September 14, 2011

Design for living: ‘Making Healthy Places blends civic planning with public health

Any zookeeper knows that habitats must be designed to keep animals safe, content and healthy. Thats also true when planning communities and facilities for human beings — some places are good habitats for us and some are not.

The editors of a new book, Making Healthy Places: Designing and Building for Health, Well-being and Sustainability, published in August by Island Press, suggest that a more thoughtful, interdisciplinary and ecologically friendly approach to planning human habitats can promote health, sustainability and greater equity for people of all abilities.

“We tend to think of the places where we pass our days just as background,” said Howard Frumkin, professor and dean of the UW School of Public Health, one of the books  editors. “The notion that we should consider where we live, work, study and play as settings in which we thrive or dont thrive — is a core concept and the basic proposition of the book.”

He added, “Our argument is that we actually can optimize multiple goals simultaneously with a thoughtful approach to the built environment.”

Frumkin edited the book with UW colleague Andrew L. Dannenberg of Urban Design and Planning and Environmental and Occupational Health Sciences and Richard L. Jackson, professor and chair of the Department of Environmental Health Sciences at the University of California, Los Angeles. Making Healthy Places expands on Frumkin and Jacksons 2004 work, Urban Sprawl and Public Health.

The book contains writing by its editors as well as chapters by researchers Frumkin called “the very cream of the crop” in their respective areas. Contributors include James Sallis, Karen Glanz, Jonathan Samet, Ichiro Kawachi, Reid Ewing, William C. Sullivan and Timothy Beatley, among others.

With chapters on healthy homes, work places, schools and health care settings as well as sustainability, transportation, food systems, community engagement, safety, emergency planning and more, the book suggests nothing less than a cultural change toward planning and public health.

Howard Frumkin

Howard Frumkin

Frumkin said the two disciplines were more often linked in previous eras. “When the early urban planners were starting their work and Frederick Law Olmsted was designing parks and communities, there was a sense that the ultimate reason to do all this was the public welfare — for human health and well-being. But then the professions diverged,” he said. “So what were really doing isnt discovering something new but rediscovering old wisdom and implementing it in modern times.”

Making Healthy Places makes the case that thoughtful planning can bring social “co-benefits” as well, such as promoting physical activity to reduce obesity and providing more equitable access for vulnerable populations.

“This is really about giving people choices,” Frumkin said. “Its a recognition of the fact that our predominant pattern of design and build in the last 50-60 years has reduced peoples options.”

These co-benefits, Frumkin said, should be researched and fully accounted for as we decide how to build the places we inhabit. “We need to take the principles of biomedical research — rigorous thinking, hypothesis generation and routine collection and analysis of data — and apply them to the built environment so that we can make evidence-based recommendations about whats safe, whats health-promoting, whats cost-effective and what has spinoff benefits as well.”

He asked, “Whats the best design strategy that will both satisfy peoples needs for  green space access and minimize the environmental footprint? Thats the sort of thing about which we need more research.”

People need privacy, but they also need to be around other people. The idea of the “third place” — a gathering place that is neither home nor work — may help explain the meteoric success of Starbucks. But how should such places be created? “Should we recommend that developers of subdivisions build public spaces? Should we require those? Or, should we allow the private sector to provide them?”

Frumkin added, “Our ancestors, two centuries ago, would never have thought of omitting parks, squares and greens, but the typical suburban developer now doesnt do that because he wants to maximize the profit return from his land.”

Andrew Dannenberg

Andrew Dannenberg

Social justice goals also can be served with such planning, Frumkin said. That means using Universal Design, or creating facilities for use by the very young, the very old and people with disabilities. “It also means paying meticulous attention to good design for those at the bottom of the socioeconomic ladder.”

The idea of crossing academic borders runs throughout Making Healthy Places. Frumkin said. “Its my firm belief that theres almost no big question that can be answered within the confines of any one discipline anymore. Public health and the clinical professions — medicine, nursing and social work — all have to link with urban planning, architecture, landscape architecture, transportation, engineering — all of the professions that go into creating human habitats.”

He added, “Its very exciting. This is how you get the answers right.”

Frumkin praised the UW for its excellence in urban planning, architecture, engineering and public health and noted that because of its urban location, “a lot of people are thinking deeply and leading in many of these issues.”

He said, “One of the reasons I was so excited to come to Seattle was that I think this place can be a cutting-edge, vanguard community in doing the research, applying research results in practice, and monitoring the impacts so we know that were getting it right.”

Frumkin added, “It calls on us as educators to think very broadly about the way we educate. … We have to help our students see that being as effective as they can be means reaching across to other disciplines.”

That process has already begun — and students have been returning the favor. Co-editor Andrew Dannenberg has been teaching a class on the subject matter for a couple of years now called Public Health and the Built Environment. “The book was written as a textbook for the course,” he said. “And last year we used drafts from the book for the course and got feedback from some of the students, which got incorporated into the final version.”

Dannenberg also teaches a class on health impact assessments and runs a monthly Healthy Places Research Group at the UW that brings in monthly speakers from across many disciplines who are interested in this topic. The next one is in October, and you can learn more online.

Dannenberg said the theories behind Making Healthy Places align well with current market demands. “There is a market for walkable communities compatible with the principles of this book,” he said.

With a smile, Frumkin concluded, “As a physician I have become an amateur urban planner … and colleagues and friends who are urban planners or landscape architects are now increasingly thinking of themselves as public health professionals — and this is all to the good.”