Making Healthy Places: An Essential Tool For Urban Designers (Book Review)


A few months ago many were outraged by the case of Raquel Nelson, who was convicted of vehicular homicide because she crossed the street to get home instead of walking up to the traffic light, and her son was killed by a drunk and drugged driver. It was and remains outrageous, but what causes our cities to be so badly designed, so unhealthy, so dangerous?

A new book from Island Press tries to answer these questions. Making Healthy Places brings together doctors, planners, health experts and others, delivering solid research and information that "explain how design, land use, and transportation decisions can promote health and improve quality of life in a community."


Image credit Sploid

One of the editors, Richard Jackson, nails the problem in the Preface:

We must rethink the ways in which our physical environments, homes, offices, neighborhoods, regions, and transit systems are designed and constructed, understand how they impact health and ensure that they foster equity and sustainability.

He continues:

The health threats we fasce cannot be countered by medical science alone, Although there are medicines to help us lose weight, they will never be as safe or as cheap as a good diet and excrcise, particlarly the incidental exercise that was a routine part of earlier generations' lives as they waked to shops, churches, and workplaces and climbed stairs in buildings.


I interviewed editor Andrew Dannenberg on TreeHugger here

It is just about the most authoritative and thorough examination of how our urban design (and house design) affects our health and wellbeing, and should be on the desk of every urban designer and planner as an important reference; every essay has an extensive list of references, a useful summary of key points, a list of questions raised and a research agenda. For example, Transportation and Land Use has key points:

  • The 5 D's of development--density, diversity, design, destination accessibility, and distance to transit--affect the physical, social, and mental health of community residents.
  • The 5 D's influence whether a community is attractive and walkable, can support transit, and has convenient destinations that support quality of life and reduce automobile dependency.
  • Approaches related to the 5 D's, such as smart growth, New Urbanism, transit-oriented development, LEED-ND, and Active Living by Design, can facilitate healthy community design.
  • Land-use and transportation policies that promote health include changing the rules of development to favor smart growth in the approval process; adopting pedestrian-friendly site and building design standards; providing workforce housing near jobs; adopting a complete streets policy; making routes to schools safer; giving funding priority to compact, transit-served areas; and redirecting transportation funding from roads to pedestrian, bicycle, and transit facilities.

Discussion Questions:

  1. What features of the built environment encourage physical activity? What features discourage physical activity?
  2. How do development patterns impact environmental quality?
  3. What policies facilitate development that is consistent with the 5Ds of development? Of these, which are most feasible for your city or region and why?
  4. Why might some land use and transportation planners be reluctant to incorporate health considerations into their decisions?
  5. How can more interactions between public health departments and planning departments be encouraged?

And a research agenda, available online here.

Most of the chapters are written with the non-academic in mind and are eminently readible, even to the point of having a sometimes annoying personalization of each chapter with a story of how design affects real people, such as the beginning of the chapter on Community design for physical activity:

Rinaldo is luckier than most children in his neighborhood because he can look out his window and see a nearby park....however he doesn't go to the park very often because there is a ten-lane freeway between his window and the park.

On the other hand, while one can read the key points and discussion questions on line at their very thorough website, this book is designed to be accessible, to reach the broadest possible audience.

I cannot imagine writing about urban issues involving food, health, safety or transportation without picking this up for a quote or a reference; it is going to be an essential tool.

More at Making Healthy Places website, and Island Press.

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