Community assessment: Understanding the built environment within a neighborhood health context

Purpose: Research shows evidence of associations between the built environment (BE)—housing, commercial buildings, community resources, and infrastructure—and health outcomes. However, there is less research describing the spatial variation of BE conditions. The Community Assessment Project (CAP) demonstrates the impact of this variation with a database describing the BE within a neighborhood health context.

Hypothesis: The hypothesis tested by CAP is two-fold: 1) the assessment tool enables the quantification of BE conditions, and 2) the data generated offer a comprehensive index for relating the BE to public health.

Methods: Trained assessors canvassed 17,242 tax parcels in Central Durham, NC using a standardized visual assessment of 40 distinct BE variables. Data were summed into 8 indices—housing damage, property damage, security level, tenure, vacancy, crime incidents, amenities, and nuisances. Census blocks were assigned an index based on the summary score of primarily and secondarily adjacent blocks.

Results: The indices describe the spatial distribution of both community assets and BE conditions that are likely to affect the health of residents. Housing damage, property damage, security level, vacancy, crime incidents, and nuisances all contained higher scores for blocks located in areas characterized by high minority and low socioeconomic status. Similarly, a low tenure score described those same blocks, indicating that the majority of residential properties within those blocks are renter-occupied.

Conclusions: The CAP assessment tool offers a comprehensive inventory of the BE, facilitating the generation of indices measuring neighborhood health. These resulting data are useful to community members, researchers, and government leaders.