Dr. Richard Jackson: “We Are No Longer Creating Wellbeing”

Dr. Richard Jackson, Chair of the School of Health at UCLA, and former head of the National Center for Environmental Health at the Centers for Disease Control and Prevention (CDC), argued that how we shape our environment impacts our health. There are now deep-rooted structural issues with the built environment that are creating epidemics of obesity, diabetes, and depression. Also, the current way of dealing with these structural issues is only just increasing the annual amount of spending on healthcare (now at 17 percent of GDP), instead of addressing the underlying problems. “We are now medicalizing the problems people are experiencing with their environment. We are no longer creating wellbeing.”

Instead of addressing the public health impacts of the absence of trees, low-albedo streets (which contribute to the urban heat island effect), as well as a lack of sustainable transportation planning, which can help spur the growth of public transit options, we are instead “looking at the end of the pipeline,” the medical effects. Our environment is sending us a message: “We are appendages to our cars.”

Jackson outlined a few of the structural issues that need to be addressed:

How we build affects how often we are injured

Jackson said 24,000 lives could be saved each year if the country had the same low car crash fatality rates as New York City. The city provides easy access to public transit and safer street designs. 

How we build affects the air we breathe and the water we drink

“Any place where we can cool the air, we can improve health.” When ground-level heat indicators go up, ozone levels also rise. Ozone is a leading contributor to asthma, a chronic disease that disproportionally impacts inner-city areas.

Cars are heavy contributors of ozone so “we need to invest more in public transit and biking.” One “natural experiment” demonstrated this: In Atlanta during the Olympic Games, people drove less, taking public transit to get into the city center. As a result asthma hospitalizations dropped by some 30 percent.

How we build affects what we eat

Each year, the CDC calls between 100,000 and 200,000 people nationwide, and goes through an hour-long questionnaire about their health. Through these studies, public health policymakers have found that obesity rates have gone through the roof. “Now there’s only one state where less than 20 percent of the population is obese.” Over the past twenty years, the obesity rate for teenagers has also tripled.

Obesity is a “common cause epidemic,” and a related health impact, diabetes, is now a “crushing health crisis,” driven in large part by the sedentary, car-based lives we are leading. Sprawl, in effect, kills.

How we build affects how active we are

Less density equals more driving. “We are engineering exercise out of people’s lives” by creating suburban cul-de-sacs and putting places of work and living far from each other. Higher density equals more walking. “This is an issue of life and death,” argued Jackson.

He also called for Fitnessgrams to be added to every report card. “Right now, 3/4 of graduating high school students can’t run or walk a mile in under 12 minutes.” By creating car-dependent communities,” we are taking away walking,” exacerbating the epidemic of obesity among kids as well.

How we build affects our home (earth)

There have been dramatic increases in C02 emissions over the past 150 years. More recently, our air has gotten hotter, the ground has gotten hotter (which impacts the fertility of soils), and ocean temperatures have gotten hotter (which combined with increased C02 levels has led to acidification).

Weather change is just oscillation around a central average, but climate change is impacting “hardiness zones.” Over the past twenty years, in New Jersey, “we’ve moved from hardiness zone five to seven.” This will have major impacts on what trees can exist in these areas.

Another major issue: reduced water. California alone is facing billions of new infrastructure investment to deal with the reduced ice caps in its mountain regions.

Part of the solution may be to design for wellbeing, which can also reduce the negative impacts of the built environment on public health.

For example, new green hospitals are including organic food gardens that help patients recover faster. Studies of patient experience demonstrates that views of nature (or even just images of nature) improve patient outcomes. Most patients respond positively to nature art; looking at nature (or images of nature) can reduce the need for medication; and exposure to sunlight shortens hospital stays.

To sum up, Jackson said, “cars are not more important than people or trees.” But landscape architects also need to plant the right trees in the right places, and create long-term plans to keep trees in place. Additionally, capturing water on site is important given increased water shortages. He also called for ASLA to lead a charge on school gardens, adding that “ASLA members could adopt school gardens” in their neighborhoods and help integrate organic food into communities.

At the national level, the upcoming transportation bill, where President Obama has focused his continuing recovery efforts, will need to dramatically increase investment in public transit, bike routes, and safe routes to schools. 

To learn more, read “Built Environment: Designing Communities to Promote Physical Activity in Children,” a policy statement from the American Academy of Pediatrics (see earlier post). Also, read Dr. Jackson’s book, “Urban Sprawl and Public Health: Designing, Planning, and Building for Healthy Communities” and check out his upcoming PBS special.

Dr. Jackson made the case that landscape architects are “health leaders,” and since the days of Frederick Law Olmsted have been focused on improving people’s health and wellbeing. See an interview with Paul Morris, FASLA, on CDC’s Healthy Communities program, and how design can improve health.

Image credit: Suburban Parking Lot / Sprawled Out

7 thoughts on “Dr. Richard Jackson: “We Are No Longer Creating Wellbeing”

  1. ERDİNC M. ACAR 09/16/2010 / 11:43 am

    There is the proverb that reads if you do not want to loose your human nature do not lose NATURE. Well being comes as we take NATURE as our teacher or healer. Even if we do not ıntend to do so it comes as a given as we are born.What I would suggest is hospitals with gardens mımıcıng jungles and complıcated terrains and healing comes the second we enter. Every patient can own 3 yards square in designated spots of the jungle garden where he/she can plant and produce vegetables for his/her own use.

    Just an idea.
    Landscape Architect Erdinc M. Acar

  2. Alyce Kirk 09/21/2010 / 3:33 pm

    With current medical insurance plans it’s doubtful that a patient would have time to plant a seed, much less plant and produce vegetables.

  3. Janice Flahiff 09/22/2010 / 4:59 am

    I think Acar has a point. A hospital in our area had an area that was not “developed”, it was mostly rubble and weeds (mixture of native and invasive species??). In my head I was thinking, what a nice place for a demonstration herbal garden. Within a few years the land was used for a huge orthopedic center, about the size of a medium large department store.

    Well, maybe a herbal garden wouldn’t have been the best way to use the land. Still, I think maybe a combination greenhouse/ outside jungle/garden would have been a better decision. And for the orthopedic center? The head is a great doctor, visionary, etc. and the orthopedic center has a great reputation. Still…I think there is room for a hospital to be more holistic, starting with gardens….

    I think Kirk brings up a point, the lack of time…but with all our hurriedness (putting up buildings fast, personal cars racing around)….I think we are just setting ourself by…well …repenting at leisure…and repenting collectively with diabetes, obesity, etc…..

    Just some early morning thoughts….thank you for the article…

  4. Stephen Pooler 10/04/2010 / 6:24 pm

    I believe every word of this and mostly of how we affect the air we breath and the water we drink. I have always had asthma but never has bothered me since I lived in a small town. Now that I go to Madison College every five days my asthma has been worst than ever.

  5. Clare Cooper Marcus 12/02/2010 / 1:16 pm

    Exercise has not been “engineered out of our lives by cul-de-sacs”. Dr Jackson has apparently “bought” the whole New Urbanist rhetoric on this topic. Research by Susan Handy at the University of California, Davis shows that children living on cul-de-sacs engage in outdoor play more often than those living on through streets where parents call for traffic calming measures. None of the parents of cul-de-sacs in this study had concerns about traffic, hence their willingness to let their children play outdoors in the public domain. See the City of Davis,CA for excellent examples of where cul-de-sacs abut onto greenways and a grid of walking and biking paths allows for non-auto movement throughout much of the city.

    • Mike 06/30/2011 / 4:57 pm

      That’s is fine that you cite Handy’s study on the link between cul-de-sacs and outdoor play, but what Dr Jackson is trying to describe is more than just play time for a specific age group. Think about it this way. Say your teenage son has a friend that lives just beyond the back of his house. Now, take into consideration there is no through street at the end of the cul-de-sac, likely possibility of fencing off of property, etc, that kid will end up driving around the block to get where he needs to be. The larger picture is that communities that are built with such designs aren’t the types of places that are walk-able in the first place. A lack of accessible shopping, recreation, and parks hardly instigates people to explore on foot. To get where you need to be you have to drive. Driving becomes a crutch and walking starts to look like a foreign concept. A little walking can go a long way, no pun intended. Many studies show that certain chronic conditions like diabetes can be abated with 30 minute walks a few days a week.

  6. Great synopsis of an excellent talk. I was heartened first that ASLA invited Dick Jackson to be one of the keynote speakers for this year’s ASLA conference (and Majora Carter as the other!), and second by Jackson’s message. Just as “engineering exercise out of people’s lives is a life or death issue,” designing exercise and health into people’s lives is paramount. And we as landscape architects can play a critical role. For people interested in the ways that the built environment shapes human health and well-being, I recommend the Therapeutic Landscapes Network website. Though our focus is primarily on gardens in healthcare, we address other green spaces such as school and community gardens, sensory gardens, memorials, labyrinths, and more.

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