The Built Environment, Mental Health, and Health Equity: What Are We Missing?
It’s that time of year where longer days and warmer weather means summer is here. Have you been spending time outdoors?
With the COVID-19 pandemic, there have been more conversations about the built environment, public health and public spaces. One example is that in urban centers, access to public outdoor green spaces (like parks) has been a contentious issue. It is also clear that mental health and well-being is a rapidly growing problem worldwide, with the pandemic having exacerbated social isolation and rates of depression and anxiety. As global mental health concerns and the populations in urban centers concurrently rise, there is an increasing recognition that these issues are linked.
As a doctoral candidate in Environmental Studies, with a background in Public Health and Architectural Design, this is a key area of interest. I am also a Board Member at the Global Alliance for Behavioral Health and Social Justice and co-chair of the Student and Early Career (SEC) Task Force. I study the links between the built and natural environments and health equity. More specifically, my dissertation research focuses on the experiences of people of color in urban green spaces and the links to mental health and well-being, taking an intersectional anti-racist lens.
The COVID-19 pandemic has highlighted the gross underlying structural social and health disparities that exist. It is worth taking the time to reflect on our experiences. Have you had access to private indoor and outdoor space during this time? Have you been able to stay home safely and work from home? Have you had access to a private vehicle and what does public transit look like in your neighbourhood? These are some of the factors that impacted who was more likely to contract COVID-19 and who was able to mitigate the significant stress and anxiety brought on during this time.
Although the pandemic has increased discussions about the built environment, mental health and health equity, we’re missing some critical links.
Each discipline has a unique perspective on this complex issue, so what are some of the questions that could be asked by public health, environmental studies and critical theory?
From a public health perspective, we might ask how can we address the social and structural determinants of mental health and improve mental health outcomes for those populations facing greater health inequities? What are the broader social, cultural and environmental factors that impact someone’s mental health and well-being?
Environmental studies is about the built, natural, social, organizational and political/structural environments as well as the relationships and interactions between them. From this perspective, we can ask how can we address inequities between different neighborhoods within cities? These inequities exist across access to different types of public infrastructure such as sidewalks, cycling infrastructure, public transit, quality green spaces, healthy affordable food options and affordable quality housing. The images below begin to give a sense of how built environments can vary and form a vital part of our communities.
Research has demonstrated that these aspects of the built environment can influence mental health and well-being, so how do we design environments for health?
From a critical race theory perspective, we could ask how does the relationship of race and racism to the built environment impact mental health and well-being? Taking an intersectional approach (as conceptualized by Kimberlé Crenshaw), how do people’s intersecting identities impact how people navigate the built environment? In addition to race, a person’s age, gender, sexual orientation, disability and citizenship status can affect how they navigate the built environment and how safe they feel. This is a result of broader structural factors like racism, xenophobia, sexism, transphobia, classism, ableism, homophobia and biphobia.
To improve mental health outcomes, it is important to break down these disciplinary silos. Addressing mental health and well-being requires bridging multiple systems including public health, planning, healthcare, housing, transportation, education and social services.
To tackle the links between the built environment and mental health, we need an interdisciplinary approach. As we slowly move out of the COVID-19 pandemic, there is an urgent need to learn from and collaborate with other disciplines to strengthen research, practice and policy responses.
As we move forward and seek to create more equitable and mental health-promoting built environments through interdisciplinary action, these efforts align with the principles and recommendations outlined in the Global Alliance’s recent editorial. Specifically, this area of work aligns closely with the call to address structural racism in creating racially just and equitable communities and the recommendation to focus on behavioral health and well-being across the life course. Built environments must consider children, youth, families and seniors in ensuring safe, vibrant spaces to play, work, live and move. The built environment has a unique role to play in creating and organizing communities and systems in pushing forward mental health, behavioral health and well-being for all.
This blog post was written by Global Alliance member, Nadha Hassen, and does not necessarily represent the policy position of the Global Alliance.