Poor Design of Built Environment Linked to Sick Kids

WASHINGTON, DC, April 10, 2006 (ENS) - National Public Health Week focused this year on the fact that the modern built environment is harming the health of American children. The week, which ended on Sunday, focused on building better environments that might produce healthier children.

Across the country, children are facing serious medical problems as a result of living in unhealthy built environments because poorly designed neighborhoods and buildings, roads, and sidewalks do not foster health, according to the American Public Health Association (APHA).

"Healthy communities for kids are on the verge of being engineered out of existence," said Dr. Georges Benjamin, executive director of the American Public Health Association. "We created these harmful built environments and we're equally empowered to change them."


Chicago's Dan Ryan Expressway looking north. Freeways split former neighborhoods and make walking for pleasure difficult. (Photo courtesy Chicago Imagebase)
U.S. Senator Barack Obama of Illinois and Congresswoman Hilda Solis of California, both Democrats, introduced a bill in Congress to address the built environment’s health effects, such as diabetes, obesity and asthma, on the nation’s children. Among other measures, the legislation would provide additional support for research on the relationship between the built environment and health, as recommended by two Institute of Medicine reports.

“Improvements to the built environment can have significant health benefits, as measured by greater physical activity, healthier diets, fewer injuries, a reduction in toxic emissions, and improved air, water and soil quality,” said Obama.

There are still few researchers documenting the damage to health of bad neighborhood design, but the APHA says lack of sidewalks, safe play spaces, and access to fresh foods contributes to increases in childhood obesity. More than nine million children are now overweight and only about half of children age 12 and older engage in regular physical activity.

The lack of safe places to walk, bike and play leads to preventable injuries in children. Pedestrian injury is the second-leading cause of injury-related death in kids.

Poor indoor and outdoor air quality leads to asthma, now the most common chronic childhood disease.

Many children, especially those living in rural or low-income communities, do not have a nearby doctor or pharmacy to provide them with the care they need.

At home, at school and outdoors, children are exposed to toxics that can cause serious diseases. Some 24 million homes in the United States have lead-based paint hazards, which can have an adverse effect on children's intelligence, learning abilities, behavioral disorders, and school failure.


Too little exercise and too much food means obesity for more American children than ever before. (Photo credit unknown)
“The important connection between the design of our communities and the health of our constituents is often overlooked in our national health care debate over cost and quality," said Congresswoman Solis. "It is often the foods we eat, the places our children play, and the sidewalks on which we travel that impact our health and ability to engage in healthy activities."

The Atlanta based federal Centers for Disease Control and Prevention (CDC) agrees. In a new report, the CDC says, "While pediatricians are accustomed to thinking about health hazards from toxic exposures, much less attention has been given to the potential for adverse effects from 'built environments' such as poor quality housing and haphazard land use, transportation, and community planning," write authors Dr. Richard Joseph Jackson, director of the National Center for Environmental Health, and Dr. Susan Kay Cummins, the Center's senior health policy advisor.

In fact, children spend little time in natural environments compared to the time they spend indoors and in neighborhoods, they write.

"Today’s cities sprawl into forest and farmland with ever widening roadways but no sidewalks or bicycle routes. With their vast asphalt parking areas and treeless streets, these cities coddle the automobile while denying children the opportunity to experience the wonder and joy of the natural world. What child can be allowed independent exploration in cities experienced as dangerous and lacking parks and sidewalks?" write Jackson and Cummins.


Long commutes are part of life in and near the nation's capital. In this traffic cam image oncoming traffic is on the Outerloop of the Capital Beltway moving towards the I-270 interchange. Traffic moving away is on the innerloop of the Capital Beltway moving towards College Park, Maryland. (Photo courtesy Maryland DOT)
"Parents exhausted by long commutes and endless traffic can scarcely cope with their own needs after long days," they write.

"In this setting, virtually every task requires a car, even a trip to school, church or the library, and the quality time for parents and their children is reduced to brief conversations in the car. The developmental and psychological effects of barren and commercialized landscapes need to be further examined," they say.

With the projected doubling of the U.S. population over the next century, the CDC report says, "protection of water sources, both underground and surface water - lakes and rivers - is no longer solely an aesthetic issue but a critical health protection need as well."

Forests sustain the planet because they provide shade and cooling and contribute oxygen to the atmosphere. When forestland is destroyed, rapid runoff of rainwater introduces silt, road wastes, and toxic materials to source water. Poorly maintained private septic systems cause groundwater contamination that can last generations, the CDC report warns.

As examples of how to build a healthier environment, the American Public Health Association recognized five communities as national models for solutions that protect kids' health and foster smart economic growth.

  1. Riverside County, California, known for the worst sprawl in the nation, is now at the forefront of livable communities nationwide, the APHA said. A pedestrian master plan, comprehensive maps of walking trails and collaboration with local developers will ensure a healthier future for Riverside's kids.


    Highlands Garden Village, Denver. The new mixed-use urban village includes market rate and below-market rate residential units and senior housing, as well as retail, commercial and civic buildings. (Photo courtesy Denver Urban Renewal Authority)
  2. Highlands' Garden Village in Denver, Colorado was once an abandoned amusement park. The 27-acre site now hosts environmentally friendly, mixed-income housing. Nearby office and retail spaces eliminate the need to drive to work or shopping and neighborhoods are connected by a network of pedestrian-friendly walkways and parks.

  3. Centennial Place in Atlanta, Georgia used to be home to the nation's oldest - and some of the most dilapidated and dangerous - housing projects. The first mixed-income, mixed-use community in the country, Centennial Place blends affordable housing with market-rate units and includes ample outdoor and indoor recreation spaces where kids can play safely.

  4. Delaware County, Ohio is the fastest growing county in the state. Unchecked growth had begun to impact residents' health when the community launched a rigorous assessment to identify areas for improvement. As a result, more parks are being built and community programs were created to encourage families and children to be more active.

  5. Winchester Greens in Richmond, Virginia is a new mixed-use, mixed-income community built on the site of an old barracks-style apartment complex that was a magnet for violent crime. The community now is home to families living in healthy housing connected by sidewalks and parks filled with children playing.
Boston's Lead-Safe Yard Project received an APHA Honorable Mention. This program, created in 1998 by the Boston University School of Public Health (BUSPH) and the U.S. Environmental Protection Agency (EPA), provides low-cost methods to eliminate lead in urban residential house lots.

Lead contaminated soil in older Boston neighborhoods remains a source of exposure that has not received widespread attention. Even when houses have been de-leaded, yard soil has rarely been sampled or treated, the EPA said.

Between 1998 and 2002 nearly 100 house lots in North Dorchester and Roxbury received lead-safe yard improvements. Contaminated soil was removed and mulch was added to raise the level of the ground on which children play. Compost was added to garden plots from which contaminated soil had been removed. Bare soil areas were improved with lawns, mulch, and stepping stone paths.

“Children are often the silent victims of lead poisoning,” said Patricia Hynes, BUSPH environmental health professor and co-principal investigator of the original project. "The Lead-Safe Yard Project is an exemplary public health program that is protective of children, is low-cost, able to be maintained by homeowners, and is easily replicable."

The Lead Safe Yard Project has developed a how-to handbook for individuals, neighborhood associations, community agencies, and local government, to encourage program replication, online at: http://www.epa.gov/region01/leadsafe/. The handbook is still online although the EPA closed EMPACT, the Environmental Monitoring for Public Access and Community Tracking program, in 2001.