Healthy Cities: your zip code influences your health more than your genetic code

Este artículo está también disponible en / This post is also available in: Spanish

A person’s zip code affects their life expectancy more than their own genetic code. We often relate chronic diseases to habits such as diet, lack of physical exercise, smoking or heredity. However, the factor that most influences health is the environment in which we live and circumstances such as poverty, lack of decent housing, overcrowding, environmental safety or exclusion or remoteness from basic services have a very negative impact on it.

The IDB’s Housing and Urban Development Division, through its Cities Laboratory, in its commitment to improve lives in Latin America and the Caribbean (LAC), produced a documentary to analyze the important relationship between urbanism and health. Sociologists, architects, epidemiologists, neurologists, housing experts and residents of informal neighborhoods participate in this interesting audiovisual document. Keep reading for some of the details of this short film, which addresses the urgency for all urban planning policies and interventions to integrate the health lens and continue to reinforce multi-sectoral interventions. How you build or improve housing, neighborhoods, or green spaces, how you connect different areas of the city or access public services effectively contributes to your life expectancy. Don’t miss it!

Where you live conditions your health status

What is the first thing that comes to mind when you think of health? Possibly, you visualize doctors, hospitals, and clinics. This happens because, implicitly, we believe that with more hospitals we will be healthier. However, many health specialists would tell you that health is just the opposite: not needing to go to a doctor.

There is evidence that shows how the environment is one of the main determinants of people’s health. This statement probably does not sound strange to you, as you may have experienced it yourself when visiting a small town surrounded by nature, with clean air, unprocessed food, no traffic, no pollution. On the contrary, some living conditions, such as noise, light and air pollution, among other variables, mean that living in cities, or in certain areas of cities, is associated with chronic non-transmissible diseases, such as cancer, diabetes, cardiovascular and pulmonary ailments.

Overcrowding is one of the factors affecting the health of people living in vulnerable neighborhoods.

Likewise, the spectrum of mental illnesses also tends to become more acute in cities. Critical factors in urban environments determine their presentation, prevalence, and progression. Diseases such as depression, anxiety or post-traumatic stress disorder are 49% more prevalent if you live in a city than in a rural area. Continuous exposure to noise not only decreases the ability to concentrate, but also has a long-term impact on health, causing insomnia, or even favoring the development of dementia and severe cognitive impairment in the long term.

This does not mean that living in a city is detrimental to health, but that there are certain environmental factors that condition our health. For example, did you know that it has been shown that life expectancy is longer depending on the area/neighborhood of the city where you live?

Our cities should be healthy spaces, regardless of our zip code

LAC is the most urban region on the planet, with almost 80% of its population living in cities. In addition, we are the most unequal region in the world (8 of the 20 most unequal countries are in LAC). The COVID-19 pandemic made these inequalities evident from a health perspective. The poorest and most segregated parts of the cities were the most infected and where more people died. This makes it clear that when we talk about health and cities, inequity is something to pay attention to and we must understand it as something that can be changed.

Inadequate water and sanitation infrastructure in vulnerable neighborhoods makes them hotbeds of disease.

The study of Urban Health in Latin America (SALURBAL) has studied almost 400 cities in 11 countries in the region, comparing health levels between cities with the aim of understanding why some cities are healthier than others or why some neighborhoods are healthier than others. The results are unequivocal, proving that inequality is a key determinant of health and health inequalities. The study shows that life expectancy in all the cities analyzed is higher in “rich” neighborhoods than in “poor” ones, for both men and women.

Inequity manifests itself in many ways in the urban environment, for example, in these aspects:

1. Levels of environmental, light and noise pollution.
2. Access to green spaces
3. Housing habitability conditions: drinking water, sanitation, ventilation, etc.
4. The safety of the environment
5. Access and quality of educational services
6. The levels of poverty and marginality of a neighborhood, something that even influences the possibilities of being hired for a job.
7. Access to and quality of medical care
8. The quality of the public transportation system (including last-mile transportation).

Would you like to know in detail how all these factors related, directly and indirectly, to urban planning affect health? If so, you should not miss the documentary prepared by the IDB Cities Lab.

How can we improve health in Latin American and Caribbean cities?

Health does not only depend on having good hospitals and clinics. In fact, major improvements in health are not about medical interventions, but about social and economic changes. All decisions made about urban development have a positive or negative impact on public health. Therefore, public policy must have a health lens.

To support urban planners in LAC in applying a health approach to their planning, in a future article we will explain how the IDB is facilitating the creation of diagnostic tools that will provide insight into the state of integration of health policies in urban planning in LAC cities. Until then, so as not to miss any updates on this topic, we recommend you follow us on our social networks, on LinkedIn, Facebook and Twitter, and sign up for our monthly newsletter. See you soon!

Text based on “Salud y Ciudad – Tu código postal importa más que tu código genético”, by Ana V. Diez-Roux, Kevin Martínez-Folgar, Alejandro Aravena, Carolina Piedrafita, Patricia Jara, Mario Orellana, César Sanabria, Agustín Ibañez, Guido Ledesma and Diego Medolla. Production and Direction: Paula Corzo.

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