Built Environment
Built environment refers to the physical, human-made structures or surroundings where people live and work.
This can encompass buildings, infrastructure for utilities, water, roads, and bridges that people use every day. The design of built environments can have a direct impact on a person’s safety, well-being, and access to necessary amenities that promote healthy living.
Here’s what you’ll learn:
How Neighborhood and Built Environment Impacts Olivia
Meet Olivia—grateful to have a home with her aunt after experiencing homelessness, but dreaming of a place with more nearby amenities. Her old car could break down at any moment, so Olivia hopes to find affordable housing with walkable shops and public transport.
Get to Know OliviaHow Neighborhood and Built Environment Impacts The Jackson Family
Meet the Jacksons—living in a safe, diverse neighborhood where they enjoy parks, community centers, and time together. Nichelle loves the nearby resources for her kids, Marcus is a foodie who appreciates easy access to the grocery, and Jayden enjoys walking with his grandma Evelyn through the neighborhood. Yet, they remain mindful of their surroundings.
Get to Know The Jackson FamilyHow Neighborhood and Built Environment Impacts The Garcia Family
Meet Elena—a widowed mom living in rural Indiana who faces long commutes, limited internet access, and rising fuel costs. Without nearby resources or safe places to walk, she struggles to balance work, errands, and family time. She dreams of a fresh start in a neighborhood with better access to child care, internet, and other amenities.
Get to Know The Garcia FamilyHow Neighborhood and Built Environment Impacts Chris
Meet Chris—a substitute teacher who relies on housing vouchers, rideshares, and public transit. Accessibility issues in his apartment and the lack of safe, walkable spaces nearby make daily life challenging. Despite using public transit and paratransit, Chris hopes for a future where transportation is less of a daily struggle.
Get to Know Chris
Terms to Know
Accessibility is the practice of making physical structures usable for as many people as possible, including those with disabilities. Some examples of physical accessibility can include wheelchair access, braille signs for people who are blind, or elevators for those who have limited mobility.[1]
Green spaces are areas of nature in urban settings. These can include parks, gardens, green roofs, and nature reserves.[1]
Squalor is living in an unsanitary, unhealthy space due to poverty or neglect. It’s more common in rented homes, households with lower income, crowded dwellings, and significant community deprivation.[1] If left unaddressed, visible signs of disorder, such as litter, graffiti, abandoned cars, and blight, can lead to further neighborhood deterioration.[2]
[1] Household factors and prevalence of squalor: meta-analysis and meta-regression. BMC Public Health
[2] Health, equity, and the built environment. Environmental health perspectives
The walkable built environment prioritizes pedestrian access and safety so people can walk or bike to community amenities such as shops, restaurants, libraries, schools, and parks. Low-income areas are less likely to have safe and accessible pedestrian paths.
Zoning refers to laws that govern how land and property can be used. Zones might allow single- or multi-use for industrial, agricultural, business, or residential areas. While zoning has a predominant role in creating and maintaining built environments, the reliance on outdated zoning regulations contributes to environmental and social inequalities.[1]
Key
Facts
- Rural residents face higher mortality rates across all ages and conditions compared to other residents due to built environment and other barriers.
- Low-income neighborhoods in urban areas have 42% less park space.
- Less than 5% of U.S. housing is accessible for people with moderate mobility disabilities.
- 3.6 million Americans go without medical care each year due to transportation problems.
- 16% of Hoosiers do not have high-speed internet, which is considered a “super determinant” of health.
Places
Where a person lives and their built environment can affect their life expectancy.[1] For example, safe housing, green spaces, and roads all contribute to a higher quality of life. These elements support physical and mental well-being and encourage a more inclusive environment for all residents.
However, historically discriminatory housing policies and practices, such redlining, have created segregated built environments that contribute to health disparities experienced by residents.
Location
The types of areas where individuals live—urban, suburban, or rural areas—determine the ratio of natural versus built environments, population density, as well as access and proximity to community amenities.
Urban areas are densely populated areas with at least 5,000 residents. Urban areas include cities, towns, and their surrounding environments.[1] About 80% of U.S. residents live in urban areas, which only make up 3% of the country’s land area.
Urban areas have more diversity of race, ethnicity, socioeconomic status, and education. However, urban infrastructure can expose residents to increased industrial activity and pollutants. Other public health concerns, such as overcrowding, housing quality, and water infrastructure, significantly affect resident’s overall health.[2]
[1] United States Census Bureau
[2] Housing and health: time again for public health action. American journal of public health
Suburban areas are generally located outside the center of a city or urban area. They are less densely populated than urban areas and are primarily designated for residential use. About 52% of Americans say they live in the suburbs compared to 27% who describe their neighborhood as urban or 21% as rural.[1]
Suburban areas have more single-family homes and are often designed for motorized transportation.[2] The increased car traffic in these areas can further contribute to poor health outcomes stemming from the concentration of pollution and injuries or deaths caused by vehicle accidents.
Rural areas tend to be far away from urban areas and have low housing and population density. These areas make up roughly 97% of land in the U.S. and are characterized by a high ratio of natural environment to built environment. About 19% of Americans live in a rural area.[1]
Residents in rural areas, especially high-poverty counties, face higher all-cause mortality rates compared to residents in urban and suburban areas. For example, rural residents have higher rates of infant mortality and cardiovascular disease.[2] Lack of access to public transportation, reliable broadband, and community amenities, as well as socioeconomic factors and health behaviors, all contribute to these disparities.
[1] United States Census Bureau
[2] Rural-urban disparities in health outcomes, clinical care, health behaviors, and social determinants of health and an action-oriented, dynamic tool for visualizing them.
Green spaces
Living near green spaces, like parks and gardens, is linked to better health. Green spaces improve the air quality, encourage physical activity, and promote better sleep.
Low-income neighborhoods have 42% less park space per person compared to high-income areas.[1] Improving access to urban green spaces can reduce health inequities. However, enhancing green spaces in these areas must involve direct community input to avoid displacing residents due to increased property values.[2]
[1] Neighborhood income matters: Disparities in community recreation facilities, amenities, and programs. Journal of Park and Recreation Administration
[2] Health, equity, and the built environment. Environmental health perspectives
Housing
Accessibility
About 12% of U.S. adults have a disability that affects their mobility.[1] Yet, less than 5% of U.S. housing is accessible for people with moderate mobility difficulties. Less than 1% is accessible to wheelchair users.[2]
Some homes can be modified to meet accessibility needs, but in many cases, these changes are unaffordable. Other accessibility modifications for people with disabilities are impossible to implement in existing built environments or structures. Thus, it is critical to consider the needs of people with disabilities while designing built environments to make spaces where people live and work universally accessible.
Quality
Poor housing quality and conditions can cause serious physical and mental health problems and lead to chronic diseases and injuries. For example, houses with mold, lead, and asbestos can affect residents’ health, especially children. Unsafe materials are linked to respiratory conditions, high blood pressure, and poor mental health.[3]
Children, older adults, low-income individuals, people with disabilities, and residents living in poor neighborhoods are disproportionately impacted and exposed to higher rates of contaminants and unsafe conditions.
[1] U.S. Centers for Disease Control and Prevention
Transportation
Reliable, accessible, and affordable transportation is essential for all Hoosiers. It influences where people live and affects their access to jobs, education, nutritious food, health care, and social activities. Transportation challenges disproportionately impact children, older adults, minorities, and people with disabilities or low incomes.[4] Transportation issues alone cause 3.6 million Americans to go without medical care each year.[5]
In many U.S. areas, infrastructure prioritizes roads and vehicle traffic over other methods of transportation.[1] This has historically contributed to the segregation of neighborhoods and a disproportionate impact of health hazards associated with traffic pollutants. Further, people in low-income areas often have higher transportation costs and longer commutes.
Public transit is often limited to large cities. Ride-share services are limited in rural areas and don’t serve people using mobility devices. In Indiana, there are limited public transit options outside of its urban areas. Even in Central Indiana, public transportation can be inaccessible due to gaps in bus routes, distance of closest bus stops, and level of walkability in areas leading to those bus stops.[1] Therefore, it is no surprise that nearly 94% of Indiana households have at least one vehicle.[2]
Broadband
Broadband or high-speed internet access is a “super determinant” of health, playing a key role in outcomes in education, employment, and access to health care.[1] Without it, people can’t use telehealth services and have more challenges in accessing timely and convenient health care.[2]
Communities with broadband experience improved health literacy and outcomes, including better medical care access, fewer preventable hospitalizations, and lower rates of obesity and diabetes.
However, the digital divide remains and contributes to health disparities. About 42 million Americans, including 16% of Hoosiers, do not have high-speed internet.[3] The disparities are even greater among people aged 65 or older, individuals with disabilities, and those who are Hispanic, Latino, African American, American Indian, or Alaska Native.[4] Areas without access are typically rural or pockets of segregated urban areas.
[1] Substance Abuse and Mental Health Services Administration (SAMHSA)
[4] National Telecommunications and Information Administration
Barriers
- Affordability of high-speed internet
- Lack of broadband infrastructure and access
- Lack of appropriate technologies to use broadband
- Digital and health literacy
Key
Takeaways
- Many Hoosiers, particularly those in rural areas, lack reliable transportation and broadband, which are essential for accessing jobs, health care, education, and social activities.
- Underserved and vulnerable populations are disproportionately impacted by the conditions and infrastructure of their built environments.
- Inclusive, universally accessible design of the built environment can promote healthy communities by improving access to health care, amenities, and resources and limiting exposure to environmental hazards.
Other
Surroundings
Topics
Neighborhoods
Neighborhoods are where people live and connect. They impact quality of life, including health, education, employment, and overall well-being.
Transportation: Reliable transportation, whether it’s public, private, or accessible pedestrian paths, is essential for people to commute to work and access resources and health care. Lack of transportation options and additional barriers, such as car problems, can put individuals at risk of losing their employment or missing necessary care.
Infrastructure hazards: Residents in poorer urban and suburban neighborhoods have higher exposure to pollutants that affect their long-term health. This may lead residents to need more costly care, which can affect their long-term financial stability.
Rural areas: Residents of rural areas experience geographic isolation, which limits their access to libraries, community centers, and higher education institutions. They also experience additional financial burdens associated with relocating or commuting to areas with colleges or universities.
Broadband: Similarly, a lack of reliable broadband access can prevent people from taking advantage of online education.
Access: People in rural areas have less access to medical care than people in cities. If someone living in a rural area is unable to drive, they may have limited alternative options for receiving care or treatment.
Broadband: Broadband or high-speed internet allows residents to find the resources they need. Someone with low health literacy might also use the internet to answer any questions they have after their doctor’s appointment. For those communities that lack high-speed internet, the barriers to accessing appropriate health care lead to worse overall health outcomes.
Walkability: Green spaces and other recreational areas encourage physical activity and mental well-being. However, residents can’t take advantage of these amenities if there are no safe, walkable, or accessible paths.
Built environment: Black residents are more likely to live in areas without natural green spaces and with heat-trapping infrastructure. As a result, Black residents are 40% more likely to die from extreme heat.[1]
[1] The Brookings Institution
Inclusive design: A neighborhood without inclusive or accessible design may exclude residents from participating and thriving in their communities. Residents with limited mobility or other disabilities may feel isolated if there are few or no reliable options for them to get around the community and access necessary resources.