks and green areas, which encourage activity in children and promote a sense of community in a neighborhood. Though they may seem trivial, crime rates in areas without them tend to be elevated and the physical activity levels of children tend to be lower. In addition, cities and suburbs contain many liquor and tobacco advertisements and lack easily-accessible grocery stores with healthy foods. The resulting effect is a city that not only harbors unhealthy behaviors but also encourages them.

Most cities and suburbs in America do not embody the aspects of an ideal built environment, but they certainly have the potential for improvement.

Decisions that affect the built environment are typically made by legislatures without the help of public health professionals, so the first order of action would be to include them in decisions regarding the layouts of cities and suburbs. Doing this would force legislatures to factor health into city planning choices and policies; this could possibly lower crime rates, modernize city structures, open the door to more affordable housing, and make our cities cleaner.

With approximately 1 in 5 deaths linked to social and environmental factors, it’s extremely important that a person’s built environment is one that promotes health. In Tennessee, steps are being taken to promote a healthy built environment.

In many of Nashville’s surrounding neighborhoods, there are no sidewalks– this is one of the reasons why approximately 91% of Nashvillians rely on cars and spend approximately 45 minutes in traffic each day (though this is likely underestimated since the referenced study was conducted in 2009 and Nashville has grown significantly since then). However, Metro is aiming to change Nashville’s reliance on cars by taking steps to initiate the construction of new sidewalks and the repair of pre-existing sidewalks in many of Nashville’s oldest neighborhoods. This would result in a more active and walkable environment, however, Nashville is still behind with only about 2% of city workers walking to work and 2.2% using public transportation.

To increase this statistic, Nashville would have to either construct more high-density neighborhoods with access to public transportation or offer a more extensive and accessible public transportation option.

Nashville is in the process of addressing built environment concerns which, once resolved, will result in a healthier population and a more efficient and advanced city structure.