One of Davis' sons was in the emergency room every other week, sometimes for a few days at a time, because of asthma. He often missed school for doctor appointments. But now his asthma is under control, and the occasional attacks are eased by medication.

"He is definitely healthier," Davis said of her son." That was one good thing about moving."

The most recent studies didn't address why community matters, but public health officials and past research have found that a variety of factors may make a difference.

Old housing stock in some neighborhoods can contain mold, dust and other bacteria that can cause asthma and other respiratory ailments to flare up. When families can't go for walks because their neighborhoods are dangerous and can't buy healthful food because there are no nearby grocery stores, it can lead to weight gain. The stress of living in neighborhoods with violence can also lead to mental health problems, such as depression.

Some poor neighborhoods also don't have access to good jobs, which can be a problem because most Americans get health insurance through their employers. Some neighborhoods also aren't near hospitals, although that is less true in Baltimore, where health care is a major industry.

Much of the debate and policy surrounding health has been focused on medical care. Many in the field hope that as more studies are devoted to neighborhood disparities, social issues will foster more attention.

Dr. Michelle Gourdine, a Maryland physician and health consultant, said creating healthier communities can be accomplished through policy changes as simple as creating tax incentives to attract grocery stores to poor neighborhoods or as controversial as implementing fast-food bans in poor neighborhoods. Planning boards can require new developments to have features such as walking paths and parks.

Better health outcomes can lead to other improvements in life. When the HUD program was first implemented, one of the main goals was to improve participants' chances at finding a job, said Erika Poethig, a deputy assistant secretary in HUD's Office of Policy. The agency wasn't looking at health outcomes, but it figured out the two go hand-in-hand.

"By improving people's health, you are improving their employment opportunities," Poethig said. "They can sustain a long work day and people are able to keep a job. While that is not the outcome we thought we'd get or the reason for the initial study, we realize health can create better outcomes in many ways."

andrea.walker@baltsun.com

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