Optimizing Health: Understanding and Managing the Key Environmental Factors Impacting Your Well-being

Health and well-being are influenced by a complex interplay of factors.

While genetics and individual behaviors play a role, emerging research highlights that health is also profoundly shaped by the environments in which we live, work, study, pray, and play.

Environments can either support or hinder health and quality of life.

This article explores evidence-based insights on how key environmental factors impact well-being and provides recommendations on optimizing environments to enhance health.

Poor air quality and visibility at Toronto Downtown due to Quebec burning wildfires.

Defining Health, Well-being & Environmental Influences

The World Health Organization (WHO) defines health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" [1].

Well-being is a broader concept reflecting optimal psychological, social, and physical functioning [2].

There is growing recognition that health and well-being are interdependent - good health supports well-being, and positive well-being reinforces health [3].

Environments refer to the physical, social, economic, and political conditions in which people are born, live, work, play, and age [4].

These environments shape health through multiple pathways. For instance, physical environments impact factors like air quality, while social environments influence social connection.

Environments also impact access to basic needs like nutrition, education, housing, and healthcare.

The Expanding Evidence on Environmental Impacts

Traditionally, health promotion focused narrowly on individual behavioral factors like diet, exercise, and smoking. However, research increasingly shows that environments exert a powerful influence.

According to the study 'County Health Rankings: Relationships Between Determinant Factors and Health Outcomes,' socioeconomic factors were found to have the greatest impact on health outcomes, accounting for 47% of the variation in health outcomes.

Health behaviors, such as smoking and physical activity, accounted for 34% of the variation in health outcomes.

Clinical care, such as access to preventive care and treatment for chronic diseases, contributed 16% to the variation in health outcomes, while the physical environment, encompassing factors like air quality and access to healthy food, played a smaller role, accounting for just 3% of the variation [5].

Other research also underscores the importance of enhancing environments like neighborhoods, schools, and workplaces, which yields significant health improvements that often exceed the impacts of individual behavior change efforts [6].

These findings illuminate the need to broaden health promotion strategies beyond individual behavioral approaches to multilevel interventions that also transform social and physical environments.

This 'ecological' perspective is now widely embraced in public health [7].

Key Environmental Domains Impacting Health

Many environmental factors influence well-being. Here we explore several high-impact domains.

Physical Environments

Physical environments - the natural and built settings where people live, work, study, and play - have profound health effects.

For instance, environmental exposures like air pollution, toxic substances, and temperature extremes directly impact physiological health [8].

The built environment also matters. Neighborhood design features like parks, sidewalks, and bike lanes can encourage physical activity [9].

Accessible public transit enhances mobility for non-drivers. Safe green spaces and social meeting places can reduce stress and isolation [10].

Housing also matters. Substandard housing puts occupants at risk of illnesses like lead poisoning or asthma [11].

Access to healthy affordable food impacts nutrition [12].

Community design should optimize health-promoting amenities like recreation facilities, and limit harmful exposures like pollution and noise.

Social Environments

The social climate of environments significantly influences well-being. Key aspects include [13]:

Social inclusion - environments that promote belongingness and value diversity have beneficial health effects. Discrimination and stigma take a toll on health.
Social capital - places that foster positive social connections, trust and reciprocity enhance community resilience and wellness.
Safety - environments that promote security and limit violence create conditions for individuals and communities to flourish.
Participation - settings that encourage civic engagement, collective action, and democratic processes boost health and empowerment.

In short, nurturing environments where all people feel welcomed, connected, secure, and involved maximize health benefits.

Economic Environments

Economic environments shape access to health-promoting resources like education, healthcare, nutrition, and housing.

For example, research shows that higher national wealth (GDP) is linked to longer life expectancy [14].

However, the relationship is complex - economic growth alone does not ensure health equity. While affluence may enhance access to health-promoting goods and services, it does not guarantee their equitable distribution.

Wealth must therefore be coupled with strategies that allocate resources in ways that meet the needs of all community members, especially those experiencing socioeconomic disadvantage.

This requires addressing the root causes of inequities like poverty, racism, and gender discrimination that restrict opportunities for health.

Information Environments

The modern information ecosystem - encompassing traditional media, digital, and social media - is an integral health determinant. Media influences knowledge, attitudes, and social norms around health behaviors [15].

Unfortunately, misinformation also spreads readily, underscoring the need for health literacy initiatives.

Digital spaces can harm well-being through cyberbullying, predatory behavior, and addictive technologies that displace sleep and physical activity [16].

However thoughtfully designed technologies like telemedicine and social media support groups can also enhance access to care and social connection.

Optimizing information environments requires minimizing risks and maximizing benefits.

FORT LAUDERDALE, FLORIDA - Lots of people enjoy walking and biking on the brick walkway at Riverwalk Park, downtown.

Recommendations for Environmental Improvements

Creating health-promoting environments requires participation across sectors and settings. Here are some evidence-based strategies [17]:

Physical Environments

Improve neighborhood walkability through sidewalks, trails, and pedestrian safety measures.
Expand public transit access and affordable active transport options like bike share programs.
Limit environmental hazards through policies to reduce air pollution, water contamination, and toxic exposures.
Ensure adequate availability of parks, recreation facilities, and affordable healthy food outlets.
Create zoning policies that situate residents within easy reach of health-promoting amenities.
Implement housing policies to eradicate lead paint, asthma triggers, and other home hazards.

Social Environments

Cultivate organizational cultures that foster diversity, equity, inclusion, and a sense of belonging.
Promote community cohesion and social capital through initiatives like participatory neighborhood improvement planning.
Reduce exposure to violence through tailored prevention strategies and mental health support.
Create citizen advisory boards to encourage democratic participation in local decision-making.
Provide accessible gathering spaces to facilitate social connection.

Economic Environments

Address concentrated poverty through targeted investments in equitable education, living wages, affordable housing, and social services.
Ensure universal healthcare through reforms that make care comprehensively accessible and affordable for all.
Implement place-based initiatives to build community wealth and regenerate disadvantaged neighborhoods.
Use social impact investing and purchasing policies that direct resources into health-promoting community goods and services.

Information Environments

Prioritize health literacy through public education on media analysis skills and health resources.
Partner with media organizations to disseminate evidence-based health information.
Implement telehealth and mobile health innovations to increase healthcare access.
Enact policies to improve technology safety, privacy, and prevention of digital threats.
Provide resources to increase digital access along with skills to use technologies in health-promoting ways.

The Road Ahead

Achieving equitable improvements in population health and well-being requires broadening strategies beyond individual interventions to transform the environments that shape life circumstances and opportunities.

This ecological approach - coordinated through multisector partnerships - is critical for creating the conditions that allow all people and communities to flourish.

References

[1] World Health Organization. Preamble to the Constitution of the World Health Organization. 1946. https://www.who.int/about/governance/constitution

[2] Dodge R, Daly AP, Huyton J, Sanders LD. The challenge of defining wellbeing. International Journal of Wellbeing. 2012;2(3):222-235. doi:10.5502/ijw.v2.i3.4

[3] Great Britain Department of Health. Compendium of factsheets: wellbeing across the life course; the relationship between wellbeing and health. 2014. https://www.gov.uk/government/publications/wellbeing-and-health-policy

[4] World Health Organization. Social determinants of health. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1

[5] Hood, Carlyn M., et al. "County Health Rankings: Relationships Between Determinant Factors and Health Outcomes." American Journal of Preventive Medicine, vol. 50, no. 2, 2016, pp. 129-135. ISSN 0749-3797, https://doi.org/10.1016/j.amepre.2015.08.024.

[6] Sallis, J. F., Owen, N., & Fisher, E. B. (2008). Ecological models of health behavior. In K. Glanz, B. K. Rimer, & K. Viswanath (Eds.), Health behavior and health education: Theory, research, and practice (pp. 465–485). Jossey-Bass.

[7] Golden SD, Earp JAL. Social Ecological Approaches to Individuals and Their Contexts: Twenty Years of Health Education & Behavior Health Promotion Interventions. Health Education & Behavior. 2012;39(3):364-372. doi:10.1177/1090198111418634

[8] Prüss-Ustün A, Wolf J, Corvalán C, Bos R, Neira M. Preventing disease through healthy environments: a global assessment of the burden of disease from environmental risks. World Health Organization; 2016. https://apps.who.int/iris/handle/10665/204585

[9] Sallis JF, Floyd MF, Rodríguez DA, Saelens BE. Role of built environments in physical activity, obesity, and cardiovascular disease. Circulation. https://doi.org/10.1161/CIRCULATIONAHA.110.969022

[10] Francis J, Wood LJ, Knuiman M, Giles-Corti B. Quality or quantity? Exploring the relationship between Public Open Space attributes and mental health in Perth, Western Australia. Social Science & Medicine.. https://doi.org/10.1016/j.socscimed.2012.01.032

[11] Krieger, James MD, MPH; Jacobs, David E. PhD, CIH; Ashley, Peter J. DrPH; Baeder, Andrea MPH; Chew, Ginger L. ScD; Dearborn, Dorr MD, PhD; Hynes, H. Patricia MA, MS; Miller, J. David PhD; Morley, Rebecca MSPP; Rabito, Felicia PhD; Zeldin, Darryl C. MD. Housing Interventions and Control of Asthma-Related Indoor Biologic Agents: A Review of the Evidence. Journal of Public Health Management and Practice 16(5):p S11-S20, September/October 2010. | DOI: 10.1097/PHH.0b013e3181ddcbd9

[12] Walker RE, Keane CR, Burke JG. Disparities and access to healthy food in the United States: a review of food deserts literature. Health & Place. https://doi.org/10.1016/j.healthplace.2010.04.013

[13] Morgan A, Ziglio E. Revitalising the evidence base for public health: an assets model. Promotion & Education.. https://doi.org/10.1177/10253823070140020701x

[14] Baird S, Hicks JH, Kremer M, Miguel E. Worms at work: long-run impacts of child health gains. The Quarterly Journal of Economics.. https://doi.org/10.1093/qje/qjw022

[15] Thomson GE, Mitchell F, Williams MB, editors. Examining the Health Disparities Research Plan of the National Institutes of Health: Unfinished Business. Washington (DC): National Academies Press (US); 2006. G, Public Communications and Its Role in Reducing and Eliminating Health Disparities. https://www.ncbi.nlm.nih.gov/books/NBK57046/

[16] Twenge JM, Martin GN, Spitzberg BH. Trends in U.S. adolescents’ media use, 1976–2016: the rise of digital media, the decline of TV, and the (near) demise of print. Psychology of Popular Media Culture. http://dx.doi.org/10.1037/ppm0000203

[17] Institute of Medicine. 2011. For the Public's Health: Revitalizing Law and Policy to Meet New Challenges. Washington, DC: The National Academies Press. https://doi.org/10.17226/13093