Design For Health

Health in the Green Economy


One of the reports in the series

A new WHO briefing paper series on Health in the Green Economy proposes links between climate change mitigation and improved health. There are a number of related publications dealing with housing and transportation. For example, the housing report highlights the health consequences for non-communicable diseases of extreme heat and cold, dampness, and ventilation problems that may be associated with climate change. It also points out the potential rise of vector-borne diseases. Indoor air quality is a key concern as houses become more air tight.

This is a useful set of summary reports.

Aging, Health, and Environments

For those interested in health and aging, the U.S. Environmental Protection Agency is perhaps a surprising source of useful information. Their Aging Initiative has a useful web site and list serve, bot accessible at http://www.epa.gov/aging/index.htm. Topics covered include environmental health, aging and smart growth, and environmental activism for older people. It is well worth a look.

The EPA’s National Agenda for the Environment and Aging
received input from listing sessions during 2003.

Other resources on older people, health, and planning are available on the Design for Health web site at http://designforhealth.net/resources/seniors.html

Research: High Density and Overweight Adolescents

I typically don’t report on scholarly studies in this blog but recently came across a nicely designed study that makes a larger point—that the links between health and place are complex. Fei Xu, JieQuan Li, YaQiong Liang, ZhiYong Wang, Xin Hong, Robert S Ware, Eva Leslie, Takemi Sugiyama, and Neville Owen have produced a report  on the Nanjing High School Students’ Health Survey, published in the Journal of Epidemiology and Community Health in 2010 (64, 1017-1021, http://jech.bmj.com/content/64/11/1017). Titled: “Residential density and adolescent overweight in a rapidly urbanising region of mainland China” the study used data collected from 2,375 adolescents in 2004 to examine the relationship between (large-scale) district level densities and weight.

New high rise behind village
residences in suburban Shanghai, 2010

Densities are reported per square kilometer but in range from 5 persons per hectare to 307.  The study divided the sample into high, medium, low density residents. Youth in the middle and higher density areas (that is over > 35 person per hectare) were roughly  twice as likely to be overweight.

The relationship was reduced a bit but still significant after controlling for TV time, study time, recreation, age, gender, and parents education. Physical activity data came from self reports through a version of the International Physical Activity Questionnaire (IPAQ) that only asked about some kinds  of activities. Given a lack of data on overall physical activity and food intake the authors speculate on a number of reasons for this difference e.g. youth in higher density and potentially higher income areas eating more, higher density areas having less recreational space, or (and here I am paraphrasing quite loosely) that higher density areas may just be too convenient with too much internet access so youth don’t have to expend much energy getting places. The high densities in China are also quite high compared with the US and Australia in particular, where much research has been done. They are also increasing rapidly—the authors report overall densities in Nanjing, presumably including some rural districts, increasing from 14 persons per hectare in 1997 to 23 in 2007.

The study is interesting because in many studies of adults, those in higher densities walk more for transportation (though they may not walk more overall) and some find they are thinner (though not all studies measure this or find it to be true, including my own). In this study of youth, with a large group and fairly good measures, those in higher densities are chubbier. While it is important not to make too much of one study, this is yet another example of the complexity of the relationship between health and place, and the importance of social factors.

Technical Resource 2: InformeDesign

InformeDesign (http://www.informedesign.org/) is an online database of research on people and environments. With substantial funding from the American Society of Interior Designers, and based in the University of Minnesota Department of Design, Housing, and Apparel, the database emphasizes research at the building and component level. However, there is enough other work to make it worth a visit, even for urban planning scale investigations.

The site is basically a database of research summaries in a standard format: introduction, design issue or topic, design criteria or implications, key concepts or central ideas, research methods, limitations identified by the authors of the piece, commentaries on limitations noticed by the InformeDesign reviewers as well as additional information, and a full citation.
The site offers several navigation and search options though not all are obvious. A simple search window is on the home page. There is also an advanced search engine that I found to be well designed though results are listed by URL only and one has to click on the link to the summary to get more information such as titles. Also on the home page are buttons titled “space,” “issues,” and “occupants” that link to lists of subtopics that are further subdivided on later pages. When a user clicks on a subtopic, or a sub-subtopic, articles are listed by name and author and have check boxes to add to a personalized list.
For those interested in more general information about the project, a main menu links to useful information about the site, its sponsors, and the database. An online tutorial on Research 101 provides a refresher on research vocabulary and concepts.

Therapeutic Landscapes Network at http://www.healinglandscapes.org/


Garden landscape
(Photo by Ann Forsyth)

Focusing on gardens and other landscapes, with a particular emphasis on gardens in healthcare settings, the web site of the Therapeutic Landscapes Network is a well-designed and maintained resource. I have found the following sections to be particularly helpful:

The evidence-based design section at http://www.healinglandscapes.org/ resources-ebd.html includes online searchable databases, books, and articles.

The gardens overview at http://www.healinglandscapes.org/gardens-overview.html links to ressources on various kinds of healing gardens including those in healthcare, community gardens, prison gardens, and memorial gardens.
A section on art and health http://www.healinglandscapes.org/related-art-health.html [no longer available] provides a succinct overview of important resources.

For further reading, the Design for Health web site deals with planting and mental health at: http://www.designforhealth.net/resources/mentalhealthissue.html

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