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© 2003 American Public Health Association
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).
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ABSTRACT |
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 TOP ABSTRACT INTRODUCTIONTHE PROGRAMDISCUSSION AND EVALUATIONNEXT STEPSKEY FINDINGSReferences |
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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.
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INTRODUCTION |
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TOPABSTRACTINTRODUCTIONTHE PROGRAMDISCUSSION AND EVALUATIONNEXT STEPSKEY FINDINGSReferences |
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MOST AMERICANS LIVE IN urban areas; 80% live within or in close proximity to a metropolitan area. Physical features of the urban environment influence the way city residents live and work, and they have a direct impact on mobility and social interactions. Some aspects of the urban infrastructure (e.g., water distribution and sewer systems) have dramatically improved public health over the last century; however, other urban planning practices (e.g., the urban grid, single-use zoning) may actually contribute to the epidemics of obesity,1 diabetes,2 and depression3 that are sweeping the United States.
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.6–9 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.
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THE PROGRAM |
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TOPABSTRACTINTRODUCTIONTHE PROGRAMDISCUSSION AND EVALUATIONNEXT STEPSKEY FINDINGSReferences |
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The Sunnyside neighborhood of Portland, Ore, is a moderate-income, urban community with a population of 6513 persons and 3466 households. Most neighborhood residents are White (88%), followed in decreasing order of representation by Asians (4.5%), Hispanics (3.4%), and Blacks (1.7%). Most residents (65%) are renters. In January 2001, a group of residents initiated monthly meetings to devise ways to improve the livability and vitality of the community. During the 9 months of discussions, workshops, design plans, outreach, and block parties that ensued, a new and artistic approach to community-initiated urban development evolved.
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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What could have been a formidable challenge to the permitting and approval process was mitigated by the community’s decision to involve the City Repair Project (a local nonprofit organization11), resident landscape designers and architects, and other community members who brought a modified ordinance (no. 175937) to the city council for approval. In September 2001, residents embarked on an urban experiment to create a sense of place, identity, and belonging by painting a giant sunflower motif across the intersection (Figure 2
). The site was transformed from a busy intersection where streets intersect into a place where people meet.
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In May 2002, a second phase was approved by city officials and implemented as part of a community enhancement project: an art wall made of cob (a traditional building material composed of clay, straw, water, and sand) was built with colorful mosaics, shapes, and niches; to facilitate social interactions, a cob information kiosk was installed for the exchange of messages and notices; a solar-powered fountain tiled with glass mosaics was constructed to invite passersby to pause to the sound of running water and to interact with one another (Figure 3
).
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DISCUSSION AND EVALUATION |
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TOPABSTRACTINTRODUCTIONTHE PROGRAMDISCUSSION AND EVALUATIONNEXT STEPSKEY FINDINGSReferences |
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Two years after its creation, the Sunnyside Piazza remains a catalyst of sidewalk conversations, as passersby read the signs about the community project, tourists take photographs, children throw pennies into the wishing pond, joggers run an extra lap around the sunflower, and strangers pause to admire the art. In April 2003, of 507 pedestrians observed to pass through the intersection, 164 (32%) interacted with the piazza in ways similar to those described above, compared with 7% (P < .01) at a similar, unimproved intersection. Walking and biking seems to have increased, as people go out of their way to enjoy the richness of the urban experience at the Sunnyside Piazza.
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.
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NEXT STEPS |
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TOPABSTRACTINTRODUCTIONTHE PROGRAMDISCUSSION AND EVALUATIONNEXT STEPSKEY FINDINGSReferences |
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This "intersection repair" project, which has institutionalized the bureaucratic approval process through city ordinances, has gained support from urban planners, politicians, and citizens. Thus, it is now possible to implement additional sites throughout the city and work with communities to meet their needs. Furthermore, we are now in a position to design a panel study with pre- and postintervention measurements on the same study subjects, thereby controlling for potential confounding. Intersection repair projects will be realized in 3 communities in the coming months. We are in the process of administering such a survey to measure sense of community, social interactions, perceived neighborhood control and participation, and self-reported indicators of physical and mental health. If improvements in social networks, community capacity, and well-being can be documented, it can be argued that neighborhood organizing around urban design can improve the health of the public.
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KEY FINDINGS |
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TOPABSTRACTINTRODUCTIONTHE PROGRAMDISCUSSION AND EVALUATIONNEXT STEPSKEY FINDINGSReferences |
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- Engaging city officials and community members early in the planning stages accommodated their ideas and concerns and facilitated completion of the Sunnyside Piazza project.
- Collaboration between urban planners, community groups, and nonprofit organizations helped to implement new urban design features that are conducive to social interactions and community stewardship.
- Creating an artistic public gathering place fostered social capital and social cohesion that may reverse alienation and isolation.
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Acknowledgments |
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Funding for this study was obtained from a faculty enhancement award from Portland State University and the Community Initiatives Small Grant Program from the Bureau of Housing and Community Development at the City of Portland. Funding also was obtained in part from local fundraising, businesses, and in-kind donations, particularly from Uroboros Glass and The Laughing Planet Café.
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.
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Footnotes |
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Peer Reviewed
Accepted for publication May 16, 2003.
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References |
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TOPABSTRACTINTRODUCTIONTHE PROGRAMDISCUSSION AND EVALUATIONNEXT STEPSKEY FINDINGSReferences |
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1. Kumanyika SK. Minisymposium on obesity: overview and some strategic considerations. Annu Rev Public Health.2001;22:293–308.[Web of Science][Medline]
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;345:790–797.
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;59:115–123.
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;155:507–515.
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):64–73.[Web of Science][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;180:428–433.
7. Silver E, Mulvy EP, Swanson JW. Neighborhood and structural characteristics and mental disorders: Fairs and Dunham revisited. Soc Sci Med.2002; 55:1457–1470.
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: 177–185.[Web of Science][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;56:48–55.
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.
This article has been cited by other articles:
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  J. C. Semenza and T. L. March An Urban Community-Based Intervention to Advance Social Interactions Environment and Behavior, January 1, 2009; 41(1): 22 - 42. [Abstract] [PDF]
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 J. C. Semenza and P. V. Krishnasamy Design of a Health-Promoting Neighborhood Intervention Health Promot Pract, July 1, 2007; 8(3): 243 - 256. [Abstract] [PDF]
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 J. Fisk Deterrent to Healthy Lifestyles in Our Communities: In Reply Pediatrics, May 1, 2007; 119(5): 1042 - 1042. [Full Text] [PDF]
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