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Preface Richard J. Jackson,
Part I. Introduction,
Chapter 1 An Introduction to Healthy Places Howard Frumkin, Arthur M. Wendel, Robin FranAbrams, and Emil Malizia,
Part II. The Impact of Community Design on Health,
Chapter 2 Community Design for Physical Activity James F. Sallis, Rachel A. Millstein, and Jordan A. Carlson,
Chapter 3 Food Environments Carolyn Cannuscio and Karen Glanz,
Chapter 4 Community Design and Air Quality Jonathan M. Samet,
Chapter 5 Injuries and the Built Environment David A. Sleet, Rebecca B. Naumann, and Rose Anne Rudd,
Chapter 6 Community Design for Water Quantity and Quality Lorraine C. Backer,
Chapter 7 Mental Health and the Built Environment William C. Sullivan and Chun-Yen Chang,
Chapter 8 Social Capital and Community Design Caitlin Eicher and Ichiro Kawachi,
Chapter 9 Vulnerable Populations and the Built Environment Chris S. Kochtitzky,
Part III. Diagnosing and Healing Our Built Environments,
Chapter 10 Transportation and Land Use Reid Ewing, Gail Meakins, Grace Bjarnson, and Holly Hilton,
Chapter 11 Healthy Homes James Krieger and David E. Jacobs,
Chapter 12 Healthy Workplaces Donna S. Heidel, L. Casey Chosewood, Matthew Gillen, Paul Schulte, Gregory Wagner, Kenneth M. Wallingford, and Liz York,
Chapter 13 Healthy Health Care Settings Craig Zimring and Jennifer DuBose,
Chapter 14 Healthy Schools Howard Frumkin and Jared Fox,
Chapter 15 Contact with Nature Howard Frumkin and Jared Fox,
Chapter 16 Resiliency to Disasters Timothy Beatley,
Part IV. Strategies for Healthy Places: A Toolbox,
Chapter 17 Behavioral Choices and the Built Environment Margaret Schneider,
Chapter 18 Policy and Legislation for Healthy Places Lisa M. Feldstein,
Chapter 19 Community Engagement in Design and Planning Manal J. Aboelata, Leah Ersoylu, and Larry Cohen,
Chapter 20 Measuring, Assessing, and Certifying Healthy Places Andrew L. Dannenberg and Arthur M. Wendel,
Part V. Looking Outward, Looking Ahead,
Chapter 21 Training the Next Generation to Promote Healthy Places Nisha D. Botchwey and Matthew J. Trowbridge,
Chapter 22 Healthy Places Research: Emerging Opportunities Richard J. Jackson, Arthur M. Wendel, and Andrew L. Dannenberg,
Chapter 23 Urban Health in Low- and Middle-Income Countries Jennifer C. Johnson and Sandro Galea,
Chapter 24 Built Environments of the Future Anthony G. Capon and Susan M. Thompson,
Glossary,
About the Editors,
Contributors,
Acknowledgments,
Index,
An Introduction to Healthy Places
Howard Frumkin, Arthur M. Wendel, Robin Fran Abrams, and Emil Malizia
Key Points
• The environment consists of the external (or nongenetic) factors—physical, nutritional, social, behavioral, and others—that act on humans, and the built environment is made up of the many aspects of their surroundings created by humans, such as buildings, neighborhoods, and cities.
• Health can be defined as complete physical, mental, and social well-being. This definition extends beyond the absence of disease to include many dimensions of comfort and well-being. While clinicians care for individual patients, public health professionals aim to improve health at the level of populations.
• The design professions include urban planning, architecture, landscape architecture, and transportation planning. Each of these focuses on an aspect of the built environment.
• Both the public health profession and the design professions took modern form during the nineteenth century, in response to rapid population growth, industrialization and urbanization, and the resulting problems of the urban environment.
• Public health practice is evidence-based, relying heavily on surveillance and data collection.
• Leading causes of morbidity and mortality include heart disease, cancer, diabetes, stroke, injuries, and mental illness. Many of these are related to community design choices.
• Even though public health has evolved as a distinct field from planning and architecture, these domains have numerous opportunities to collaborate, and this collaboration can lead to improved health, well-being, and sustainability in many ways.
Introduction
The citizens of Bay City were fed up. Getting across town to go to work or shopping had become an ordeal; the streets seemed perpetually clogged, and it was impossible to find parking. For people who had bought homes in the suburbs, life seemed to take place more and more in their cars—chauffeuring children to school and soccer games, driving long distances to stores, and worst of all, commuting to work. Meanwhile, the Bay City Courier reported a steady drumbeat of bad news: air quality was worsening, the health department reported a growing epidemic of obesity, and nearly every day there was a tragic car crash that killed or injured somebody.
The mayor, the city council, and the transportation department teamed up to address some of the quality of life problems. They envisioned an ambitious program of road building. Key components included a six-lane arterial highway along the bay shore, two new arterials crossing the city, and thousands of new parking spaces. Although this plan would destroy historic and beautiful bay views, sever a few older neighborhoods, and remove half of a prized city park, it would move traffic more effectively.
But the roads were never built. The local health department, urban planners, architects, physicians and nurses, park officials, historic preservationists, environmentalists, and neighborhood associations all came together in a remarkable display of unity. The coalition they formed proposed an alternative plan, one that centered on extensive pedestrian and bicycle infrastructure, investments in bus and light-rail transit, mixed-use development along the bay shore, and investments in parks throughout the city. The plan emphasized equity and included policies to avoid displacing established communities and to ensure a mix of housing types. The cost of this alternative plan would be slightly less than that of the combined road projects, and it would create a similar number of construction jobs.
The alternative plan won the day. It took more than twenty years to implement, and it required considerable political leadership to stick with it during the inevitable cost overruns and budget crises. But after twenty years, a remarkable series of changes had ensued.
The proportion of people walking or biking to work had risen from 3 percent to 14 percent, and the proportion of students walking or biking to school had risen from 5 percent to 21 percent. Transit ridership had increased more than fourfold. Traffic volume had actually decreased, air quality had improved marginally, and the epidemic of obesity had stabilized and was showing signs of reversing. Because many young families had moved into the city, the public schools had improved considerably and were now among the best in the state. And Bay City had become a destination city, attracting several prized high-tech and biotech firms because of its...
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