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J Urban Health. 2016 April; 93(2): 292–311.
Published online 2016 March 8. doi:  10.1007/s11524-016-0027-z
PMCID: PMC4835353

Hospitality Invites Sociability, Which Builds Cohesion: a Model for the Role of Main Streets in Population Mental Health


The aim of this study was to investigate the contribution of main streets to community social cohesion, a factor important to health. Prior work suggests that casual contact in public space, which we call “sociability,” facilitates more sustained social bonds in the community. We appropriate the term “hospitality” to describe a main street’s propensity to support a density of such social interactions. Hospitality is a result of the integrity and complex contents of the main street and surrounding area. We examine this using a typology we term “box-circle-line” to represent the streetscape (the box), the local neighborhood (the circle), and the relationship to the regional network of streets (the line). Through field visits to 50 main streets in New Jersey and elsewhere, and a systematic qualitative investigation of main streets in a densely interconnected urban region (Essex County, New Jersey), we observed significant variation in main street hospitality, which generally correlated closely with sociability. Physical elements such as street wall, neighborhood elements such as connectivity, inter-community elements such as access and perceived welcome, and socio-political elements such as investment and racial discrimination were identified as relevant to main street hospitality. We describe the box-circle-line as a theoretical model for main street hospitality that links these various factors and provides a viable framework for further research into main street hospitality, particularly with regard to geographic health disparities.

Keywords: Social integration, Public space, Social psychiatry, Health disparities, Main streets, Built environment, Social interaction, Urban design, Planning, Geographic inequality, Neighborhood effects, Sociability, Hospitality


As social psychiatrists, we approach the urban landscape from the position that social cohesion is a condition of optimal health. The data support this idea, demonstrating that increasing degrees of community social integration correlate with improvements in mental health and physical health of community members.19 Conversely, loss of social cohesion is associated with social problems such as violence and incarceration,10,11 as well as illnesses such as HIV.12 On the strength of such evidence, public health practitioners, city planners, and policy makers ought to consider how best to foster social cohesion in the built environment.

According to one well-established theory, community social integration—in particular the type of integration that transcends class and clique—is constructed incrementally on a scaffolding of looser connections between members of different groups, or “weak ties.”8,1316 Weak ties, in turn, form in the public space through the casual, unplanned interactions that Jane Jacobs termed the “sidewalk ballet” and Jan Gehl called the “life between buildings.”1721 Casual contact in the city is a means of building trust, cohesion, awareness of others, and a sense of belonging, all of which are prerequisites for the establishment of mutual understanding.14,16,18 Such understanding is key to a property of human groups known as “collective consciousness,” the ability of multiple individuals to operate and problem-solve in a unified, cohesive, and goal directed manner.21 Collective consciousness is one of the strengths of the human species: a human group can accomplish a cognitive task more effectively than its best-performing member,22 and this ability to solve problems collectively is central to human groups’ long-term health.21

The Role of Main Street

Main streets anchor “regional geographies” through which residents of the urban built environment trace pathways patterned not only by where they live but also by the places with which they identify, the places in which they feel safe and welcome, the movement networks available to them, the examples set by others in their communities, and the distribution of the goods, services, and resources they require.23 When these pathways repeatedly overlap with those of others, the intersections have the potential to become the loci of social interaction, even the briefest of which may have the potential for a host of salutary downstream effects for the individual and the community.

If encounters on main streets lead to weak ties, which are building blocks for collective consciousness, which in turn allows us to solve problems and sustain healthy communities, it stands to reason that those main streets most conducive to casual interaction will have the greatest potential to promote community social cohesion. Jan Gehl identified three types of activities that can be observed in urban public spaces—the necessary, the optional, and the social—all of them occurring in a “finely interwoven pattern.”18 The public space promoting such activities, argue Gehl and others, is desirable. According to architect William Morrish, a successful main street is “convivial, crowded, and congested” (Morrish, personal communication). This may seem counterintuitive; crowding (meant to signify the close proximity of many people within a space) and congestion (meant to signify the convergence and resultant slowing of movement through a space) are not often thought of as desirable. But, taken together within a convivial atmosphere marked by friendly openness, the result mirrors Gehl’s sociable milieu, with a high volume of positive unplanned encounters.

If sociability—which we use to mean a tendency toward social interaction—is a desired function of main streets, what are the properties of main streets that promote this outcome? In searching the literature and speaking with colleagues who study streets, we have identified many efforts to think about social interaction in the public space, but have yet to find a widely agreed-upon term that encompasses these properties. We, therefore, propose our own—hospitality—which we define here as the combination of those traits of a main street that determine its effectiveness in promoting casual social interaction. Put another way, hospitality is the multi-level substrate of sociability in the built environment, and thus a foundation for health.

Social Disparity in the Urban Built Environment

Throughout the twentieth century, political decisions, economic interests, and patterns of investment that promoted segregation and geographic inequality led to the “sorting” of the American city by race and class.2431 Contemporary cities are marked by geographic disparities in collective efficacy and other indicators of social well-being resulting from the cyclical reinforcement of poverty, disadvantage, and instability.11,32 There is a growing literature linking residential segregation with health disparities,3335 and it stands to reason that much of this relationship may be related to the downstream effects of constantly sorting the city to the marked disadvantage of the most vulnerable. While it is widely accepted that this arrangement is detrimental to those low on the socioeconomic ladder, it is becoming increasingly clear that those further up are likewise locked into a social arrangement that produces stress and yields subpar societal cohesion and social function, resulting in diminished health and well-being at virtually all levels of the unequal society.36

Health disparities pose a major moral and economic challenge.37 The built environment has the potential to help foster social interaction and therefore cohesion, while the loss or destruction of urban place, a process that is unequally distributed, has the potential to further exacerbate community breakdown, social isolation, inequality, and epidemics of physical and mental illness. The equitable distribution of hospitable urban places, we argue, is a potentially important tool for addressing health disparities. In this case, we are examining main streets—in our view an under-studied unit of urban space—seeking to connect the multiple components that constitute their hospitality and thus their potential role in ameliorating or exacerbating health disparities. The political and social context of main streets, so heavily affected by sorting and inequality,24,29 must play an important role in any analysis of this concept. By approaching main streets in a holistic, multi-level fashion, this study attempts to lay groundwork for an ongoing effort to conceptualize the contribution of hospitality, and specifically main-street hospitality, to community health.


The Main Streets Study was carried out in three parts between 2008 and 2013. The first part involved visits to delimited commercial centers of 50 cities across the USA, France, and Japan focused on understanding and arriving at a definition encompassing the various iterations of main streets by walking them, photographing them, and participating in typical uses of the street such as lingering on a bench, patronizing a store or third place,38 people-watching, or attending a public event. Our observations followed four axes:

  1. Content: businesses, services, civic institutions, public spaces, and other amenities, as well as the mix of land uses including residential, commercial, and industrial
  2. Character: traits unique to the street, such as ethnic or linguistic heritage, businesses of cultural or historic importance, or evidence of community activities including festivals, streets markets, and parades
  3. Connection: availability of public transit, the scale and connectivity of the roads with regard to pedestrian and automotive use, the presence or absence of barriers, pedestrian infrastructure (such as lighting, seating, path-marking, and safety features), and the density of immediate and easily navigable connections to surrounding neighborhoods
  4. Construction: types, styles, and sizes of buildings, the relationship of buildings to the street, building size, the coherence, scale, and permeability (to human gaze or interaction) of the street wall

The second part involved participant observation of Englewood, Jersey City, Asbury Park, and Orange (all located in northern New Jersey), including frequent visits to their main streets and participation in related community activities like public meetings and design processes. These communities were not chosen at random, but rather on the basis of connections to appropriate community leaders through whom we were able to engage with the community. This portion of the study was designed to investigate how community members imagine and relate to main streets as social spaces.

The third part, an examination of the main streets of Essex County, New Jersey, carried out from 2012–2013, was designed to explore a key observation of the study’s initial phases: that “hospitality” appeared to be a function of the physical integrity of main street blocks, the neighborhood in which the blocks were embedded, and roadways along which the blocks were located. We called these three levels box, circle, and line, respectively.

We chose Essex County for several reasons. First, within the county’s 130 or so square miles exists practically every iteration of the urban, suburban, and exurban built environment. The county is also diverse socioeconomically and racially.39 Second, the cities and neighborhoods of Essex reflect many of the most fundamental forces that have shaped the twenty-first century urban landscape, including policies of racial and socioeconomic exclusion, deindustrialization, sprawl, urban renewal and forced displacement, and New Urbanism.25,26,2931,40 Third, Essex County’s geography is conducive to study. The county is layered in a vaguely semi-circular pattern comprised of successively more suburban rings around Newark, New Jersey’s largest city. Although the county blends with Passaic and Union counties to the North and South, respectively, Essex’s own historic logic means that many of its main roads and highways lead to and from Newark. To trace them outward from the city center is to cut a transect through layers in the urban ecosystem and their interfaces.41 The remainder of the methods section specifically addresses this third part of the project.

Site Selection

From August to the end of October 2012, we visited each of the 23 municipalities in Essex County, conducting visual observations of selected main streets (Fig. 1). For our purposes, we defined the term “main street” (lowercase) to refer to the section of a street (or streets) along which lay the chief corridor of commerce, services, and public administration for a town or, in the case of larger cities, a neighborhood or other relevant unit of urban space. We evaluated any additional main street exceeding two or three blocks of sustained commercial activity not intersecting directly with the primary main street within the zone of study. We relied on a combination of freely available mapping tools and local knowledge to identify main street corridors, limiting our observations to two main streets per municipality, except in Newark, where we evaluated a main street representing each of the city’s five wards and the downtown core, which we refer to as the “Central City.” Three municipalities lacking identifiable main streets were not evaluated. We did not standardize the length of street segment but always focused on the block or blocks characterized by peak pedestrian activity and commercial density.

FIG. 1
An overview of Essex County, New Jersey, depicting the main streets studied and their hospitality rating. Newark is divided into separate wards and the “Central City” section. Streets are labeled according to municipality or ward, except ...


We have proposed that a collection of observable main street traits collectively termed hospitality influences the street’s ability to foster and sustain a localized density of social interactions, or sociability. We assessed the first of these two variables of interest, hospitality, by selecting a range of physical and symbolic characteristics of the main streets we studied. As noted above, we hypothesized—based on our knowledge of the literature and on earlier phases of our work—that social interaction on main streets was influenced by their physical organization at three levels: that of the main street blocks themselves, the neighborhoods within which those blocks were situated, and the connectivity of the roads on which the main street blocks were found. We organized this hierarchy according to a typology we call the box-circle-line model, which characterizes the main street as a multi-level physical infrastructure for social interaction, and hospitality as the quality of this infrastructure. Within the spaces of the box, circle, and line, we made detailed observations about key characteristics of each as noted in Table Table11.

A summary of the box-circle-line model of main street hospitality, describing key features for each level

Sociability, the second variable of interest, was assessed using the proxy measure of directly observed social interaction. Main streets with substantial numbers of pedestrians engaged in any sort of social interaction24 or other stationary activities such as window-shopping, sitting or standing in place, and eating were considered high sociability. Main streets that had extremely limited pedestrian activity with minimal or no observable social interaction were considered low sociability. Streets with some pedestrian activity—including walking, shopping, and use of public transit—but lacking substantial social interaction, optional uses of street space, or evidence of community activity were categorized as moderate. We assigned main streets the highest reasonable level under these criteria.

Scope of Observation and Analytic Approach

We observed main streets during business days, spending 2–3 h on average in each location conducting a visual assessment, avoiding periods of inclement weather. We then aggregated street-level photographs taken during these visits with extensive field notes, contemporary and historical maps, and publicly available aerial photos1 “design sketchbook pages.” The design sketchbook is an analytic tool developed by the urban designer Daniel Rothschild that provides a holistic, multi-layered approach to conceptualizing a physical place. The sketchbook analysis involves combining information (street-level and aerial photographs, field notes, maps, and demographic information) into pages that are laid out in an accessible manner, allowing researchers to evaluate multiple scales of information and understand connections or themes that may not have otherwise been readily obvious. We used the design sketchbook pages to examine the ways in which box-circle-line was constructed for each main street. Then, we assessed the degree of sociability in each of those spaces.

Strengths and Limitations

The main streets sampled for this study were largely in New Jersey, a dense and culturally diverse state that is not representative of the US as a whole. We made a limited number of visits to each site, and only visited during specific hours, although we attempted to visit during hours where business and pedestrian activity would be substantial and to be consistent between streets. We did not collect a quantified census of businesses and other activities on the main streets, which would have added substantial detail, nor did we systematically quantify social interaction.

The major strength of our approach lies in the richness of data gleaned from direct, on-the-ground experience of the places we have studied. We have collectively spent many hours immersed in main streets, experiencing main streets firsthand as social places, economic places, community places, historic places, and so on. This multi-sensory experience, which would have been impossible without directly observing the streets we studied, allowed us to examine a wide array of variables. As two observers looking at the same spaces and frequently discussing what we were seeing, we were able to develop frameworks of assessment that had a high level of inter-rater reliability.


There are three main findings of our work. First, hospitality varied across main streets and was, in turn, influenced by regional patterns of movement and investment. Second, sociability also varied across main streets in Essex County, and this was correlated with hospitality. Third, the comings-and-goings on a main street constituted a system of collective exchange helping to create local, regional, and national solidarity, what we think of when using the term “Main Street” to refer to the “American People.” The process of identification, however, was constrained by the geography of difference.

Hospitality Varied among Main Streets

We observed a significant variation in environmental attributes we examined, including the physical makeup of the street, the integrity and accessibility of the surrounding neighborhoods, and the street’s position—both geographic and symbolic—within the movement network of a densely interconnected metropolitan region.

The Box

The first level of our model of main street hospitality is the “box,” which characterizes the enclosure formed by the road, sidewalk, and walls of the buildings on either side. Our observations of the physical qualities and local content of main streets suggest the box is defined by both form and content.

The Ironbound District’s Ferry Street features good pedestrian infrastructure—wide sidewalks, clearly marked crossings, adequate street lighting, and wayfinding signs, while the restriction of cars to one lane in either direction limits the speed and volume of traffic, facilitating pedestrian flow throughout the enclosure. Commercial storefronts occupy ground level for multiple blocks, largely uninterrupted. The street wall is highly permeable, meaning the continuous line of building fronts has large windows, sidewalk displays, and/or obvious and inviting points of entry.

By contrast, driveways, parking lots, and office parks frequently interrupt the buildings of Livingston Avenue. Crossings are infrequent and the street is wide, hampering pedestrian movement. There is little seating, much of which faces the busy road. Other lower hospitality main streets in Essex feature some combination of wide streets, multiple interruptions in the street wall (either by the absence of buildings or by the presence of blank walls and shuttered storefronts) narrow sidewalks, and limited seating.

Among the main streets of Essex County, coherent, permeable street walls featuring a variety of storefronts, narrow road width, frequent pedestrian street crossings, and quality seating all correlated with observations of street social function. These are all traits of human-scaled street design,4245which physically facilitate the use of a street as a “public living room”18 where people can engage in a variety of activities all while occupying the same well-defined space. Figures 2 and and33 provide examples of selected high- and low-hospitality main streets, respectively, from the standpoint of the box.

FIG. 2
Street-level scenes from two high-hospitality main streets, Ferry Street, Newark East Ward (top), and Main Street, Orange (bottom), depicting elements of the box, including narrow streets, human-scale street wall with permeability, features for pedestrian ...
FIG. 3
Street-level scenes from two low-hospitality main streets, Livingston Avenue near Northfield Road, Livingston (top), and Main Street, East Orange (bottom), depicting elements of the box characteristic of low-sociability main streets, including wide roads, ...

The Circle

One level up, geographically speaking, in the model of hospitality, the circle characterizes the attributes of the neighborhoods surrounding a main street and their relationship to it. The circle symbolizes local connectivity and bidirectional sustenance: main streets benefit from neighborhoods that are healthy, and vice versa. Traits relating to this level, derived from visual observation and assessment of maps and aerial photographs, include neighborhood connections, pedestrian infrastructure, and housing and neighborhood quality and accessibility in the surrounding areas.

In Livingston, where surrounding neighborhoods often lack sidewalks and individual buildings are widely separated, pedestrian routes to the main streets are prolonged, unclear, and in some cases dangerous, a situation exacerbated by the presence of intervening parking lots and other kinds of spaces. Other low-sociability main streets are regularly crossed by neighborhood streets with sidewalks but, for other reasons, may be difficult to reach; in East Orange, for example, pedestrian access to the main street is limited from the south by a railway, freeway, and large areas of tarmac and vacant land.

In Newark’s East Ward, Ferry Street regularly intersects streets leading to the adjoining neighborhoods that, aside from a few parking lots or vacant parcels, mostly contain relatively dense, intact housing. The roads all have sidewalks, allowing local residents to easily access the main street. Figures 4 and and55 give aerial views that help illustrate the contrast between a less hospitable main street and a more hospitable main street at this level, respectively.

FIG. 4
An aerial photo of Ferry Street, Newark (East Ward), a high-hospitality main street. The photo depicts traits characteristic of an intact “circle” including walkable, well-connected neighborhoods closely abutting the main street. The main ...
FIG. 5
An aerial photo of Main Street, East Orange, a low-hospitality main street. The photo is annotated to depict deficiencies in the “circle,” including fewer and more widely spaced neighborhood connections, wide highways cutting off adjacent ...

The Line

Main Streets do not exist in isolation from one another, and any model characterizing them as such would be incomplete. The third component of our model, the line, recognizes that main streets are streets, and therefore components in the densely interconnected network of movement; it contains the symbolic and physical traits of the regional geography that pattern this movement and, thus, access to hospitable places.

In metropolitan areas like Essex County, people from one community may frequently work, shop, socialize, or access services in another, especially considering that some facilities, such as movie theaters, no longer exist on every main street. The interconnection of main streets within Essex County also suggests that they are likely to affect one another and that variation among main streets will likely be experienced as a county-wide phenomenon. Thus, the strength of a main street’s line depends on the strength of the entire region, as well as on a particular main street’s integration with it.

The way in which this operates is visible in Essex. Orange’s Main Street has discount stores, clothing, and beauty supplies, Maplewood’s has a movie theater and a bookstore, and Montclair’s has an array of restaurants. These unique assets compliment one another; therefore, people move around to find what they need or to enjoy the ambiance. Even the disinvested main streets have retained unique businesses—many of them much loved “third places”44 that draw the knowledgeable from great distances. Limmin’s Trinidadian restaurant in East Orange and Bragman’s Jewish Deli in Newark are examples of this. Having the ability to navigate the complex system of main streets is a sign of being an “insider” in Essex County, as it is in other socioeconomically diverse places like New York City. But, this feature—that one must be an “insider”—is evidence that the variation in main streets undermines the countywide system of hospitality.

To leverage the variety of main streets and breadth of social connection they may offer, residents of a region rely on the integrity of the main street network as a whole. This integrity derives only in part on physical transportation infrastructure, which in Essex County is generally well developed and includes substantial bus, rail, and road connections throughout the area. The ability for outsiders to feel safe and welcome when they utilize regional main streets—an ability potentially threatened by fear, segregation, racial tension, policing practices, and economic exclusion, among other things—is also a fundamental prerequisite to an intact line. Figure Figure1,1, introduced earlier, helps visualize the line level as each street’s relationship the the network of Essex County’s main streets and also indicates hospitality, suggesting its distribution within this network to be somewhat geographically segregated. If the we split Essex County into three bands—an “inner band” consisting of Newark neighborhoods and the most immediate adjacent suburbs, a “middle band” of the next ring of communities, and an “outer band” of newer and more sparsely populated suburbs—we can see that many of our study’s highly hospitable main streets cluster roughly in the middle band, while the less hospitable main streets are primarily in the inner city and outer suburbs.

Sociability Varied, Correlated with Hospitality

When we visited Newark’s North Ironbound District, the Brazilian and Hispanic heritage of Ferry Street was proudly on display. Window signs read in Portuguese and English, and restaurants offered grilled meats and loaves of glazed bread. Shopkeepers lingered near front entrances, calling to passersby. On a weekday afternoon, the sidewalks were filled with workers on break, schoolchildren walking home, and elderly residents catching up with one another.

Compare this to Livingston Avenue at Northfield Road in Livingston. On a clear fall afternoon, the sidewalks were nearly empty. Outside Livingston Bagel, a well-known deli, families mingled on an outdoor patio, but the space was set back from the street apart from the sidewalk and reserved for patrons only. The descriptions of Livingston Avenue and Ferry Street depict the contrast we observed between main streets with low and high degrees of sociability, respectively.

Sociability varied widely throughout Essex County. Although we did not conduct any formal analysis, this variation did not obviously mirror socioeconomic status, racial makeup, density, or size of the surrounding community in any direct sense. What we did observe was that the sociability related to hospitality (see Table Table2).2). The main streets characterized by a high level of integrity in the box-circle-line were those that were likely to be occupied by lots of people, coming and going and appearing to enjoy crossing paths with one another. When sociability varied on a single main artery, it reflected changes in the integrity of the built environment as the road passed from one city or section to another. East Orange and Orange, which share a common border, provided a striking example of this: two poor cities, side-by-side, the former with a bedeviled main street and the latter with one of the most active main streets in the state.

Main streets studied, categorized according to hospitality, with observed sociability described as well

From Socializing on Main Street to Sense of Self

The final finding of our work is the observation of an important symbolic role for main streets. Main streets, by furnishing a sense of belonging and affiliation to residents of small towns and major cities alike,4 play an important part in place attachment46 and in the American identity. The twin roles of main streets—as both place and symbol—are underscored by the fact that there is “main street” and then there is “Main Street,” a metonym for average middle- and working-class Americans. People go to main streets to be themselves, carrying out routine tasks, and to see themselves, taking stock of their identities, history, affiliations, culture, self-worth, and aspirations.14,17,18,47 Observing main streets, we could readily see both the routine (post offices, liquor stores, nail salons, restaurants) and the symbolic (cultural festivals, parades, civic buildings, statues).

Heeding the box, circle, and line, this conversation between place and symbol occurs both on and among the main streets. Maplewood has two main streets, one the heart of the “village,” and the other a part of Springfield Avenue. The village main street is a modestly hipper version of Andy Griffith’s Mayberry. But, the other leaves the serenity of Maplewood and plunges into the traumas of Newark: Springfield Avenue in Newark was the heart of the 1967 riots, and the street still bears the scars of the policies that triggered the riots and impeded recovery from them. The shock of transition is so profound that people navigating the county learn to avoid it and the disturbing questions it raises. But, in accepting the disconnect, we rip “Main Street”—that is, the American people—into subunits that have lost their interconnection and their solidarity.


We have defined and characterized hospitality, the constellation of traits that facilitate social interaction on and among main streets, whose components include the integrity of the street (the box), the connectedness and viability of surrounding neighborhoods (the circle), and the main street’s relationship to the regional network of streets (the line). We have made the case that main street sociability plays a critical role in community health and yet varies substantially. Given the evidence linking social integration and health, we posit a role for this variation in downstream health disparities.

The importance of the physical form of the street, the walkability of the urban neighborhood, and access—both real and perceived—to an integrated regional network of main streets is not a novel idea; the box-circle-line model as a framework for hospitality fits into the tradition of a social view of urbanism, identifying the street and its surroundings as a crucial venue for community life in the city.1520,43,44,4850 We do, however, believe that our model adds substantial value to the discourse by integrating multiple levels at which policy and structural inequality may affect the sociability of a main street and thus become important to community health and health disparities. We are not focused on economic development, but rather on social cohesion, and our model highlights areas of study most germane to this question.

Hospitality, Health, and Disparity in a Geographic and Historical Context

Given the relevance of variation in main street hospitality, it is worth considering some of its potential causes. We have already described a geographic patterning in Essex wherein many of the county’s less hospitable main streets are located either in the innermost region of the county (including Newark itself and the inner suburbs) or in the outer ring of communities farthest from the city (see Fig. 1). What ties these two areas together, when at face value they appear quite different from one another across a variety of variables such as race, class, economy, and housing density?

Main streets in the innermost area of the county primarily serve communities of color that have been subjected to a cycle of policies whose net effect has been the dismantling of the inner city. These policies include residential segregation and redlining (discriminatory lending and insurance practices); the Housing Act of 1949 resulting in urban renewal, displacement (often to low-quality housing projects removed from community life), and the construction of freeways that linked white suburbs to downtowns while bypassing and cutting-off minority neighborhoods; further disinvestment and physical deterioration; deindustrialization; and mass incarceration.26,30,31 This cycle, characteristic of the sorted-out city, affects main streets at every level of the box-circle-line model.

Main Street, East Orange, is a case study in this process. Once a thriving commercial corridor, Garden State Parkway, and later Interstate 280 served to simultaneously cut the main street off from adjacent neighborhoods to the south and east, while encouraging predominately white commuting drivers to bypass the area altogether, thus undermining the street’s connection to the regional network (the line). The street’s surrounding neighborhoods (the circle) were destabilized by the contagious spread of disinvestment and housing destruction affecting Newark in the aftermath of redlining and urban renewal. The street itself began to deteriorate, as businesses that were once geared toward pedestrians and transit riders were dismantled and replaced with fast food restaurants, strip malls, and parking lots better suited to the drivers passing through the area (the box). Ultimately, the loss of physical integrity and the instability of the community may have been sufficient to undermine the ability of locals to identify with and celebrate the area. At no level were the changes affecting East Orange isolated; those affecting the community’s physical structure altered its place in the planning schema of the county. What happened to East Orange happened to most of Newark, to Irvington, to Bellevue, and to hundreds of inner-city neighborhoods across the country.31

By contrast, many, though not all, of the Essex communities farthest from Newark are suburbs that realized the full extent of their development only in the latter portion of the twentieth century, the high age of the automobile. This suggests that planning choices made during this era affected these main streets so as to preclude hospitality from the start. To borrow from Jan Gehl, street life was “built out” of them.18 Take Livingston Avenue as an example. Accommodations for cars, planned from the inception of the community, disrupt the coherence of the streetscape (the box). To suit the needs of cars, the buildings are spread out, and driveways frequently intersect pedestrian pathways. The local neighborhoods (the circle) are also built for cars, with widely spaced houses and often lacking sidewalks. The resulting main street, though placeless and difficult to visit or identify with, does feature notable third places, such as Livingston Bagel. Like Livingston, many of Essex’s outer suburbs were built primarily for whites fleeing the inner city with the intention of commuting back there only to work. The highways laid down to meet their needs were often the very same highways tearing apart the minority neighborhoods left behind.26

Whatever the politics, both suburban construction and urban dissolution have led, it appears, to a final common pathway: loss of enclosure, the loosening of the urban fabric, the neglect or closure of transit routes, the predominance of automobile traffic, businesses, amenities, and neighborhoods that actively discourage pedestrian access, the virtual absence of usable community spaces, and thus the loss of a local civic identity and regional cohesion. The assumption implicit in this view is that streets built at a time when cars were not widespread and which have avoided disinvestment, abandonment, and piecemeal dismantling tend, almost by default, toward high hospitality. This theory, evidenced by the geography of Essex County, may speak to the inherent attraction of main streets as gathering places, but also to their vulnerability to unfavorable political decisions, racial segregation, and the unequal distribution of built environment resources.

Disparity of Main Street as a Fracturing of Collective Consciousness

When it comes to the local main street, the typical experience of an Essex County resident will vary from that of a highly coherent, connected, and ultimately sociable place that sustains community, interaction, and identity to that of a loosened and scattered place without the ability to attract people, much less sustain them in robust and regular social interaction.

These latter communities, whose main streets indeed suffer from placelessness, risk losing the ability to foster localized social cohesion, a loss that could contribute to the well-documented inequality in collective efficacy and other markers of cohesion at the neighborhood level.11 These communities also risk losing the ability to attract others from the region and elsewhere. Alienated perhaps by the lack of what JB Jackson called “the stranger’s path,”51 outsiders may not only cease to make the inhospitable main street part of their own path, but in doing so divest themselves of whatever struggles and goals they might conceivably share with those living in such communities. Thus, while the uneven distribution of hospitable main streets is itself a form of geographic inequality (which, as we have pointed out, correlates with a deterioration in a variety of aspects of public health), it also sets up division, tension, and an erosion of the collective consciousness required to address critical societal challenges at the scale of action required.


Further research will be needed to refine the construct of hospitality and eventually measure its relationship to sociability and to health outcomes of interest in a more precise manner. In its present form, however, the box-circle-line model is primarily a framework for conceptualizing hospitality—the observable traits of a main street which contribute to its sociability—and thus for identifying various levels at which city, regional, state, and federal policy might affect a main street’s ability to serve in the building and maintenance of community social cohesion. Zoning codes, street planning, and development permitting processes may affect the box, while housing policy, bank practices, and the provision of fire and police services affect the circle. The line is subject to regional transportation planning and other policies that dictate movement options, as well as deeper structural concerns that affect people’s ability to welcome and be welcome. Because humans often draw cues from their environments, the ability of main streets to represent and capture people’s imagination will depend on all of these things, as well as on policies supporting the community’s efforts to identify, sustain, and celebrate its cultural heritage, whatever that may be. The geography of Essex County suggests that hospitable main streets must be both built and preserved and that policies that fail to do both will undermine the social function of the street, the social cohesion of communities, and the physical and mental health of all.


The authors acknowledge funding support from the Medical Student Research Fellowship Program at the Yale University School of Medicine.


1From Google Inc, Mountainview, CA


1. Leighton AH. My Name Is Legion. New York, NY: Basic Books; 1960.
2. Hughes CC, Leighton AH. People of Cove and Woodlot. New York, NY: Basic Books; 1960.
3. Lin N, Ye X, Ensel WM. Social support and depressed mood: a structural analysis. J Health Soc Behav. 1999;40(4):344–359. doi: 10.2307/2676330. [PubMed] [Cross Ref]
4. Barnett PA, Gotlib IH. Psychosocial functioning and depression: distinguishing among antecedents, concomitants, and consequences. Psychol Bull. 1988;104(1):97–126. doi: 10.1037/0033-2909.104.1.97. [PubMed] [Cross Ref]
5. Evans GW, Kutcher R. Loosening the link between childhood poverty and adolescent smoking and obesity: the protective effects of social capital. Psychol Sci. 2011;22(1):3–7. doi: 10.1177/0956797610390387. [PubMed] [Cross Ref]
6. Blazer DG. Social support and mortality in an elderly community population. Am J Epidemiol. 1982;115(5):684–694. [PubMed]
7. Eng PM, Rimm EB, Fitzmaurice G, Kawachi I. Social ties and change in social ties in relation to subsequent total and cause-specific mortality and coronary heart disease incidence in men. Am J Epidemiol. 2002;155(8):700–709. doi: 10.1093/aje/155.8.700. [PubMed] [Cross Ref]
8. Berkman LF, Glass T, Brissette I, Seeman TE. From social integration to health: Durkheim in the new millennium. Soc Sci Med. 2000; 51: 843–857. doi:10.1016/S0277-9536(00)00065-4. [PubMed]
9. Berkman LF, Syme SL. Social Networks, Host Resistance, and Mortality: A Nine-Year Follow-Up Study of Alameda County Residents. Am J Epidemiol. 1979; 109: 186–204. doi:10.1016/j.jdent.2015.12.004. [PubMed]
10. Sampson RJ. The neighborhood context of well-being. Perspect Biol Med. 2003;46(3x):S53–S64. doi: 10.1353/pbm.2003.0073. [PubMed] [Cross Ref]
11. Sampson RJ. Great American City: Chicago and the enduring neighborhood effect. Chicago, IL: The University of Chicago Press; 2012.
12. Wallace R. Social disintegration and the spread of AIDS—II. Soc Sci Med. 1993;37(7):887–896. doi: 10.1016/0277-9536(93)90143-R. [PubMed] [Cross Ref]
13. Granovetter MS. The strength of weak ties. Am J Sociol. 1973;78(6):1360–1380. doi: 10.1086/225469. [Cross Ref]
14. Cattell V, Dines N, Gesler W, Curtis S. Mingling, observing, and lingering: everyday public spaces and their implications for well-being and social relations. Health Place. 2008;14(3):544–561. doi: 10.1016/j.healthplace.2007.10.007. [PubMed] [Cross Ref]
15. Gehl J. A Changing Street Life in a Changing Society. Places Journal. 1989; 6(1): 7–17. Available from:
16. Forrest R, Kearns A. Social cohesion, social capital and the neighbourhood. Urban Stud. 2001;38(12):2125–2143. doi: 10.1080/00420980120087081. [Cross Ref]
17. Jacobs J. The death and life of Great American Cities. New York, NY: Vintage; 1961.
18. Gehl J. Life Between Buildings. Copenhagen, DK: Island Press; 2011.
19. Appleyard D. Livable streets: protected neighborhoods? Ann Am Acad Polit Social Sci. 1980;451:106–117. doi: 10.1177/000271628045100111. [Cross Ref]
20. Whyte WH. The social life of small urban spaces. New York, NY: Project for Public Spaces, Inc; 1980.
21. Wallace R, Fullilove MT. Collective consciousness and its discontents: Institutional distributed cognition, racial policy, and public health in the United States. New York, NY: New York State Psychiatric Institute; 2008.
22. Clement RJG, Krause S, Engelhardt von N, Faria JJ, Krause J, Kurvers RHJM. Collective Cognition in Humans: Groups Outperform Their Best Members in a Sentence Reconstruction Task. PLoS ONE. 2013;8(10). doi:10.1371/journal.pone.0077943. [PMC free article] [PubMed]
23. Cummins S, Curtis S, Diez-Roux AV, Macintyre S. Understanding and representing “place” in health research: a relational approach. Soc Sci Med. 2007;65(9):1825–1838. doi: 10.1016/j.socscimed.2007.05.036. [PubMed] [Cross Ref]
24. Hanchett TW. Sorting Out the New South City. Chapel Hill: The University of North Carolina Press; 1998.
25. Taggart HT, Smith KW. Redlining: an assessment of the evidence of disinvestment in Metropolitan Boston. Urban Aff Rev. 1981;17(1):91–107. doi: 10.1177/004208168101700106. [Cross Ref]
26. Newman K. Newark, decline and avoidance, renaissance and desire: from disinvestment to reinvestment. Ann Am Acad Polit Social Sci. 2004;594(1):34–48. doi: 10.1177/0002716204264963. [Cross Ref]
27. Schulz A, Williams D, Israel B, et al. Unfair treatment, neighborhood effects, and mental health in the Detroit metropolitan area. J Health Soc Behav. 2000;41(3):314–332. doi: 10.2307/2676323. [PubMed] [Cross Ref]
28. Gee GC, Payne-Sturges DC. Environmental health disparities: a framework integrating psychosocial and environmental concepts. Environ Health Perspect. 2004;112(17):1645–1653. doi: 10.1289/ehp.7074. [PMC free article] [PubMed] [Cross Ref]
29. Fullilove MT. Urban Alchemy. New York NY: New Village Press; 2013.
30. Fullilove MT, Wallace R. Serial forced displacement in American cities, 1916–2010. J Urban Health. 2011;88(3):381–389. doi: 10.1007/s11524-011-9585-2. [PMC free article] [PubMed] [Cross Ref]
31. Fullilove M. Root Shock. New York, NY: Random House LLC; 2005.
32. Morenoff JD, Sampson RJ, Raudenbush SW. Neighborhood inequality, collective efficacy, and the spatial dynamics of urban violence*. Criminology. 2001;39(3):517–558. doi: 10.1111/j.1745-9125.2001.tb00932.x. [Cross Ref]
33. White K, Haas JS, Williams DR. Elucidating the role of place in health care disparities: the example of racial/ethnic residential segregation. Health Serv Res. 2012;47(3 Pt 2):1278–1299. doi: 10.1111/j.1475-6773.2012.01410.x. [PMC free article] [PubMed] [Cross Ref]
34. Kramer MR, Hogue CR. Is segregation Bad for your health? Epidemiol Rev. 2009;31(1):178–194. doi: 10.1093/epirev/mxp001. [PMC free article] [PubMed] [Cross Ref]
35. Acevedo-Garcia D, Lochner KA, Osypuk TL, Subramanian SV. Future directions in residential segregation and health research: a multilevel approach. Am J Public Health. 2003;93(2):215–221. doi: 10.2105/AJPH.93.2.215. [PubMed] [Cross Ref]
36. Wilkinson RG, Pickett K. The Spirit Level. London: Allen Lane; 2009.
37. Frieden TR, Centers for Disease Control and Prevention (CDC) CDC health disparities and inequalities report - United States, 2013. Foreword. MMWR Surveill Summ. 2013;62(Suppl 3):1–2. [PubMed]
38. Oldenburg R, Brissett D. The third place. Qual Sociol. 1982;5(4):265–284. doi: 10.1007/BF00986754. [Cross Ref]
39. Ehret J, Ferdetta F. County Community Fact Book. New Jersey Department of Labor and Workforce Development; 2013. Accessed Sep 15, 2015
40. Lee BA, Reardon SF, Firebaugh G, Farrell CR, Matthews SA, O’Sullivan D. Beyond the census tract: patterns and determinants of racial segregation at multiple geographic scales. Am Sociol Rev. 2008; 73(5): 766–791. doi:10.1177/000312240807300504. [PMC free article] [PubMed]
41. Kelbaugh DS. Toward an Integrated Paradigm: Further Thoughts on the Three Urbanisms. Places Journal. 2007; 19(2): 12–19. Available from:
42. Kelbaugh DS. Repairing the American metropolis. Forum Appl Res Public Policy. 2001;1:6–12.
43. Leyden KM. Social capital and the built environment: the importance of walkable neighborhoods. Am J Public Health. 2003;93(9):1546–1551. doi: 10.2105/AJPH.93.9.1546. [PubMed] [Cross Ref]
44. Mehta V. Lively streets: determining environmental characteristics to support social behavior. J Plan Educ Res. 2007;27(2):165–187. doi: 10.1177/0739456X07307947. [Cross Ref]
45. Mehta V, Bosson JK. Third places and the social life of streets. Environ Behav. 2010;42(6):779–805. doi: 10.1177/0013916509344677. [Cross Ref]
46. Fullilove MT. Psychiatric implications of displacement: contributions from the psychology of place. Am J Psychiatry. 1996;153(12):1516–1523. doi: 10.1176/ajp.153.12.1516. [PubMed] [Cross Ref]
47. Orvell M. The Death and Life of Main Street. Chapel Hill, NC: The University of North Carolina Press; 2013.
48. Mitchell D. The Right to the City. New York, NY: Guilford Press; 2003.
49. Rogers SH, Halstead JM, Gardner KH, Carlson CH. Examining walkability and social capital as indicators of quality of life at the Municipal and neighborhood scales. Appl Res Qual Life. 2011;6(2):201–213. doi: 10.1007/s11482-010-9132-4. [Cross Ref]
50. Cain KL, Millstein RA, Sallis JF, et al. Contribution of streetscape audits to explanation of physical activity in four age groups based on the microscale audit of pedestrian streetscapes (MAPS) Soc Sci Med. 2014;116:82–92. doi: 10.1016/j.socscimed.2014.06.042. [PMC free article] [PubMed] [Cross Ref]
51. Jackson JB. Landscapes. Worcester, MA: Univeristy of Massachussetts Press; 1970.

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