HealthThe Global Is Local

The Architecture of Our Psychological Health

By October 18, 2013 4 Comments

A beautiful old mansion would be easier to redevelop than a home where someone was murdered.

This week’s post by Lindsey Davis spurred me to think again about how our environment influences the way we experience the world around us, and the impact it has on our lives. Lindsey points out the balance that is struck when planners and city leaders determine that a neighborhood or area of the city would be better demolished than repaired.

Perhaps, she argues, these parts of the city should start a new story, free from the architecture that haunts their past.

I think she is probably right. Their present is the part that I have been thinking about, though, and the impact that living with a history and an environment may have upon the residents in any neighborhood. Each of us experiences Baltimore in a different way, and so that architectural impact is different for all of us, depending on our habits and our pre-existing constitution. Many of us cut a fairly narrow slice of the Baltimore pie (or whichever city or pastry you live in), because of where we work, study, play, or live, and the locations and routes between these activities vary for all of us.

This past weekend, the Baltimore Marathon (which I watched, but did not run) wound it’s way through much of the city, hitting the Inner Harbor, Druid Hill, Waverly, and many miles in between. The Baltimore Bike Party often has a similarly winding route, and I appreciate that both attempt to expose both residents and guests to parts of the city that typically do not get seen by tourists, commuters, and — more often than not — white people like myself.

There is no way to understand the city from the Johns Hopkins Homewood campus, or from the Inner Harbor, or from the Under Armor headquarters. The particular portions of the city that Lindsey makes reference to are not pretty, and in fact may be derelict or downright abandoned, but are integral to understanding what makes this place. Neighborhoods stricken by urban blight have an enormous impact on the financial, social, and psychological health of the city.

From a public health standpoint (which, I have argued before, is perhaps the best lens through which to analyse a human population), there are a number of concerns that urban blight brings up, including correlation with poverty, high disease burden, low literacy rates, crime and violence incidence, access to food and services.. the list goes on, of course. However, an issue that is harder to quantify is the psychological impact of a blighted neighborhood.

A 2002 article in the British Journal of Psychiatry linked found statistically significant associations between the built environment and rates of depression. Another study published in 2002, this one in the Journal of Social Science & Medicine,  found that “neighborhood disadvantage was associated with higher rates of major depression and substance abuse disorder” among other negative psycho-social conditions.

This is not surprising. Think about your own home, and your favorite room or space in it. What are a few of the things that you like about it? Pick two or three of them and then meet me at the next paragraph…

Hi, welcome back. Although I can’t be sure, I strongly suspect that the things you like about your favorite room in your house have to do with beauty, comfort, positive memories or associations, or attractiveness. Now reverse that scenario, imagine your least favorite part of your home, and I would again be willing to bet a bowl of freshly roasted pumpkin seeds that the space you just identified has negative connotations, gives you feelings of dread, disappointment, or even disgust (if you’re struggling to get your walls out of the 1970s, I hear wood paneling looks great with a coat of white paint). Now scale these impressions to a street or a neighborhood, and the correlation with psycho-sociological outcomes starts to make a lot of sense.

It all comes back to the poverty/wealth disparity, in my opinion. Will money make you happy? Certainly not in isolation, but if it buys/rents you a decent place on an attractive street in a part of the city with strong civic engagement, then you’ve probably got a head-start on happiness compared to someone who lives sandwiched between abandoned buildings, has to rely on an unpredictable bus system to get to their job, and lives in one of only a half dozen occupied homes in a three block radius. Besides, once you’re in that nice neighborhood, there’s a good chance that grocery stores will be easier to get to, crime rates will drop, and transportation options will be better (well, maybe that last one is a stretch…).

The question that lingers for me is one that Lindsey also raised — is there a point where the “institutional memory” of a place is so malign that the only recourse is to remove the architecture of those memories? According to Lindsey, that may be the case. The individuals who collectively hold and live these institutional memories may be the most compelling reasons of all, however. Preserving a neighborhood of decay and bad memories is no way to effectively raise morale and standard of living. Instead, city planners may hope to cause social change through infrastructure improvements, a tired, but tried and true strategy that has had positive results in the past.

Author Adam Conway

Adam Conway is a recent transplant to Baltimore, an advocate for intelligent, holistic policy in government and industry, and a potter. After receiving undergraduate degrees in art and psychology, Adam pursued a career in mental health care, serving those with mental illness in residential and community settings. In 2011, he completed a Master's in Public Health Policy at the University of Pittsburgh, and is now devoted to addressing systemic issues affecting the entire population- health, environment, food, and policy. He also has been making functional and decorative pottery for over ten years (www.FreeRangePottery.com) in community studio settings because he likes people and is inspired by their work. Any opinions expressed in Adam’s articles are his own and are not intended to represent those of any agency or organization for which he is employed.

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Join the discussion 4 Comments

  • Love your take on psychological topography, Adam. One thing I think is missing from this discussion, though, is that many people who live in areas and buildings we would consider “distressed”, derelict and depressing form strong emotional attachments to those places because, after all, they are home. We shouldn’t be so quick to dismiss this and let our do-gooding/improving impulses get the better of trying to appreciate complexity. Certainly many of the things you say are true and we should make an effort to improve infrastructure and the built environment for everyone. But even project towers – places we would assume are only dens of misery and despair – can be places not only for nostalgia but profound connection, connections that structure existence. I’d compare it to a way of thinking that apparently is making the rounds in social services (so I’m told by people in the field) that it’s sometimes better to keep a child in a household that would generally be considered unsuitable or even abusive while providing the necessary support, rather than immediately remove them because even a tormented bond is crucial to child development and well-being, and tearing children away can be even more disastrous. A troubled place can also be a cherished place.

  • Adam Conway says:

    A fair point, and should have clarified that I don’t believe for a second that health, wealth, or housing status are simple inputs to happiness or other beneficial outcomes (the “better” one is in each category, the “better” you will be as a person is an equation that is flawed in it’s makeup).
    Instead, I am thinking more in terms of the nature vs. nurture equation. Apparently genetic makeup predisposes us about 75% of the way, but nurture’s 25% are heavy hitting percentage points. The outcomes are anything but guaranteed- evidenced by wealthy drug-addicted dropouts and professors born in squalor- and I am not proposing that any home or neighborhood that doesn’t meet an arbitrary standard be bulldozed.
    However, from a population health standpoint, understanding the impacts of the built environment on the people who live in it can be a valuable tool for designing and delivering the supportive services you mentioned and advocating for improved transportation infrastructure, street cleaning, zoning decisions, and so forth. Too often these kinds of decisions are made with an eye exclusively for economics, or exclusively for crime reduction, or something. The design of neighborhoods, especially in an old city like this one, make it challenging to envision something different, because it might mean taking away or changing the historical context where people live, work, and play.

  • thegoodplan says:

    I remember spending a bit of time in a South African township and talking to residents about how many of them have the opportunity to move out of the physically removed, low lying, dry dusty area. The residents told me that they wouldn’t want to leave. This was their home- this is where their families are. That said, these places were occupied, full of life, colorful. Far removed and poor, yes, but alive. The places I pointed to aren’t full of life- they’re deserted and dead. There isn’t the sense of ownership needed to make a place live again. I’ve been in quite a few slums where there’s vitality and good and happiness, too – so there’s a factor of ‘person’ that we’re leaving out. There are health issues associated with each (high density v. low density). So Adam, I wonder, what do we do in a place where people are poor, happy, and unhealthy? Do we forcibly remove them to a new place where there is clean water, grocery stores, and an intact sewage system? In which case is the psychological damage worse, even though the actual scientific health is better?

  • Even though there are a lot of boarded up row homes doesn’t mean that those places aren’t full of life.

    Sure, the narrative you see is boarded up row homes, crime, poor health but that’s not the only narrative of those communities. I’ve had a chance to go and meet some residents of Middle East this past week and I would say there is definitely vibrancy there. Both Adam’s and Lindsay’s article makes me think of Detroit where narratives of urban blight and crime live right on top of narratives of Detroit’s hay day and those communities still left today. Adam’s example about the house is a great example of this – your favorite places and least favorite places often times lives together.

    Should we tear down plantation houses because of the long history of slavery? I see few arguments for that. Every historic place is home to an abundance of narratives. So which narrative wins out?

    When you destroy those homes, you can never get that positive narrative back. You are instead imposing a new one, one that often times does not include the community that was there before. At least from what I’ve seen in Baltimore when developers plow down row homes, it isn’t for the communities who already live in those areas. We’re not talking about destroying “institutional memory,” when we tear down row homes, we’re talking about destroying communities and destroying a tie to that place.

    Adam makes a good point in this piece – “Certainly not in isolation, but if it buys/rents you a decent place on an attractive street in a part of the city with strong civic engagement, then you’ve probably got a head-start on happiness compared to someone who lives sandwiched between abandoned buildings, has to rely on an unpredictable bus system to get to their job, and lives in one of only a half dozen occupied homes in a three block radius.”

    Destroying row homes doesn’t solve the fact that our transportation system isn’t serving those in poverty, those in communities that don’t have a strong voice to advocate for options. Destroying row homes displaces the few people left in the community advocating for change. Those remaining in row homes are also not going to invest in the properties they have for fear that their home too will be knocked over for a new development.

    Certainly we need to address the serious problems of vacancies in Baltimore but I think we need to do that by celebrating and helping the communities already there. The strong positive narratives that rarely see the light of day in this city. Instead of paving over and starting anew.

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