Links Between the Built Environment and Human Health: An Introduction by 33z50F

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									The Built Environment and
 Human Health: An Initial
‘Sight’ at the Local Status

               Max A. Zarate, Ph.D.
              East Carolina University

      The 3rd Annual Jean Mills Health Symposium:
 Making Research Real in Reducing Health Disparities and
             Transforming Health Services
                                        February 9, 2007
            OUTLINE

► The   built environment
► Influences   on physical activity
► North Carolina and Pitt County
 health statistics
► Healthstatistics and the built
 environment
 THE BUILT ENVIRONMENT

► Typesof environments that affect
 human health
   Natural –water, air, soil  food
   Built –indoor (buildings) and outdoor (roads,
    parks, walking & biking paths, shopping
    centers/malls, etc)
   Social –SES, schools, jobs, churches, etc
THE BUILT ENVIRONMENT
(cont’d)
► Indoor:trend  improved design,
 operation, and environmental quality of
 buildings
   Base: linking people’s use of space to
    physical measurements of indoor
    environmental quality
   Technology: making buildings more
    environmentally friendly, productive to
    live/work in, and economically to operate
THE BUILT ENVIRONMENT
(cont’d)

► Outdoor:interest of urban planning in
 human behavior  urban design and
 transportation planning
   Theoretical, empirical, and practical work
    aimed at the following public health goals:
    ►Enhancement   to quality of life
    ►Improvement in system efficiency
    ►Reductions in environmental impacts
THE BUILT ENVIRONMENT
(cont’d)
Dimensions of the Built Environment                                      (Source: Handy et al, 2002)

Dimension               Definition                       Examples of Measures
Density and intensity   Amount of activity/area          Persons/acre or jobs/square mile
                                                         Commercial floor space : land area ratio

Land use mix            Proximity of different land      Distance from house to nearest store
                         uses                            Share of total land area per use

Street connectivity     Directness and availability      Intersections/square mile
                        of alternative routes            Average block length

Street scale            Three-dimensional space on       Buildings height : street width ratio
                        a building-bounded street        Average distance from street to buildings

Aesthetic qualities     Attractiveness and appeal of     Percent of ground in shade at noon
                        a place                          Number locations with graffiti/square mile

Regional structure      Distribution of activities and   Rate of density decline with distance from
                        transportation facilities        downtown
                        across the region                Based on activity concentrations and
                                                         transportation network
THE BUILT ENVIRONMENT
(cont’d)
   INFLUENCES ON PHYSICAL
          ACTIVITY
A range of theories and models has been
 used to specify variables believed to
 influence physical activity (PA) and other
 human behaviors. Researchers test
 hypotheses by assessing:
   Associations that help to “understand and
    predict” behaviors
   Interventions that are designed to modify
    the influences believed to lead to behavior
    change
INFLUENCES ON PHYSICAL
ACTIVITY (cont’d)
► Thelogic of causality: defining correlates
 and determinants
  There are few examples of absolute causal
   factors that “cause” the outcome in 100% of
   cases, but none in the behavioral realm
    Correlates: reproducible associations or predictive
        relationships
    Determinants: causal factors (variations in these
        factors are followed systematically by variations
        in PA behavior)
INFLUENCES ON PHYSICAL
ACTIVITY (cont’d)
► The   logic of causality (cont’d)
  What causes coronary heart disease (CHD)?
    Probable causal variables include: physical inactivity,
     high cholesterol levels, tobacco use, and genetic
     factors
    This group of factors may contribute to micro-
     physiologic changes (e.g. PA may reduce CHD risk
     through improvements in cardiac endothelial cell
     function, collateral circulatory changes, or
     through improved oxygen uptake)

								
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