Chapter 6 - Eco-Social Perspective: Neighborhoods, Cities, and Health

According to the WHO, a Healthy City is ....

"one that is continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all the functions of life and developing to their maximum potential"

In 2001, pedestrians and bicyclists were, respectively, ____ and ____ times more likely than car occupants to be killed per kilometer traveled

23 and 12

By 2019, there were _____ megacities with the majority located in the Global South

30

Cities consume about ____% of the global energy production and as the world becomes more urbanized, greenhouse gas emissions will largely be driven by energy required for lighting, heating, and cooling urban areas

80

What are two of the most widespread methods used to describe neighborhood boundaries in the United States?

Census data and zip codes

What kind of neighborhoods are more likely to be located closer to sources of industrial pollutants than their counterparts?

Minority and lower socioeconomic status

"City proper" approach

The "city proper" approach designates a city based on administrative boundary

"Urban agglomeration" approach

The "urban agglomeration" approach considers the extent of the contiguous urban area, or built-up area, to delineate a city's boundaries

Healthcare facilities, services, and personnel are more numerous and accessible in ______.

cities

Regardless of the precipitating factors, food deserts pose a challenge for the American population. Although food deserts are a nationwide issue, _______ and ______ _______ suffer the most from lack of access to health food

cities and urban areas

Urban area =

community with > 2,500 people

The built environment can be crafted to .....

increase physical activity, reduce obesity rates, and decrease the risk of cardiovascular diseases and lung cancer

Walking and biking are some of the most affordable, feasible, and dependable methods to address the growing ________ _________ in the United States. Further, walking and bicycling contribute to decreasing reliance on cars, which in turn leads to less ........

obesity epidemic air pollution, noise, and motor vehicle crash injuries

The Department works on initiatives to reduce the population health burden of .......

obesity, diabetes, heart disease, HIV/AIDS, tobacco addiction, and substance abuse, and is always prepared, if necessary, to confront the threat of bioterrorism

The World Health Organization (WHO) initiated the Healthy Cities movement .....

to cope with the issues that are emerging with ever-expanding urbanization worldwide.

Healthy Food Financing Initiative

to reduce numbers of neighborhoods with food deserts and encourage healthy food retailers to cater to underserved communities

megacities

with populations exceeding 10 million inhabitants

Healthy Cities Alliance -

working since 2003 to extend the concept of Healthy Cities beyond the scope of existing members

2008 Farm Bill, the US Congress defined a food desert as

an "area in the United States with limited access to affordable and nutritious food, practically such an area composed of predominantly lower income neighborhoods and communities"

Close-knit neighborhoods generally maintain social control that ....

discourages crime and other harmful behaviors that can directly or indirectly influence health

Rural populations experience significant health inequities compared to the general population. Such inequalities produce such untoward outcomes as .....

higher incidence of disease and disability, higher mortality rates, and lower life expectancy

Moreover, municipal governments can indirectly influence health through setting ________ that promote health in areas such as transportation, recreation, public safety, criminal justice, welfare, housing, and employment

policies

Cities generally have better infrastructure than _______ areas when it comes to provision of basic services such as clean water, sanitation services, and housing.

rural

In 1990, there were only ___ megacities, accounting for 7% of the world population

10

What significant barriers to accessing healthcare that may affect health outcomes do residents of rural areas face?

Further, residents of rural areas face significant barriers to accessing healthcare that may affect health outcomes. These barriers include cultural attitudes toward illness and financial restraints, which are often compounded by lack of trained physicians, fragile infrastructure, limited availability of reliable high-speed internet, and fewer public transportation options

____________ __________ influence the health of city dwellers by providing services and regulating activities that affect health

Municipal governments

________ ___________ __________ play an important role in improving the health of city dwellers

Municipal health departments

Choice Neighborhood initiative

One is the Choice Neighborhood initiative, which aims to strengthen the underlying social structure of neighborhoods. The initiative provides grants for strategies to revitalize struggling neighborhoods. Projects funded by the initiative focus on improving housing conditions, education quality, commercial activity, and neighborhood safety

Slums

Slums are densely-populated areas characterized by substandard housing conditions and low standards of living

food deserts

Such areas where sources of healthy foods are scarce

The 2008 Farm Bill

The 2008 Farm Bill directed the Secretary of Agriculture to address the issue of food deserts in the United States. The bill required more research on the causes and prevalence of food deserts and the impact of food deserts on populations. Moreover, the bill mandated the Department of Agriculture to provide recommendations to reduce and, ultimately, eliminate food deserts. The bill also encouraged community involvement and partnerships to address food deserts, and incentives for opening food stores offering healthy and affordable selections in designated food deserts

"Metropolitan area" approach

The third approach is the "metropolitan area", which defines a city's boundaries according to the degree of economic and social interconnectedness of nearby areas

In 2008, the Department of Agriculture reported that counties with more food deserts generally spend more per capita on _____ ______ than their counterparts

fast food

Our zip code can tell us more about our health than our _____________

genetic code

Most definitions of neighborhoods in the scientific literature rely on ......

geographic boundaries defined by administrative agencies.

A Healthy City creates ....

health-supportive environments, provides basic sanitation and hygiene, and ensures access for healthcare of its residents

We mostly live in _______-______ environments

human-made

Civil society operates ......

in all areas not controlled by the government or the market

There are profound racial, ethnic, and socioeconomic differences in neighborhood proximity to facilities that produce ________ __________ in the United States.

industrial pollutants

Cities are neither good nor bad for our health. Characteristics of cities simply _______ health; some make our health better, others make it worse

influence

The places where we ________ shapes the air we breathe, the water we drink, and the food we eat. Places shape how we ________, ________, and ________

live think, feel, and behave

The Department provides a broad range of services including access to .......

low-cost clinics, restaurant inspections, and investigations of disease clusters throughout the metropolitan area.

Providing public transportation systems that are fairly distributed throughout urban neighborhoods is beneficial to those living in .....

low-income neighborhoods

Social cohesiveness of neighborhoods impacts _____ ______ of the residents

mental health

The issue with food deserts is not just a matter of inconvenience; living in food deserts is also linked to a higher risk of .....

noncommunicable diseases (NCDs) including higher rates of obesity and type 2 diabetes

HUD (US Department of Housing and Urban Development) initiative - Moving to Opportunity Program

option for low-income families to move to a higher-income neighborhood

In the public health literature, neighborhoods usually refer to ....

people's immediate residential environments that have both material and social characteristics related to health.

Moreover, cities provide better ......

quality education, employment, and public transportation

Where we live influences our access to ....

quality education, municipal services, public transportation, healthcare services, and employment opportunities