摘要：Mounting evidence suggests physical and mental health problems relate to the built environment, including human-modified places such as homes, schools, workplaces, parks, industrial areas, farms, roads and highways. The public health relevance of the built environment requires examination. Preliminary research demonstrates the health benefits of sustainable communities. However, the impact of mediating and moderating factors within the built environment on health must be explored further. Given the complexity of the built environment, understanding its influence on human health requires a community-based, multilevel, interdisciplinary research approach. The authors offer recommendations, based upon a recent conference sponsored by the National Institute of Environmental Health Sciences (NIEHS), for research and policy approaches, and suggest interagency research alliances for greater public health impact. THE BUILT ENVIRONMENT— human-modified places such as homes, schools, workplaces, parks, industrial areas, farms, roads and highways—is our most important habitat, since 80% of North Americans live in towns and cities and spend 90% of their time indoors. 1 To date, much discussion of the built environment has focused on the challenges of providing adequate transportation (roads, highways, infrastructure, public transportation), urban sprawl, air pollution due to increased traffic, the lack of sidewalks, and the diminishing natural environment. New evidence, however, increasingly recognizes that even the places we live and work clearly affect our health. 2 Nevertheless, causal relationships between the built environment and specific human illnesses are often difficult to ascertain. 3 Recent research explores the effect of improved built environments on physical activity, 4 asthma, 5 obesity, 6 cardiovascular disease, lung cancer mortality, 7 and mental health. 8, 9 However, a pressing need remains for more concerted research to identify mechanisms by which the built environment adversely and positively impacts health and to develop appropriate interventions to reduce or eliminate harmful health effects. The growing health burden and attendant economic costs associated with higher chronic disease incidence (e.g., obesity, asthma, cardiovascular disease, cancer) require such research efforts. These complex diseases are attributable to an interaction of genetic and environmental influences, and many of the latter can be directly connected to the built environment. While research has focused on the negative public health consequences of the built environment, there has been very limited focus on the benefits of living in sustainable communities. A research agenda on the public health and quality-of-life benefits of sustainable communities is necessary.
