BACKGROUND: The built environment has a significant impact on the health of communities, including chronic disease outcomes and risk factors such as obesity, diabetes, cardiovascular disease, and mental health. The Colorado Department of Public Health and Environment (CDPHE) identified a lack of available data on the built environment from traditional chronic disease data sources. A module was added to an existing statewide survey to look into built environment factors in more depth and identify any disparities in the use and safety of neighborhood features including sidewalks, streets, public transportation, and recreational spaces.
METHODS: The Attitudes and Behaviors Surveys on Health (TABS on Health) was conducted in 2015 to collect information about health behaviors and outcomes in Colorado adults. Approximately 7,500 adults participated in this telephone survey. One module added to the 2015 survey was the Built Environment module, which collected data on use and safety of built environment factors within neighborhoods. Responses to this module and demographic breakdowns of these responses were analyzed using SAS software survey procedures.
RESULTS: Disparities were found in access, use, and safety of various built environment characteristics. Sex differences were found in reported safety and access to safe recreational opportunities. Differences between racial/ethnic groups were found across many factors, including access to parks and fitness opportunities within recreational areas, as well as reported safety across multiple dimensions. Income and poverty level demonstrated significant differences across nearly all measures including access to parks and safe areas for recreation, availability of recreational opportunities, and neighborhood and sidewalk safety.
CONCLUSIONS: Data from this statewide survey supplements existing data sources and helps identify specific disparities within built environment characteristics in Colorado. The disparities found through this survey demonstrate the need to improve neighborhood resources in order to provide equitable access to these resources for all Coloradans. Addressing this issue through public health and related planning requires acknowledgement of the complex history of disparities in the built environment in order to make improvements in building communities that are healthier, safer, and more equitable.