The Built Environment as a Determinant of Health

This chapter has a focus on the influence of upstream, macro level approaches to addressing human health conditions as well as midstream, intermediate levels of action.
We begin in the first half of this chapter by reviewing current research about diseases that are closely related to the built environment, including chronic diseases such as cardiovascular disease and diabetes. We then consider some macro level approaches used by governments to ameliorate the adverse environmental and health impacts of modern living in urban settings such as the use and influence of town planning instruments, urban design policies and building regulations. Using a case study of designing suburbs for human movement, we examine how these macro level influences can be applied to make urban environments sites for promoting human health and well being.
We use the second half of this chapter to hone in on the relationship between people’s health and the most common single element of urban development to which we are all exposed – the house. In the context of this chapter we consider the house as an intermediate level ‘health enabling’ or ‘health debilitating’ artefact. Whilst we acknowledge that the poor health and housing statistics for Indigenous Australians is influenced strongly by a host of related upstream factors (such as access to health care, employment and education opportunities), we use the topic of Indigenous housing to illustrate the very immediate and potentially health compromising nature of the household. In so doing we position housing as an influential midstream factor that has a daily impact on people’s health.