Links between the built environment, climate and population health: interdisciplinary environmental change research in New York City.

Global climate change is expected to pose increasing challenges for cities in the following decades, placing greater stress and impacts on multiple social and biophysical systems, including population health, coastal development, urban infrastructure, energy demand, and water supplies. Simultaneously, a strong global trend towards urbanisation of poverty exists, with increased challenges for urban populations and local governance to protect and sustain the wellbeing of growing cities. In the context of these 2 overarching trends, interdisciplinary research at the city scale is prioritised for understanding the social impacts of climate change and variability and for the evaluation of strategies in the built environment that might serve as adaptive responses to climate change. This article discusses 2 recent initiatives of The Earth Institute at Columbia University (EI) as examples of research that integrates the methods and objectives of several disciplines, including environmental health science and urban planning, to understand the potential public health impacts of global climate change and mitigative measures for the more localised effects of the urban heat island in the New York City metropolitan region. These efforts embody 2 distinct research approaches. The New York Climate & Health Project created a new integrated modeling system to assess the public health impacts of climate and land use change in the metropolitan region. The Cool City Project aims for more applied policy-oriented research that incorporates the local knowledge of community residents to understand the costs and benefits of interventions in the built environment that might serve to mitigate the harmful impacts of climate change and variability, and protect urban populations from health stressors associated with summertime heat. Both types of research are potentially useful for understanding the impacts of environmental change at the urban scale, the policies needed to address these challenges, and to train scholars capable of collaborative approaches across the social and biophysical sciences.

Oral health and health care for older adults: a spatial approach for addressing disparities and planning services.

The purpose of this paper was to examine the geographic distribution of New York City adults aged 65 and older by race/ethnicity and poverty status. Also analyzed was seniors' access to dental care as defined by the location of dental providers and their proximity to the subway system lines in Manhattan and the Bronx. ArcGIS software was used to create a geographic information system (GIS) incorporating relevant data from a variety of sources. Individual and overlay maps were then produced to examine the aims of this analysis. Data showed that Black race, Hispanic ethnicity, and poverty status tend to co-occur spatially among seniors in Northern Manhattan and the South Bronx. Further, a spatial/transportation barrier may inhibit access to dental care for seniors who reside in these areas. By presenting multiple layers of local information juxtaposed, GIS can help provide directions for planning oral health service delivery for seniors.

Sorting out the connections between the built environment and health: a conceptual framework for navigating pathways and planning healthy cities.

The overarching goal of this article is to make explicit the multiple pathways through which the built environment may potentially affect health and well-being. The loss of close collaboration between urban planning and public health professionals that characterized the post-World War II era has limited the design and implementation of effective interventions and policies that might translate into improved health for urban populations. First, we present a conceptual model that developed out of previous research called Social Determinants of Health and Environmental Health Promotion. Second, we review empirical research from both the urban planning and public health literature regarding the health effects of housing and housing interventions. And third, we wrestle with key challenges in conducting sound scientific research on connections between the built environment and health, namely: (1) the necessity of dealing with the possible health consequences of myriad public and private sector activities; (2) the lack of valid and reliable indicators of the built environment to monitor the health effects of urban planning and policy decisions, especially with regard to land use mix; and (3) the growth of the "megalopolis" or "super urban region" that requires analysis of health effects across state lines and in circumscribed areas within multiple states. We contend that to plan for healthy cities, we need to reinvigorate the historic link between urban planning and public health, and thereby conduct informed science to better guide effective public policy.