Christopher Coutts

Neighborhood Urban Form, Social Environment, and Depression

We examined whether neighborhood urban form, along with the social environment, was associated with depressive symptoms in a sample of Miami residents. Using a validated measure of depressive symptoms, we found that living in neighborhoods with higher housing density was associated with fewer symptoms. A larger acreage of green spaces was also linked to fewer depressive symptoms but did not reach significance in the full model. Our results suggest that how residents use the environment matters. Living in neighborhoods with a higher density of auto commuters relative to land area, an indicator of chronic noise exposure, was associated with more symptoms.

Green Infrastructure, Ecosystem Services, and Human Health

Contemporary ecological models of health prominently feature the natural environment as fundamental to the ecosystem services that support human life, health, and well-being. The natural environment encompasses and permeates all other spheres of influence on health. Reviews of the natural environment and health literature have tended, at times intentionally, to focus on a limited subset of ecosystem services as well as health benefits stemming from the presence, and access and exposure to, green infrastructure. The sweeping influence of green infrastructure on the myriad ecosystem services essential to health has therefore often been underrepresented. This survey of the literature aims to provide a more comprehensive picture—in the form of a primer—of the many simultaneously acting health co-benefits of green infrastructure. It is hoped that a more accurately exhaustive list of benefits will not only instigate further research into the health co-benefits of green infrastructure but also promote consilience in the many fields, including public health, that must be involved in the landscape conservation necessary to protect and improve health and well-being.

Greenway Accessibility and Physical-Activity Behavior

Public health initiatives have made important but relatively modest gains through individual-level and nonecological health-promotion efforts aimed at increasing physical activity. The previously overlooked built environment is now being considered as facilitating or hindering ones ability to be active. The multiuse greenway is an example of a facility that can support physical activity, but its level of use may be influenced by the accessibility characteristics of the areas surrounding the greenway. In this study, an unobtrusive methodology using GPS and GIS technology was employed to test whether two variables used to measure accessibility, proximity (population density) and opportunities (land-use mixture), predicted the use of greenway segments. The results presented here allow us to confirm that smaller walking and bicycling scales of analysis are better predictors of physical-activity behavior. The results also suggest that solely bringing environmental support for physical activity closer to concentrated areas of population does not necessarily equate to more use. It is important that areas with increased population density have correspondingly increased levels of land-use mixture if increasing physical activity is the goal.

Using geographical information system to model the effects of green space accessibility on mortality in Florida

The loss of green space in an increasingly developed landscape may not only have negative environmental impacts but may also be detrimental to human health. The relationship between green space and health is dependent on not only the presence but also access to green space. This cross-sectional ecological study uses a geographical information system to examine the relationships between the presence and accessibility of green space and county-level mortality in the state of Florida. After controlling for some of the leading influences of mortality – including the levels of obesity, smoking, old age, and education – we found that the amount of green space within defined distances of census tracts in each county was associated with both all cause and cardiovascular mortality. Neither the gross amount of green space in a county nor the average distance to green space from census tracts in a county were significantly associated with our mortality measures.

Planning for the Disposal of the Dead

Problem: Concurrent with the dramatic increase in the nations elderly population expected in coming decades will be a need to dispose of larger numbers of our dead. This issue has religious, cultural, and economic salience, but is not typically considered a planning problem. Although cremation rates are rising, burial is projected to remain the preferred alternative for the majority of the U.S. population, and urban space for cemeteries is limited in many communities. Purpose: We outline issues related to cemeteries and burial, describe a number of alternatives to traditional cemeteries, and explain how planners might usefully contribute. Methods: This work is based on a literature review. Results and conclusions: Alternatives to the cemetery are emerging, but remain limited. Some require changes to laws or public perceptions. Planning practice could be advanced by case studies showing how to integrate burial grounds into existing communities and how to alter public policy to permit alternatives to burial. Takeaway for practice: As population demographics change, environmental concerns intensify, and demand for urban space grows, future land use decisions will have to balance a diverse set of social, cultural, and environmental expectations, including taking into account burial practices. There are only a handful of alternatives to traditional burial in a cemetery: burial in a multiple-use cemetery; natural burial; entombment in a mausoleum; cremation, with the ashes preserved in a columbarium or scattered elsewhere; and burial in a grave that will be reused in the future. This article provides planners with information about each of these alternatives, examples of how the planning process can address disposal of the dead, suggestions for avoiding environmental externalities, and ideas for better integrating the landscapes of death into community life. Research support: None

The Portrayal of Natural Environment in the Evolution of the Ecological Public Health Paradigm

This paper explores the conceptualization of the natural environment in an evolving ecological public health paradigm. The natural environment has long been recognized as essential to supporting life, health, and wellbeing. Our understanding of the relationship between the natural environment and health has steadily evolved from one of an undynamic environment to a more sophisticated understanding of ecological interactions. This evolution is reflected in a number of ecological public health models which demonstrate the many external and overlapping determinants of human health. Six models are presented here to demonstrate this evolution, each model reflecting an increasingly ecological appreciation for the fundamental role of the natural environment in supporting human health. We conclude that after decades of public health’s acceptance of the ecological paradigm, we are only now beginning to assemble knowledge of sophisticated ecological interdependencies and apply this knowledge to the conceptualization and study of the relationship between the natural environment and the determinants of human health.

Cities and health: An evolving global conversation

Abstract The Cities and Health journal sees its launch in 2017. Looking back over half a century of growth and global expansion in economic activity, although there have been societal benefits, negative impacts are starting to take their toll on planetary resources and human health. As we enter what is being termed The Anthropocene, the city is becoming the preferred habitat for humanity. The imprint of city lifestyles, in terms of both resource use and waste, is found across the globe, threatening the ecosystem services that support our health. In cities themselves, due to risks and challenges to health, we are witnessing a rise in non-communicable disease, twinned with infectious disease for the many who live increasingly in informal or slum urban development. High levels of health inequity are found within urban populations. The resultant health problems are placing increasing strain on health services, with pressure only set to increase due to continuing urbanization and ageing populations. Evidence increasingly demonstrates that many aspects of city and neighbourhood form, urban and transport design, and residential environments play an important role in mediating health and health equity outcomes. The new journal Cities & Health is being launched to support political, academic and technical leadership and transdisciplinarity in this field. For this endeavour we will need to re-examine the nature of evidence required before we act; to explore how academics, policy-makers, practitioners and communities can best collaborate using the city as a laboratory for change; and to develop capacity building for healthier place-making at professional and community levels.

Green Infrastructure and Public Health in the Florida Communities Trust Public Land Acquisition Program

Abstract The Florida Communities Trust (FCT) program provides grants to local governments to preserve open space. In doing so, this program plays an important role in supporting public health. A total of 617 FCT applications submitted between 2001 and 2006 were examined to determine in what ways the FCT is supporting public health. Results revealed that the FCT is supporting health most notably through the provision of park and greenway settings for physical activity and the protection of water quality. These findings are important because they reveal that programs such as the FCT have a latent ability to support public health. Making the important social benefit of public health more explicit can provide further justification for public land acquisition.

Greenways as Green Magnets:The Relationship between the Race of Greenway Users and Race in Proximal Neighborhoods

Abstract Although advances have been made in research examining race and the use of public parks, there has been little attention paid to urban greenways. Using Geographic Positioning System (GPS) and Geographic Information System (GIS) technology, this exploratory study examines whether the racial composition of neighborhoods surrounding two urban greenways in Michigan acts as a barrier to trail use or whether these urban greenways operate as “green magnets,” facilitating links between neighborhoods of varied racial composition. The results of this study revealed that the racial composition of the neighborhoods greenway users passed through did not predict the race of users on a given segment. These findings suggest that greenways might facilitate racial comingling in urban public space.

Extent and Context of Human Health Considerations in London's Spatial Development and Climate Action Strategy

The protection of human health is among the original justifications for urban planning, but it is underexamined as one of the myriad benefits of planning for climate change. A conceptual content analysis of the spatial development strategy and climate action plans of London, United Kingdom, was performed to reveal how health was portrayed in climate change adaptation goals and actions. In London’s spatial development and climate action plans, there was a total of 300 instances of the keyword ‘health’ with weighted percentages of coverage in the documents ranging from 0.19% to 0.45%. The conclusions from this analysis are that stated threats to health are truly localized, policies that address health acknowledge both adaptation and mitigation, and health inequalities and creating an environment supportive of health are the most salient cross-cutting issues.