Get outside. What does it mean to most people? Your answer may vary based on your surroundings. If someone lives near a park, taking the dog for a walk might be optimal. If you live near a local gym, perhaps getting in a mile or two on the treadmill is your choice.
But what can you when do when your options are limited? How can someone go for an evening jog if the neighborhoods they traverse are unsafe at night? How can children play outside if the streets are perpetually congested? For many low-income individuals, opportunities to “get outside” are rarities.
In the United States, this reality is being depicted by an idea called the “ghetto miasma.” Coined by New York Times writer Helen Epstein, ghetto miasma is best described as a myriad of diseases including cancer, diabetes, asthma, and high blood pressure that is killing America’s urban poor. The high concentration of traffic and industry pollution, lack of access to health resources, and limited supply of healthy food stores nearby devastates inner-city populations. Additionally, the stress of poverty and racism causes the deterioration of their bodies. Scientific research suggests that simply living in urban areas is accelerating the aging process of low-income black Americans (Hache, 2015).

Internationally too, the impoverished generally struggle to exercise and spend time in nature. For example, in Moldova, a small former Soviet country in eastern Europe, the concept of “sporty” seems to only be used in reference to fashion; it is not connected to healthy living or people’s lifestyles. Though there is great appreciation for nature in Moldova’s capital city of Chisinau, the poorer areas of the country are in disrepair. Much like the disadvantaged areas of the U.S., leisure locations such as shopping malls, movie theaters, and ice-skating rinks are rare. When in town, you may see many people resting on blankets or park benches, even in colder weather. However, their public parks do not have any playgrounds for children. Instead, many of them are filled with dilapidated exercise equipment that go unused. Natural areas such as forests and ponds have muddy, unpaved paths that are not conducive to walking and are hence, rarely visited (Adamson, 2019).
Change began to arise for the Moldovan people in 2015, when they held their first annual marathon in Chisinau, drawing in participants and spectators from all over the country. The “marathon” is actually a sporting event composed of four different races: a full marathon, a half marathon, a ten-kilometer race, and a five-kilometer “fun run.” This makes the event more appealing than traditional marathons, as it is inclusive of all age ranges and ability statuses. It also gives those who aren’t quite in shape to run a full marathon, as it typically takes months to train for one, a place to start.

Of course, American cities are no strangers to marathons. Both Chicago and New York City hold annual marathons. Not only is this a great way to encourage urbanites-, both participants and spectators-, to spend time outdoors, but the wheelchair race is also inclusive of those with disabilities. A way to improve this would be to introduce shorter events such as half-marathons, a10k, or a 5k to encourage participation from those who cannot train for a full marathon.
Another way to incorporate nature and health into low-income, especially urban, areas is to open the area up to vendors (Irimia, et al., 2016). The rising dependency on street vendors in urban ecosystems in the global south has helped merge the gaps between “formal” and “informal” economic systems. A study conducted in the cities of Delhi, India and Phnom Penh, Cambodia used oral accounts from street vendors and documented inventory of product sold to assess the demographics of street vendors. It was found that vending is a great economic opportunity for low-income urbanites, especially those who may be lacking education or other skills. It was also found to be a fairly gender inclusive trade, with about 60% of vendors being women (Hummel, 2017).

In 2001, the Street Vendor Project was founded in New York’s Lower East Side. This project pooled together money for the Push Cart Fund, offering loans to street vendors. Beneficiaries of this program include Munnu Duwan, a Bangladeshi-American man who was able to expand his business of Indian and Arabian food in a time of declining hot dog sales-, Jiang Chao Qun, a Chinese-American woman who sells fruits and vegetables on the streets of Chinatown-, and Margarita Villegas, a Mexican-American woman who sells tamales in East Harlem, where Subways and Taco Bells had begun to takeover. Not only has the rising popularity of street vendors allowed locals to integrate themselves with urban nature, it has given urbanites some much-needed access to health foods in areas where they are typically scarce and has also given a way to maintain an area culture that is more authentic than gentrified.

For further reading:
- Hache, J., & Chalifoux, T. M. (2015). Enough to Make You Sick. A Case Approach to Perioperative Drug-Drug Interactions,903-907. doi:10.1007/978-1-4614-7495-1_203
- Figure 2f from: Irimia R, Gottschling M (2016) Taxonomic revision of Rochefortia Sw. (Ehretiaceae, Boraginales). Biodiversity Data Journal 4: E7720. https://doi.org/10.3897/BDJ.4.e7720. (n.d.). doi:10.3897/bdj.4.e7720.figure2f
- E. Ferrara et al., “A Pilot Study Mapping Citizens’ Interaction with Urban Nature,” 2018 IEEE 16th Intl Conf on Dependable, Autonomic and Secure Computing, 16th Intl Conf on Pervasive Intelligence and Computing, 4th Intl Conf on Big Data Intelligence and Computing and Cyber Science and Technology Congress(DASC/PiCom/DataCom/CyberSciTech), Athens, 2018, pp. 836-841. doi: 10.1109/DASC/PiCom/DataCom/CyberSciTec.2018.00-21
- Figure 2f from: Irimia R, Gottschling M (2016) Taxonomic revision of Rochefortia Sw. (Ehretiaceae, Boraginales). Biodiversity Data Journal 4: E7720. https://doi.org/10.3897/BDJ.4.e7720. (n.d.). doi:10.3897/bdj.4.e7720.figure2f
- Macdonald, R. (2004). JSTOR: A History20047Roger C. Schonfeld. JSTOR: A History. Princeton, NJ: Princeton University Press 2003. 412 pp., ISBN: 0691115311 US$29.95 (hardback). The Electronic Library,22(1), 84-85. doi:10.1108/02640470410520203
- Hummel, C. (2017). Disobedient Markets: Street Vendors, Enforcement, and State Intervention in Collective Action. Comparative Political Studies,50(11), 1524-1555. doi:10.1177/0010414016679177