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In social science, a built environment is “the humanitarian-made space in which people live, work, and recreate on a day-to-day basis.” It “encompasses places and spaces created or modiﬁed by people including buildings, parks, and transportation systems,” as well as supporting infrastructure such as waste disposal systems and overhead power lines. In recent years, public health research has explored the relationship to physical and mental health of neighborhood features such as “walkability”, “bikeability”, healthy food access, and community gardens. The association with depression of these and other environmental exposures such as housing conditions and noise level has also been assessed. Notably, exposure to adverse environmental conditions such as poorly maintained housing and high levels of ambient noise are not randomly distributed and tend to concentrate among the poor and ethnic minorities, resulting in health disparities.

History
Early concepts of built environment date to Classical Antiquity: Hippodamus of Miletos, known as the “father of urban planning,” developed Greek cities from 498 BC to 408 BC that created order by using grid plans that mapped the city. These early city plans inspired the City Beautiful movement in the late 1800s and early 1900s, of which Daniel Hudson Burnham was a great proponent. Burnham, a reformist for the Progressivism movement, advocated for “a reform of the landscape in tandem with political change.” The eﬀort was in partnership with others who believed that beautifying American cities would improve the moral compass of the cities and encourage the upper class to spend their money in cities. This beautiﬁcation process included the establishment of parks and aesthetically pleasing architecture.

Modern built environment
Currently, the term built environment refers to an interdisciplinary ﬁeld that addresses the design, construction, management, and use of man-made surroundings as an interrelated whole, and their relationship to human activities over time (rather than a particular element in isolation or at a single moment in time). The ﬁeld is not considered a traditional profession or academic discipline in its own right, instead drawing upon areas such as economics, law, public policy, management, geography, design, technology, environmental sustainability, and public health.

Public health
Neighborhood design can aﬀect both physical and mental health. Built environments with features designed to promote physical activity - such as well-maintained sidewalks - are in fact associated with higher rates of physical activity, which in turn improves health. Neighborhoods with more "walkability" - which is affected by perceptions of safety, the condition of sidewalks, and distance to amenities, among other factors - had lower rates of obesity and increased physical activity among residents. They also had lower rates of depression, higher social capital, and less alcohol abuse.

Geographic information systems (GIS) programs facilitate assessments of walkability. One such program, Street Smart Walk Score, determines distances to grocery stores and other amenities; connectivity; and intersection frequency for any given physical address. This kind of technology can be used by city and county planning departments to enhance walkability in their communities.

Other neighborhood features associated with improved health are "bikeability", healthy food access, and community gardens. Bikeability refers to ease of biking and is enhanced by the creation of dedicated, safe spaces for biking such as bike paths and bike lanes. Healthy food access refers to a neighborhood’s physical proximity to sources of fresh, healthy food and the affordability of such food.

Increased density of convenience stores, which are typically stocked with high-calorie, processed foods, has been associated with obesity in children. In contrast, improved access to community supermarkets and farmers’ markets is correlated with lower child body mass index (BMI) and overweight status. In low-income neighborhoods, which tend to have comparatively few health promoting features, the presence of a local grocery stores was correlated with lower BMI and risk of becoming overweight. Similarly, access to community gardens was associated with increased fruit and vegetable intake among gardeners. Community gardens may have other salutary effects on residents such as reducing stress, lowering blood pressure, and instilling an overall sense of wellness.

The built environment exists at the intersection of public health and other disciplines such as environmental planning, policy development and land-use planning. Mixed land use and good street connectivity are associated with increased physical activity. In addition, those who prefer to walk and live in walkable environments have lower obesity rates and drive less than those who prefer living in auto-dependent environments. The Centers for Disease Control and Prevention (CDC) underscores the significant role of the built environment in the development of obesity in its Common Community Measures for Obesity Prevention Project, in which fully eight (of 24) strategies are devoted to “creat[ing] safe communities that support physical activity.”

Depression

Those living in poor built environments have higher rates of depression. This association has been observed over the past 10-15 years in studies examining neighborhood design, housing conditions, and residential ambient noise.

Neighborhood features

Gariepy, et al. (2015) found that the presence of neighborhood amenities such as healthy food stores, fast-food restaurants and healthcare services were associated with a reduced risk for a depressive episode among those with low past-year prevalence of depression. The presence of a local park was similarly associated with reduced risk for a depressive episode among those with both low and moderate past-year prevalence of depression. However, the risk for a depressive episode among those with the highest past-year prevalence of depression appeared unaffected by neighborhood features, suggesting the need for more intensive interventions in this group.

Housing conditions

Galea, et al. (2005) found that poor quality internal (e.g., broken appliances) and external built (e.g., deteriorating conditions) built environment features were positively associated with past six-month and lifetime depression among residents of 59 New York City neighborhoods. Specifically, non-functioning kitchen facilities, heat breakdowns, peeling plaster or paint, evidence of external building deterioration, and incidence of structural fires were independently significantly associated with past six-month and lifetime depression.

Noise

Lercher et al (2002) found that higher levels of exposure to ambient noise was associated with increased reporting of depression and anxiety symptoms in elementary school children in a linear dose-response fashion. This effect was magnified in children who had early life biological risk factors such as low birth weight or pre-term birth.

Challenges/solutions
Policies to increase vegetation may provide opportunities for physical activity, reduce harmful exposures, increase social engagement, and improve mental health. In addition, deliberate planning for communities with central gathering places can increase the likelihood that people will socialize casually, which may also lead to improved mental health among residents.

Current barriers to improving adverse environmental conditions include the cost of repairing an aging infrastructure, the existence of problems that are considered higher legislative priorities, and institutionalized racism. It is estimated that over $3.6 trillion will be needed to fund repairs to current infrastructure in the United States by 2020, and priority will almost certainly be given to improvement or restoration of essential services such as safe water in Flint, Michigan. The concentration of exposures to poor environmental conditions in low-income communities and/or those with large numbers of ethnic minorities is likely due to institutional racism and could be partially rectified by raising awareness about institutional racism generally and by empowering vulnerable populations to participate in community- and state-level political decision-making processes.