Category Archives: Built Environment and Health
In 1995, Tom Stoner and his wife Kitty discovered a tiny urban park in the middle of a busy London neighborhood that had been used as a refuge during World War II. On the backs of many of the park’s benches, the Stoners found loving thoughts and peacetime memories that had been etched by Londoners during the horrors of war. They realized that if an urban park could be a source of quiet and solace during a time of bombing and destruction, then similar natural environments could certainly offer spaces for reflection, recovery and respite for people dealing with the stress of modern life. With that idea the Stoners created the TKF Foundation to support the creation of urban green spaces.
“The speed, violence and alienation that characterize our current period in human history create an important need for open spaces, sacred places,” says Tom Stoner.
In 2010 Tom and Kitty began the National Nature Sacred Awards Initiative, designed to support the creation of public greenspaces to serve as demonstration and research sites to study the impact of nature on the human spirit. NewPublicHealth recently spoke with Tom Stoner about the intersection of green space and improved health and lives.
A one-of-its-kind pedestrian traffic walk signal recently turned heads in Portugal with a dancing figure that entertained people as they waited for him to tell them when it was safe to cross the street.
The signal—not planned for mass circulation anytime soon—was developed by the manufacturer Smart to advertise its cars’ safety features. And if it saves lives along the way, it’s in sync with the U.S. Department of Transportation (DOT), where the National Highway Traffic Safety Administration (NHTSA) has found that 4,432 pedestrians died in traffic crashes in 2011, up 3 percent from 2010. More than a quarter of the accidents resulting in death happened at traffic intersections, both at marked crosswalks and intersections with traffic lights. Andrea Gielen, PhD, head of the Johns Hopkins Center for Injury Research and Policy at Johns Hopkins University, says the school’s research shows that many of these accidents occur because pedestrians are distracted by music in their earphones or by speaking or texting on cellphones.
NHTSA began a campaign to keep pedestrians safer last year and highlights community projects that improve pedestrian safety in a stories section on its website on pedestrian safety. One project, developed at University of California, San Diego, was a presentation at a low-income elementary public school in San Diego, Calif. The English- and Spanish-language presentation demonstrated dangerous scenarios and how to prevent them, such as kids dressed in only dark clothing, which makes them difficult to see at night. NHTSA is updating the site regularly to help communities develop their own safe walking programs.
As for traffic lights themselves, makeovers could be ahead. The Transportation Research Board of the National Academies of Sciences has a traffic light subcommittee that presents new research on traffic signal safety at the board’s annual meeting each January. Upcoming topics of interest are likely to include computerized traffic signals that can respond to traffic flow by switching to green sooner when there’s no congestion ahead, as well as a recent study from the Massachusetts Institute of Technology (MIT) that found that traffic lights are easily hacked, which could lead to traffic jams and collisions. Preventing some of the hacking could be as simple as strengthening the passwords of the engineers who control the traffic signals, according to computer engineers at MIT.
Wendy Landman, executive director of the pedestrian advocacy group Walk Boston, says intersections could be safer if city agencies talked more. She said the deciding factor for how long a traffic signal should be green for pedestrians is often based on how quickly traffic experts think drivers want to be back on the gas pedal—but that may be too short for many pedestrians, especially at intersections on main roads.
>>Bonus Content: Read a previous NewPublicHealth interview with Andrea Gielen.
A new report on public transit, Who’s on Board: The 2014 Mobility Attitudes Survey, has good news for developers and planners. The review of transit across the United States by TransitCenter, a New York City-based non-profit aimed at increasing and improving mass transit, finds that Americans across the country think about and use public transit in remarkably similar ways. That can result in communities adopting good ideas from other regions—reducing cost and speeding up new and improved transit systems.
“We commissioned this survey to take a deeper look at the public attitudes which are propelling recent increases in transit ridership,” said Rosemary Scanlon, Chair of TransitCenter and Divisional Dean of New York University’s Schack Institute of Real Estate. “As Millennials begin to take center stage in American life and the Baby Boom generation confronts retirement, both the transit industry and the real estate industry will need to adjust.”
The survey—the largest of its kind, according to TransitCenter—reviewed online survey responses from nearly 12,000 people from 46 metropolitan areas across the country, including a mix of what the group refers to as “transit progressive” cities (such as Miami, Denver, Seattle and Minneapolis) and “transit deficient” cities (such as Tampa, Dallas, Fresno and Detroit.)
Among the findings:
- When choosing whether or not to take public transportation, riders of all ages and in all regions place the greatest value on factors such as travel time, proximity, cost and reliability, putting them above safety, frequency and perks such as Wi-Fi.
- There is a high demand for quality public transportation nationwide, but such infrastructure is often missing in the places where people currently live.
- Fifty-eight percent of survey respondents said their ideal neighborhood contained “a mix of houses, shops and businesses,” but only 39 percent currently live in that type of neighborhood.
- Mass transit attracts the wealthy as well as the poor. In New York City, Philadelphia, Washington, D.C., and Chicago, people with a salary of $150,000 or greater are just as likely to ride public transportation as people with a $30,000 salary.
“There is a desire for reliable, quality transportation in communities across all regions of the U.S., and among riders of all ages, backgrounds and financial status,” said David Bragdon, Executive Director of TransitCenter. “Unfortunately, this desire is largely going unmet, to the detriment of many local economies. To serve and attract residents and workforces today and in the future, cities need to unite land use and transit planning to form comprehensive, innovative infrastructures that can support this demand.”
The report is based on an online survey that TransitCenter plans to update regularly. Bragdon said that one innovation is the increased number of transit options in suburban areas for people who don’t plan to move to the city, but who still want some of the conveniences of city life. Daybreak, Utah, a suburb of Salt Lake City, for example, now has a buses, light rail stations, sidewalks and bike lanes. Planners say Daybreak took a “transit first” approach to new community development rail stations.
According to Bragdon, the survey will be updated and conducted regularly to track changes in transit rider attitudes and regional trends over time.
Most parents send their children off to school expecting they’ll have their minds enriched and expanded—they don’t expect that their kids’ health to be jeopardized.
But the reality is that the environmental conditions in aging or deteriorating school facilities can harm kids’ health and compromise their ability to learn. This is partly because children may be exposed to a variety of environmental hazards—such as lead, asbestos, molds, radon and volatile organic compounds—as well as toxic chemicals and pesticides at school. Half of U.S. schools have problems with indoor air quality, according to the Environmental Protection Agency (EPA), and research suggests that the poorest children in the poorest neighborhoods have schools that are in the worst condition.
Sixty percent of kids suffer health and learning problems that stem from the conditions of their schools, according to the Coalition for Healthier Schools’ Towards Healthy Schools 2015 report. Children are especially vulnerable because they’re smaller; their organs are still developing; they spend more time on the ground; and they breathe more air and drink more water per pound of body weight than do adults, according to the EPA. They also may not be able to identify obvious hazards and move away from them.
Reducing environmental risks in schools offers significant payoffs in multiple domains. Improving indoor air quality can reduce asthma attacks by nearly 40 percent and upper respiratory infections by more than 50 percent, according to the 2006 report Greening America’s Schools: Costs and Benefits. What’s more, a study weighing the costs and benefits of developing green schools for Washington State estimated a 15 percent reduction in absenteeism and a 5 percent increase in test scores, according to the Towards Healthy Schools 2015 report.
“A healthy school has a building that promotes health and learning—it will be clean, dry, and quiet. It will have good control of dust and particulate matter. It will provide good ventilation and good air quality,” said Claire Barnett, founder and executive director of the Healthy Schools Network Inc., a non-profit organization dedicated to children’s environmental health and safety in schools. “This also assumes there’s no lead in the pipes, no PCBs in lighting or other old building materials, and no routine spraying of pesticides indoors or out. It shouldn’t be hard to have a building that meets these standards but it is. Parents shouldn’t take it for granted that a school facility is healthy.”
With research indicating that fewer children are walking or biking to school than in decades past—and with the childhood obesity epidemic in full swing—health experts have been brainstorming solutions that would address both issues. In recent years, a simple but effective concept has been gaining traction at the grass-roots level: Why not organize a “Walking School Bus”—a group of kids who walk to school with one or more adults, so that kids can get exercise on their way to and from school?
A Walking School Bus is “just like a regular school bus, but without the walls and seats, and instead of wheels, we use our feet,” explained LeeAnne Fergason, education director for the Bicycle Transportation Alliance in Portland, Ore., which has a thriving Walking School Bus program. Other communities around the country that have well-established Walking School Bus programs include Chapel Hill, N.C.; Sacramento, Calif.; Burlington, Vt.; Columbia, Mo.; and Duluth, Ga. In the Fall of 2014, many more schools—including Grand View Elementary in Manhattan Beach, Calif.; Greenacres Elementary in Scarsdale, N.Y.; Madison Elementary in Redondo Beach, Calif.; and several elementary schools in Spokane, Wash.—will be joining the trend.
Created by the National Center for Safe Routes to School, these programs help kids sneak some extra physical activity into their day while also addressing parents’ concerns about getting their kids to school safely. It can be as simple as a few neighborhood families taking turns walking their kids to school. Or it can be more elaborate, with prearranged routes, timetables and stops along the way to pick up more “passengers”; with this model, there’s usually an adult “driver” at the front and an adult “conductor” bringing up the rear. A variation on this theme, the bicycle train, in which two or more adults accompany and supervise kids as they ride their bikes to school, has also become popular.
Viewed as a way to fight childhood obesity, improve school attendance rates and ensure that kids get to school safely, the Walking School Bus concept is garnering positive reviews from public health experts. In July 2013, Michelle Obama voiced her support of these programs in her remarks to mayors gathered at the White House.
“I've heard more and more of this kind of walking school bus happening all over the country—so that kids can get exercise on the way to school, kind of like we did when we were growing up," she said. “It’s about people all across this country coming together to take action to support the health of our kids.”
Besides providing an opportunity for movement, the Walking School Bus also allows kids to socialize with their peers, gain a bit of independence and learn important road safety skills. All of these benefits are also important for children’s health and wellbeing.
Google Hangout Convenes Culture of Health Prize Winners to Discuss Lessons Learned in Creating Healthy Communities
This past June, the Robert Wood Johnson Foundation (RWJF) announced the six winners of its 2014 Culture of Health Prize, which honors communities that place a high priority on health and bring partners together to drive local change. Each community, selected from more than 250 across the nation, received a no-strings-attached $25,000 cash prize in recognition of their accomplishments.
Last week, RWJF brought together representatives from two of this year’s winners and one from last year in an online discussion, “Building a Culture of Health: What Does it Take?” Each community representative spoke about the barriers they’ve faced, how they overcame them and the role partnerships play in their ongoing success.
The discussion was moderated by Julie Willems Van Dijk, co-director of the RWJF County Health Rankings & Roadmaps and director of the RWJF Culture of Health Prize.
Alisa May, executive director of Priority Spokane and representing 2014 winner Spokane County, Wash., said that as a largely rural community of 210,000 people they’ve placed an emphasis on improving education at all levels. And they took a data-centric approach.
“Priority Spokane—which is a collaboration of community leaders—looked at the data, pulled community members together to talk about the issues that were most important to them, and educational attainment rose to the surface,” said May.
If you’re reading this, then YOU can prevent wildfires. Also forest fires.
Both are indelible messages from Smokey Bear—an icon of public health and a friendly face from everyone’s childhood—who is celebrating his 70th birthday. Born August 9, 1944, the creation of the U.S. Forest Service and the Ad Council has over the decades become the center of the longest-running PSA campaign in U.S. history.
As part of the birthday celebration, the U.S. Forest Service and the National Association of State Foresters have launched a new round of PSAs featuring outdoor enthusiasts thanking Smokey for his years of work.
Since the campaign’s launch in 1944, the average number of acres burned by wildfires has decreased from 22 million to 6.7 million. However, they still remain one of the country’s most critical environmental issues—as well as one of its most misunderstood. While many people believe that lightning is the cause of most wildfires, the reality is the vast majority—9 out of 10—are manmade. The causes range from unattended campfires and burning debris on a windy day to improperly discarded smoking materials and operating equipment without spark arrestors.
Earlier this month, following the heatstroke death of a Georgia toddler who was left in a sweltering car for hours, Tennessee became the first state in the nation to pass a law that specifically protects people from liability for forcibly breaking into cars and rescuing kids they think are at risk of heatstroke. The law requires those individuals to call 911 first and follow instructions.
Many states have Good Samaritan laws that may protect people in such instances, but the specifics vary from state to state, according to Cristina M. Meneses, JD, MS, a staff attorney with the Network for Public Health Law’s Eastern Region. A recent Today show poll found that 88 percent of the 44,000 people asked would break into a car to rescue a child they thought was in danger, but specific laws can increase the response—and potentially remove penalties—while raising awareness of the issue. More such laws could soon follow. Janette Fennell, founder and head of KidsAndCars, a nonprofit based in Kansas City, Mo., which advocates for laws that will protect kids from heat in vehicles, said she’s received inquiries from two states about those laws since Tennessee’s law was passed. Another set of laws that KidsAndCars tracks are those that penalize adults for leaving kids in cars. Nineteen states currently have such laws on the books.
“It’s a good deterrent for anyone who might think, ‘Oh, I’ll just leave them in the car for a minute,’” said Fennell, “because it’s often that minute that turns into much longer and results in injury or death.”
According to the National Highway Traffic Safety Administration (NHTSA), more than 40 kids—often under age 2—die each year of “vehicular heatstroke.” Seventeen U.S. kids have died after being left or trapped in car since the beginning of 2014. Fennell and other experts say many people just don’t realize how quickly temperatures can climb in a car, even if the window is cracked open a bit—when outside temperatures are in the low 80's, the temperature inside a vehicle can reach deadly levels in only 10 minutes, even with a window rolled down two inches. Children's bodies, in particular, overheat easily; and infants and children under four years old are at the greatest risk for heat-related illness.
NHTSA research shows that heatstroke deaths and injuries often occur after a child gets into an unlocked vehicle to play without a parent or caregiver's knowledge. Other incidents can occur when a parent or caregiver who is not used to transporting a child as part of their daily routine inadvertently forgets a child sleeping in the back.
Last week, KidsAndCars launched a petition drive to encourage NHTSA to require technology in all cars that would remind a driver that there is a child in the back. There are devices parents can install, but a 2012 study by NHTSA found that none that the agency studied were consistently effective.
“You get a warning if you don't buckle your seatbelt, leave a car door open, your gas is low or you leave your headlights on,” said Fennell. “If a child is left behind then you absolutely need a warning.”
Guidelines from NHTSA and other safety experts aimed at never leaving a child unattended in a car include:
- Make a habit of looking in the vehicle—front and back—before locking the door and walking away
- Ask childcare providers to call if a child doesn't show up for care as expected
- Put items in the back seat you’ll have to retrieve such as a purse or briefcase, or put a stuffed animal in sight of the driver to indicate there’s a child in the car.
In 2012, a new campus was constructed for the Buckingham K-5 public school in rural Dillwyn, Va., replacing the original middle and high school buildings that had stood since 1954 and 1962.
The Charlottesville, Va., architectural firm VMDO Inc., which constructed the campus, says the sites were transformed into a modern learning campus with the aim of addressing the growing concerns of student health and wellbeing. New facilities include a teaching kitchen; innovative food and nutritional displays; an open servery to promote demonstration cooking; a food lab; a small group learning lounge; scratch bakery; dehydrating food composter; ample natural daylight; flexible seating arrangements; and outdoor student gardens.
The firm took advantage of the school’s natural setting surrounding a pine and oak forest and wove them into the design and construction to showcase the “active landscape.” The school’s project committee and design team worked collaboratively to create a total learning environment in order to support learning both inside and outside the traditional classroom. Each grade level enjoys age-appropriate outdoor gardens and play terraces, which encourage children to re-connect and spend time in their natural surroundings. Inside the schools, in addition to core classrooms, each grade level has small group learning spaces that transform pathways into child-centric “learning streets” that have soft seating and fun colors that communicate both collaborative and shared learning experiences.
To study the impact of the healthy design features, VMDO teamed with Matthew Trowbridge, MD, MPH, an associate professor at the University of Virginia School of Medicine, with a special interest in the impact of the built environment on public health to study how health-promoting educational design strategies can support active communities and reduce incidence rates of childhood obesity.
NewPublicHealth recently spoke with Trowbridge about the project.
NewPublicHealth: How did the project come about?
Matthew Trowbridge: Through a collaboration between me and Terry Huang, who was a program officer at the National Institute of Child Health and Human Development and a leader in that institute’s childhood obesity research portfolio. [Editor’s note: He is now a Professor and Chair of the Department of Health Promotion, Social & Behavioral Health University of Nebraska Medical Center College of Public Health.] Back in 2007, Terry had been thinking about how architecture, and particularly school architecture, could be utilized as a tool for obesity prevention. The thinking behind that is that schools have always been a particularly interesting environment for child health very broadly, but also obesity prevention in particular, partly because children spend so much time at school and because the school day provides an important opportunity to help children develop healthy lifelong attitudes and behaviors.
One of the insights that Terry had was that while public health had done a lot to develop programming for school-based obesity prevention, the actual school building itself had really not been looked at in terms of opportunities to help make school-based obesity prevention programs work most effectively. In 2007, Terry actually wrote a journal article outlining ideas for ways in which architecture could be used to augment school-based childhood obesity prevention programs that was published in one of the top obesity journals. When I met Terry at NIH, we realized we both shared an interest in moving beyond studying the association between built environment and health toward real world translation. In other words, providing tangible tools and guidelines to foster collaboration between public health and the design community to bring these ideas into action.
Building a Culture of Health means building a society where getting healthy and staying healthy is a fundamental and guiding social value that helps define American culture...and it’s a mission that communities across the country are eagerly taking on. They include the six communities honored by this year’s Culture of Health prizes from the Robert Wood Johnson Foundation (RWJF), who are coming together today and tomorrow at RWJF’s Princeton, N.J. campus to celebrate their efforts and share the lessons learned. Picked from more than 250 submissions, these six communities are leading some of the nation’s most innovative public health efforts.
The RWJF Culture of Health Prize was launched to further the work of the County Healthy Rankings & Roadmaps program, which aims to educate the public and policy makers on the multiple factors that influence community health—such as education, economic conditions and the physical environment—and to provide solutions that will improve community health. The prizes honor communities that place a high priority on health and bring partners together to drive local change.