The medical value of social interaction, social places

One way to understand the health benefits of community and human interaction is to look at the health risks of isolation. Isolation defined here is not the same as solitude where people live on their own and prefer seeing few friends contently, but rather when they feel they are cut off from people and don't easily have someone to turn to.

A 1987 report in Science stated, "Isolation is as significant to mortality rates as smoking, high blood pressure, high cholesterol, obesity, and lack of physical exercise." For instance, smoking increases mortality risk by 1.6, while social isolation does so by a factor of 2.0. Some other findings:

- Isolated men are at greater risk than isolated men;
- Isolated men were 2-3 times more likely to die as men with close social ties;
- Isolated women were 1.5 times more likely to die as women with close social ties;

According to the best seller Emotional Intelligence: Why It Can Matter More than IQ, the source of this entry, this men-women difference may be explained by evidence that women are more effective at building social relationships than men.

Which brings us to the value of creating places that facilitate social interaction, such as via third places, events and scenes, and an extraordinarily social interactive means of seeing these come to fruition; via crowdsourcing.

Read about more cool town health benefits here.

Image source: Long Street, South Africa by cliffsdepot.

How does the planning of neighborhoods and cities affect your health? Thanks to the U.S. Green Building Council (USGBC), the Congress for the New Urbanism (CNU) and the Natural Resources Defense Council (NRDC), that's answered in the first report that comprehensively summarizes the impact of the built environment on public health, and how changes can be implemented.

The study, the LEED-ND Report on Public Health & the Built Environment, measure five areas of health:

- Respiratory and cardiovascular health
- Fatal and non-fatal injuries
- Physical activity
- Social capital
- Mental health

over the following built environment characteristics:

- Regional Accessibility/Location of Development - Developments sited in central cities or central business districts generate fewer automobile trips and emissions.
- Population and Employment Density - Higher density developments are correlated with increased physical activity, lower body masses and lower obesity rates.
- Land Use Mix - A doubling of neighborhood mix would result in a 5% reduction in vehicle miles traveled (VMT)
- Access to Transit - The highest level of transit use is observed at employment centers located within 500 feet of transit stops, 1/4 mile from residences.
- Streetscape Design/Pedestrian Amenities - Residents of a highly walkable/bikable neighborhood are likely to exercise for at least 30 minutes one additional day per week.
- Bicycle Amenities - Physical activity studies reveal that access to, quality of, and density of bicycle amenities is correlated to higher levels of bicycling for recreational purposes.
- Access to Recreational Facilities - Increased physical activity is associated with decreases in obesity as well as a host of illness, most prominently diabetes, hypertension and cancer.
- Distance from Roadways - Studies found that increased negative health impacts from PM, NOx, hydrocarbons, and CO are found between 2 to 300 meters from busy streets.
- Diversity of Population/Income in Communities - Research has determined that the homogenization of communities is a key factor in reducing social capital.
- Roadway Network (encompassing network design, intersection traffic controls,
access management and traffic calming) - Research shows that vehicle speed and volume are the two primary causes of traffic and automobile/pedestrian crashes.
- Street Cross Sections (encompassing street width, on-street parking, and
pedestrian countermeasures) - The weight of evidence suggests that narrower streets are safer.

Personal healthy living in an urban retreat

Many of us wish we could live our yoga. The founders of Sage Spa Living felt the same way, and invested in bringing it closer to reality with Stillwater, an urban residence in Helena, Montana. From their press release, "The founders have the simple vision of changing the world, one guest at a time by inspiring personal health and promoting community stewardship.

While it does cater to the high-end, it provides a progressive model for integrating health with architecture and daily living that we can all benefit from, including:

- Floor-to-ceiling windows, open floor plans and over-sized balconies that bring the outdoors (fresh air, light) into the indoors.
- Natural building materials, colors and landscaping that reveal a more relaxed, stress-free atmosphere.
- Membership to Sage's spa on the ground floor of the residential complex, including workshops on healthy living and in-home service.
- Energy-efficient heating and cooling systems that promote overall environmental health.

The health aspects don't end there. Across from a college, Stillwater is nestled in a civic tourism-oriented, walkable (very healthy!) downtown retail district with independent restaurants and shops, multiplex theater, carousel featuring Montana's indigenous animals, science and culture museum, a Lewis & Clark experience, along with other main street businesses, offices and condos.

Back to the future for our own health's sake

From the late 1800s to early 1900s our public health was largely linked to our built environment. People were dying from communicable and waterborne diseases tied to overcrowding, poor sanitation and polluted air. As a result, cities began to feature more open spaces, advanced public works and cleaner transit options - a public health model.

In the mid to late 1900s, we shifted to what is known as the 'medical model' approach to public health, with a focus on doctors treating specific illnesses, which required hospitals, which in turn required health insurance programs, which in turn is causing many an economic crisis.

In the 2000s, we may very well evolve back to the public health model, according to Neal Kaufman, MD, MPH, profiled in yesterday's story and based on this article. Kaufman says that "the vast majority of improvement in life expectancy derived not from medicine but from public heath. Individuals’ life spans are increasing, but their performance spans are not. They’re living to their 80s and 90s, but they’re becoming increasingly debilitated or infirm as they age."

What will be the next version for a vastly improved public health model? It's essentially the kinds of walkable, mixed-use communities that are featured on this website, or in other words, the opposite Kaufman's present medical-model driven lifestyle: "They drive to work long distances, they sit at their desk, they come home exhausted after commuting, and they end up either working or falling asleep in front of the television, without expending calories."

If your city's healthy for kids...

...it's healthy for just about everyone else, and communities in Europe, Australia, New Zealand, and Canada have been conducting such audits for 25 years. The public health term for this is a health impact assessment (HIA), which measures the potential impacts of decisions on health (physical, emotional and mental), and identifies actions that can improve the results of those decisions".

According to Neal Kaufman, MD, MPH*, an HIA on our schools would result in:

- "Siting it where the parents of a preschooler can walk their child there to get physical activity and getting to know their neighborhood. If that school is the center of the neighborhood, the neighborhood cohesion will maintain that school’s function for much longer."
- "Having it small enough so students feel comfortable and understand the environment around them".
- "Providing more daylight/sunlight that actually helps stimulate childrens' brain development."

Thankfully organizations like New Schools Better Neighborhoods advocate these principles full time. As far as buildings in general, some health-oriented organizations have already taken the lead on, as profiled in this previous entry.

*Kaufman is also a professor of pediatrics and public health at the UCLA School of Medicine and co-director of the UCLA Center for Healthier Children, Families and Communities, and commissioner for First 5 L.A.

Walkable buildings

Americans have been gaining weight an average of one pound a year. If they walked up stairs for just two minutes a day, they'd lose 1.6 pounds a year instead, according to James Sallis, a professor of psychology at San Diego State University in a Wall Street Journal article, New Buildings Help People Fight Flab.

An excerpt: "Buildings have long been designed so people can get from one place to another with minimum physical effort. Now, in a bid to fight a rising tide of obesity, companies, universities and other institutions are embracing the opposite idea: buildings that force employees to move around a lot more."

Now, we've long heard about the benefits of a walkable community, but why not a walkable building? What does that mean?

- More prominent stairways and slower elevators at Virginia Commonwealth University
- Elevators that stop on every third floor at the CA Dept. of Transportation (there's a separate elevator for the disabled.)
- Stairwells are brightly lit and hung with paintings; the elevators are slower at Sprint.
- The steps on the main staircase are wider with lower risers; the cafeteria and key meeting rooms are located on the perimeter of the new building, at the Robert Wood Johnson Foundation

There's some truth to this - the elevator in my building is so slow that I walk up the seven flights instead, and thankful for it. Human-scale buildings that don't require elevators also add more character and sense of place to a neighborhood.

Image - No elevators at Hogwarts.

City living healthier than in the suburbs?

Yes, according to a report on public health as it relates to development patterns by the Ontario College of Family Physicians.

As you can see on the graph from their report, the greater the density (sprawl index), the fewer the fatalities per 1000 people, as calculated over 83 U.S. regions that covered two-thirds of the total population. Why are people dying? The reports showed lower densities have higher incidence of cardiovascular and lung diseases including asthma in children, as well as cancer, diabetes, obesity, traffic injuries and deaths, exacerbated by an increase in air pollution, gridlock, traffic accidents and lack of physical activity.

Their recommendations?

- Moving to a town or city that has a reliable public transportation system;
- Choosing a place to live that has bicycle lanes and pedestrian paths;
- Choosing a town with parks and wildlife areas to clean and cool the air;
- If possible, choosing a community where you can walk to work, stores and schools;
- Getting to know your neighbors and volunteer in the community.

Read more about the connection of health and fitness to cooltowns.

Finally! Health insurance for free agents!

It's long been a frustration for individual entrepreneurs (aka free agents) who have to pay a lot more to get less health insurance than that of larger companies.

This is no longer the case for the independents and free agents in urban downtowns! Thanks to the National Main Street Center, a nonprofit that assisted well over 2000 main streets across the country. They helped initiate the National Trust Insurance Services which provides health insurance to main street tenants at competitive premiums and benefits as corporations have for their employees. For instance, it dropped my insurance premiums from $121 to $93 with the same deductible, yet increasing coverage from 80% to 100% - keeping my same doctor.

The bottom line is this is great news for any local economy - it's the individual entrepreneurs that are most responsible for any city's job growth (outside of stealing other cities' companies), so it's certainly not in the local economy's best interests to put them at a financial disadvantage.

Has insurance hampered you as a free agent? Speak your mind below...

Cobblestone streets are good for you

We know cobblestone streets aren't the best for driving on, but that probably means just the opposite for people. Behavioral researchers from the Oregon Research Institute are proving it's true.

Their studies show that people who walk on cobblestone streets enjoy significant improvement in balance, measures of mobility and blood pressure. The stones seemed to serve as a vast community of massage therapists for the feet. The surprising result was that the study lasted only 16 weeks. Imagine what would happen after a year or two!

This is just further evidence that there's more to designing a place for people rather than cars - that we live in an environment that's far less oriented to humans; to our health and well being than we think.

What other subtle design features do you feel would cater more to people? Speak your mind below...

Evidence shows walkable towns healthier

In a recent large-scale study* of 16 pairs of neighborhoods, one that has a typical main street and a mix of apartments and houses has a proportion of people with BMI (body mass index) over 25 (considered a healthy level) at 35% of the population, but in areas of single-family homes with 'poorly connected streets and a shopping center on its edge with a big parking lot', BMI over 25 matched the national average of 60%.�

Michigan governor Jennifer Granholm has made health and fitness a priority for her administration by promoting walkable communities through the only statewide 'CoolTown-oriented' program, the Cool Cities Initiative, a program she founded and backed up with state funds. The administration states that the cost of physical inactivity in 2002 in Michigan was assessed at close to $9 billion, and if one in 20 citizens became routinely active, there would be savings of $575 million a year.

*National Institutes of Health-funded research conducted by the Active Living Research and Active Living Leadership initiatives at San Diego State University (SDSU), founded by the Robert Wood Johnson Foundation in conjunction with the Centers for Disease Control and Prevention.

How important does health and fitness seem in your community? Speak your mind below...