Goal

The goal of the research is to explore the relationships among social status, neighborhood characteristics and health risk factors in a country each in the Global North and South (maybe two countries with a long association and migration history as case studies, but not necessarily so) with a view to informing built environment- health- planning, policies and practice. The purpose of the research is to construct inclusive meaning and experiences in the knowledge of built environment-health relations with regional and global differentiation utilizing case studies of developed and developing countries to suggest people- centred, local and global governance policies and practices with transnational validity. It allows for multidisciplinary investigation of socio-ecological-health models especially the effect of culture on the flourishing of humans in different social and built environment contexts of the developed and developing worlds

Opportunity

The consciousness about built environmental-health research and multidisciplinary research is still low in many parts of the developing world, in fact, multidisciplinary research is scarce in the developing world. In a sense, this is a pioneering exploratory study to which subsequent studies will refer and build on. It allows for collaboration between individual researchers and institutions across the continents and therefore knowledge exchange and transfer especially of actionable knowledge. The methodology that will privileges people's perspectives has potential contribution to knowledge for research, theory and practice.

Roadblocks

The roadblocks include locating people with similar interests, research experience and knowledge across the continents. Putting together multidisciplinary team in the developed and developing countries chosen as case studies. The next will be strategizing on the methodology that exactly fit into the different contexts, avoid bias in data collection, define and agree on what is ethical in the contexts. Also, being able to delimit the health risks to be considered out of the many Non-Communicable Diseases (NCDs) and Communicable Diseases to be considered may also be an issue. The lack of ready data in the developing world may be problematic.

Breakthroughs Needed

Network of individual researchers to start multidisciplinary research in built environment-health studies in the two countries of the developed and developing world to be used as case studies. The multidisciplinary team will cut across environmental studies, health, social sciences and humanities. The teams will start meeting to discuss details of the research design to attain the short-term, mid-term and long-term objectives. The study areas have to be delimited and mode of collecting health data strategized on and relevant institutions/agencies contacted for ethical clearance. Data on Communicable and Non-Communicable diseases in the case study areas need to be collected from the health agencies to know their prevalence, distribution and occurrence in the neighborhoods before later self-rated data from people. Reconnaissance studies have to be carried out to understand and the neighborhoods and their characteristics and pilot studies will have to be done on small areas to test methodology, survey instruments and validate them. The multidisciplinary teams in institutions and countries from the health sector, social sciences, humanities and environmental studies will make these breakthroughs possible.

Key Indicators of Success

First Year- Compendium of Research Design and Outline with research instruments developed and validated in pilot studies
Second year- Compiled Aggregate Health Data of People living in Sampled neighborhoods and Data on Physical Characteristics of Neighborhoods
Third year- Compiled Quantitative and Qualitative data from People living in the neighborhood. Analysis of all relationships between different data
Fourth year- Synthesized data as subjects of Papers for Academic and Non-Academic Publications, Conferences, Seminars and Workshops
Fifth year to the Seventh year and later years- Policy Guidelines for National and International Bodies, Organizations and Institutions such as the World Bank, WHO, UN.

Additional Information

Socio-ecological models posit that a person's health status is influenced by individual b ehaviour, socioeconomic characteristics and defined levels of the person's objective and perceived individual or group environment (Schulz, Romppel and Grande, 2016). The environment itself can be disaggregated into the social and built environment. The social environment consists of person to person factors such as social network, social capital, social support and racial discrimination. It includes person to public, institutional or political system issues of income inequality, social deprivation and levels of exclusion (McNeill, Kreuter and Subramanian, 2006). The built environment is anthropogenic or modified to suit human activities and is in turn affected by human activities in diverse ways with reciprocal influence on human behaviour and health (Schulz, Romppel and Grande, 2016). Corburn (2017) has argued that a 21st century approach should not frame places as either 'natural' or 'built environment' since human activities cannot be 'outside' of nature and cities are not a human attempt to willingly destroy nature and create spaces detrimental to other living species.
Four major Non-Communicable Diseases(NCDs)- cardiovascular disease, cancer, respiratory diseases and diabetes- explain 77% occurrence of diseases, about 86% of premature mortality and 80% of all premature NCD deaths (WHO, 2012; 2019). NCDs account for 71% of all deaths globally and 85% of the 'premature' deaths between the ages of 30 and 69 years occur in low and middle income countries (https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases, 2019).
By 2020, seven out of every ten deaths in developing countries will be attributed to NCDs (Khuwaja and Kadir, 2010). Non-communicable diseases (NCD), including cardiovascular disease risk factors such as diabetes and hypertension will exceed communicable diseases as the leading cause of morbidity and mortality in Sub Saharan Africa by 2030.
Neighbourhoods are known to offer different benefits to the residents including a range of health risks. The infrastructure, collective efficacy and social capital in a neighbourhood can affect both physical and mental health (Mari´-Dell'Olmo, Novoa, Camprubı, Peralta, Vasquez-Vera, Bosch, Amat , Dı´az, Pale`ncia, Mehdipanah, Rodrı´guez-Sanz, Malmusi, Borrell, 2017). The relationship of some built environment features such as land use mix, intersection density, and recreational facilities to some individual health outcomes such as body mass index, physical activity, healthy eating have been shown albeit inconsistently (Schopfloche , VanSpronsen and Nykiforuk, 2014). For example, Burgoyne's concept of deprivation amplification argues that obesity among the less educated is due to exposure to fast food outlets (Townshend and Lake, 2017). There has been an increasing call for research to develop tools for evaluating the built and social environments and establishing evidence to support how these affect individual and neighbourhood health outcomes (Glanz , Handy , Henderson , Slater, Powell and Davis, 2016).The link between the built environment, physical activity, food access and deprivation require more research.
The study will utilise mixed methods of quantitative and qualitative research.
Responses and intervention can be borrowed across the continents to attain sustainable development goals and human flourishing through this comparative study.

REFERENCES
https://pubmed.ncbi.nlm.nih.gov/16650513/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5334671/
https://pubmed.ncbi.nlm.nih.gov/20444764/ https://journals.sagepub.com/doi/abs/10.1177/0020731416684292
https://pubmed.ncbi.nlm.nih.gov/29349125/

COLLABORATORS
Oluwatoyin.asojo@hamptonu.edu
Danielle.Sinnette@uwe.ac.uk
Uwe.bittlingmayer@ph-freiburg.de
adesegunfatusi@yahoo.co.uk
dolapoamole@yahoo.com