community

Wellness Wednesday: The Importance of Neighborhood

Right now I am in the middle of something big with my neighborhood. We are rallying and banding together to prevent the development of a huge water bottling plant in our agricultural and research oriented riverside neighborhood. Yeah, I know ! Outrageous isn’t it ? More on that later. 

I am learning what good people I have around me. I have truly been blessed. My neighbors are educated, considerate, flexible, and well spoken. They are from old to young. They come from a variety of economic and social backgrounds. They have a wide range of politics. But one thing’s for sure, we have some shared values. Those include feelings of stewardship for good soil and our pristine aquifer. 

It goes deeper. I have a sense of having a neighborhood of people who would help me if I had a flat tire. I have seen random busy people stop their cars to help shoo someone’s cows back into a pasture. I would never worry about my kids walking to school. But not everyone has these types of advantages. 

A Rand foundation report called “ Neighborhoods and Health”  indicates the following:

“ Just as conditions within our homes have important implications for our health, conditions in the neighborhoods surrounding our homes can have major health effects. Social and economic features of neighborhoods have been linked with mortality, general health status, disability, birth outcomes, chronic conditions, health behaviors and other risk factors for chronic disease as well as with mental health, injuries, violence and other important health indicators."

reference:

http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2011/rwjf70450

Did you know, for example, that heath habits or disease habits are contagious ? That’s right, things like obesity, smoking, or on the other side, jogging and gardening are contagious too ? Neighborhoods can influence health in this way. 

Even the physical layout of a neighborhood can have its effects. Are there sidewalks, playgrounds and good lights ? A “ bad neighborhood” where it is not safe to walk or play outside severely constrains people’s ability to be active. It keeps people inside with the shades drawn, and bad behaviors like drinking can potentially go unchecked because there is no social accountability.  Such a lonely hostile environment greatly contributes to people’s stress, and of course stress truly contributes to many disease processes. 

Green spaces in neighborhoods turn out to be especially important. These serve as places to congregate and places to play. They also expose people to nature in places where it may be scarce, and research tells us that exposure to nature is beneficial to health in specific measurable ways. Please see my 2015 post on Nature and Health HERE. I remember being delighted with the particulars of what I unearthed when I did the research for this post. 

Here is a strange, wondrous and reproducible statistic:

An increase of ten additional trees on a city block on average, increases self reported health equivalent to a $10,000 annual increase in income or being 7 years younger. That’s right, adding ten trees to your block will add seven years to your life, at least from your perspective. The health they are talking about here is “cardiometabolic conditions” such as heart disease and diabetes. Several studies have tried to determine how this works. It seems to start by getting people outside, more active, with lower stress and lower blood pressure. More green space also seems to help reduce aggression and crime. 

What about the food environment of a neighborhood ? Is there local food ? Is food grown and sold ? Are there bars, grocery stores or convenience stores ? There is such a thing as a “ food desert” and I don’t mean dessert. A food desert is place which has nowhere to easily get healthy affordable food. The food environment has a huge obvious effect on food choices and health. 

Have you ever heard of a Ciclovia ? A Ciclovia is a open street programs that closes major roads to motor vehicles so they can be used exclusively by bicyclists and pedestrians. Ciclovias are being studied in large urban centers like Los Angeles in an effort to increase physical activity and sense of community in urban areas. 

What about sense of community ? What does that do ? This goes back to my original description of our neighborhood. It involves trust. There is trust and accountability in the continuity of these neighborhood relationships. Dan Beuttner, in his book Blue Zones, speaks of the decade-spanning friend groups of Japanese women, the “ moai” and their role in promoting the extreme healthy longevity of these women. The trust and connection of these long relationships provide a basis for the best things in life, such as celebration. 

These neighborhood relationships also uphold us when the going gets tough. I can remember nearly 27 years ago, I was between med school and residency, when I was pregnant with Forest. I had preterm labor and was put on bedrest. I was living in this same rural neighborhood, but in a tiny aging cottage which has since been torn down. I had a four year old, and my husband worked long days. Neighbors I barely knew, from newly married young women to aging matriarchs arrived with casseroles and pies. When it snowed, the drive just got plowed. These people became friends, and some have since passed. But their kindness left a permanent mark. 

In my search of Pub Med, which is the US National Library of Medicine at the National Institutes of Health, I found a fairly recent article stating “ The study of neighborhood health effects has grown exponentially over the past 15 years. “ Do not think for a minute that this is not real science nor that there are not real monetary and human resources being devoted to it. 

Neighborhoods affect the physical and mental health of their constituents. One study from the Archives of Psychiatry introduced me to some useful terminology as they highlighted the effects of neighborhoods on health. “ Concentrated disadvantage” was strongly associated with mental health problems for children. On the other hand, collective efficacy (the ability of neighbors to work together) and organizational participation mediated the effects of concentrated disadvantage on the effects of children. 

My neighborhood is demonstrating collective efficacy and organizational participation at its best. We have got our Facebook and Twitter pages for our cause and a great many of us plan to show up at the County Commissioners’ Office  to register our thoughts on the matter. I anticipate the group will bring some scientific and oratorial firepower to bear. 

It turns out that bad neighborhood environments generate their own vicious cycle and good neighborhood environments generate an even stronger virtuous cycle. Understanding this dynamic gives people a handle on how to make things better, no matter where they are starting from. 

How do you make things better ? Twenty two years ago I purchased an unconventional poster to decorate my office. It was shrink-wrapped, and backed in cardboard. When my practice got going, we had it framed and glassed. I still see its message every day. It is by an artist named Karen Kerney, and I will share it with you through an Amazon link. It is titled, “ How to Build Community”. It is for everyone who does not yet have a nice neighborhood to live in. It was ahead of its time. The folk wisdom it contained has now been largely validated by the science on neighborhoods and health.  I hope you enjoy it. 

Structure Sunday: The Structure of Friendship

Tonight I had dinner with a friend I have known since early high school, about 40 years ago. I love the the idea that we have been friends that long. I actually don’t like the idea of ever losing any of my friends, regardless of time or distance. And there has been a great deal of time and distance between me and most of my friends. Nonetheless, I think old friendships hold the world together. 

This friend took the initiative to keep in touch. We went to the same small high school and left there in 1977 and 1979 respectively.  Our high school was an intense, supportive and inspiring place, and as a group, we departed there meaning to do good in the world. He and I went off to separate colleges a continent away, and went about marrying, having kids, going to school, school, and more school. I became a physician and he became a researcher for the World Health Organization, among other things. 

After Facebook reunited many people, he decided it would be nice to visit. And so he did, especially since I live in eminently visit worthy place. Of course, truth is stranger than fiction, so during his visit, he naturally he fell right in love with my wonderful neighbor and returned later to stay many months with her. Eventually they parted ways as friends and he still visits to this day. 

So tonight I had my good neighbor and my old friend over for dinner since he is visiting. It was such a treat since I also invited my niece and nephew over as well so they could meet my old friend. For you see, my friend did go out and do good in the world, and I wanted to share it with these kids. 

He recently finished his residency in Anesthesia, as he decided later in life to become a doctor. At the end of his residency, the Ebola outbreak began, so he departed for Sierra Leone, one of the hardest hit areas, to help. He spent six weeks there, and at tonight’s table, he told us about all we wanted to know and more, from the percentages that lived, to the special suits he wore, to his American co-worker who contracted the disease and lived. I was so pleased that he could share all this, especially with the kids present. It not only tied us together, it tied us together with all the Ebola fighters, and even put us degrees closer to the Ebola patients themselves, and helped us understand their humanity in a near first hand way. Best of all, he told us about the preliminary announcement from about three weeks ago, that an effective Ebola vaccine is on the horizon. 

So as the night wore on, and the topic of Ebola played itself out, we realized that my nephew plans to travel to just the area of Italy where my old friends and my neighbor have visited: Venice. So I was the happy recipient of colorful descriptions of Venice. My nephew was given numerous recommendations about places to visit, things to do, and travel strategies to use. I got to listen to exuberant descriptions and enthralled questions about this place, which at this point, to me, is nearly mythical, yet now more real. 

So because of this long friendship, tonight, at my own table, I traveled from darkest Africa to brightest Venice. We were able to appreciate each far flung place as the real place that it is, and understand that hope blooms in both. We renewed bonds, and shared all this with the younger generation. 

Are your friendships in good shape ? They are so important to our collective well being, that I suggest having a look.