Case Study: Built Environment Policy Change

Topics: Population health, Public health, Health care Pages: 5 (2118 words) Published: June 22, 2013
CASE STUDY FINAL (4-29-2013)

Presented by: ***
Strategic Direction: Healthy and Safe Physical Environments
Title: Improving Physical Environments to Increase Health for High-Risk Residents Alignment with CTG: Reducing obesity and diabetes in adults

“Housing is important to healthy and sustainable communities because a community is strongest and most successful when workers and families, especially children, have safe and affordable homes. Housing and neighborhood conditions can promote or adversely impact health outcomes. Health is especially influenced by housing location, home maintenance and design, and housing costs.” California Department of Housing and Community Development Issues

In *** County more than 16% of the population has been diagnosed with diabetes or are borderline diabetic, 56% of adults and 44% of children age 5 – 19 are overweight or obese and therefore at high risk of developing diabetes and other chronic illnesses such as high blood pressure and heart disease. Epidemiological research has made the connection between poor health, including heart disease, obesity, and depression, with living in disadvantaged neighborhoods – unsafe neighborhoods with housing that is crowded, unsafe, and too costly. For households where earnings are at or below the median income in *** County ($76,728), finding affordable places to live in safe, clean neighborhoods is a major problem. This is especially true for the 55% of families who are renters and earning less than $50,000 per year, and who are most often Hispanic working families, single-female head of household, elderly, or special needs residents. The majority of these families (88%) pay more than 30% of their income for housing, limiting their ability to purchase healthy, fresh foods. Lack of affordable housing results in families living “wherever they can afford”, which can be housing that has poor ventilation and heating and unhygienic living conditions such as old carpeting, peeling paint, and infestations. It has been demonstrated that these conditions lead to a variety of health conditions and disease including mental stress, high blood pressure, heart attacks, asthma and death. These low-income residents live in neighborhoods where there are less public and private resources such as parks, walk/bike paths, grocery stores, and community gardens. Insufficient lighting, lack of cross walks, crime, and traffic contribute to low levels of physical activity for families who can little afford physical activity outlets such as gyms and organized sports. In addition, children and youth living in low-income, crowded conditions are less likely to complete a high school education or college degree, which develops into a self-perpetuating problem since education determines earning potential, and level of income is directly linked to health outcomes. Subsidized housing, both public and private, has had a positive impact in the United States by increasing the quality of living conditions for low-income residents and by reducing housing costs, thus increasing budget for food and other needs. However, the existing number of units of “affordable” housing does not meet the current need of the County, which grows exponentially each year. In addition, many of these subsidized housing developments are located in neighborhoods that are not conducive to healthy/active living due to lack of infrastructure; and, land that has been identified through City/County General Plan Housing Elements for future housing affordable housing development has similar environmental challenges.

The studies examined for the purpose of this proposal conclude that in order to produce population-level change, efforts related to changing built environments must utilize a comprehensive approach that includes strategies in three areas: * Policy change that leads to the development of safe, healthy housing and health-supportive environments that will help to improve health for all...
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