Planning for Healthier Communities

When Nisha Botchwey talks about healthy communities, she’s not being metaphoric. An assistant professor in the School of Architecture at U.Va., Botchwey’s work unites urban planning and public health. She is concerned with the obvious connection between a community’s design and the health of its inhabitants—a relationship that leads planners to advocate for crosswalks for the elderly and appropriate street lighting. She’s also interested in more subtle links—uncovering the ways that the built environment affects the lifestyle decisions that determine health.

A study being conducted by Viktor Bovbjerg, an associate professor in the Department of Public Health Sciences in the School of Medicine, has proven to be an ideal platform for this research. With funding from the National Institutes of Health (NIH), Bovbjerg is studying the effects of diet and physical activity on people with type 2 diabetes. As part of this project, the research team is offering two 42-month, community-based intervention programs in Virginia that include a year of meetings with dieticians and trainers as well as regular support groups.

Bovbjerg and Botchwey have now received a supplemental grant from the NIH to determine if a person’s involvement in a community organization—a place of worship, a social club, or a charitable organization—increases the effectiveness of Bovbjerg’s intervention.

Botchwey is tracking a group of nearly 400 program participants from Richmond, Roanoke, Harrisonburg, and Charlottesville. She has collected data on the frequency and duration of visits to community organizations as well as the proximity of these organizations to the participants’ homes. The next step is to correlate this data with the results of Bovbjerg’s intervention.

Botchwey’s analysis so far is suggestive. She has found that more than 67 percent of the participants are involved in religious and other organizations, an association that allows individuals to benefit from access to social capital. “These people can tap networks of support and trust that encourage them to take action,” she says. “They can get reinforcement from the other participants and gain a sense of personal empowerment from being part of a group.”

Botchwey’s research has also shown that the most common source of social capital is a house of worship. Of all community organizations frequented by study participants, 43 percent are religious organizations, and people voluntarily spend an average of eight hours a week with religious groups compared to two hours with other groups.

Botchwey’s other studies support her contention that the built environment can impact a person’s efforts to follow a healthy lifestyle. Collaborating with Pamela Kulbok, an associate professor of nursing and public health sciences, Botchwey went to Clintwood and Charlotte Court House, small towns in rural Virginia, and documented the reasons that teenaged girls decided not to smoke. “The girls highlighted built environment components that support the social environment, which included routine encounters with teachers, coaches, and religious leaders and institutional resources,” Botchwey observes. “And this makes a significant difference.”