Amina Rakhimbayeva

BSPH-202-01

Health Equity and Disparities

Reflection paper #6

Neighborhoods, Built Environment, and Health

Understanding the intricate relationship between neighborhoods, built environments, and

health equity is particularly crucial in the context of San Francisco, a city known for its diverse

communities and complex urban development. This understanding not only sheds light on the

disparities that exist within the city but also offers insights into the ways in which these

disparities can be addressed to promote a healthier and more equitable living environment for all

residents. The importance of understanding the relationship between neighborhoods, built

environments, and health equity in San Francisco. This understanding serves as a crucial

foundation for addressing existing disparities and promoting a more equitable living environment

for all residents. By recognizing the disparities that exist within the city, including variations in

access to resources and services across different neighborhoods, this understanding provides

insights into effective strategies and interventions for promoting equity. Given the complex

urban development in San Francisco, characterized by diverse communities and intricate

landscapes, it is crucial to comprehend these complexities to devise comprehensive solutions that

foster a healthier and more equitable living environment.

Growing up in my neighborhood, I have witnessed firsthand the profound impact of the

built environment on the health and well-being of the community. My neighborhood was

characterized by a lack of green spaces, limited access to fresh produce, and inadequate

recreational facilities. The absence of parks or playgrounds meant that children in the area had

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limited opportunities for outdoor activities and physical exercise. Additionally, the scarcity of

grocery stores offering nutritious food options contributed to the prevalence of unhealthy eating

habits among residents. Moreover, the neighborhood was surrounded by busy roads and

highways, resulting in high levels of air pollution and noise, which had adverse effects on the

respiratory health of residents, especially the elderly and individuals with pre-existing health

conditions. Furthermore, the absence of proper sidewalks and bike lanes made it challenging for

pedestrians and cyclists to navigate the area safely, leading to an increased risk of accidents and

injuries. These observations have made me acutely aware of the impact of the built environment

on the overall health and quality of life of individuals within a community. It became evident to

me that the lack of essential amenities and the presence of environmental hazards significantly

contribute to the prevalence of health issues such as obesity, respiratory illnesses, and mental

health concerns within the neighborhood. My personal experiences have underscored the critical

importance of creating a well-planned and inclusive built environment that promotes physical

activity, ensures access to healthy food options, and minimizes environmental risks to safeguard

the health and well-being of all community members.

Understanding the intricate relationship between neighborhoods, built environments, and

health equity in a diverse city like San Francisco serves as a crucial foundation for addressing

existing disparities and promoting a more equitable living environment for all residents. This

understanding sheds light on the disparities within the city, encompassing variations in access to

resources, services, and opportunities across different neighborhoods, significantly impacting

residents' overall well-being and health outcomes. By acknowledging this relationship, it

becomes possible to develop strategies and interventions aimed at creating a more balanced and

fair living environment for all individuals, irrespective of their background or location within the

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city. The complex nature of urban development in San Francisco, with its diverse communities

and intricate urban landscape, adds layers of complexity to this relationship, highlighting the

necessity of comprehending these intricacies to devise comprehensive and effective solutions

that foster a healthier and more equitable living environment for all.

The readings offer a comprehensive understanding of health equity and disparities in

neighborhoods and the built environment, emphasizing the significance of ensuring fair access to

resources and services for all individuals. Health equity involves providing equal opportunities

for everyone to achieve optimal health, regardless of their socioeconomic status or geographical

location, by addressing key determinants such as housing, education, and healthcare. These

concepts align with my experiences in my neighborhood, where I've witnessed disparities in

accessing healthcare and recreational facilities, particularly affecting low-income residents. The

readings also highlight the role of historical discriminatory practices, like redlining, in

perpetuating health disparities in marginalized communities, reflected in the unequal distribution

of resources and green spaces in my neighborhood. Addressing these disparities requires a

multifaceted approach considering social, economic, and environmental factors, emphasizing the

need for equitable resource distribution and inclusive policies that prioritize community well-

being. Community engagement and empowerment are crucial for advocating policies that foster

a more equitable and healthier living environment for all residents.

The readings highlight disparities and inequalities in health outcomes related to the

neighborhood and built environment, including issues such as limited access to healthcare,

nutritious food, and safe living conditions. These disparities contribute to higher rates of chronic

diseases like obesity, diabetes, and cardiovascular conditions in marginalized communities.

Environmental hazards, such as air pollution and inadequate housing, are linked to increased

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respiratory illnesses and asthma prevalence in neighborhoods with poor air quality and

substandard housing. Inadequate access to healthcare services leads to delayed diagnoses and

untreated conditions, resulting in poorer health outcomes and higher morbidity and mortality

rates in underserved communities. These disparities underscore the urgent need for targeted

interventions and policies aimed at promoting equitable access to healthcare, creating safe built

environments, and fostering community-based initiatives to improve overall health outcomes and

well-being for all residents.

The readings and personal experiences emphasize the importance of further research to

address health equity and neighborhood disparities. This includes exploring the links between

social determinants of health and the built environment, as well as their impact on community

health outcomes. Additionally, there is a need for comprehensive studies to understand the

lasting effects of historical discriminatory practices on present-day health disparities, guiding the

development of inclusive policies and interventions. Research on community-driven initiatives is

crucial to evaluate their effectiveness in promoting health equity and sustainable community

development. Understanding the role of community empowerment in advocating for policy

changes and equitable resource distribution is vital for long-term improvements in neighborhood

health outcomes. Moreover, investigating the implications of climate change and environmental

degradation on neighborhood health disparities is essential, emphasizing the need for resilience-

building strategies and sustainable urban planning approaches for underserved communities.

Collaborations among policymakers, researchers, and community stakeholders can facilitate

evidence-based interventions that foster health equity and resilient neighborhoods for all

individuals.

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 Recognizing the intricate relationship between neighborhoods, built environments, and

health equity is crucial in fostering a fair and balanced living environment, especially in diverse

cities like San Francisco. Understanding resource disparities among neighborhoods facilitates the

development of effective strategies for equitable living. Personal experiences highlight the

importance of inclusive environments promoting physical activity, healthy food access, and

reduced environmental risks. Addressing health equity necessitates addressing social, economic,

and environmental factors, prioritizing equitable resource distribution and inclusive policies.

Further research is vital in exploring connections between social determinants of health,

historical discriminatory practices, and community-driven initiatives, promoting sustainable

policies for health equity. Interdisciplinary collaborations and evidence-based interventions are

pivotal in creating a more equitable and healthier living environment for all individuals in San

Francisco and beyond.

References:

1. Acevedo-Garcia, D., & Osypuk, T. L. (2008). Invited commentary: Residential

segregation and health—the complexity of modeling separate social contexts. American

Journal of Epidemiology, 168(11), 1255-1258. doi:10.1093/aje/kwn306

https://www.migrantclinician.org/explore-migration/migrant-health-

issues.html#:~:text=Explore%20Migrant%20Health%20Issues,special%20mention%20in

%20mobile%20populations

2. https://www.sfdph.org/dph/hc/HCAgen/2019/May%207/CHNA%20Health

%20Commission%205.7.19.pdf

3. Massey, D. S., & Denton, N. A. (1993). American Apartheid: Segregation and the

Making of the Underclass. Harvard University Press.

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4. Ross, C. E., & Mirowsky, J. (2001). Neighborhood disadvantage, disorder, and health.

Journal of Health and Social Behavior, 42(3), 258-276. doi:10.2307/3090214

5. https://health.gov/healthypeople/objectives-and-data/browse-objectives/neighborhood-

and-built-environment

6. Schill, M. H., & Wachter, S. M. (1994). The spatial bias of Federal housing policy: How

redlining contributed to the decline of the inner city. Housing Policy Debate, 5(1), 1-29.

doi:10.1080/10511482.1994.9521169

7. Sallis, J. F., Floyd, M. F., Rodríguez, D. A., & Saelens, B. E. (2012). Role of built

environments in physical activity, obesity, and cardiovascular disease. Circulation,

125(5), 729-737. doi:10.1161/CIRCULATIONAHA.110.969022

8. https://www.scientificamerican.com/article/past-racist-redlining-practices-increased-

climate-burden-on-minority-neighborhoods/