The Gillings School researches how the built environment impacts health, focusing on microbial control, physical activity, access to health care and more.
When public health researchers talk about the built environment, they are referring to all human-made structures that create the environment we live in. Homes, schools, workplaces, grocery stores, restaurants, hospitals and more come together to create the environment in which we live out our days, and they have an enormous impact on human health.
Researchers at the Gillings School approach this work from many different angles.
One example is the Gillings School’s collaboration with Duke University, North Carolina State University, N.C. A&T University and UNC-Charlotte to lead the Precision Microbiome Engineering, or PreMiEr, research center. PreMiEr studies the microbiome – or community of organisms that live within a given environment – of the entire built environment. It originated during the COVID-19 pandemic and was created to gain a better understanding of how different types of buildings and building operations affected the spread of microbes, and thus diseases.
Professors Joe Brown, PhD, PE, and Barbara Turpin, PhD, both in the Department of Environmental Sciences and Engineering, represent the Gillings School at PreMiEr. Brown’s research evaluates how to prevent the spread of microbes in indoor spaces, particularly in homes, hospitals, workspaces and other large spaces where people congregate and where infection has a high chance of spreading.
“PreMiEr is studying both conventional and new methods of microbial control in built environments.”
– Joe Brown
“PreMiEr is studying both conventional and new methods of microbial control in built environments, and this work requires that we understand the roles that HVAC, plumbing and other aspects of construction play in a building’s ecosystem,” said Brown. “We’re looking at things like how to improve ventilation to reduce airborne pathogens or how to prevent the spread of harmful bacteria on surfaces in hospitals. We believe that this work will be increasingly important in the future, because killing these microbes is going to become even more difficult with worsening antibiotic and antimicrobial resistance.”
Killing these microbes is going to become even more difficult with worsening antibiotic and antimicrobial resistance.
The built environment also has an enormous impact on a person’s daily physical activity levels. Those who live in high-traffic areas with poor street connectivity and without a good sidewalk system are far less likely to bicycle or walk to work or other locations they frequent. And if a person’s home is not near a high-quality park, they are far less likely to regularly take their children to play at the park.
Natalicio Serrano, PhD, assistant professor in the Department of Health Behavior, studies how environmental and policy strategies related to the built environment can increase physical activity and improve health. In many communities in N.C. and throughout the U.S., driving is the only safe and reliable transportation option, which promotes sedentary behavior and raises the risk of many chronic diseases.
“I’m looking at how we can address this by improving land use design and zoning policies, such as bringing in more mixed-use development, facilitating better street connectivity and improving sidewalk access,” said Serrano. “But I’m also studying how we can improve the built environment in a way that doesn’t harm the people who are already living in an area. Making neighborhoods safer and more accessible also makes them more desirable and increases housing costs, so it’s important that as we change land use policies, we do so in a way that provides affordable housing provisions to protect the people who are living in that community.”
Kelly Evenson, PhD, professor in the Department of Epidemiology, also studies the impact of the built environment on physical activity, with a special focus on walking and bicycling.
She encourages local leaders to try short-term modifications in their communities and learn what works best. For instance, during the pandemic there was a greater need for outdoor restaurant seating in downtown locations, so parking lanes were roped off to extend outdoor seating. Similar modifications can be tested out on roads, temporarily adding walking and cycling lanes, and the use of those modified lanes can be measured to assess if the changes actually increase walking and bicycling in a community.
“It can feel overwhelming to think about how we improve our built environments to foster better health, especially when dealing with things like existing road networks. But there are short-term changes we can try and then measure to assess if they improve outcomes or not,” said Evenson. “Small changes to the built environment can make a big difference, and it’s worth it to create healthier environments in the future. We don’t have to be stuck with the same unhealthy environments repeating over and over.”
Other examples of Gillings School research in this area include the work of Leah Frerichs, PhD, associate professor, and Arrianna Marie Planey, PhD, assistant professor, both in the Department of Health Policy and Management. Frerichs studies how physical environments influence youth health behaviors in underserved communities, while Planey studies how the built environment affects access to and utilization of health care. The list of how the built environment affects public health goes on and on, so it will remain an important area of focus as Gillings School researchers seek to make daily life healthier and better for all people.
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