What is the Universal Basic Neighborhood?

There is broad understanding that small geographies, such as zip codes or neighborhoods, have profound impacts on the health outcomes of all the people who live there. However, the civic investments, supportive assets, protective characteristics, and environmental risks that drive those health outcomes are not evenly distributed. The Social Determinants of Health, County Health Rankings, and other health equity work has raised awareness about the need to address health disparities through broad coalitions. However, this understanding about broad action has not translated to population-level interventions. In practice, efforts to address health equity are applied at individual scales.

To make gains towards health equity, instead of diagnosing and treating individuals, we propose diagnosing and prescribing neighborhood-level interventions by establishing a Universal Basic Neighborhood (UBN) framework and quantitative tool.

We reviewed scientific, national, and global literature related to urban design and healthy cities to develop a rubric that accounts for both health-promoting and health-limiting place-based characteristics. Then, we determined to what degree these factors were present in and absent from two Louisville, Kentucky neighborhoods with differing health outcomes. Using the UBN framework, we can estimate where assets and strengths exist, where vulnerabilities exist, and which neighborhood characteristics, when modified by interventions such as community investments, may hold the most potential to improve neighborhood health and ultimately health equity.

A UBN is one that supports individuals and families by addressing the basic, human need to live in a place without toxic factors and with the natural, social, and economic resources to support healthy growth and aging. The UBN concept offers a promising framework for incorporating and building upon neighborhood assets and strengths when developing interventions to improve health.

Universal Basic Neighborhood Framework

Major Activities

One: Evaluate health-related factors and frameworks that investigate health and place to develop a baseline framework for a Universal Basic Neighborhood (UBN).

Two: Conduct a legal and policy review to identify potential pathways and hurdles towards policy action to develop model legislation and guidance supportive of a UBN.

Three: Conduct an IRB-approved field study including surveys, asset mapping, and focus groups in two demographically and economically distinct neighborhoods to understand the fabric of each place and to discover neighborhood assets directly from community members.

Four: Evaluate 25 years of neighborhood plans, city budgets, and related variables to calculate civic investments and impacts, understand what forces move neighborhood planning from vision to implementation, and understand if and two what degree civic investment promotes community well-being.

Five: Conduct a comparative analysis of two Louisville neighborhoods to illustrate how, and to what degree, basic neighborhood factors are present or not present and differentiate between factor areas that drive health outcomes.