Our lunch keynote, Dr. Richard Jackson, joined the 2nd annual Edge of Amazing conference in Snohomish County, where he talked about the conditions needed in a community, to be healthy. He laid out the health challenges and some of the 'treatments' needed to assist everyone in our communities in being healthy.

1. Richard J Jackson
MD MPH FAAP
HonAIA HonFASLA
dickjackson@ucla.edu
UCLA Fielding School of Public
Health
/
Designing and Building
for Health, Well-Being
and Sustainability

2. The Edge of Amazing
“Connecting Neighborhood to Nation to
Improve Community and Population Health”

3. Community Connections
22nd Century Healthy Community
Design
Health System Transformation

4. Summer 2016 Heat Map USA

6. Average Global Temperatures
Since 1880

8. The Built Environment is Social Policy
IN CONCRETE

9. Atlanta Journal-Constitution, March 10, 2006

10. We Used to Build Real Towns and
Neighborhoods but Now…

11. Housing Policy Is Social Policy
Howard Frumkin MD DrPH

12. Two houses, adjoining back yards
(From Streetsblog, 02/28/2013)

14. Pedestrian Fatality Rates for
Collisions at Different Speeds
Zegeer et al 2002

15. For every age group
from 3 through 34--
crashes were the No. 1
cause of death

16. USA Today 10/20/2011

17. US Adult Obesity Rates 1990

18. US Adult Obesity Rates 1995

19. US Adult Obesity Rates 2000

20. http://stateofobesity.org/adult-obesity/
US Adult Obesity Rates 2016

21. 0
25
50
75
100
Relationship Between BMI and Risk
of Type 2 Diabetes
Chan J et al. Diabetes Care 1994;17:961.
Colditz G et al. Ann Intern Med 1995;122:481.
Age-AdjustedRelativeRisk
Body Mass index (kg/m2)
Men
Women
<22 <23 23
-
23.9
24
-
24.9
25
-
26.9
27
-
28.9
29
-
30.9
31
-
32.9
33
-
34.9
35+
1.0
2.9
1.0
4.3
1.0
5.0
1.5
8.1
2.2
15.8
4.4
27.6
40.3
54.0
93.2
6.7
11.6
21.3
42.1

22. US Diabetes Rates 1995

23. US Diabetes Rates 2003

24. US Diabetes Rates 2016

25. David B Allen MD
New England Journal
of Medicine
April 29, 2012
“…over 30 years…new-onset type 2
diabetes in adolescence has increased
from 3% to ~50% today”.

26. Diabetes Prevalence NHANES
(using Hemoglobin A1c , FPG)
Sample of US Population
All Age Groups, Races, Income and Education
1988-1994 2000-2002 2011-2012
9.8% 10.8% 12.4%
For Prediabetes
36.5%

27. 10,000 steps
• 3234 people with Pre-Diabetes
(IGT –Impaired Glucose Tolerance)
• Walked or exercised five times a week
for 30 minutes for six months
• Lost 5% to 7% of their body weight
• Reduced their risk of diabetes by 58%

28. “The Status of
Baby Boomers’
Health in the
United States:
The Healthiest
Generation?”
JAMA Internal
Medicine
February 4, 2013

29. Overall Health Status US
Persons Aged 46-64
NHANES 1988-1994 NHANES 2007-2010
Report “excellent” health
32% 13%
Limitations to Life Functions
9% 14%
Using Walking Assist (wheelchair, cane, etc)
3% 7%

30. “Lifestyle Factors” US
Persons Aged 46-64 (NHANES)
1988-1994 2007-2010
Smoking
28% 21%
Obesity
29% 39%

31. “Lifestyle Factors” US
Persons Aged 46-64 (NHANES)
1988-1994 2007-2010
No Regular Physical Activity
17% 52%

32. Life Expectancy at Birth and Health Spending
2011

33. Buford Highway Atlanta, Georgia

35. Medline Keyword Search:
“Built Environment” and “Health”
Sept1993 – Sept 2003
58 Articles
American Journal of Public Health
Built Environment and Health Issue
September, 2003

37. Data and Science

38. The Built
Environment:
Designing
Communities to
Promote Physical
Activity in
Children
Policy Statement American
Academy of Pediatrics
June 2009

39. Medline Keyword Search:
“Built Environment” and “Health”
Sept1993 – Sept 2003
58 Articles
Sept 2003 – May 2013
665 Articles
American Journal of Public Health
Built Environment and Health Issue
September, 2003

40. Institute of Medicine
Report
Accelerating Progress
in Obesity Prevention
May 8, 2012

41. Educational Benefits of
Walking and Biking to School
• Increases
concentration
• Improves mood and
ability to be alert
• Improves memory
and learning
• Enhances creativity

42. Charlotte, NC, Light Rail Opened
November, 2007

43. After 2 Years…
Light Rail Transit Users Had
• An average reduction of 1.18 BMI
points
– For a person who is 5’5” --equivalent to a
weight loss of 6.45 lbs.
• An 81% reduced odds of becoming
obese over time.

44. Education

45. American Institute
of Architects
Local Leaders—
Healthier
Communities
Through Design
2013

46. The High
Line
NYC
A 20 block walk
in Manhattan
without a cross
street–
and it was delightful even
with a 2 year old.

47. NYC Active Design Guidelines
• Resilient Bldgs
• Energy
Efficient
Buildings
• Healthy Bldgs
• Smart zoning
and locations
http://www.nyc.gov/html/ddc/html/design/active_design.shtml

48. Ten
Principles
for Building
Healthy
Places
The Urban Land
Institute 2013

51. Policy

52. Under current statute, the California general plan is presented
as a collection of seven “elements,” or topic categories
• Required
– Circulation
– Housing
– Conservation
– Open Space
– Noise
– Safety
– Air Quality
• “Optional”
– Health
– Equity
– Community Development
– Water
– Resiliency
– Others as communities request
or need. “Optional”
C

53. Every Chapter of the 2015 Draft California
General Plan Has the Byline:
Designing Healthy, Equitable,
Resilient and Economically
Vibrant Places

54. Caltrans Mission and Vision
Effective 2014

55. CalTrans Goals
Effective 2014

56. “Relinquishment” of State Highway Jurisdiction in
Downtown Urban Areas

59. Financing

61. British Columbia’s Carbon Tax
Revenue Neutral by Law
• Implemented July 2008
• Covers fuel use and carbon emissions.
• 2008: $10 per tonne of carbon dioxide
– Increased by C$5 p/y.
• In 2014 $30 per tonne ($0.26/gal)
• "Revenue neutral" by law.
• BC has cut $760 million income and other
taxes

62. Per capita consumption of Petroleum Products
Subject to BC carbon Tax (% change)
2007-2012
British Columbia down16.1%
Rest of Canada up 3%

63. Happiness and Joy

64. CicLAvia Los Angeles April 2012

65. Indianapolis Cultural
Trail
• 8 miles $69 million
• First $15 million from Glick
family (start with philanthropy)
• $2 million for Art
• Links the city together
• Revitalized Business
• Helps to Recruit and Retain
Top Talent
• And, yes, a GOP Mayor
Importance of Art and
Beauty and Nature

67. Atlanta Beltline/Atlanta City Streetcar System Plan
Approved by City Council Dec 8, 2015
A
• 50+ miles of street car
lines
• 5 Cross town routes
• 22 miles of Beltline
Corridor
• “Atlanta is a city that brings
people together and connects
them to opportunities,” said
Councilmember Andre Dickens, ABI
Board member and sponsor of the
legislation.
http://beltline.org/2015/12/09/atlanta-beltline-receives-approval-for-the-first-long-range-public-transit-plan-for-the-city/

68. Westside Subway Extension
• “When built, the subway will provide a high-capacity, high-speed, dependable alternative
for those traveling to LA’s “second downtown.” The area includes key job destinations
such as Miracle Mile, Beverly Hills, Century City and Westwood including the UCLA
campus. Over 300,000 people travel into the Westside every day for work from areas
throughout the County.” http://www.metro.net/projects/westside/overview/
Alternative 5:
Santa Monica
Extension &
West
Hollywood
Extension

69. Boyle Heights, Los Angeles. The Evolution into Mariachi Plaza

70. For Mariachi Plaza….”proposed eight-story medical office building and a six-level
parking garage, plus a three-floor building with street-level retail would take out a
small row of shops immediately north of the plaza…