2024 ULI Carolinas Meeting: How the Built Environment Impacts Health and Equity in Our Communities

A general session at the ULI Carolinas Meeting, moderated by Risa Wilkerson of Healthy Places by Design, showcased how the convergence of the built environment, health, and equity forms a complex web that impacts every facet of human life. Dr. Malo Andrew Hutson, a distinguished academic at the University of Virginia’s School of Architecture, provided a deep dive into how residential segregation and the built environment contribute to health disparities. Through his lecture, Hutson underscored the necessity of interdisciplinary collaboration to tackle the challenges posed by fragmentation within communities.

Hutson presented a comprehensive model detailing the factors affecting health, which include not only genetics but also social and economic policies, institutions, neighborhood conditions, living standards, social relationships, and individual risk factors. He made it clear that while genetics plays a role, it’s only a fraction of the equation, with a large portion of health outcomes being determined by the environment and social conditions.

Hutson drew on his experiences while teaching at the University of California, Berkeley, where he observed firsthand the impact of environmental neglect on health. In Richmond, California, children played in streams contaminated by a nearby petroleum plant, a stark illustration of the health risks prevalent in disadvantaged communities. These observations raised critical questions about the social determinants of health and the varied nature of their effects across different communities.

The discussion pivoted to the concept of health equity, which Hutson defined as the attainment of the highest level of health for all people, emphasizing the necessity for full and equal access to opportunities that enable individuals to lead healthy lives. However, achieving this is not without its challenges, as he illustrated through the story of a proposed central kitchen/urban farm education center that met neighborhood opposition. The project’s failure to engage with the community members about their concerns exemplified a broader issue within urban planning: the importance of involving those who are most affected by such projects.

Mitchell Silver, a renowned urban planner and principal at McAdams ASLA, transitioned the focus from planning to parks, an area that has a more visceral connection with community members. He referenced an influential book, Making Healthy Places, which provided valuable insights into designing spaces for overall well-being, highlighting the importance of physical and mental health.

Silver detailed initiatives from his time as Parks Commissioner of New York City, which aimed to ensure that all citizens, regardless of age, could lead active and healthy lives. The Community Parks Initiative, Parks without Borders, and Play Streets were pivotal in this regard, focusing on enhancing the quality and accessibility of parks and recreational spaces.

DEIA—Diversity, Equity, Inclusion, and Accessibility—was a significant theme in Silver’s narrative. He clarified the meanings of these terms and applied them to his urban planning work. For Silver, equity was particularly challenging to implement as it called for fairness and justice in an environment where historical injustices had often skewed resource distribution. His tenure as commissioner was marked by a commitment to evaluating both the proximity and quality of parks, leading to substantial improvements in underinvested areas of the city.

Risa Wilkerson, acting as the moderator and executive director of Healthy Places by Design, expanded the conversation to include social determinants of health from a global perspective. She shared narratives from Buffalo Bayou in Houston and an informal settlement in Chile, showing how community priorities can diverge significantly from planners’ intentions. These examples illustrated the need for planners and developers to engage with communities genuinely to understand and address their specific needs.

The session also explored the role of teenagers, particularly teenage girls, who are often neglected in park design. Projects in Columbus demonstrated how altering the physical landscape to improve sightlines and organizing female-friendly events could create more inclusive spaces.

The presenters did not shy away from discussing the less tangible aspects of planning, such as the role of public art in fostering community identity and belonging. Silver’s experiences in New York City highlighted the economic value of parks and the transformative power of public/private partnerships in urban development.

The symposium concluded with a call to action for urban planners and developers to conduct equity audits, engage with communities authentically, and facilitate policy changes that address systemic issues such as homelessness and gentrification. Silver always makes sure to clarify what community members mean by “gentrification” when they complain about it because it can mean different things to different people, so he prefers using the term “displacement.”

The speakers collectively emphasized the need for a multifaceted approach to urban development that prioritizes community resilience, personal health, and the creation of spaces that encourage social interaction and connection with nature. The challenge ahead is vast but essential for building environments that foster health and equity for all.

The dialogue concluded with a Q&A session, where the audience engaged with the speakers on topics ranging from public-private partnerships in urban park development to addressing economic mobility and equity through urban planning initiatives. The speakers encouraged conducting equity audits to understand disparities and the value of community engagement in enhancing project outcomes. When going into community sessions, they encouraged hard questions early in the process to get them out of the way, and if there was systemic disenfranchisement, to apologize and seek remedy for past wrongs, even if the developer was not involved. Then just listen. If a team is not able to budget for community needs or wants, then it might be better to not engage any further, rather than risk appearing disingenuous.

They also discussed the role of art in urban spaces, its contribution to cultural identity, and its ability to bring people together, thereby enhancing social cohesion and well-being.

Overall, the session captured a multifaceted conversation on how urban environments can be designed and managed to promote health, equity and a sense of belonging among all residents, highlighting the integral role of community engagement and empathetic planning in achieving these goals