On SAGE Insight: Health Dynamics in the Built Environment: An Urban Intensity Perspective


Article title: Health Dynamics in the Built Environment: An Urban Intensity Perspective – An Exploratory Study in Trinidad and Tobago

From Environmental Health Insights

The built environment is inextricably linked to the health and well-being of its inhabitants, shaping patterns of health through both direct and indirect pathways. It is regarded as one of the most defining outputs of urbanisation, the global proliferation of which has resulted in health dynamics in the built environment emerging as a critical area for research and policy making. The impacts of the built environment on health are complex. Building and infrastructure design, transportation modes, land-use patterns, and physical environmental quality are the main factors which can directly contribute to critical urban health issues, inclusive of obesity, associated chronic disease conditions, infectious diseases, depression, and cardiovascular and musculoskeletal diseases.

The statistically validated Urban Intensity Index (UII) is built systematically from a logical sequence of steps from physical data on the built environment of 581 communities in Trinidad and Tobago. These steps start with reduction of the number of potential variables, selected from the original dataset, to a smaller set of key relatively discriminating characteristics. The most applicable of these are extracted by exploratory factor analysis (EFA) from this reduced variable set as a group of orthogonal latent multivariate factors, which represent the different dimensions of urban intensity. 

The survey used in this research was administered online for a period of 6 months. It targeted residents of Trinidad and Tobago. Using multiple modes, such as email invitations, social media posts, and posts on the University of Trinidad and Tobago’s website, Data from the survey were obtained for 561 participants who resided in various communities within all 14 regional corporations and municipalities in Trinidad and communities in Tobago. This study makes a significant contribution to expanding the limited knowledge base of the impacts of urbanisation on health and environmental quality concerns in Trinidad and Tobago. The study is novel in its approach by its utilisation of perception data. National health statistics and physical environmental data alone do not provide a comprehensive picture of the quality, access to, and trends of these services. Perception data better reflect the attitudes and ways individuals internalise their environmental quality and health care access. Ultimately, the outputs of this study can potentially support efforts to diminish the gap between rhetoric and reality, through provision of critical information for policy and decision making, as the global development agenda moves towards evidence-based policy making.

Abstract

The built environment encompasses the physical components of the environment, inclusive of infrastructure, households, buildings, streets, and open spaces, within which individuals reside and carry out their daily activities. It affects both indirectly and directly on the outdoor and indoor physical environment as well as the socio-economic environment. The elements which comprise the built environment and those of the physical and socio-economic environments, which are affected by it, are recognised as key determinants of health. In this study, health dynamics in the built environment are explored along the urban-rural gradient in Trinidad and Tobago. The gradient is measured by a statistically validated Urban Intensity Index developed previously, using physical data from the built environment. Published physical health data from National Surveys as well as data collected on perceptions of health care access and environmental quality are utilised in conjunction with the Urban Intensity Index values to model chronic illness. Multivariate statistical analysis and maps are used to explore and illustrate these dynamics. Ultimately, the outputs of this study can potentially support efforts to diminish the gap between rhetoric and reality, through provision of critical information for policy and decision making, as the global development agenda moves towards evidence-based policy making.

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Article details
Health Dynamics in the Built Environment: An Urban Intensity Perspective – An Exploratory Study in Trinidad and Tobago
Samantha Chadee, Valerie Stoute
First Published November 29, 2018 Research Article
DOI: 10.1177/1178630218811342
Environmental Health Insights


     
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