New APHA book connects public health, built environment
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* Teddi Dineley Johnson

In the United States today, one in three children is overweight, asthma rates are rising sharply and Type 2 diabetes is expected to double — perhaps triple — over the next 40 years.

The nation is confronting a “perfect storm” in which an avalanche of chronic diseases, economic struggles and environmental challenges are converging to put Americans on a trajectory of declining overall life expectancy, according to a new book. Spotlighting the link between urban design and health challenges such as obesity and chronic disease, “Designing Healthy Communities” calls for achieving the kinds of environments that allow Americans to live in harmony with their health needs.

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/41/7/4.2/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/41/7/4.2/F1)

“How we build our cities, our towns and our communities has powerful effects on health,” author Richard J. Jackson, MD, MPH, told *The Nation’s Health*. “We built America to work reasonably well for cars and we have forgotten the needs of people. We have particularly forgotten the needs of poor people, young people who can’t drive, old people who can no longer drive and disabled people,” said Jackson, professor and chair of environmental health sciences at the University of California Los Angeles School of Public Health.

Co-published by APHA and Jossey-Bass, the book aims to raise awareness of the public health challenges that arise from the existing built environment. Jackson calls for retrofitting or redesigning the nation’s communities to reflect new information, such as the fact that contaminated air is a factor in asthma; that having insufficient sidewalks, bike paths and parks is a factor in obesity; and that a lack of access to fresh food and farmers markets is a factor in diabetes.

“Our urban design, especially the buildings and roads we make and maintain, can give people access to the places that help them fill their life needs, including food, shelter, work and health care, or take it away,” Jackson writes in the book’s preface. “This human-made environment, or ‘built environment,’ is at the core of environmental health.”

Written in nontechnical language, the book is intended to help readers understand the current built environment and shares a range of options to effectively push for healthy changes. Divided into three parts, the book describes the characteristics of healthy communities, examines communities that are working to transform themselves and investigates ways in which the average citizen can have a voice and help change the future of her or his community.

“I have a great deal of hope,” said Jackson, who is former director of the National Center for Environmental Health and a former state public health officer for California. “It took us 50 to 70 years to build this sprawling, car-dependent United States, which cannot continue with the increasing cost of oil and increasing difficulty of obtaining it. It will take a generation to get to a point where things really work well.”

APHA Annual Meeting-goers will be able to attend a book signing with Jackson at 10:15 a.m. on Monday, Oct. 31, in the Everything APHA section of the meeting’s Public Health Expo. In addition, the book will be the topic of Annual Meeting session 3011 on Oct. 31 at 9:30 a.m. The book is also the subject of a four-hour Public Broadcasting Service series to be aired in 2012.

For more information, visit [www.aphabookstore.org](http://www.aphabookstore.org) or email apha{at}pbd.com. For more on APHA’s Annual Meeting, which will be held Oct. 29–Nov. 2 in Washington, D.C., visit [www.apha.org/meetings/annualmeeting](http://www.apha.org/meetings/annualmeeting).

*   Copyright The Nation’s Health, American Public Health Association