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NCHPAD - Building Healthy Inclusive Communities

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Environmental Disability


Image of a Chinese restaurant’s sign “Buffet King”
Image of a Chinese restaurant’s sign “Buffet King” 
There is an old saying: The way you make your bed is the way you sleep in it. That may be true to some extent, but there is another twist to that saying that greatly affects our health: the way your environment is structured is the way your health will go. What this means in the simplest of terms is that an environment filled with inaccessible building structures, streets, sidewalks, and stores, and one that is devoid of good role models, will spawn poor health habits among its residents. People generally role play others in their community - smokers breed smokers, inactive people breed more inactive people, and poor eating habits reinforce others to do the same. It's easy to justify engaging in poor health behaviors when much of the community is engaging in those same behaviors. On the flip side, people who live in communities with safe sidewalks and nice landscapes, a low crime rate, friendly neighbors, grocery stores that sell fresh fruits and vegetables, clean and safe parks, smoke-free homes and workplaces, and inexpensive exercise facilities, are much more likely to have better health and a higher quality of life.

People who cannot afford to live in healthy environments often have no choice but to reside in settings where there are often no sidewalks or safe streets to roll, stroll, or bike; the landscape is bare and lacking greenery; and the only stores in close proximity are small gas stations with 24-hour food marts that sell packaged and canned products laden with sugar, salt, or fat. The main intersection is often cluttered with fast-food restaurants -- one on top of the other - with specials in neon signs advertising Super Meals for a few bucks. An unsupportive medical system forces residents to wait several hours to refill a medication or to see a doctor, and rarely is there a discussion about doing something besides taking medication to improve health. Any hope or interest in changing certain behaviors is met with a barrage of micro-, meso- and macro-barriers that make even the most determined and health-conscious person feel like he/she is climbing Mt. Everest.

A fair amount of disability is often born from an environment that lacks role models and supporting networks and systems that give people the opportunity to practice good health behaviors. Ask a mother of four to maximize food resources on $15 per day and odds are she'll return with two armfuls of fast food, knowing that she must purchase the most calories for the dollar for her young progeny. In most fast-food restaurants, $15 will buy you a lot more that what you can get in the local fruit/vegetable section of a grocery store. Sure, there are other things that can be purchased in grocery stores that are less expensive, but the "good" foods such as high-fiber breads and fresh juice are more expensive than "white" breads and frozen or combined juice/sugar drinks.

Environmental disability is caused by multiple factors that result in the inability of people to engage in healthy behaviors. While there are things that can be done by communities to foster healthy environments, policymakers and the food industry must take the lead in creating and rewarding communities that support the health of its citizens.


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