Dr. Richard Jackson, Chair of the School of Health at UCLA, and former head of the National Center for Environmental Health at the Centers for Disease Control and Prevention (CDC), argued that how we shape our environment impacts our health. There are now deep-rooted structural issues with the built environment that are creating epidemics of obesity, diabetes, and depression. Also, the current way of dealing with these structural issues is only just increasing the annual amount of spending on healthcare (now at 17 percent of GDP), instead of addressing the underlying problems. “We are now medicalizing the problems people are experiencing with their environment. We are no longer creating wellbeing.”
Instead of addressing the public health impacts of the absence of trees, low-albedo streets (which contribute to the urban heat island effect), as well as a lack of planning, public transit, or safe streets, we are instead “looking at the end of the pipeline,” the medical effects. Our environment is sending us a message: “We are appendages to our cars.”
Jackson outlined a few of the structural issues that need to be addressed:
How we build affects how often we are injured
Jackson said 24,000 lives could be saved each year if the country had the same low car crash fatality rates as New York City. The city provides easy access to public transit and safer street designs.
How we build affects the air we breathe and the water we drink
“Any place where we can cool the air, we can improve health.” When ground-level heat indicators go up, ozone levels also rise. Ozone is a leading contributor to asthma, a chronic disease that disproportionally impacts inner-city areas.
Cars are heavy contributors of ozone so “we need to invest more in public transit and biking.” One “natural experiment” demonstrated this: In Atlanta during the Olympic Games, people drove less, taking public transit to get into the city center. As a result asthma hospitalizations dropped by some 30 percent.
How we build affects what we eat
Each year, the CDC calls between 100 and 200 people nationwide, and goes through an hour-long questionnaire about their health. Through these studies, public health policymakers have found that obesity rates have gone through the roof. “Now there’s only one state where less than 20 percent of the population is obese.” Over the past twenty years, the obesity rate for teenagers has also tripled.
Obesity is a “common cause epidemic,” and a related health impact, diabetes, is now a “crushing health crisis,” driven in large part by the sedentary, car-based lives we are leading. Sprawl, in effect, kills.
How we build affects how active we are
Less density equals more driving. “We are engineering exercise out of people’s lives” by creating suburban cul-de-sacs and putting places of work and living far from each other. Higher density equals more walking. “This is an issue of life and death,” argued Jackson.
He also called for Fitnessgrams to be added to every report card. “Right now, 3/4 of graduating high school students can’t run or walk a mile in under 12 minutes.” By creating car-dependent communities,” we are taking away walking,” exacerbating the epidemic of obesity among kids as well.
How we build affects our home (earth)
There have been dramatic increases in C02 emissions over the past 150 years. More recently, our air has gotten hotter, the ground has gotten hotter (which impacts the fertility of soils), and ocean temperatures have increased (which combined with increased C02 levels has led to acidification).
Weather change is just oscillation, but climate change is impacting “hardiness zones.” Over the past twenty years, in New Jersey, “we’ve moved from hardiness zone 5 to 7.” This will have major impacts on what trees can exist in these areas.
Another major issue: reduced water. California alone is facing billions of new infrastructure investment to deal with the reduced ice caps in its mountain regions.
Part of the solution may be to design for wellbeing, which can also reduce the negative impacts of the built environment on public health.
For example, new green hospitals are including organic food gardens that help patients recover faster. Studies of patient experience demonstrates that views of nature (or even just images of nature) improve patient outcomes; most patients respond positively to nature art; even looking at nature can reduce the need for medication; and exposure to sunlight reduces hospital stays.
To sum up, Jackson said, “cars are not more important than people or trees.” But landscape architects also need to plant the right trees in the right places, and create long-term plans to keep trees in place. Additionally, capturing water on site is important given increased water shortages.
He called for ASLA to lead a charge on school gardens, adding that “ASLA members could adopt school gardens” in their neighborhoods and help integrate organic food into communities.
At the federal level, the upcoming transportation bill, where President Obama has focused his continuing recovery efforts, will need to dramatically increase investment in public transit, bike routes, and safe routes to schools.
To learn more, read “Built Environment: Designing Communities to Promote Physical Activity in Children,” a policy statement from the American Academy of Pediatrics (see earlier post). Also, read Dr. Jackson’s book, “Urban Sprawl and Public Health: Designing, Planning, and Building for Healthy Communities.”
Dr. Jackson made the case that landscape architects are health leaders, and since the days of Frederick Law Olmsted have been focused on improving people’s health and wellbeing. See an interview with Paul Morris, FASLA, on CDC’s Healthy Communities program, and how design can improve health.
