nursing schoolSuburbs, countryside, or city. Most of us make a choice and settle down. But others, particularly those living in poverty, don’t always get to make that choice—the choice that could actually determine our quality and length of life.

Johns Hopkins University School of Nursing (JHUSON) PhD Candidate Laura Samuel was first intrigued by the topic of environment and health when she worked as a family nurse practitioner. Samuel could see the way poverty was placing some of her patients at risk for disease and disability. “It didn’t take long for me to realize that poverty needed to be addressed as a fundamental determinant of health,” she says.

Taking this health challenge on as her research dissertation at the JHUSON, she is examining just how our environment and its characteristics may actually improve—or hurt—our health. Samuel chose to analyze how factors of social integration (neighborhood social cohesion, emotional support, loneliness) and socioeconomic status might impact people's rates of smoking, physical activity, and diet—and ultimately change their cardiovascular health. “We know that these three behaviors are the underlying causes that account for over one-third of deaths in the U.S.,” says Samuel.  “But it’s also important to know whether our income or our feelings of neighborhood unity or alienation can actually affect these behaviors, and in turn our quality of life.”

Studies show that in many cities across the nation, life expectancy can differ by 10 years across neighborhoods—even those side by side. So do socioeconomic and social integration factors make a difference in these numbers? That’s what Samuel is hoping to find out.

While there is still much research to be done, Samuel already knows that the solution won’t be one size fits all. “If we really want to address socio-economic disparities, we need to tailor our interventions to specific individuals and communities. We need to consider people’s social networks, their socioeconomic status, and the social context in which they live their day-to-day lives.”