Built Environment: A Framework for Evaluation

We propose a framework for evaluating the built environment, and programs and policies to shape it, which uses the domains of health, equity, and sustainability. Health includes both mental and physical health, and is more than the absence of disease. Equity refers to the extent to which a feature, program or policy impacts one group more than another, perpetuates existing injustices, or contributes to the reduction of disparities. Sustainability examines a feature's current environmental impacts and whether future burdens result from current activities or if a feature's benefits are durable. Ignoring any of these domains can have serious implications even if a program or policy has a health-promoting effect (narrowly assessed). For example, an internal bike/walking path in a gated community may promote physical activity. But it may also reduce the support for facilities outside that community or reduce the feasibility of walking and biking (if it is not connected to a regional or neighborhood network) in the surrounding area - equity issues. It may also negatively affect storm water runoff if it results in the paving of critical open spaces - a sustainability problem. This framework connects built environment and health research to social justice concerns and the environmental sustainability movement. It can inform Health Impact Assessment and is useful for policy makers, communities, and health advocates. This presentation presents an overview of this evaluation framework, connects it to other similar work, and provides examples of how it can be used.