As a former local public health director and current faculty member in the Master of Public Health Program at Michigan State University, I periodically conducted surveys related to health perceptions. I asked questions about hundreds of people's personal health status and health risk behaviors, including graduate students in the MPH Program at MSU. The purpose was to understand more about perceptions of health and what influences health.
One survey question, “What is environment to you?” The common theme that emerged from responses to this question was, “Environment includes nature, the physical environment, our communities and social interactions with other people. Our environment influences all aspects of our lives.”
MPH students had the opportunity to elaborate: “Compared to family, job and recreation, how important is the environment to you?” Many said they didn’t know what could be more important to them than family but reflected on the significance of environmental factors of health and concluded that family and environment were both tops in importance.
Each of us could take a moment to reflect on major environmental trends in our communities and how they shape our health. Consider, for example, urbanization. Urbanization is the shift in the habitation of human populations from largely unaltered, rural areas to developed areas. This shift has been going on for centuries.
Today, about 82% of the United States' total population lives in cities and urban areas. This means most of the people in the United States live in environments we have built.
Environmental factors of health
The built environment includes all the human-made physical parts of where we live, such as homes, buildings, streets, open spaces and infrastructure. We naturally have a strong need for safety and security in our environment. We also look for physical comfort, and we seek a psychologically comfortable environment, such as environments that are familiar but offer the right amount of stimulus.
There is a growing body of evidence that the built environment influences the health of people who live there. For example, inaccessible or non-existent sidewalks, bicycle paths and or walking paths contribute to sedentary habits. These habits lead to poor health outcomes, such as obesity, cardiovascular disease and diabetes. On the other hand, building amenities that support physical activity promotes public health.
Less obvious is the environment can facilitate, or discourage, interactions among people and influence the benefits of social support. For example, an inviting space with comfortable chairs and privacy can encourage people to stay.
The environment can influence people's behavior and motivation to act. An area filled with debris will invite people to leave another item in the area, whereas a clean, well-kept area will encourage people to keep the site clean.
The environment can influence mood. Research on the impact of healthcare settings reveals that hospital rooms with bright light, both natural and artificial, can improve health outcomes such as reduced depression and agitation.
Importantly for health, the environment can create or reduce stress, impacting our bodies in multiple ways. The stress of a noisy environment might result in a person feeling worried, sad, or helpless, experiencing higher blood pressure, heart rate and muscle tension. Hormones released in response to such emotional stress could suppress a person’s immune system. Creating an environment that reduces stress promotes health.
The United States spends more on health care than any other nation. Still, it ranks poorly compared to other countries on basic indicators of health such as infant mortality and life expectancy. Rates of such health problems have been shown to increase with poverty and proximity to health-relevant resources, such as proximity to healthy or unhealthy food stores.
Our health is largely influenced by the choices we make for ourselves and our families. And our ability to make healthy choices depends greatly on the physical conditions in our communities.
People who live in communities with access to healthy foods, quality, affordable housing, good schools and safe places to play are healthier than those that don't. These physical and social factors can significantly impact our health.