Neighborhood Vitals in Practice

Places, not just people, have vitals.

Where we live impacts our health. Health systems need to be looking at neighborhood level data and trying to improve Neighborhood Vitals. I’ve written before about how my experience in community health in Nairobi illustrates this concept, and why I believe we need a consolidated framework to talk about the vitals of individual neighborhoods (See: Neighborhood Vitals). 

This big concept manifests in small and beautiful ways. When talking about Neighborhood Vitals, I’ve been particularly interested in:

• Air quality, because of it’s near universal applicability and the plummeting cost of sensors to monitor it, and 

• Environmental factors that impact mental health and obesity

Mental health conditions and obesity are on the rise, and they cost our health system a lot of money. Solutions to problems that cost our health systems a lot of money are a good starting point because they can be easier to find funding for.

There are individuals and groups that are already using the Neighborhood Vitals approach. Here are some of my favorite examples of places using local data to promote healthier environments.

Weight 

Obesity globally, and especially in America, has been skyrocketing. Where you live plays a role in your weight. The number of states in which at least 35% of residents are obese has nearly doubled since 2018 (CDC) with the pace of change much faster in some states. Oklahoma City was the 8th fattest city in America according to Men’s Fitness when  former mayor Mike Cornett in his New Years Eve address in 2007 announced he was putting the whole city on a diet. 

The Oklahoma City diet worked. With a background in journalism and TV reporting, the mayor’s initial diet campaign was focused on awareness and healthier eating choices. But awareness can only get us so far. I’ve always known I should exercise regularly. When I lived in Nairobi and did not have a sidewalk in my neighborhood, I usually drove to the grocery store just a half a mile down the road. But in New York, I had some of my best workouts racing between meetings on a CityBike.

People will generally move more when you give them interesting things to go and do, and ways to get there besides cars. “Cornett could see that the “built environment” was key to continuing the momentum of his campaign to lift up Oklahoma City.” (Politico) He invested in downtown revitalization, making sure people could walk and bike to new attractions. The city collectively logged the loss of over a million pounds, and has dropped off Men’s Fitness’ list of the fattest American cities.

Air Quality 

We may all share the same Earth, but we are all breathing very different air. In Kenya where I’ve worked in healthcare, air pollution is the 4th largest risk factor causing death and disability. Around the world from Fresno to New York to Mumbai, our air ranges from good to hazardous. A lot of things influence air quality: indoor cooking on wood or coal stoves, crowded spaces, poorly enforced emissions standards, wildfires. The resulting air pollution can cause a range of health complications from stress to asthma. It’s not just your country that matters, it is your neighborhood and your block too. 

Louisville, Kentucky has one of the highest asthma rates in the U.S. AIR Louisville was a project that tackled this. They recruited people to use inhalers that were equipped to track their location and the time of day, feeding the project data about where people were when they actually needed to use their inhaler. AIR Louisville collected data from over 1,000 people and created a series of maps showing “hotspots” for inhaler use. This data could be viewed next to other city data such as where and when traffic jams occurred, and where they had parks and trees. 

The city committed to taking action on improving tree cover in high-risk asthma areas, and re-routing trucks. Even before the infrastructure improvements hit, AIR Louisville participants reduced asthma attacks by up to one-third just from having access to the data. 

Access to Play  

Children play outside a lot less than they used to. They have less recess time and more digital distractions than previous generations. Children in low-income communities have fewer playgrounds, and are even more likely to go without recess. (Kaboom research) The decline of play has the potential to harm both emotional and physical health for children. 

Kaboom is a nonprofit on a mission to end playspace inequality. They have developed custom Playspace Infrastructure Assessments, which leverage data fed to them by community groups. These assessments map playspace inequality, which in turn guides their fundraising and expansion strategy. When building new permanent spaces, they start with local children’s drawings to inform design.

Healthy Places = Healthy People 

These initiatives are improving people’s health. People are losing weight, controlling asthma, reducing risk of cardiovascular disease and improving mental health -- all through collaborations with public sector actors, philanthropy, the private sector and engaged citizens. These stories signal the small beginnings of a much larger trend that will continue to grow. Healthy Places create the right structures for healthy people. Healthy Places are fed by and respond to data: government infrastructure data, citizen reporting, data from digital devices and more. 

In our own lives, we can look around and start to be more conscious of our environments, and the neighborhoods of others when we are passing through. Our Neighborhood Vitals impact our own vital signs. Let’s start to pay more attention to them. Are there initiatives like these near you? What can we add to this list? Please add them in the comments!