Authored by: Sahaar Khoja
Art by: Michelle Choi
Recent studies have shown that where you live may have a greater impact on your health and overall well-being than your genetic makeup. James Krieger, an epidemiologist for the Seattle Department of Public Health explains that where an individual works, goes to school, and lives can have a profound impact on their health. Factors such as violence, crime, access to grocery stores, and even next-door neighbors are critical determinants of health [1]. These determinants can be sorted into two categories: physical environment and social environment. Physical determinants encompass environmental factors such as air quality, clean water, housing conditions, and transportation access. Social determinants include societal factors like income, education level, employment status, and neighborhood safety [2]. Both determinants can directly impact an individual’s health.
For instance, physical activity is fundamental for reducing prevalent chronic diseases like obesity and hypertension [3]. Safe, clean residential and commercial areas increase walking, but in communities with poor infrastructure or high crime rates, residents are less likely to venture outside for exercise and recreation [4]. This effect can also be seen with those who live in socially disadvantaged areas, where primary sources of food consist of fast food chains. Residents of such areas have been found to have higher rates of gallstone disease, which comes from overconsumption of ultra-processed, fatty foods [5]. Housing quality and availability according to geographic area can also have a significant effect. Children who are raised in substandard housing, common in urban and low-income communities, are more likely to be exposed to asthma triggers like pest allergens, mold, and pollution. Long-term exposure can lead to an increased risk of emergency department visits, hospitalizations, and unscheduled doctor's office visits [6].
To combat these issues, a community-first approach needs to be taken, promoting initiatives that directly involve residents in research and decision-making to create policies that best reflect real lived experiences. For example, the Breathe Easy Home project is an initiative created to improve the indoor air quality of homes, specifically for individuals with respiratory issues. Residents collaborated with contractors to identify and mitigate asthma triggers through inspection of existing homes. Based on the results of the assessment, the project implemented strategies to reduce these triggers, such as adding HEPA-filtered ventilated systems to vacuums or replacing carpets with hard surface flooring [7]. Similarly, the Detroit Black Community Food Security Network (DBCFSN) is an organization launched by a communal desire to start an organic garden collective in response to food insecurity in urban areas. Residents collaborated with urban planners and health experts to build a farm that could provide for areas in the community with limited access to fresh produce. Local volunteers then worked together to maintain the farm and grow a wide variety of fruits and vegetables [8]. This initiative not only tackled the immediate problem of food scarcity but also empowered residents to take charge of personal nutritional health. Therefore, promoting resident-driven, participatory action research projects can encourage community members to advocate for their health needs.
Sources Cited:
Why place matters: (n.d.-b). https://www.policylink.org/sites/default/files/WHYPLACEMATTERS_FINAL.PDF
(N.d.). https://odphp.health.gov/healthypeople/priority-areas/social-determinants-health
Booth, F. W., Roberts, C. K., & Laye, M. J. (2012, April). Lack of exercise is a major cause of chronic diseases. Comprehensive Physiology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4241367/
Wang, Y., Steenbergen, B., van der Krabben, E., Kooij, H.-J., Raaphorst, K., & Hoekman, R. (2023, June 20). The impact of the built environment and social environment on physical activity: A scoping review. International journal of environmental research and public health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10297989/
Dupont, B., Dejardin, O., Bouvier, V., Piquet, M.-A., & Alves, A. (2022, October 27). Systematic review: Impact of social determinants of health on the management and prognosis of gallstone disease. Health equity. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629913/
Lindsay.Capozzi. (2023, July 19). Housing disparities and asthma: Reinvesting in neighborhoods to promote health equity. Housing Disparities and Asthma: Reinvesting in Neighborhoods to Promote Health Equity. https://policylab.chop.edu/blog/housing-disparities-and-asthma-reinvesting-neighborhoods-promote-health-equity#:~:text=Children%20who%20live%20in%20substandard,of%20being%20diagnosed%20with%20asthma.
State of Rhode Island: Department of Health. (n.d.). https://health.ri.gov/projects/breatheeasyathome/#:~:text=The%20mission%20of%20the%20Breathe,against%20the%20landlord%20if%20necessary.
Home. DBCFSN. (n.d.). https://www.dbcfsn.org/
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