How your neighborhood affects your health

Note: This interview was originally published in Doing Well, a health news outlet from ASU Media Enterprise and ASU Learning Enterprise. Subscribe to Doing Well to get interviews with health experts delivered to your inbox weekly.

By Natasha Burrell

The places we live quietly shape our health every day — often in ways we don’t realize.

The built environment that surrounds us — sidewalks, grocery stores, public transportation, lighting and access to green space — influences how much we move, what we eat, the air we breathe, and even how safe and connected we feel in our own neighborhoods. In turn, these influences, in combination with factors like housing, education and access to health care, can determine how long we live and the quality of our lives.

These influences are the research focus of Jordan Miller, a professor at Arizona State University's College of Health Solutions and School of Technology for Public Health. 

In the below Q&A, Miller talks about how built environments — the human-made spaces and structures that surround us every day — influence our health, why green spaces matter, and what we can do to advocate for healthier spaces in our own communities.

Note: This interview has been edited for length and clarity.

Question: How does our built environment impact our health?

A: Our built environment impacts our physical, emotional (and) mental health.

We’ll start with roadways and walking paths. If you have good walking paths in a neighborhood, people are more likely to walk. If you have safe, protected bike lanes, people are more likely to ride bikes. Also, our lighting structures. Safety (has) a real impact on how we engage in physical activity outside of our homes. So, if we choose to walk, bike — whether just for fun or for transportation — depends a lot on whether those sidewalks and bike lanes are well lit.

Then, look at the food environment. We think of a food desert as a place where people don’t have access to affordable produce close enough that they’ll go to the grocery store and buy it. There are also food swamps, which has to do with the proportion of fast food that might be in a neighborhood. It’s really easy for these environments to impact what we choose to eat. We have busy lives, and we only have so much time. For example, people in rural areas may only have so far they can travel to get fresh produce. And if the store that’s closest to them doesn’t have good-quality produce or produce that’s affordable, it’s just not what they’re going to choose to eat.

Beyond what we eat and how we exercise, our environment impacts the air that we breathe. For example, if you live closer to a highway where there’s a lot of exhaust, kids are more likely to develop asthma.

The area that I’ve done the most research in is the impacts of green space on health. Even just walking in sight of green space lowers our heart rate and blood pressure. It has measurable effects on mood and mental well-being and connects us socially. So people report better relationships with neighbors in areas where they have parks and green space.

I’ve done research on the impacts of community gardens, specifically on crime, and we find basically the same benefits to community gardens as most green spaces and parks, except additional benefits in that they yield food. They bring people together, create more social cohesion, and that does a lot for building up really healthful neighborhoods. But the part that became really interesting to me is the impacts on crime — both green space and community gardens reduce crime in neighborhoods.

Q: Can you tell us about a place that you’ve lived or visited that really shaped the way that you think about the built environment?

A: I have to say it’s moving to Arizona. I don’t love going into a gym. I like hiking and biking and being in nature and doing physical activity for fun. So, I tend to just sort of walk where I want to go. I like to live in a walkable neighborhood and bike everywhere. When I moved to Arizona, I found that it was so hot and there were so few sidewalks. I remember walking to Target and there was no sidewalk. I could tell I was standing out; I was hot. I gained quite a bit of weight when I first moved to Arizona because my physical activity levels just changed a lot based on those neighborhood features.

Q: That’s very real. How have you found success in adapting those behaviors since moving here?

A: I have a stationary bike in my house now, and I listen to podcasts and ride my stationary bike, which doesn’t take care of the environmental piece in terms of reducing my impact on the environment but it gets me activity, and I have lost that weight.

There’s a really interesting concept called reciprocal determinism, where we talk about a triangle between an individual, their environment and the social norms.

I have students who are really interested in biking, and they will develop advocacy campaigns to improve the bike lanes and safety for bikers where they live. And if they’re successful, and a city or town builds more bike lanes, more people will use the bike lanes. And those social norms will change, where people will see, for example, "Oh, everybody kind of bikes to work, and if I’m driving my car, I’m really the one who’s out of step with the culture." It will encourage more people; they’ll see that it’s fun and it’s safe and people are enjoying their bike ride and they’re staying fit. It’ll encourage those people to bike and then maybe that workplace sees, "Oh, 60% of our employees bike to work; we should have bike storage for them and maybe even showers for when they get to work." They’ll build showers, which then will encourage more people to engage in biking or walking to work. It’s a self-reinforcing cycle that happens when we support built environment changes that encourage good health behaviors.

Q: Some of these built environment elements feel out of our control. If someone does notice that their neighborhood lacks safe walking paths or bicycle lanes, healthy food options — how can they advocate for change?

A: I’m always inspired by my students. I have an assignment in one of my classes where they can take direct action for advocacy. I’ve seen a student lobby her city government to include more speed bumps in her neighborhood, and then she raised the money to have them installed. I think the world is more changeable than we tend to give it credit for. There are a few steps. One is to advocate, to think of your city council and county representatives as human beings who also are your neighbors, who also want to live in good neighborhoods.

People can raise awareness. You don’t need to take my class, for example, to learn to write an op-ed, write a policy brief. So the student who advocated for the speed bumps to be installed wrote a policy brief in my class, which is just a form of communicating scientific information in a very straightforward way for decision-makers. When she brought that to the county government, they were impressed. They’d never seen someone come prepared with a policy brief before. And that was part of why they listened to her and they were persuaded.

You can Google how to write a policy brief. It is something anybody can do ... raising awareness, seeing yourself as powerful, and rolling up your sleeves.

Q: Loneliness is on the rise, and a lot of people are seeking more human connections. How does the work of changing your built environment impact social connection?

A: I go back to community gardens. We have research that community gardens impact social cohesion. So, the idea of, "We worked on this community garden together. I have a sense that if I needed a cup of sugar, for example, you might give it to me or I might be willing to give you a cup of sugar if you needed one because I know that you are part of my garden and we share together."

It creates those kinds of bonds of trust. It does have direct benefits on the formation of relationships, which can positively impact our health. And that’s a whole other line of research that is really interesting — how a sense of community and a sense of feeling cared about can extend our lives. These community projects are a great excuse for people to come together. People may have become a little more shy and hesitant in putting themselves out there and forming relationships. Having a community project gives them an excuse to come together. There’s something to do — maybe you don’t even have to talk to anybody, but over time, people become more comfortable and build those bonds of trust.

A: Our digital environment has made it much easier for people to learn how to do things.

The city of Detroit is an amazing example. Twenty-five years ago, Detroit was talked about as being emblematic of the Rust Belt decline — the manufacturing jobs had left, people had so much less money. Crime was on the rise, poverty was on the rise; people were really struggling. The citizens of Detroit came together and said, "Well, we have all these boarded-up buildings, we have all this vacant land, people have moved out — let’s make something of it." And they created incredible gardens. They have city beekeeping, they’re keeping chickens, they’re growing food, and it is really a story of hope and resilience.

If people want to come together like that, we now have the know-how right at our fingertips. If we want to learn beekeeping, it’s right there. If we want to learn to install a garden, we can open up our phones. The tools and resources are there. And the human spirit is triumphant, so I’ll remain hopeful.