What is meant by “built environment” ?

How can it impact health?

It refers to how the design, construction, and placement of buildings within a community (e.g. zoning, sidewalks, parks) may impact human health.

It can impact health b/c it can determine: if one has the ability to get to health resources (e.g. transportation); if people have places to exercis (parks) -->obesity, diabetes

What is meant by “social environment” ?

How can it impact health?

It refers to the behaviors, connections, norms, social capital, and socio-demographic charcteristics of people (residents, business owners, etc) in an environment that may impact their health.

It could impact helath by the norms set forth in an environment (e.g. excercising or not, eating healthy or not); the connections-if someone's neighborhood isn't friendly that might affect helath

What is the poverty tax?

What circumstances might perpetuate it?

Poverty tax: Things in low income area tne dot be more expensive. Due to multiple factors including the supply & demand issue (bulk vs. more expensive little things)

cycle of disinvestment: when rich ppl leave areas business leave with them, an dwhen these reas begin to decline business don't feel the need to investment as much in it. Sometimes this is due to social olicies

What is an ethnic enclave? 

• Social support b/t ethnicities
• This support can assist & guide with financial needs
• Concentrated academic support
• The ethnicities will likely be in similar social classes solower comparison of themselves (an ethnicity) to others --> lower stress

• Lower access to resources and health care
• Lack of economic power --> lack of political power
• Lower quality schools
• Might separate residents from jobs
• Limited access to healthy foods

The WCPC found that ethnic enclaves were “good” for Asian immigrants but not so for Hispanic immigrants.  Why?

B/c on average the Latino immigrants were working in the agricultural sector and had greater exposure to mosquitos pesticides,e tc, comparied to Asian immigrants that were working in mroe white collar areas.

did not have EXTERNAL validity. This does not apply to all

In urban areas: Supermarkets move to the suburbs and leave behind fast-food restaurants & convenience stores

In surburban areas: Inrease in supermarkets, bu tout of walking distance.

Because of food and energy density:

Some of the most energy dense foods are also the eunhealthiest, e.g. cookies, peanut butter, popcorn. 

This causes a problem b/c low-income individuals usually eat these uhealthy foods, b/c they are more energy dense (fill them up), and end up obese. 

These high density foods also tend to be much less epensive then healthy low density foods, persuading low-income indivdiuals to purhcase them.

• There tend to be fewer chain stores (w/ cheaper prices) and more small/non-chain stores
• Price per ounce: 
• Supply:These small grocers stock smaller quanitities and smalle quantities cost more per ounce
• Demand: Poorer indviduals buy in smaller quantities (e.g. not bulk) and thus these small products are more expensive

Who tends to have better health on average: rural or urban residents?

What are some mechnisms:

Urban residents.

This is due to the Urban Advantage: Rurual residents tend to have higher rates of age-adjusted mortality, disability, and chronic disease than residents ofurban areas.

Why?/Mechanisms, Relative to metro residents, rural residents:

- Are older

- Have lower education levels & lower income

- Have higher incidence of smoking, obesity, & lower levels of physical activity

- Experience lower access to helath care (affordability,

  proximinty & quality)

- Are more likely to be self-empoloyed --> lack health 

  insurance

- Have lower levels of social support/cohesion 

What would McKeown think about comprehensive v. selective PHC?