Correlates of Health, Sustainability and Environmental Metrics for 50 of the Most Populous U.S. Cities

Health, socioeconomic, education, and environmental (e.g. air and water quality) indicators are often correlated and may serve as markers for other underlying community issues. These diverse measurements are usually not fully integrated and rarely evaluated in the context of sustainability metrics. We derived an integrated community health index (ICHI) for 50 of the most populous cities in the US using extant environmental, health and sustainability metrics and assessed relationships with sociodemographic measures. To derive the ICHI we used data from two sources: 1) SustainLane\'s (www.sustainlane.com) 2008 report card on urban sustainability which includes metrics such as energy and climate change policy, metro street congestion, metro transit ridership, and natural disaster risk, and 2) Earth Day Network\'s (www.eathday.net) Urban environmental report including a health metric which incorporates asthma, cardiovascular disease, diabetes, and obesity rates; and three environmental variables a) toxics and waste b) air quality c) drinking and surface water quality. Using these metrics we developed three separate indicators for health, sustainability and environment for each city. The ICHI was created by averaging across these three indicators. We used data from the 2010 Census (median family income, % of persons below the poverty level, % with a high school degree, % with college degree, and racial diversity (% White, nonwhite Black, Asian, and Hispanic) to assess relationships between the ICHI and sociodemographic characteristics. We compare mean values for various demographic measures for those cities with the "best" integrated community health index (highest 25^th percentile) with those cities in the lower 25^th percentile using t-tests. Cities with the better ICHI demonstrated 1) a higher % of persons with health insurance (20.1 vs 13.4 %; p< 0.001), 2) a lower (better) green economy score (13.7 vs. 36.8; p< 0.00001), 3) a lower toxic and waste score (2.4 vs.3.5; p< 0.001) and 4) a higher % of persons with college degrees (38.7 vs. 28.2%; p< .005). Comparing cites with lower percentages of individuals below the poverty level (highest 25^th percentile) with those cities in the lowest 25^thpercentile demonstrated 1) a lower score for toxic and waste (2.85 vs. 3.48; p