Health and Urban Design

In my HTH 354: U.S. Health Care Systems class, my small group has been given the daunting task of reforming the U.S. Health Care System. Here are the following topics that we have to examine: Financing, Health Care Professionals, Primary Care, Health Care Technology, Long Term Care, and Vulnerable Populations.

The project has been very difficult for a number of reasons. First of all, our health care system is very complex and hard to understand. Secondly, there are several health problems that need to be addressed like access to quality health care, the number of uninsured people, the growing age of our society, and the need for long term care facilities. Furthermore, everyone has a different idea on how the system could be “fixed” (e.g. more government involvement, privatization of health care).

I’m not going to go into the various proposals that my group has discussed — I don’t want to bore you. Instead, I want to talk about the role of urban design in community health. I am a strong believer in the idea that a person’s environment strongly influences his/her lifestyle and behavior. If cities and counties in the U.S. focused on urban design principles I don’t think that we would see some of the health problems that currently plague our population.

Good urban design places emphasis on mixed-use, high density development, affordable housing, and pedestrian-friendly environments. So, how do these components affect community health?

  • Mixed-use: In a mixed use development you have homes, shops, offices, apartments, recreation, and institutional facilities located in the same area/region. This mix of uses is beneficial to community health because people can easily access doctor offices, pharmacies, and recreational facilities. People don’t have to travel as far to meet their daily needs, and this eliminates one of the barriers to quality health care — distance.
  • High Density: High density areas are beneficial because they encourage social interaction among neighbors. If an elderly person were to need assistance or medical help, he/she could find someone close by to help out. High density areas prevent the elderly from being isolated from the outside world, and this reduces the need long term care facilities such as retirement and assisted living homes. Elderly people can maintain their independence while knowing they have a friendly neighbor looking after them.
  • Affordable Housing: Sixteen percent of the population is uninsured. Many people do not have insurance because they are unemployed, their employers don’t offer health insurance, they don’t qualify for Medicare or Medicaid, and/or they can’t afford private insurance. Affordable housing would help relieve the financial burden placed on people that don’t have health insurance. They could find an affordable home close to where they work.
  • Pedestrian Friendly: Pedestrian friendly environments are extremely important for community health because they allow people to easily access their daily needs and they give people exercise. Obesity is one of the biggest health issues in the U.S. right now, and if people could easily walk to their work, the corner store, or the movie theatre, I think we would see a significant decrease in obesity. Furthermore, I don’t want to say that all elderly people are bad drivers, but I think it’s safe to say that there are a lot of unsafe elderly drivers out there on our roads. Pedestrian friendly environments would allow the elderly to safely travel and exercise.

Health is more than the absence of illness and disease. A person’s health is a combination of his/her social, mental, physical, and spiritual well-being. As our cities continue to grow and redevelop, it is important that we keep this holistic definition of health in mind.


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