Learning from Las Vegas. A 2013 update

April 18th, 2013

Learning from Las Vegas. A 2013 update.

Robert Venturi and Denise Scott Brown wrote their famous book, Learning from Las Vegas forty years ago. The book had two well-known ideas:  they divided buildings into either decorated sheds (those  that relied on ornamentation to communicate function) and ducklings (those that communicated their meaning by their physical form and they proposed that the architecture of Las Vegas  was meant to be seen by cars traveling by at 35-40 miles per hour.

I was in Las Vegas recently and I decided to reassess these ideas while there.

1. The decorated shed/duckling dichotomy is still valuable for considering architecture. But we now know that some buildings lie (the New York casino is not really New York). Also, a great many building simply have nothing to say. The curse of many buildings and neighborhoods is that they are dull. Or ugly. The fact that they are trying to say something is irrelevant.

2.  The architecture of the suburban strip may be meant to be observed at 35 miles per hour, but suburban traffic means that these speeds are rarely achieved. The architecture of the big box store behind acres of parking is immediately recognizable. But the slower speeds diminish their impact.

3.  In Las Vegas, new development eliminates the big setback from the street. The buildings now closely hug the sidewalk. So the very urban form the authors were celebrating, the conditions that facilitated the ability to appreciate commercial strips are no longer there.

4. Commercial strip architecture, essentially born in the post war era, is now old and feels dated. It’s not something new and trendy, if under appreciated. It’s what our parents like. It’s time for a new idiom to be born.

Obesity 4

April 11th, 2013

Other things about obesity

1.  Someone somewhere may be fit but fat, but you are not one of them.  And you’ll never be one of them either.

2.  Losing even ten or twenty pounds can have positive health benefits.

3. Set goals and evaluate how you are doing at regular intervals. Every month or so, do a self-assessment and see how you are doing. Above all avoid gaining weight.

4.  People who are overweight or obese know they are. They don’t need you to remind them or scold them. Be nice. It’s not easy to keep the weight off.

5. Obesity is not a personal moral failure, it’s a social (group) moral failure.

6. Avoid drugs and over the counter weight loss aids. They are unsafe or ineffective. Though surgery may help if you are severely obese.

7. Being too thin is a health risk as well. There are a lot of people with eating disorders and they need professional help and everyone’s deep sympathy and support.

8. There may be a sweet spot for maximum longevity around a BMI of about 26. This is just over the oversight line. But the maximum for overall good health is lower than that, squarely in the normal weight category.

9. Smoking to keep the weight off may work, but it’s extremely wrong.

10.  Weight lifting is a critical part of healthy living. Everyone who can and should do it.

11.  Buying cheap exercise equipment (and expensive equipment) so you’ll work out at home rarely works because most people don’t have the self-motivation to use it consistently.

Obesity 3

April 4th, 2013

Physical activity

1.  It’s impossible to get enough physical activity solely by going to the gym. No one who is gainfully employed or in a relationship (or looking for one) can get to the gym consistently enough.

2.  Therefore, you are going to have to incorporate physical activity into your day to day life. This means walking a half hour a day. Every day, good weather and bad.

3. Long commutes are bad for your health. You’ll never make up the time and you’ll spend far too much time sitting and being stressed.

4.  Even a little regular physical activity is good if you are sedentary.

5. Take the stairs.  Park further from your office or the mall entrance. Every step adds up.

6. Unless you are a college athlete, too much exercise doesn’t help. After about a half hour of vigorous physical activity, the marginal benefit declines.

7. It’s hard to get to the gym every day. And that fifth straight day at the gym doesn’t get you too much. Your body needs some rest.

8. Based purely on personal observation at the gym, one mistake beginners make is to spend too much time stretching. Five minutes is enough (there is little evidence that stretching helps prevent injuries though it may be good for long term heal and flexibility). But I’ve seen people spend half an hour or more stretching. They stretch rather than exercise. Not good. You only have so much time.

9. A personal trainer can be a great way to get fit or meet fitness goals. But not all are good. Avoid those that emphasize strange exercises that require help to perform. Or trainers that have you do dangerous exercises.

10. For me at least, there really is an exercise high where I feel invigorated. Try to see if you have can get there too

11. The advantage of a gym is that it is socially acceptable to check out the good looking bodies. But be discreet. Don’t be creepy.

12. Walking to get frozen yogurt does not improve health and fitness.

13. Don’t sit. Stand up every 15-20 minutes and walk some. This is good for your weight, back muscles, and eyes.

14. Walking seems to be good for mental health and avoiding cognitive decline. Walk. Walk as much and often as you can.

Obesity 2

March 28th, 2013

13. Unless you have a serious chronic illness, don’t bother with gluten free or other fad diets. If they appear to help, it’s most likely a placebo effect you’re experiencing. The other problem is that the more restrictive a diet is, the harder it is to keep to it.

14. If you do have a serious chronic illness, then definitely explore gluten free or other types of special diets. Though the science isn’t there yet, the anecdotal evidence is intriguing.

15. Don’t ever feed your children chicken tenders. Humanity existed for 100,000 years before they were invented. They may get you through a few picky eating years, but you’re setting your child up for a lifetime of bad eating habits and a taste for over indulging in salty processed fried food.

16. Keep adults away from the blue cheese and ranch dressings. Most salad dressings. They are all fat, salts, and sugar. You might as well put MnMs on your salad.

17. A little wine with dinner is good for you. If you have a substance abuse problem, No! Avoid any and all wine. Otherwise, have a glass at dinner. Just one glass. And maybe you shouldn’t drive after that.

18. Needing 8 glasses of water a day is a myth. But why not drink water instead if a soda or sweetened fruit drink.

19. Avoid sodas and most fruit drinks. They are bad whether sugar free or not.

20. Fasting may be good for spiritual health, but not for physical health. Do not fast.

21. A cleanse is pure pseudo-science. Avoid taking any advice from anyone who tells you it’s a good thing.

22. If it’s on the Internet, chances are it’s pure bunk.

23. Telling someone to talk to their doctor is the medical equivalent of the fine print in your cell phone contract. Your doctor doesn’t know because they weren’t trained in nutrition. The person giving you the advice is just covering their butt so they won’t get sued.

24. At any given meal, half your plate should be fruits and vegetables. Then some starch, preferably whole grain, then just a tiny amount of neat, if any. Eat your vegetables and fruits first.

25. Some things have to be eliminated from your daily life. Sorry, but no mochas, smoothies, cupcakes, etc.  You grew up without a daily dose of these things, be a child and go without them again.

26. But limited your food intake does not mean a life of deprivation. Go for better quality food and savor what you do eat. And if it doesn’t taste great, don’t eat it.

28. Don’t grocery shop when you are hungry. You’ll be more likely to buy things that are bad for you.

29. Develop a repertoire of healthy, easy and quick to make meals. Then make them.

Obesity 1

March 21st, 2013

Obesity 1

Having spent fifteen years researching obesity related topics, here is my take on how to achieve a healthy weight.

1.  Some scientists say that to lose a pound you must eat 3500 calories less than you burn, this is based on simple thermodynamics models. But because the human body can adjust its efficiency at using calories, the reality might be higher and the deficit may be over 4000 calories per pound. It’s not going to be easy to avoid weight gain or to lose weight

2. In general, each individual’s body does establish its own equilibrium point between calorie consumption and energy expenditure. Some scientists say that it is very difficult to change this point. Unfortunately, it is easy to adjust it up so that the body requires more food and tries to maintain itself at a higher weight. That’s one reason it’s so hard to lose weight and one reason that your first goal should be to not gain weight.

3. No one knows how many calories are in anything by just looking at it. No one knows what a portion size is.  So you have to drastically overestimate your portion sizes and underestimate calories per portion to be on the safe side.  Better still, check product information when you can.

4. Plan ahead. Check restaurant web sites for menus and calorie information if you can.

5.  Use small plates. They seem to trick the eye into believing you are eating more and the result is that you will eat fewer calories.

6. Avoid processed foods. They tend to have too many calories and too much salt. Sugar too.

7.  Eat as many vegetables and fruits as you can. But fried, salted, sugared, and buttered ones must be avoided.

8. Never finish a meal. Share or save for later. Never join the clean plate club

9. Never eat until you are groggy full. Well on Christmas, Thanksgiving, and your birthday you may. No other times.

10.  Those healthy alternatives at fast food restaurants?  Don’t believe it. They lie.  “Healthy items” often contain fats, processed chemicals, sugars, and who knows what else.

11. Meatless Mondays?  How about going the opposite and only eat meat once a week. Or only on special occasions? Or not at all?

12. Unless you are a woman of childbearing age, eat more fish. Women of childbearing age should also eat fish, but be careful to eat only fish from low on the food chain.

Chelsea, Massachusetts Water Front Park

March 14th, 2013

This is great news!  Ill post pictures when the park opens later this year.

Boston Globe Article

 

Climate change

March 7th, 2013

Of the ten largest snowfalls since 1935, 3 have been since 2000, 5 since 1997.  We were warned by climate change scientists this would happen.

 

http://www.bostonglobe.com/metro/2013/02/09/boston-biggest-snowstorms/DzYKmJfGEdy7C9Wd7uKmXM/story.html

The Built Environment and Obesity: What We Know and What We Need to Know

February 28th, 2013

OBECTIVES:

 

  1. Summarize current research and evaluate state of knowledge on the built environment/obesity link.

 

2.         Outline gaps in current knowledge and suggest additional needed research.

 

 

ABSTRACT

 

A number of studies have been published exploring the relationship between the built environment and obesity.  The vast majority of these studies have been suburban and cross sectional, comparing current outcomes to current conditions.  A very limited number have studied obesity before and after an environmental amenity has been built and none have been longitudinal with obesity as an outcome.  Few have focused on inner city and minority populations.  This is an appropriate time to assess the current state of the evidence.

 

While the some of the literature suggests that there may be a relationship between the built environment and obesity, there are a number of important research needs including:

 

Statistical/Epidemiological issues:  Are multilevel studies appropriate models for studying built environment/obesity relationships?  Does the evidence meet conventional standards of causality?

 

Longitudinal studies.  Do people move to automobile focused neighborhoods because they are already overweigh? Or does weight rise after moving to sprawled communities?

 

Interventions.  A limited number of neighborhoods might benefit from the installation of sidewalks or other pedestrian amenities.  But many other communities might not be so easily retrofitted.  What can be done to address obesity in the vast majority of already built neighborhoods?

Special Populations.  Most studies to date have focused on predominately suburban neighborhoods.  What can be done to improve the built environment in inner cities and communities of color? How does this research apply to people with disabilities?

 

Addressing these issues are critical if the current obesity epidemic is to be reduced.

Promoting Active Environments: A Public Health Approach to Large-Scale Behavioral Change

February 21st, 2013

Background

The public health profession has developed theories and methodologies to promote behavior change on both the individual and population level. From reducing tobacco use to encouraging seat belt acceptance, many behavioral change campaigns have been successful.  This paper suggests ways these theories and methodologies could be used to create large-scale, nationwide change to promote active living.

Active living environments is used here to mean communities that foster walking, biking, and public transportation through mixed use, compact and dense development forms, and transportation systems that reduce car use. The alternative is conventional development: large lot zoning, strict separation of land uses, and streets heavily engineered for cars.

Evidence suggests that active environments promote physical activity, reduce obesity, improve mental health, and strengthen social capital.  These may increase health and reduce morbidity and mortality.

 

Objectives

This analysis aims to provide the beginning of a discussion of what a broad public health campaign to promote the creation and use of active living environments might look like.  Objectives include:

  • Identify models of behavioral change that might assist policy makers and advocates to promote active living environments with an emphasis on families with children and communities of color.
  • Encourage efforts to change social norms that prioritize active communities.
  • Propose strategies for advancing the preference for active living.

Two outcomes were prioritized:

  • Increase demand.  How might we encourage individuals and families to choose to live in active environments?
  • Increase supply. How might we encourage governments to implement changes to codes and development guidelines that would result in more active communities?

 

Methods

This analysis included a scan of the public health literature on promoting behavior change.  In addition to broad theoretical models of change, it drew on experiences including reducing tobacco use as models for promoting change at both the individual and community level.

 

Results

Traditionally, public health has focused on promoting behavioral change on the intrapersonal, interpersonal, and population level.  All these levels must be addressed if we are to increase both the supply of and demand for active environments.  Specific examples include:

Intrapersonal Level. Health belief models of change suggest that public health efforts include working with individuals and families to help them understand that by living in active environments, they can increase physical activity and reduce obesity risk. Thus they should be educated regarding the ways that conventional environments can pose barriers to health, particularly for children, and that health may improve by living in active environments. These campaigns should utilize planned behavior theory and encourage changes in attitudes toward living in active environments, increase perceptions that moving to these environments would mean adopting new social norms that prioritize active living, demonstrate that families with children have the ability to live in these communities in ways that would enhance their health and well being, and identify specific neighborhood attribute choices that would promote health.  Stages of change theory suggest encouraging families to the point where they contemplate moving to an active environment and then help them make that move (a priority target would be people of color most at risk for obesity).  It also suggests that strategies to help those who already live in active environments not to leave (perhaps targeting inner-city residents considering moves to the suburbs).

Intrapersonal Level. Social cognitive theory suggests that campaigns to promote active living environments should aim to change expectations regarding the kinds of neighborhoods people should live in (for example, currently many families believe that conventional neighborhoods are the only appropriate place for children).  It would communicate the idea that individuals and families have the ability to demand and choose healthy neighborhood designs. Social network theory suggests changing norms of behavior so that conventional environments are seen as less desirable.  At the same time, living in active communities would be promoted as more healthy.

Population Level.  Communication theory suggests that information campaigns are necessary so that the public understands the health consequences of conventional development with special outreach to linguistic minorities.  Diffusion of innovation models would imply the targeting of key individuals (particularly in minority communities) as the starting point in changing social norms and behavior.  Community mobilization experience demonstrates the need for planning, coalition building, and action.

 

Conclusions

If we are to move towards having a sizable portion of the US (and other countries) living in active environments, then there is a need to initiate large scale attitude and behavioral change strategies. These initiatives should include working with individuals to increase the number of people who desire to live in active environments and to develop a constituency that supports changes in zoning and development guidelines. On the community level, these strategies would have the ultimate goal of creating more opportunities for active living.  Together, they may move societies toward better health.

The Metropolitan Environment and Health: The Impact of Income Inequality, Racial Segregation and Urban Sprawl on the Risk of Physical Inactivity

February 14th, 2013

Background

 

Physical inactivity is a risk factor for obesity, cardiovascular disease and premature mortality. But despite health warnings, many Americans remain inactive.

 

Methods

 

The data source was the 2001 Behavioral Risk Factor Surveillance System, a telephone survey of US adults.  Respondents living in all metropolitan areas defined in 2000 were included.  This study used multilevel analysis combining metropolitan level factors:  income inequality (GINI Index), Black-White residential segregation (Dissimilarity Index), urban sprawl (the Urban Affairs Review Sprawl Index) and per capita income along with individual level factors:  sex, age, income, race/ethnicity and education.  The risk of being physically inactive was compared to meeting current CDC guidelines for physical activity.

 

Results

 

The final sample consisted of 121,894 adults in 315 metropolitan areas.  In the full multivariate analysis, increased levels of income inequality (odds ratio: 1.052, 95% CI = 1.033, 1.072), segregation (1.008, 95% CI = 1.005, 1.012) and urban sprawl (1.006, 95% CI = 1.003, 1008) were associated with an increased risk of physical activity.

 

Implications

 

Addressing the physical activity, and its health consequences, may require attention to the structural characteristics of the metropolitan environment.  While recent research highlights the role of the built environment as affecting inactivity, this study suggests that the social environment is also an important predictor of inactivity.

How did we get here? A history of health and the built environment in the United States

February 7th, 2013

How did we get here? A history of health and the built environment in the United States

Research on health and the built environment, often focused on obesity and physical activity, exploded after 2000.  In the past ten years, the number of published papers has dramatically increased and a consensus has emerged as to what is the ideal environment for promoting the health of everyone.  Part of this effort has resulted in new criticisms of conventional development patterns that has features which separately and in concert contribute to a variety of negative health outcomes.

Given the health problems now associated with conventional development, observers might conclude that conventional development resulted from ideas about the built environment that consciously ignored their potential health impacts or were created without any underlying thought or theory at all; conventional development is the result of mindless chaos.  But this is wrong.  The very features of conventional development now known to be negative for health are actually the result of thoughtful responses to the perceived health and environmental problems of earlier times.

Health has played a major role in shaping the built environment since the middle of the nineteenth century.  The professions of public health and urban planning both arose during this time in response to the health and environmental problems associated with industrialization, immigration, and urbanization.  Health provided the legal rational for public policy interventions that shaped urban law, zoning, and building codes.  It was an important force in conventional suburban design theory, ideas regarding urban growth and decay, and major architectural movements such as modernism and suburban neighborhood design.

This has important implications for current efforts to produce active living environments.  Battles over the legal authority to regulate housing parallel current efforts to limit access to unhealthy food in schools and neighborhoods, for example. The findings also suggest the need for continuing reassessment and evaluation.  A central problem underlying many of the policy failures of past efforts to improve the built environment to promote health is that hypotheses were untested and implemented programs were not evaluated.  Thus the health effects of the conventional suburban cul de sac neighborhood were not assessed until the end of the 1990s, nearly 45 years after the large scale post war suburban growth surge began and over 100 years after the theory of neighborhood design that produced it began to emerge.

By learning about the struggles, successes, and failures of past policies, we can make current and future efforts to use the built environment to promote health more effective.

 

 

 

 

 

 

 

 

 

 

 

The One Percent: A Culture of Poverty?

January 31st, 2013

Most sociologists have focused on the poor. Speculating here, there may be several reasons for this. They are perceived as being a major problem for society, there are a lot of them, and they are relatively easy to study: they are often powerless to resist being poked and prodded and put under a microscope.

But what about the very rich?  From warping politics to skewing US society toward greater inequality, they are a group that has had a profound impact on US society. But they are relatively opaque. We know little about how and why they behave the way they do and what might  be the implications of their behaviors. At the very minimum, they seem to be profoundly unhappy and feel they are unappreciated lately.

So one project I am working on is to use the frameworks of analysis used to understand the poor as a means to analyze the wealthy. Te results, which should be ready for publication in the spring, are very interesting and potentially informative for public policy.

Children in cities

January 24th, 2013

For my follow up to my book on the history of using architecture and health to promote health (see Building American Public Health: Urban Planning, Architecture and the Quest for Better Public Health in the United States), I am working on a book on the history of children in US cities. It’s going to interesting. For one thing, children are very sensitive to the envieprinmental conditions around them.  Changes in social policy as well as health and environmental problems can have a profound impact on them. From th rise of US cities in the nineteenth century to changes in welfare policy in the twentieth, children have seen important changes in their living conditions

Some of the topics I intend to address include: child labor, infectious diseases, schools and segregation, environmental diseases, and obesity and the issue of whether children should live in cities at all. I am deep into the research and writing of this book.

New York Streets Neighborhood – Boston

January 17th, 2013

Henri Lefevbre famously said that urban space is socially constructed. Peter Marcuse elaborated on this by pointing out that urban form is the result of conflict  between groups.  Langley Keys used game theory to describe these conflicts, pointing out that different groups have identifiable strengths and goals they bring into these conflicts and thus the resulting form is the result of compromises and battles between these groups.

But what happens when one group has all the power and has no need or desire to compromise?  The result can be the extreme rebuilding of a neighborhood.  One community that has seen at least a half dozen of these highly unequal battles for space is Boston’s New York Streets Neighborhood.  This project is a case study documenting how extreme inequality can dramatically change urban landscapes.

A history of urban sprawl

January 10th, 2013

We know that people in the United States have been moving to the edges of cities and metropolitan areas for centuries. See Robert Bruegann’s A Compact History of Sprawl or Dolores Hayden’s Building Suburbia for the details of this history.  Even the post World War II era saw several waves of suburban development development that Hayden characterized as sitcom suburbs and edge cities. The end of the century saw extreme commutes with a lot of development in what are now often referred to as exurbs.

But what we don’t know is how much sprawl has been occurring over the past many decades and whether these trends are continuing at a steady pace, accelerating, or decelerating. One very imprecise measure is the proportion of people living in suburbs versus center cities, but this tells us very little  because some suburbs are very dense and sone central cities contain large areas of low density development. For example, some suburbs are denser than their center cities: Somerville, MA and Daly City, CA are two.  Other cities, such as Phoenix and Houston, have very low density areas within their city limits (not to mention the issue with measures for consolidated cities an counties).

A problem with many sprawl measures is that they’re relative measures. Even if you could calculate them for multiple years, they would not tell you how sprawl changed in that particular metro area.

So one project I am working on is to calculate sprawl for every metro area for each census year from 1970 to 2010. This uses a measure developed by my colleague Pat Hynes and me that is based on the difference between the proportion of a metropolitan area’s high density and low density population. A measure I call the Density Balance Sprawl Index.

The results, almost ready for publication, will surprise many people. Stay tuned.

Frieda Garcia Park

January 3rd, 2013

One of the first people I met when I moved to Boston was the great Frieda Garcia. She was a committed activist who worked hard to make a better place for Boston’s Latino community. A few months ago, they dedicated a park to her. Here are some of the pictures.  There are to a lot of Latino place markers in Boston, despite a long history here.  As far as I know there is this park, the Jorge Hernandez Center, the Rafeal Hernandez School, and most anomalous, a statue of the Argentine educator and President, Domingo Sarmiento (I’d love to find out how it came about that a statue of him was out on the commonwealth Mall).

Here are some pictures I took of the park.

Holiday break

December 19th, 2012

Between the holidays and getting a new computer, I am taking a break.  See you in January!

Toronto Parklets

December 10th, 2012

The City of Toronto has done a great job of adding some action to Yonge Street, which needs it.  The street suffers from the deadening influence of Eaton Center, a 1970s era downtown shopping mall complete with fortress like facades on Yonge.  Going north, the street is lined with strip clubs and my personal favorite, discount sushi restaurants (that was sarcastic).  Here are some of the parklets:

 

From The Built Environment and Public Health: Natural Disasters

December 3rd, 2012

The destruction in New York City reminded me of the role of public health in preparing for and responding to natural disasters.  Here is the introduction to the Natural Disasters and Infrastructure Chapter in my book, The Built Environment and Public Health

Though many people would like to think that those of us living in this most modern and wealthy society are immune to the effects of natural disasters, events in the past several decades have continued to highlight the vulnerability of people to natural disasters even in those countries that consider themselves to be the most advanced. In the United States, there have been the repeated disasters caused by hurricanes, most notably Hurricane Andrew in 1992 and Hurricane Katrina in 2005. In addition, portions of the United States are highly vulnerable to earthquakes with the 1989 Loma Prieta earthquake responsible for 63 deaths and billions of dollars in damages including the failure of a freeway in Oakland, California. More subtle, but perhaps just as deadly are extreme weather events which have killed thousands in the United States and Europe in the past 15 years. While these deaths are perhaps not as dramatic as those caused by earthquakes and hurricanes, collectively they are responsible for many more deaths.

But infrastructure is not just a factor in preventing mortality, well-built and well-maintained infrastructure can be central in the promotion of health. Much of this health affirming infrastructure is discussed elsewhere in this book, for example, the role of sidewalks in promoting health is presented in Chapter 4 and the ability of well-designed communities to promote physical activity is addressed in the Chapter 3. But there are other very valuable types of infrastructure and this chapter will include such features as parks and playgrounds and their impact on public health.

A major theme in a discussion of natural disasters, and health is that even though the exact timing of many of these events cannot be predicted, their effects can be anticipated, protective measures adopted, responses planned, and deaths and injuries prevented. There is no inevitability about the deadliness of natural disasters.

 

From Building American Public Health: Latino Demographics

November 26th, 2012

I try to avoid any political commentary, though that is not easy.  But given the election, I thought this selection from my book:  Building American Public Health:  Urban Planning, Architecture, and the Quest for Better Public Health in the United States, was relevant.

THE GROWTH OF THE US LATINO POPULATION

 

The 2010 Census revealed continuing shifts in the population of the United States.  One of the most important of these is the tremendous growth of the Hispanic population.1 What in 1990 was a modest 8.9% of the population concentrated in a few states, now represents 16% of the country’s population and almost every state has important numbers of Latinos.2 Several states are already a majority minority. Others are moving rapidly in that direction and by mid century, non-Hispanic Whites may no longer be a majority in this country.3

There are potential benefits to this population growth.  This group has represented the bulk of growth in this country in the past twenty years and some states and cities would have lost population if not for Latino immigration and high birth rates.4 Hispanics fill vital roles in this country including providing much of the workforce for the construction, manufacturing and service industries.  There is also what is known as the Hispanic paradox, Latinos, or at least those of Mexican ancestry, tend to have lower death rates than non-Latinos.5 In general, this is a healthy population, even including the native born (immigrants tend to have better health because healthy people are more likely to emigrate).

But as Hispanics assimilate, and evidence suggests that Latinos are assimilating at a faster rate than did previous migrants to the United States,6 their health status declines towards that of the non-Hispanic, native-born population.  Already, there are serious concerns with obesity, diabetes, physical activity and other issues in the Latino community.7  This may make efforts to address health problem through modifications to the built environment issues an imperative.8 Latinos are less likely to own cars and more likely to take public transportation, attributes that should be encouraged given how this lowers environmental impacts.9

 

Happy Thanksgiving!

November 19th, 2012

See you next week!

New York Streets Neighborhood Boston

November 12th, 2012

I am working on a paper on how local to global economic and social forces can dramatically reshape a community. The paper focuses on the New York Streets area of Boston. It was once a poor but close knit integrated community. Then it was destroyed by urban renewal. The neighborhood had 4500 people when it was completely demolished.  It was replaced by a failed industrial park.  The community was the home of Mel King, the great State Representative and almost Mayor of Boston.

Allison Barnett (a great writer) recently authored an article on NYS in the South End News.

Here are some pictures I took of the area.  Imagine 4500 once lived here.

 

Graphic Health Post

November 5th, 2012

Allison Morris sent this to me.  I found it profoundly important. The graphic comes from Insurance Quotes.

Inactivity Pandemic

Don’t be surprised (or insulted) if the next prescription your doctor hands you is for nothing but an exercise regimen. Globally, 20% of early deaths are preventable with moderate exercise. And for the first time last year, sitting killed 5.3 million people worldwide, more than smoking. Inactivity is now considered as a full-on pandemic by health officials. Many U.S. doctors are pushing to make a “lack of exercise” a mainstream medical diagnosis.

U.S. adults end up sitting for an average of 8-10 hours everyday. This makes the American lifestyle one of the most sedentary in the world. After long commutes and hours at our desks, we can hardly blame ourselves for posting up on the couch right when we get home. Luckily, getting enough exercise is a lot easier than most of us think. The American Medical Association says that just 150 minutes of moderate exercise is all it takes to drastically reduce the risk of lifestyle diseases like obesity, diabetes and heart diseases for most adults.

PLEASE PROVIDE ATTRIBUTION TO INSURANCEQUOTES.ORG WITH THIS CONTENT
Inactivity Infographic

First, let’s get rid of pedestrians

October 29th, 2012

Not to pick on Provincetown, Massachusetts, but the mindset there is typical of the prejudices in the US regarding pedestrians.  Macmillan wharf is a multimodal site where as many as 5,000 people travel by ferry to and from Boston and there are multiple other travelers on whale watches and fishing expeditions.  About a half dozen cars meet each ferry as well as a half dozen taxis.  So what group gets yelled out by the harbor authorities to stay in line?  The pedestrians!  They are yelled at to stand to the side, to keep out of car and parking lanes, etc.  They are the group least accomodated on the pier, even though the vast majority of people leave the wharf on foot.  Typical.

Plus. In an effort to maximize town revenue, the limited pedestrian space is cluttered with souvenir stands and excursion sellers.  Again, the pedestrians lose.  Again. Typical.  It’s a national problem.

The line of people waiting for the ferry to Boston.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Helmets and Bike Safety

October 22nd, 2012

The New York Times and the Boston Globe recently published op-ed pieces on bicycle safety.  The  Times talked about how helmets so discourage biking that their net effect is negative on health.  The Globe had a number of recommendations on how to improve safety, but they were almost all focused on bike riders, not on improving the environment.  Here are some relevant stats:

Number of bike related fatalities is about 800 per year. Note that this includes ALL bike accidents including off trail biking, not just biking on the street.

A study of bike related visits to emergency rooms in 2009 found 51,000 motor vehicle related and 368,000 non motor vehicle emergency room visits in the US in 2009.

Intracranial injuries accounted for 21,000 or 5% of visits, the sixth highest rank.  Skull and face fractures accounted for 6,600 visits, 2% of the total.  Some proportion of both of these would not be related to helmet wearing.  However, intracranial injuries resulting in hospitalizations were 5,800, 21% of hospitalizations and the number one reason for hospitalization.  So these tend to be more serious.

Head injuries are important, but they are not the overwhelming reason for injuries or hospitalizations.

Another nice review for Built Environment and Public Health

October 15th, 2012

Summer 2012   Issue 210 – 9 – Florida Journal of Environmental Health – www.feha.org
FEATURE ARTICLE
“The Built Environment
and Public Health “
by Russell P. Lopez
A book review by
Dorothea M. Volzer, MFA
Written in an easy-to-understand style,
The Built Environment and Public Health by
Russell P. Lopez contains a wealth of
information. The data supplied substantiate
the author’s concern that public health is
definitely affected by the environment that
we have built for ourselves.
Starting with community design, Mr.
Lopez shows the impact on our health. The
growth of suburbs has resulted in sprawl,
loss of farmland, more roads, and more
cars with longer commutes. These issues
in public health were not a concern until
the obesity epidemic. Promoting walking
and bicycling, reducing the need for a car,
and eating better foods can make a big
difference. Better health results from better
environment. Simple things like providing
access to goods and services, parks, and
recreation areas that can be walked to will
help with obesity and overall health. In
addition, car emissions also go down.
Obvious improvements in housing have
helped. Indoor plumbing, better appliances,
and improved building practices are all
helping to keep our environment healthier.
There is still much to be done with our air
quality, both indoor and outdoor. Major
improvements since the 1970s legislation
have significantly helped improve outdoor
air quality. Even so, ozone is still above the
EPA standards in many areas of the United
States. The Built Environment and Public Health
showed the many areas that still require
improvement. Particulates, such as road
dust and industrial emissions, harm lung
function. More homes and condos by
major highways are exposed to a lot of air
pollution. Second-hand smoke continues to
be a problem as well as the indoor air quality
within our schools. While we monitor
water quality, use graywater for irrigation,
and have started some desalinization, this
book points out many areas that need to be
addressed before our built environment will
really improve the public health.
Any program designed to address obesity
must include the food we eat. Mr. Lopez
does not disappoint in this area, and he
includes many relevant ideas. For the
majority of the United States, our food
travels thousands of miles from where it is
grown to our supermarkets. Along the way,
it can be contaminated in numerous ways as
we have experienced or heard about on the
news. Recalls are almost a daily event. The
increase in popularity and number of local
farmer’s markets will result in healthier
food and a healthier public.
Population health has been, and may
always be, related to affluence. Besides
income, race, age, and disabilities can
determine your vulnerability to poor health
in the built environment. Mental health is
also affected by noise levels, lack of parks
and green areas, and population density.
Road rage has increasingly become a
problem in the United States.
This book states that low income and
race increase the risk of poor health
because of their poor built environment.
The environmental justice movement
gives all people an equal right to a clean,
healthy environment. The mid-1980s
brought this idea to the forefront. By 1994,
the National Institute of Environmental
Health Services made the consideration of
environmental justice part of United States
federal decisions.
The last chapter deals with information
and tools available to make better health
through a better environment possible for
all of us. The guidelines contained in The
Built Environment and Public Health by Russell
P. Lopez make it a must-read for all who
work in public health.

Model tenements today

October 8th, 2012

In Boston’s South End, there is a street of buildings built as model tenements over 125 years ago.  It is still affordable with Section 8 agreements covering the 80 units.

 

Daniel Burnham

October 1st, 2012

I  personally believe that Daniel Burnham was one of the United States’ best architect/planner.  For the past few months, I have been taking pictures of his projects as I have passed by.  Here are some of them.

 

Union Station in DC

 

 

 

 

 

 

 

 

The National Mall in DC.  L’Enfant may have laid out the original plan, but Burnham and associates revitalized and extended it.

 

 

 

 

 

 

 

Burnham’s Flatiron building is as exciting today as when it opened in 1902.

 

 

 

 

 

 

 

 

 

 

Sadder is the current state of the Filene’s building in Boston.  A developer took down most of the building, except for the facade.  The recession killed the project.  Hopefully, the project is about to be restarted.

 

 

 

 

 

 

 

 

 

 

 

 

Public Art in Boston

September 24th, 2012

The Os Gemeos mural on the Rose Kennedy Greenway in Boston. Some have called this painting of a little kid in pajamas a glorification of terrorists.  I think they liven up a drab part of the Greenway.  In any case, they are temporary, to be removed in November.  They should be replaced by other art works.

 

 

 

 

 

 

 

 

Press Release for Building American Public Health

September 17th, 2012

 

 

 

 

 

 

 

 

 

 

 

PUBLICATION DATE: May 22, 2012

CONTACT:  Lindsey Ruthen, Associate Publicist

646.307.5659, Lindsey.Ruthen@palgrave-usa.com

 

Building American Public Health

Urban Planning, Architecture, and the Quest for Better Health in the United States

By Russell Lopez

 

“A rich and readable history of urban planning, public health, and the links between them.”

—Howard Frumkin, dean, School of Public Health, University of Washington

 

From the industrial revolution to the rise of the modern obesity epidemic, many generations of American reformers and advocates have sought to protect and promote health by manipulating how we build housing and neighborhoods. Each era’s conceptualization of a healthy environment is documented in its street layouts and architecture.

 

In BUILDING AMERICAN PUBLIC HEALTH: Urban Planning, Architecture, and the Quest for Better Health in the United States [Palgrave Macmillan/ Pub Date: May 22, 2012/ ISBN: 978-1-137-00243-3/ $90.00-Hardcover], author Russell Lopez provides a history of how urban planning and architecture have been deployed to improve public health in the United Sates. He highlights the work of tenement reformers, zoning advocates, Modernist architects, New Urbanists, and members of the new built environment and health movement, among others, to improve the health and social conditions of their time by modifying the environment around them.

 

BUILDING AMERICAN PUBLIC HEALTH begins in the nineteenth century, when problems in rapidly urbanizing cities threatened to overwhelm cities, and then traces the development and impact of reform movements up through the First World War, including discussions of model tenements, the ‘city beautiful’ movement, tenement laws, and zoning and building codes. Midcentury design movements, such as new efforts to plan suburbs and Modernism, along with outlines of the impacts of public housing, highway building, and urban renewal, are the focus of the middle chapters of the book. The final third examines the revival of cities and the reconnection of public health with urban planning that occurred as the twentieth century ended.

 

Russell Lopez received his Master of City and Regional Planning degree from the Kennedy School of Government at Harvard University, and a Doctorate in Environmental Health from Boston University. His research interests include urban environmental health and the role of the cities, neighborhoods, and the social and built environment in public health outcomes and health disparities. He has taught courses related to the built environment and urban health at Northeastern University and Boston University.

Analysis of the Boston Dudley-Downtown Silver Line Bus Rapid Transit

September 10th, 2012

Using the BRT Scorecard put together by the Institute for Transportation and Development Policy, I analyzed the Silver Line bus rapid transit line between Dudley, in Boston’s Roxbury neighborhood and downtown.  There is another Silver Line in Boston that connects South Station with the airport and selected South Boston locations, but the two segments are not connected (that’s a whole other issue).

 

Bottom line:  17 points out of 100.  Hardly qualifies as a bus rapid transit at all.

 

 

Here are my detailed findings.

 

Item                             Maximum Points           Silver Line Points            Explanation

 

Off Board Fares                                    7                                  0                      Pay as you board system

Multiple routes                         4                                  4                      Line has two end points                                                                                                                          downtown

Peak Frequency                        4                                  0                      Assumes 10 minute frequency

Off Peak Frequency                  3                                  0                      Sometimes 20 minute frequency

Express runs                             3                                  0                      None

Central control of runs               3                                  0                      If it’s there, it’s not working

Corridor in top ten bus              2                                  2                      It is highly used

ridership

Hours of operation                    2                                  2                      Service runs on weekends and                                                                                                               evenings

Multi corridor network              2                                  0                      None existing or planned

Busway alignment                    7                                  0                      Along curb (worst place for it)

Segregated alignment                7                                  1                      Colored pavement (mostly)

Intersection treatment                6                                  0                      Nothing to deal with cars                                                                                                               turning into the busway

Passing lanes at stations                        4                                  0                      None. buses bunch up

Emission standards                   4                                  4                      Natural gas buses

Stations set back from               3                                  0                      None meet the 120 foot standard

intersections

Center stations                          3                                  0                      None

Pavement quality                      2                                  1                      About half have been improved

Platform level boarding             6                                  0                      None

Safe and comfortable stations    3                                  0                      All are as bad as they can be

Number of doors                       3                                  3                      Not sure of criteria, giving                                                                                                              benefit of the doubt here

Docking bays and substops       2                                  0                      None on system

Sliding doors                            1                                  0                      None

Branding                                  3                                  3                      Good job on this

Passenger information               2                                  2                      Approaching times well                                                                                                                         announced

Universal access                       3                                  0                      None

Integration with system             3                                  1                      Not great

Pedestrian access                      3                                  3                      Easy to access stations

Bicycle parking                         2                                  0                      Spotty at best

Bicycle lanes                            2                                  1                      Some but not entire route

Bicycle sharing integration        1                                  0                      Only a few stops have stations

Low speeds                              -10                               0                      Unable to evaluate

Low peak time utilization          -5                                 0                      Crowded buses

Enforcement of busway             -5                                 -5                     ALWAYS cars parked in                                                                                                               busway

Gap between bus and platform   -5                                 -5                     Measure it in feet

Station encroaches on busway   -3                                 0                      No real station infrastructure

Overcrowding                           -3                                 0                      Seems overcrowded but not sure                                                                                                          of metric

Maintenance                             -3                                 0                      Not a problem

Distance between stations         -2                                 0                      Not a problem

 

 

 

Observations of a bike sharing enthusiast

September 3rd, 2012

As an avid user of Boston’s Hubway bike sharing system, I have the following observations:

1. Location is critical. I won’t walk more than a few blocks to or from a bike sharing station. If I have to walk further, it’s not worth it.

2. Using the system vastly increases productivity. I spend much less time in transit.

3. Most users don’t use helmets. (But as a public health person, I do – not that I don’t have concerns about public policy that focuses on helmets)

4. The website and app showing the status of docking stations are essential for using the service. Otherwise, one risks not finding the bike station or there may be no bikes or docking places

5. Using the system is way cool. People smile and wave at you when you are on one if te bikes.

6. The bikes are clunky. But that adds to the physical activity benefits. .

7. Bike sharing is no substitute for expensive infrastructure improvements. A cycle track is better than  bike sharing.

Congrats to the City of Boston for making this service available.

The lack of benefits of large projects

August 27th, 2012

Cities spend millions of dollars on sports arenas and cultural institutions in part because they are thought to help spur development around them. Well, not always.

The Staples Center and the next door convention center (and the Nokia Theater – rumored to be the next home of the Oscar presentations), despite being the home of two basketball teams and a hockey team, sits in a wasteland. The gruesome LA Live is next door – a mediocre attempt at a walkable area that is second rate compared to the Grove over on the Westside. It has an ESPNzone and a Flemings Steakhouse among other chain restaurants. And the Grammys Museum. Yet collectively these institutions have one nothing for the surrounding area. The largest adjacent business is a freestanding Hooters. There are many vacant lots used for parking.

There is a similar problem on the other side if downtown with the Disney Concert Hall. It’s a great building.  But you can’t eat nearby because there are no restaurants. And not much of anything else except some fortress like office buildings and apartments. It doesn’t look like Broad’s Museum of Contemporary Art is going to add to the area either.  Sorry LA.

My guess is that the lack if spinoff effects stems from LA’s automobile problem. First, since downtown is so remote from the rest of the city, no one can arrive early for an event in time to eat. Second, because LA refuses to slow down traffic on downtown streets (memo to the City of LA – ever heard of traffic calming or complete streets?). The area is scary for pedestrians.

The lesson is that building big ticket items is not enough. You need to pay attention to context.

The density of Silicon Valley

August 20th, 2012

The density of Silicon Valley

I was born and raised in the close-in suburbs of San Jose and family ties bring me back often to the city. Furthermore, my interest in community development and in high tech gizmos keeps me on the lookout for articles on creativity and city form. Of great interest are articles on why the high tech industry is so highly clustered in a triangle that roughly stretches from Redwood City to Cupertino to the south side of San Jose. Lately, the spread of high tech has widened slightly and there are exceptions, Zynga, for example, but in this triangle are the headquarters of Facebook, Hewlett-Packard, Apple, Intel, Cisco, Netflix, Google, Yahoo and Adobe and major facilities of Microsoft, Dell,  Hitachi and Sony. It’s all there.

But why?  Partly it’s an accident.  Stanford University helped spark this concentration of high technology companies fifty years ago and has nurtured new companies to this day.  Eventually, Silicon Valley has bested Boston and other rivals.  Note that New York City and Mayor Bloomburg compare themselves to Silicon Valley, not the other way around.

I think the role of luck in fostering economic growth is something to keep in mind. A lot of things happen by chance. But it takes a lot more than just luck. AnnaLee Saxenian wrote a great book comparing Silicon Valley to Boston’s Route 128 which describes why one area prospered through high tech and why the other lost out. The role of culture and law are very important. As an aside, Boston is ahead of the Bay Area in medical research. In a fairly parallel field, Boston won.

Many theorists say that San Jose is a suburban exception to the Jane Jacobs idea that density prompts interactions between strangers. Jacobs theory suggests that interaction and innovation needs urban density to thrive and some suggest that San Jose and its northern suburbs are too sparsely populated to meet this theory.   But these observers have never really lived in the region because it is no exception. While San Jose may lack a dense core, overall it is very dense. The US Census recently said it was the third densest urbanized area in the country. And as Jacobs theorized, this density results in constant interactions in collaborations. The creativity of the region needs no special explanation.

Built Environment and Public Health: Urban Gardening

August 13th, 2012

Urban gardening

The United States has a long history of individuals growing their own food, even in cities. During times of war these “victory gardens” have been promoted as a patriotic way that those on the home front can support the war effort. But even during times of peace, and particularly during economic downturns, urban gardening has been popular. In low-income neighborhoods there is the added benefits that urban gardening can preserve and protect open space that may otherwise be possibly subject to illegal dumping and other illicit activities. There are also numerous advantages for the gardeners that include increased social capital, more physical activity, and better nutrition. Studies of urban gardeners suggest that gardens provide multiple opportunities for interaction and can help the elderly keep from becoming isolated. A major concern with gardening has been pre-existing contamination of urban soils, particularly lead, on land that was formerly used for residential purposes; oils, lead, petroleum products, and solvents on land that was once used for parking; metals and other contaminants if the site was previously used for industry; and of the various unknown contaminants that may be found on any land that was once abandoned.  To address these concerns, organizations that own and develop urban gardens in conjunction with local groups often will extensively test the soils and remediate them if they are found to be contaminated.

The community benefits of gardening include the potential for managing vacant and abandoned land, their ability to bring neighbors together and thus promote increased social capital, strengthening of the local food environment, contributions to open space preservation and reductions in the amount of impermeable surfaces in the city, and positive psychological effects on neighbors and communities for having attractive well-maintained open space.  These gardens can also be significant locations of physical activity.

A major issue in some communities has been land tenure, or who owns an urban garden site. Many gardens are located in areas that have seen large-scale disinvestment and thus the parcels have been abandoned. If the city has foreclosed on these parcels and transferred title to a local non-profit organization, the long-term ownership of the site can be more certain. But often these gardens are located on parcels whose ownership has not been established or a city may be reluctant to relinquish permanent ownership to a local organization and when values begin to rise because of gentrification or competing demands for the land, the city or other landowner may try to eject the gardeners and use the land for other purposes.  This was a major issue in New York City when the city administration decided it wanted to use land that had been gardened for new housing construction. It was only ultimately resolved after long negotiations and the intervention of benefactors who helped fund local groups to purchase the land.

One solution to this problem of ownership and community control is the land trust, a community-based and/or nonprofit organization created specifically to own and manage land for gardening purposes. These organizations, which often need grant support to function, can hold on to the title of the land under gardens.  They can provide support to local gardeners, assist gardening groups to administer and manage gardens, serve as an interface between local gardening groups and city administrations, and work to ensure harmonious relationship between gardeners and the neighbors.

There have been objections to gardens. Some neighbors have expressed concerns about the establishment of gardens because they fear that criminals may hide in the gardens, they do not like the way the gardens look, they fear that there may be decreased land values around the gardens, or because of other similar reasons. The solutions to these problems with the neighbors include education, so that neighbors understand the value added by a garden, neighborhood involvement so that problems are not become a conflict between insiders and outsiders, and fencing of gardens so that they look attractive from the street. All these actions may require resources that some gardens may not have.

 

From Built Environment and Public Health: A Definition of Converntional Development

August 6th, 2012

Just in case you needed one.

As noted in Chapter 2, architects, theorists and others including Clarence Perry, Raymond Unwin, Frank Lloyd Wright, and others proposed suburban development forms intended, in part, to promote health.  These ideas had been influenced by the urban problems of the late 19th and early 20th centuries. Along with increasing affluence, new technologies, and a number of other factors, these new suburban ideas helped produce a form of the built environment that dominated most of the United States during the second half of the 20th century.  For the purposes of this book, we will call it “conventional development” and though there were variations in this form, mostly the result of the legacy of development that predated the triumph of this development pattern or changes in suburbanization that occurred as it progressed through a variety of development waves, it characterizes most of the development in rural, suburban, urban areas in these decades.  In general, conventional development consists of single family homes on lots of at least 6,000 square feet, but often on lots of a quarter acre or larger.  These houses are set back from the street with a substantial landscaped front yard and a driveway leading to a garage that can accommodate two or more vehicles. Views of the street from most of the house are not possible. Many residential streets are cul-de-sacs or semi closed off so that through traffic is discouraged.  These streets open on to collector streets which feed into arterials and then highways.  Most housing is distant from any commercial, industrial, or other non-residential uses, though there may be a park or recreational space in the neighborhood.  Schools may or may not be present and similarly, sidewalks and other pedestrian amenities are optional.

Commercial uses tend to be either in strip developments or in malls, but in both cases, stores are separated from streets by large areas of parking.  These commercial areas sometimes have sidewalks, but these are far from building entries and often along arterials built to promote the travel of high volumes of traffic at high speeds.  Walking to or between commercial developments is difficult and rare. Making them even less pedestrian friendly, an important percentage of commercial development is oriented towards highway off ramps rather than residential development.  Offices are often in large suburban developments that include a number of discreet buildings, each surrounded by substantial parking lots.  These office parks are not accessible by walking or bicycling, either. In center cities, many office and commercial developments are designed on the assumption that suburban users and visitors fear inner city crime and will only visit and use downtown buildings if they are heavily separated from surrounding neighborhoods.  Many mid 20th century urban office buildings favor blank facades at street level, entries are tightly monitored, and surface and structured parking are subsidized to make driving easier.

Building American Public Health: A Plea for Understanding

July 30th, 2012

The conclusion:

Urbanism in the United States is alive and thriving. New immigrants have brought a burst of color and energy to once dull communities, and it appears that many of the scars caused by mid-twentieth-century urban renewal are at last healing. Therefore, the future, as much as we can tell, looks bright. The current wave of urban development, which came to an end as recession took hold, has left its mark on US cities, and future observers looking back at our era, just as we have looked back at other times, will be able to identify the goals, concerns, and aspirations of our time through our architecture. They will be able to reconstruct our ideologies, values, and assumptions by examining our buildings, blocks, and metropolitan areas; and they will judge us, just as we have judged those who came before us. May they be sympathetic to our shortcomings. Let us hope that we will impress the people of the future and inspire future generations to take action as much as those who have come before us have impressed the people of our time and have inspired us to reach toward a more healthful tomorrow.

Building American Public Health: How to look at the built environment

July 23rd, 2012

From the ending of Chapter 1:

There is a basic contradiction imbedded in any book on health and the built environment. A thousand words cannot adequately describe the tranquility of a neatly landscaped postwar suburb or the dynamism of a downtown office district at 8:45 on a weekday morning. An even greater challenge is to describe a past that no longer exists except in our collective memories and prejudices. What were early reformers trying to accomplish? What would we have done given their available tools and technologies? Would we have produced any greater health improvements? This book asks readers to understand other worlds, some long gone, some contemporary but still unexamined. The only way to experience a book on the built environment is also the only way to experience a city, suburb, or rural area: be a part of one’s surroundings. In that way, one can reconsider one’s own values, ideas, and assumptions. It is hoped, therefore, that this book will prompt people to rethink the environment around them.

 

Shame on the American Planning Association – Call Bad Development, Bad

July 16th, 2012

The American Planning Association held its annual  conference in Los Angeles in April. As part if its conferences, there are a number of “mobile workshops” which take attendees out into the host city to provide educational and learning experiences.   One of these or shops was on the Bunker Hill area of downtown LA. In the words of the conference catalog:

“Explore this transit-oriented, pedestrian friendly remake of a 1950s and ’60s era downtown. ”

The reality of the area is that it is a tragic example if late 20 century redevelopment with fortress architecture, large building setbacks, big blocks, one way streets with fast traffic, mono-uses, and unwalkabke streets. Not to mention that the blurb (though I didn’t go on the tour – it may have discussed) doesn’t talk about the displaced who lived here before the development took place and nowhere appear to be invited back.

Check out the pictures!

Los Angeles - Bunker Hill Area

 

Los Angeles - Bunker Hill

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The APA should be ashamed of itself for allowing this kind of depictions in its official publications. If these are educational endeavors, they should communicate truths, not falsehoods. It the APA can’t criticize bad urban planning, who can?

An announcement for my book

July 12th, 2012

Read it here:

 

Active Living Research Newsletter

The Relationship Between Rural Status, Individual Characteristics, and Self-Rated Health in the Behavioral Risk Factor Surveillance System

July 9th, 2012

The Journal of Rural Health

 

The Relationship Between Rural Status, Individual Characteristics, and Self-Rated Health in the Behavioral Risk Factor Surveillance System

 

  1. Traci N. Bethea PhD1,
  2. Russell P. Lopez DSc2,
  3. Yvette C. Cozier DSc1,3,
  4. Laura F. White PhD4,
  5. Michael D. McClean ScD5

 

Article first published online: 31 MAY 2012

 

Abstract

 

Keywords:

  • Epidemiology;
  • health disparities;
  • obesity;
  • self-rated health;
  • social determinants of health

 

Abstract Purpose: To examine rural status and social factors as predictors of self-rated health in community-dwelling adults in the United States.

 

Methods: This study uses multinomial logistic and cumulative logistic models to evaluate the associations of interest in the 2006 US Behavioral Risk Factor Surveillance System, a cross-sectional survey of 347,709 noninstitutionalized adults.

 

Findings: Self-rated health was poorer among rural residents, compared to urban residents (OR = 1.77, 95% CI: 1.54, 1.90). However, underlying risk factors such as obesity, low income, and low educational attainment were found to vary by rural status and account for the observed increased risk (OR = 1.03, 95% CI: 0.94, 1.12). There was little evidence of effect modification by rural status, though the association between obesity and self-rated health was stronger among urban residents (OR = 2.50, 95% CI: 2.38, 2.64) than among rural residents (OR = 2.18, 95% CI: 2.03, 2.34).

 

Conclusions: Our findings suggest that differences in self-rated health by rural status were attributable to differential distributions of participant characteristics and not due to differential effects of those characteristics.

Should Modernism be preserved?

July 2nd, 2012

I love Modern architecture.  One of the highlights of last year was when I visited Phillip Johnson’s spectacular Glass House in New Canaan, CT.  The house has a serenity, an intelligence and a beauty that is difficult to describe in words.  It makes you feel, it makes you connect to it.  I am so grateful it has been preserved and made available to the public.  Other Modern favorites are Le Corbusier’s Carpenter Center at Harvard and Ludwig Mies van der Rohe’s Chicago lakefront apartment buildings.  The Seagram Building and Lever Building in New York are must see attractions in my book.

But should all Modern building be saved? No.  Too many are second rate, bad, dysfunctional.  For example, should anyone weep over the Walter Gropius’s MetLife building in New York?  No.  If it were to be torn down, all that we would lose is a firsthand example of how architects can be arrogant or unable to resist the pressure of commerce.

I don’t buy the arguments that someday, we will miss these buildings when tastes change.  A couple of years ago, James Levine presented a Boston Symphony Orchestra season long program of Schoenberg and Beethoven.  After a year of concerts, lectures and exhibits, I still don’t like Schoenberg.  I now understand why I don’t and also understand why after nearly a century, the public doesn’t either.  Modern music fails to resonate with people’s psychic needs.  It doesn’t connect. Much of Modern architecture is the same.  The public is never going to come around.  Stop waiting.  Most of these buildings should go.

Income inequality and health

June 25th, 2012

With the attention paid to the Occupy Wall Street movement and its related actions across the United States (and internationally), there has also been a ride in concern about income inequality.  There are many reasons to be concerned with the huge increase in inequality in the US and other countries over the past thirty years.  Though we can’t say for sure, this rise in inequality has been accompanied by stagnating income and lowered economic opportunities for the majority of the population.

But the concern over income inequality should be much greater because there is substantial evidence that inequality is associated with lower health.  The more unequal a society is, the worse is the health of its population.  The evidence for this first emerged when researchers such as Kawachi and Wilkinson began to report their findings in the 1990s.  Some of the evidence comes from cross national studies:  once per capita income hits about $5000 (in 1990 dollars), differences in income no longer explain differences in health.  At that point, inequality seems to be a better explanatory factor.  Other evidence comes from studies in the US.  People who live in states or metropolitan areas with greater inequality tend to have worse health as well.

The reasons for this association are not entirely clear.  Inequality may result in fewer services or reduced access to medical care.  It may reduce social capital.  As yet we don’t know.

But the association appears fairly strong.  Income inequality is bad for your health.

Public Health Approaches to Large Scale Behavioral Change

June 18th, 2012

Promoting Active Environments:  A Public Health Approach to Large-Scale Behavioral Change

Background

             The public health profession has developed theories and methodologies to promote behavior change on both the individual and population level. From reducing tobacco use to encouraging seat belt acceptance, many behavioral change campaigns have been successful.  This paper suggests ways these theories and methodologies could be used to create large-scale, nationwide change to promote active living.

Active living environments is used here to mean communities that foster walking, biking, and public transportation through mixed use, compact and dense development forms, and transportation systems that reduce car use. The alternative is conventional development: large lot zoning, strict separation of land uses, and streets heavily engineered for cars.

Evidence suggests that active environments promote physical activity, reduce obesity, improve mental health, and strengthen social capital.  These may increase health and reduce morbidity and mortality.

 Objectives

             This analysis aims to provide the beginning of a discussion of what a broad public health campaign to promote the creation and use of active living environments might look like.

Objectives include:

Identify models of behavioral change that might assist policy makers and advocates to promote active living environments with an emphasis on families with children and communities of color.

  •  Encourage efforts to change social norms that prioritize active communities.
  • Propose strategies for advancing the preference for active living.

Two outcomes were prioritized:

 

  • Increase demand.  How might we encourage individuals and families to choose to live in active environments?

 

  • Increase supply. How might we encourage governments to implement changes to codes and development guidelines that would result in more active communities?

 

Methods

 

This analysis included a scan of the public health literature on promoting behavior change.  In addition to broad theoretical models of change, it drew on experiences including reducing tobacco use as models for promoting change at both the individual and community level.

 

Results

 

Traditionally, public health has focused on promoting behavioral change on the intrapersonal, interpersonal, and population level.  All these levels must be addressed if we are to increase both the supply of and demand for active environments.  Specific examples include:

 

Intrapersonal Level. Health belief models of change suggest that public health efforts include working with individuals and families to help them understand that by living in active environments, they can increase physical activity and reduce obesity risk. Thus they should be educated regarding the ways that conventional environments can pose barriers to health, particularly for children, and that health may improve by living in active environments. These campaigns should utilize planned behavior theory and encourage changes in attitudes toward living in active environments, increase perceptions that moving to these environments would mean adopting new social norms that prioritize active living, demonstrate that families with children have the ability to live in these communities in ways that would enhance their health and well being, and identify specific neighborhood attribute choices that would promote health.  Stages of change theory suggest encouraging families to the point where they contemplate moving to an active environment and then help them make that move (a priority target would be people of color most at risk for obesity).  It also suggests that strategies to help those who already live in active environments not to leave (perhaps targeting inner-city residents considering moves to the suburbs).

 

Intrapersonal Level. Social cognitive theory suggests that campaigns to promote active living environments should aim to change expectations regarding the kinds of neighborhoods people should live in (for example, currently many families believe that conventional neighborhoods are the only appropriate place for children).  It would communicate the idea that individuals and families have the ability to demand and choose healthy neighborhood designs. Social network theory suggests changing norms of behavior so that conventional environments are seen as less desirable.  At the same time, living in active communities would be promoted as more healthy.

Population Level.  Communication theory suggests that information campaigns are necessary so that the public understands the health consequences of conventional development with special outreach to linguistic minorities.  Diffusion of innovation models would imply the targeting of key individuals (particularly in minority communities) as the starting point in changing social norms and behavior.  Community mobilization experience demonstrates the need for planning, coalition building, and action.

 

Conclusions

             If we are to move towards having a sizable portion of the US (and other countries) living in active environments, then there is a need to initiate large scale attitude and behavioral change strategies. These initatives should include working with individuals to increase the number of people who desire to live in active environments and to develop a constituency that supports changes in zoning and development guidelines. On the community level, these strategies would have the ultimate goal of creating more opportunities for active living.  Together, they may move societies toward better health.

Increase in scholarly articles on the built environment and health

June 11th, 2012

Here is a piece from my book, Building American Public Health.  It tracks the increase in the number of scholarly articles on the built environment and health.

One way to track the growth in research on a health topic is through charting the number of citations in Medline, the National Library of Medicine’s online database of peer-reviewed journal articles. The term “built environment” had nine citations older than 1991, 14 between 1991 and 1995, 21 between 1996 and 2000, and 161 in 2010 alone. The terms “walkability” and “street connectivity” first appear in Medline in 2003, “food desert” in 2005. These numbers should be interpreted with caution because many older journals may not have been added to the database and there has been an increase in the total number of articles published on all topics over the years, but the data still most likely reflect a large-scale increase in the amount of research on the built environment.

 

Breat Cancer Disparities

June 4th, 2012

The goal of this graph is to make you angry:

 

 

 

 

 

 

 

 

 

 

 

 

What this chart suggests is that while there has been about a 20% reduction in White female breast cancer death  rates since the 1970s, Black female breast cancer death rates have increased. Why?

 

 

Here are some of the risk factors for breast cancer:  Age – but the rates are age adjusted so that shouldn’t be a factor here.  Later date of first pregnancy – but the age of Blacks and whites at first pregnancy are about the same, as are overall fertility rates.  Mammography rates – these are also now about the same (thank you to everyone who worked on reducing this disparity).  Obesity  – Black female obesity rates are higher, but isn’t this more of a symptom of disparity than a cause?  Genetics – no genetic factors have been identified that would account for these disparities.

So we are left with a mystery.  And a disgrace.

Urban Space (Theory)

May 28th, 2012

Today’s post is going to be heavy on theory and theoretical models of the built environment.  The goal here is to make these theories understandable and applicable to our everyday experience.

Henri Lefebvre famously said that urban space is socially constructed.  But what did that 1970s French Marxist urban theorist mean?  I interpret it to suggest that a society’s and community’s values, assumptions, and ideologies end up shaping the way the human made environment is constructed.  Thus if a society values the personal freedom of the car and believes that single family houses provide the healthiest environments for raising children, and if that society established social norms that look down on using public transit or living in  inner cities, then the result will be a suburban focused society of single family houses on large lots:  the late 20th century US suburb.

Later urban theorists have suggested that space is the result of conflict.  Much of this theory came out of the experience of gentrification where there were often economic and physical conflicts between newcomers and those being displaced.  Thus if affluent households move into previously poor neighborhoods, the dynamic can be described as a conflict between the two groups, one that the unequal power relationships result in neighborhood change.

I’d like to put these ideas together and suggest that urban space is the result of conflicts of ideas.  Some people envision a neighborhood of low income, white ethnic families centered around Catholic parishes.  Others see the community as a place where newly arriving  immigrants from the South can find affordable housing.  The result is the racial change and conflict of the 1950s – 1990s.  But notice that the conflict “on the ground” flows from this conflict of ideas.  One group sees the neighborhood to be one way, the other another.  The result is that each group competes for the space by trying to enforce its views of the ideal neighborhood form on the physical ground.  Today, we see this conflict between those who believe in car centric suburbs and those who want walkable communities.  But again, the vision for the community precedes the actual urban form as seen on the ground.

Obesity – Maps

May 21st, 2012

Many of us first got into the field of the built environment and health because of the a series of maps that the CDC put together using data from the BRFSS.  Dr. Richard Jackson used these maps as he went around the country to incrdase awareness of the issue.

The maps can be viewed here:

CDC obesity maps

Census geography – a primer

May 19th, 2012

Sooner or later, every urban planner or public health practitioner finds themselves needing to work with census data.  Many people are uncertain as to how the census characterizes various facets of geography.  There are also complaints that the census defined geography doesn’t fit an individual’s idea of what it should be in a particular area.  Part of that comes from the need to have national standards; it is perhaps too much to expect that a national standard would exactly apply to every individual area.  Perhaps that is a topic for a future blog post.  Today, I am going to go through the various levels of census geography, starting from the most local.  I am not going to cover every level reported, there are far too many different types of geography made available.  The ones covered here represent those most often used in health and planning.

Blocks.  Blocks represent the smallest area that the census makes data available for.   In urban areas, these often correspond to actual city blocks, but in less dense areas, they may not.  However, the census tries to have them bounded by actual physical features such as roads and railroad tracks.  As valuable as the data might be on this very local level, most census data is suppressed at the block level because of confidentiality issues.

Block groups.  As the name suggests, these are amalgamations of blocks (all higher level census geographies are  collections of smaller areas).  The block group aims to have about 1500 people, but this may vary.  Note that all geographies can be of any size; in Alaska, a block group may cover thousands of square miles.  They are sized for population, not land area.  In general, most data are reported for block groups.  They represent a finer grain of analysis than census tracts, but rarely do block groups correspond to anything that residents may find identifiable.  In that sense they don’t represent neighborhoods, they are mostly analytical constructs.

Census tracts.  These are the basic reporting units of the census.  Again, they are sized for population, not land area.  In my experience, the smallest are about 100 acres, the largest was over 10,000 square miles.  The census aims for a population of about 4500 persons (or about 3 block groups).  Tracts never cross county borders, their numbering system reflects this restriction.  Many researchers talk about census tracts as if they were neighborhoods., but be very clear:  they are not!  They are drawn to try to correspond to some sort of on the ground reality, but the need to divide the country into tracts overrides any ability to reflect true neighborhood boundaries.  In some communities, the tracts are much bigger than what locals consider to be a neighborhood, in others, much smaller.  Though the “tracting” of the US began a hundred years ago (in part to assist health departments to understand local population numbers”, the tracking of the US did not become widespread until 1970 and was not fully implemented until 1990.  Tract boundaries have also changed over time.  In areas with growing populations, they have been split (I know of no circumstances where they have been combined – but that doesn’t mean that has not happened).  Also, over time, the census has moved to rationalize tracts: make them more compact and eliminate incongruities.  A tract with the same number in 2010 may not totally correspond to the same numbered tract in 1970.

Zip Code Tabulation Areas (ZCTA).  Given the popularity of the US Postal Service’s zip code, the census has moved to define ZCTAs.  Note that these are not exactly the same as zip codes.  Zip codes are defined based on the needs of delivering mail, the ZCTA might be considered to be “rounded” zip codes adapted to make them fit the constraints of census geography.  Many zip codes are for post offices or single office buildings. In general, these do not have a corresponding ZCTA.  So don’t be annoyed when you can’t find data on every zip code in your community.  Another issue is that ZCTAs (nor zip codes) can be relied upon to correspond to any way a neighborhood might be thought of.  The reality is that there is no census definition of neighborhood or any census geography level that corresponds to what we might consider a neighborhood to be.

Counties.  The US contains roughly 3400 counties and county equivalents.  Even a geography that might seem as straightforward as the county contains a few quirks.  Counties are called parishes in Louisiana and Boroughs in Alaska (I think).  Some states, particularly Maryland and Virginia, have independent cities, not considered part of any county.  Examples of these include Manassas Park in Virginia and Baltimore City in Maryland. These independent cities are considered and treated as if they were counties by the census.  The District of Columbia, treated as if it were a state by the census, does not have any counties.  Texas has the most. Note that even though counties in some states, such as Massachusetts have ceased to have any legal powers, they continue to be used by the census.

Metropolitan statistical areas.  These are made up of one or more counties with a principle urban area (think center city) of at least 50,000.  For the most part, but not always, these are what most people think of as metropolitan areas.  They are defined based on commuting patterns and in consultation with state and local government.  Sometimes, these definitions have been fairly static over time.  In other metropolitan areas, they have expanded as the metro areas themselves have grown. In addition, the federal Office of Management and Budget (the official agency that defines MSAs – it’s not the Census Bureau that does it, sometimes defines new ones).   Along with micropolitan areas, MSAs make up what are known as Core Based Statistical Areas. The names of these MSAs were changed prior to the 2010 census. In the past, they tended to be named after the single largest city in the MSA. Only a few MSAs, such as San Francisco – Oakland, had multiple cities in their names.  Now, a large number of MSAs have multiple names.  Most researchers and residents ignore the smaller city names and tend to refer to the MSA by its largest city.

Micropolitan statistical areas.  These are similar to MSAs, but they are smaller in population, the center city has between 10,000 and 50,000 people.

New England City and Town Areas (NECTA).  As noted above, counties have not real meaning in some parts of New England.  Thus defining metropolitan areas based on county might not produce totally meaningful data.  Thus in the six New England states, there are metropolitan (and micropolitan) areas based on amalgamations of cities and towns.

Metropolitan divisions.  For some of the larger metropolitan areas, the census has defined subareas, called metropolitan divisions (in New England, there are also equivalent NECTA divisions).  These consists of one or more counties.  For example, The San Francisco MSA has a San Francisco metropolitan division and an Oakland metropolitan division (actually, again a metropolitan division can have multiple cities included in its name).

Combined Statistical Areas.  Some metropolitan areas seem to be clustered together and highly economically integrated with their neighbors, yet each metropolitan area is still independent enough to make a complete consolidation imprecise.  The way this has been accommodated is by the Combined Statistical Area.  These can contain both metro- and micro-politan areas.  Again, in there are equivalents in New England for the city and town based areas.  An example is the San Jose – San Francisco – Oakland CSA.  This CSA is a cluster of six MSAs.

Transportation funding

May 7th, 2012

Here is an excerpt from my textbook, The Built Environment and Public Health.  The issue is how we fund mass transit in this country.  Highways are funded as a block grant, more or less.  The issue is how to divide the pot of money and localities don’t have to do much more than spend the cash.  In contrast, we make mass transit go through hoops.  Keep in mind that the gas tax, both local and national, pays only a fraction of the total cost of our roads.  This is not even counting the environmental impacts.  Here is what the textbook says:

Transit funding by the federal government uses a different set of procedures than that for highways. Money for highway construction is distributed using a formula that includes population, land area, and other factors. States and localities more or less get the money from the government by right. The only question is how many total dollars have been set aside in the latest highway bill. In contrast, mass transit is funded by a much more cumbersome process. For example, local transportation authorities have to apply to the federal government in a competitive process. Extensive documentation for the application is required and the application process includes an assessment regarding whether revenues are sufficient to maintain and operate the new transportation infrastructure. Funding for mass transit in recent years has been set at no more than 20% of the total federal transportation construction budget, an increase from earlier decades when funding for mass transit from the federal government was essentially zero. Thus transit funds are much more scarce than highway funds and much more difficult to secure.  Therefore, local governments have to find alternatives to fund capital and maintenance costs of transit.