A History Lesson with APHA and the Built Environment
Over the past 100 years, public health in the United States has grown in importance by leaps and bounds. Much of the field has its historical roots based in events surrounding disease prevention, population safety and a slew of regulations that were enacted to generally make the country a safer place to live. Another aspect of public health that was integral in the shaping of the country was its role in developing the built environment.
Coming back from the Health 2.0 conference in San Francisco last week, I had the opportunity to read over a fascinating article about the involvement of the American Public Health Association (APHA) in the early 1900′s, in setting precedents for urban housing. In essence, the APHA and other health professionals created regulations that were used to declare certain inner-city residential areas as “blighted” or uninhabitable. What this meant for those neighborhoods and the people living in them can be summed up with two words: destroyed and displaced.
After World War II, the state of urban neighborhoods that were populated predominantly by African Americans were considered in very poor shape. Moreover, these substandard conditions allowed for an increase in public health concerns which were noted by the APHA. Between 1937-1938, the APHA created a Committee on the Hygiene of Housing and developed guidelines that outlined fundamental requirements (including physical, mental and social health) of living conditions in order to promote better health and reduce disease.
Because housing was responsible for poor health, it became a goal of the reformers to advocate for demolition of the worst units and for a comprehensive national program of housing construction that would build as many as 13 million units from 1937 to 1945.
As good as this sounded at the time, much of the demolition that took place caused more problems – including the extensive displacement of families (with many times no relocation plans for them) and the increased negative reputation of urban neighborhoods. Many of the guidelines that were put into place also turned a blind eye to blatant racial segregation that continued to exclude African Americans from proper means of living. Bias in housing location for them apparently ran rampant. Mental health also played a role as many ousted residents (which would also include Italian and Jewish residents) would return to the old neighborhoods to try and find solace.
In essence – the public health workers had their minds in the right place however the political figures and others involved in the urban renewal process let the ball drop on quite a few important issues.
From the article:
Focusing on the health effects of the built environment, new research has shed light on the association between the physical form of neighborhoods and the physical activity levels of its inhabitants – and the role of housing in asthma.
Today, the public health field has another opportunity to examine the effects of the built environment and make positive connections and changes with regard to public health. The next few years will be an important opportunity for public health as we can no longer ignore the effects of how the built environment affects the health of its residents. From addressing childhood obesity to improving physical activity options for the entire family, I hope that we can move forward with sustainable solutions.
Additional Resources:
National Heart, Lung and Blood Institute Summary on Public Housing and Public Health (PDF)
Housing and Health: Time Again for Public Health Action (PDF article)
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