Only 3% of all Americans believe they live in bad neighborhoods. But 30% to 45% of those who live in places with crime and illegal drug sales, rats and stray dogs, hazardous waste sites, factory pollution, and abandoned and blighted buildings rate their neighborhood as poor quality. Even when these neighborhoods have good schools, parks, and other amenities, their resident's ratings do not go up. This holds true no matter who is asked - young, old, men or women, middle class, working class, or on welfare. Local health and planning officials corroborate resident perceptions. It is particularly noticeable that stress from living near a toxic waste site - the hazard that gets the biggest attention in terms of dollars spent - is low on the resident's list of fears about their neighborhoods. They'd much prefer to see the money put to fixing the immediate dangers on their block. But because federal and state government policies for protecting public health, lowering crime, and saving the environment are divided into separate bureaucratic cubby-holes, effective planning to improve these stressed neighborhoods is difficult. Beginning with the call for a definition of "environment" that fits the realities of these places, the authors argue for and propose policy initiatives that address all the desperate needs of these beleaguered neighborhoods. This book is essential reading for students, academics, and professionals in environmental studies, public health, urban studies and planning, as well as grassroots community organizers.

While New Jersey now frequently appears near the top in listings of America’s healthiest states, this has not always been the case. The fluctuations in the state’s overall levels of health have less to do with the lifestyle choices of individual residents and more to do with broader structural issues, ranging from pollution to urban design to the consolidation of the health care industry. 
 
This book uses the past fifty years of New Jersey history as a case study to illustrate just how much public policy decisions and other upstream factors can affect the health of a state’s citizens. It reveals how economic and racial disparities in health care were exacerbated by bad policies regarding everything from zoning to education to environmental regulation. The study further chronicles how New Jersey struggled to deal with public health crises like the AIDS epidemic and the crack epidemic. Yet it also explores how the state has developed some of the nation’s most innovative responses to public health challenges, and then provides policy suggestions for how we might build an even healthier New Jersey.