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FIELD ACTION REPORT |
The author is with the School of Community Health, Portland State University, Portland, Ore.
Correspondence: Requests for reprints should be sent to Jan C. Semenza, PhD, MPH, MS, School of Community Health, Portland State University, PO Box 751, Portland, OR 97207-0751 (e-mail: semenzaj{at}pdx.edu).
| ABSTRACT |
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Deteriorating physical features of urban environments can negatively influence public health. Dilapidated environments and urban blight tend to promote alienation and can be associated with social disorder, vandalism, crime, drug abuse, traffic violations, and littering, which in turn affects health and well-being.
In the late 1990s, the Sunnyside neighborhood in Portland, Ore, was plagued by many of these problems. In an attempt to invigorate neighborhood stewardship, the community organized and created a public gathering place; together, they painted a gigantic sunflower in the middle of an intersection and installed several interactive art features.
As a result of these collective actions of "place-making," social capital has increased, thus revitalizing the community, and expanded social networks among residents have stimulated a sense of well-being.
| INTRODUCTION |
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These practices are long-standing. In 1785, Congress passed a land ordinance that prescribed a rectangular grid pattern as the layout for all public lands in the West, which was also applied to the planning of cities and towns.
While this urban design improves efficiency and traffic flow, it is not conducive to social interactions and deprives residents of public gathering places. Zoning rules dictate segregated land use, which has resulted in reliance on the automobile. The resulting poorly designed and maintained neighborhood topography may be associated with physical inactivity4,5 and depression.69 Urban environments that lack public gathering places and are not zoned for mixed use (both residential and commercial) are not conducive to walking and socializing and thus tend to foster car dependence and isolation.
In this report I describe an innovative and successful community initiative to revitalize the health of a neighborhood, with the goal of revitalizing the health of its residents.
| THE PROGRAM |
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A central intersection was designed as a public gathering place: the Sunnyside Piazza (Figure 1
). A sunflower, the neighborhood symbol, was selected as the unifying theme of a multiphase plan to enhance social cohesion in the community. The plan included a variety of artistic features intended to reverse urban decay; more importantly, it was anticipated that neighborhood organizing would cultivate social connectedness and a sense of community.10
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| DISCUSSION AND EVALUATION |
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A perceived sense of community was documented as part of a cross-sectional survey that systematically sampled participants within a 2-block radius of the Sunnyside Piazza and participants of an adjacent neighborhood with a similar demographic profile (participation rate = 60%). Of 97 Sunnyside Piazza residents interviewed, 65% (n = 63) rated their neighborhood an excellent place to live, compared with 35% (52 of 147) at the control site (P < .01).
No statistically significant differences were found between the sites regarding whether residents believed that their neighborhood was a good place for children to grow up (43% vs 36% at the control site) or whether decisions that affected the neighborhood could be influenced by working together (47% vs 40%). However, a convenience sample of over 50 written comments collected on-site from passersby and participants during the painting of the intersection demonstrated the positive impact; one comment read, "It is primarily through the strength and joy of our community involvement that we begin to heal the alienation and disconnectedness, so prevalent in American cities." In the Sunnyside Piazza neighborhood, 86% of respondents reported excellent or very good general health, compared with 70% in the adjacent neighborhood (P < .01), and 57% versus 40% felt "hardly ever depressed" (P < .01).
A limitation of these findings is the potential of effect distortion through confounding. We are currently addressing this potential limitation through longitudinal measurements on an individual level.
| NEXT STEPS |
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| KEY FINDINGS |
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| Acknowledgments |
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This project would not have mastered the bureaucratic and logistical hurdles without the dedicated commitment and hard work of Daniel Lerch and Mark Lakeman from The City Repair Project. Lisa Weasel, Renee Pype, Alexia Zerbinis, Keyan Mizani, Brian Borello, Mina Hensen, Charlie Hales, and Robert Burchfield were instrumental to the implementation of the Sunnyside Piazza. Tanya March and Portland State University Capstone students collected survey data in the field. Sukita Crimmel and Rob Bauman created the art wall and information kiosk with the help of the hundreds of hard-working hands and feet of schoolchildren and community members.
| Footnotes |
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Accepted for publication May 16, 2003.
| References |
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2. Hu FB, Manson JE, Stampfer MJ, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med.2001;345:790797.
3. Narrow WE, Rae DS, Robins LN, Regier DA. Revised prevalence estimates of mental disorders in the United States: using a clinical significance criterion to reconcile 2 surveys estimates. Arch Gen Psychiatry.2002;59:115123.
4. Balfour JL, Kaplan GA. Neighborhood environment and loss of physical function in older adults: evidence from the Alameda County Study. Am J Epidemiol.2002;155:507515.
5. Handy SL, Boarnet MG, Ewing R, Killingsworth RE. How the built environment affects physical activity: views from urban planning. Am J Prev Med.2002;23(suppl 2):6473.[ISI][Medline]
6. Weich S, Blanchard M, Prince M, Burton E, Erens B, Sproston K. Mental health and the built environment: cross-sectional survey of individual and contextual risk factors for depression. Br J Psychiatry.2002;180:428433.
7. Silver E, Mulvy EP, Swanson JW. Neighborhood and structural characteristics and mental disorders: Fairs and Dunham revisited. Soc Sci Med.2002; 55:14571470.
8. Steptoe A, Feldman PJ. Neighborhood problems as sources of chronic stress: development of a measure of neighborhood problems, and associations with socioeconomic status and health. Ann Behav Med.2001;23: 177185.[ISI][Medline]
9. Weaver N, Williams JL, Weightman AL, et al. Taking STOX: developing a cross disciplinary methodology for systematic reviews of research on the built environment and the health of the public. J Epidemiol Community Health.2002;56:4855.
10. Wilson WJ. When work disappears: the world of the new urban poor. New York, NY: Vintage Press; 1996.
11. City Repair Project. Available at: http://www.cityrepair.org. Accessed April 17, 2003.
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