Presentation by Howard Frumkin, MD, MPH, DrPH at the 2009 Virginia Health Equity Conference.
Focusing on how inequities in the built environment – places where we work, live and play; transportation; food; and parks and green spaces - impact health, Dr. Frumkin described the dimensions of healthy communities and community design principles and the opportunities for effective interventions. He described the work of the Centers for Disease Control and Prevention in promoting health equity through healthy places. He also gave examples of communities that are advancing health equity through healthy places.
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Health, Equity and the Built Environment: What do Healthy Communities Look Like?
1. Health, Equity, and the Built Environment Advancing Health Equity: From Theory to Practice Richmond, VA September 10, 2009 Howard Frumkin, M.D., Dr.P.H., Director National Center for Environmental Health / Agency for Toxic Substances and Disease Registry Centers for Disease Control and Prevention
10. Selected substandard housing conditions 2005 American Housing Survey Tables 2-2 (Height and Condition of Buildings) and 2-7 (Additional Indicators of Housing Quality) http://www.census.gov/hhes/www/housing/ahs/ahs05/tab2-2.xls and http://www.census.gov/hhes/www/housing/ahs/ahs05/tab2-7.xls PER CENT
15. Active transport to school, 1969 and 2001 Source: CDC. Kids Walk-to-School: Then and Now—Barriers and Solutions. www.cdc.gov/nccdphp/dnpa/kidswalk/then_and_now.htm
16. Two approaches to school siting Hubbard Lake Elementary School Hubbard Lake, Michigan "Outstanding in Its Field"
71. Transportation and air quality: The Atlanta Olympics Friedman et al. JAMA 2001;285:897-905 Peak traffic 23% Peak ozone 28% Acute asthma among children 11-44%
72. Less driving, fewer fatalities Ewing et al. Am J Public Health 2003;93:1541-45 Sivak. UMTRI-2008-39, July 2008
85. Beyond the short term Hau de no sau nee (the Six Nations Iroquois Confederacy): planning for the seventh generation
86. Care for the individual patient Care for the community Care for future generations THE CLINICAL APPROACH THE PUBLIC HEALTH APPROACH THE LEGACY APPROACH
90. Co-benefits: Transportation Physical activity Air pollution And by the way… Infrastructure costs Social capital CO 2 emissions Depression Injuries Osteoporosis
Changes in land use from farm, field, and forest to residential.
Individual lots can be very large.
Same here—monotony and isolation. Wherever you want to go, you have to go by car.
Low connectivity.
Friedman MS, Powell KE, Hutwagner L, Graham LM, Teague WG. Impact of changes in transportation and commuting behaviors during the 1996 summer Olympic games in Atlanta on air quality and childhood asthma. JAMA 2001;285:897-905
Ewing R, Schieber R, Zegeer C. Urban sprawl as a risk factor in motor vehicle occupant and pedestrian facilities Am J Public Health 2003;93:1541-45. Sivak M. Is the U.S. on the Path to the Lowest Motor Vehicle Fatalities in Decades? University of Michigan Transportation Research Institute Report # UMTRI-2008-39, July 2008. Available: http://deepblue.lib.umich.edu/bitstream/2027.42/60424/1/100969.pdf.
Public Street Improvements and Infill Development COLFAX AVENUE, DENVER, COLORADO: Done in association with Space Analytics, LLC for Colfax on the Hill, Inc., funded in part by the Denver Foundation 1 - Existing conditions 2 - Mixed-use buildings on one corner 3 - Public street improvements: street trees, street lamps, decorative traffic signals, sidewalk bulbouts 4 - Additional mixed-use development, remodeling of existing buildings
Infill Development on declining shopping center EL CERRITO, CALIFORNIA: Done to demonstrate infill development potential on shopping center site. 1 - existing conditions 2 - Additional Stores built up to the street , Mixed-use architecture (office space above retail), zebra-striped crosswalks, street trees, street lamps added 3 - Mixed-use architecture (residential added above office space) 4 - Additional infill accommodates pedestrians and improves visibility for merchants
Traffic Calming on Neighborhood Street NAPLES PARK, FLORIDA: Done with Dover, Kohl & Partners and Glatting Jackson, Inc. to demonstrate traffic calming techniques for Collier County, Florida 1 - existing conditions 2 - Neighborhood traffic circle added, sidewalks and zebra-stripped crosswalks added, landscaped with palm trees OR 3 - landscaped with shade trees
