Drive through any town in the United States and you will likely notice that landscapes change from stately brick houses and white picket fences to depressed shotgun houses and chain link fences.
What you won’t notice?
As you drive toward the city center and home values decrease, a skyrocketing increase in heart disease, diabetes and high blood pressure is taking place. In fact, the five digits that make up your zip code are a more powerful determinant of your health than your genetic code.1
The top five causes of death in the United States—heart disease, cancer, chronic lower respiratory diseases, accidents, and strokes—are diseases with ties to how you live, rather than what’s in your genes.2 But health is more than a story of genetics and behaviors. It’s a story of place. When a culture of health that promotes health and wellness for all is not built into the fabric of the larger community, the healthy choice is not the easy choice for those facing discrimination and injustice.
Individuals and their behaviors do not operate in a bubble, but rather a web of interconnectivity. For example, low income census tracts have half as many grocery stores with fresh fruits and vegetables compared to their wealthier counterparts.3 For families without access to reliable, affordable, and connected transportation, simply getting healthy food to eat becomes increasingly burdensome. When children do not have access to healthy food to eat, they face increasing difficulties concentrating in the classroom. Children who perform lower in the classroom are less likely to graduate from high school and obtain the degree or certificate needed to enter a fulfilling career. And so the cycle continues. Simply put, place matters.
Children who have access to safe and well maintained parks and grocery stores are more likely to experience more positive health outcomes. Admittedly, a park or an apple a day by itself will not cure cancer or prevent strokes. It takes a community committed to the culture of health framework to facilitate change. But the role that planning and place play in promoting positive behavior change often goes unnoticed.
Jason Corburn, Ph.D. MCP, of the University of California at Berkeley notes in his book, Toward the Healthy City, “Health isn’t just health outcomes from exposure to toxins in the air, water, or soil—things that health departments are good at measuring. If you are going to take the environment of low-income neighborhoods seriously, you have to consider other dimensions of health.”
Health disparities are historically deeply rooted in communities, and overwhelmingly communities of color. Their cost to us a society continues to rise, yet the policies, systems, and environments around us facilitate their continuance. As planners, we are equipped with a unique skillset and knowledge that is crucial to uprooting policies, systems and environments of disparity.
We have the power to be champions of health equity through the decisions we make every day. By advocating for effective policy and investment in infrastructure that promotes healthy behaviors, we can make health a shared community value, begin to implement cross-sector collaboration to improve well being, and ultimately create more equitable communities. When we create a culture of health, we make the healthy choice the easy choice. And in turn, we are able to live and work in resilient, supportive communities where every person has the right to health, regardless of zip code.
1Roeder, A. Zip code better predictor of health than genetic code. Retrieved from https://www.hsph.harvard.edu/news/features/zip-code-better-predictor-of-health-than-genetic-code/
2Leading causes of death. (2017, March 17). National Center for Health Statistics. Retrieved from https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
2Food desert statistics. Southern Poverty Law Center. Retrieved from https://www.tolerance.org/sites/default/files/general/desert%20stats.pdf
Anna Patterson is a first-year dual degree master’s student in the Department of City and Regional Planning and the Department of Health Behavior. Her scholarly interests include health and the built environment, vulnerable populations, and community development. Prior to coming to UNC, Anna worked as a program officer for a health foundation in Alamance County, NC. She likes American folk music, slalom water skiing, and hikes along the Haw River.