Bloomberg Fellow Ivana Castellanos takes a wide view of health, and she’s grappling with big questions: How do we tackle health inequities rooted in the places where people live and work? How do we deal with the already dire and worsening impacts of climate change?
As a policy analyst for the American Public Health Association, she worked on tools meant to help communities boost active transportation like biking and walking. The tools not only help spread awareness of the value of these modes of transportation, but also highlight how they impact individual health, she says.
We sat down with Ivana, an MPH student at the Johns Hopkins Bloomberg School of Public Health, to talk about the built environment and how public health practitioners can play a bigger role in improving it.
What is one of the largest problems you see in how we approach the built environment? How would you suggest we tackle it?
I think one of the biggest challenges is health inequities in the built environment, such as limited access to safe places to walk and play, lack of clean air, or the inequitable burden from toxic sites. Whether those inequities are related to aging infrastructure or lack of climate preparedness, we need to know how to address them. For many years public health has been siloed from transportation and planning agencies. Finding ways for these sectors to collaborate would be a huge help in addressing inequities.
We need to be thinking about ways to make sure urban environments broaden their priorities beyond motor vehicles to include safe infrastructure for biking and walking. At the same time we need to invest in public transit systems and address inequities in people’s ability to get to their jobs and to essential services, like health care. I think these steps will be particularly important as climate impacts increase because we’ll want to rely less on fossil fuels. If we don’t build our environments now in a way that prepares communities to transition away from fossil fuels, the people who will lose greater access to ways of moving around will be the people who already experience health inequities.
What do you see for the future of your field and what do you see as your role in that work?
The built environment impacts so many things, including housing, roads and transit. There are so many different agencies that are responsible for and work on these issues, so there are a lot of opportunities to collaborate and really have a bigger impact than each individual agency working on its own. Bringing together all the knowledge and expertise across sectors is the only way to make the shifts that are necessary, in the context of a changing climate, to address health inequities that exist in cities today.
How do you think public health helps other sectors think about the built environment in a different way?
Say you were considering where to place a public transit stop or line. The department of transportation or the public transit department would check out how the potential line connects to the rest of the system and if it disrupts other road patterns. From the public health perspective, we’d want to place the public transit stop where it could address health inequities by connecting people to economic opportunities or other critical services.
One of the strengths of public health, in my opinion, is often its ability to work with communities and get input from them on where they think infrastructure would work best and where it would be most helpful. For example, if a public transit line was being considered for one place, but it’s not in an area that anyone in the community would feel comfortable walking to and no one would go there, then it’s a missed opportunity. Public health can help other sectors think about the other aspects that would need to be wrapped into a project to make it a success and address inequities.