Outdoor access to safe water, good sanitation,

Outdoor air pollution causes health effects that include coughing, aggravation of asthma and other respiratory diseases, as well as the exacerbation of cardiovascular disease. This results in increases in emergency room visits, hospital admissions and premature death as air quality degrades.

Research indicates even low concentrations of these pollutants can result in adverse health effects. An increase in air pollutants contributes to an increase in morbidity and premature mortality.

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2. Built Environment:

The built environments can influence physical and mental health through factors such as community design, adequate housing, access to safe water, good sanitation, safe neighbourhoods, and adequate access to education, recreational services, public transit and child care. In essence, the built structure provides the setting for many of the social determinants of health.

The built environment can also provide opportunities for social interaction through an array of social networks and organizations. Generally, the larger the urban centre, the greater the number and complexity of social networks. Social engagement in the community builds trust, efficacy and a sense of belonging that is associated with improved mental and immunological health.

Urban centres tend to be less culturally and socially homogeneous and have diverse populations. Within these cities, communities comprised of close networks of people of similar cultural and social perspectives offer the benefits of community such as social support.

Although urban areas provide many opportunities for social contact with others, they can also create anonymity and isolation. Regardless of neighbourhood density, many urban dwellers say that they do not know their neighbors, a number of elderly residents live alone, and those who are not connected with the greater community can experience isolation.

Overcrowding and poorly ventilated houses can also increase susceptibility to disease. The number of people per dwelling has been known to greatly impact the physical and mental health of inhabitants, including raising the risk of acquiring tuberculosis.

Homelessness is also a health issue. It is difficult to measure how many people are homeless as homelessness is a continuum with a variety of short and long term experiences. Some of these people become homeless as a result of inadequate income, living in a community with inadequate housing, or having a mental illness, which may hinder opportunities for employment and income.

While homelessness can affect a broad range of people, approximately one-third of the homeless are between the ages of 16 and 24 years. A lack of housing contributes to a vicious circle influencing eligibility for income supports, community benefits, voter registration and employment options that could bring about changes in living conditions.

As well, about half of youth living on the street have been involved with the child welfare system at some point during their lifetime. An equal share were abused as children and left home as a result. Many street youth dropped out or were expelled from school.