A doctor's passion for healthy communities

Review of Designing Healthy Communities, by Richard J. Jackson with Stacy Sinclair, Jossey-Bass, 2011, 261 pp., $50 hardcover.

When Richard Jackson spoke during the CNU congress in Atlanta in 2010, his passion and eloquence registered on me and everyone else in the audience. A leading figure among public health professionals fighting for better community design, Dr. Jackson believes America must pay far greater attention to the effect that streets, sidewalks, buildings, parks — all the elements of the built environment — have on people’s physical and mental well-being.

Only upon reading his latest book did I discover that Dr. Jackson, who chairs Environmental Health Sciences at ULCA, was propelled toward a career in health and medicine by experiences that began early in life. He was just three years old, in Portland. Maine, when his father suddenly died of polio. A few years later, growing up in New Jersey after his mother remarried, he found there often seemed to be not enough food for a household of nine. In a family with five boys, “we would go and get USDA surplus milk powder, macaroni, and other foods,” he recalls.

At 18, he entered a seminary where “for two years I prayed five hours a day, lived mostly in silence, spoke in Latin, and learned the Jesuit life and the insights of Greek, Roman, Catholic, and modern philosophers.” After leaving the seminary, squeezing a range of college science courses into two years, and then completing medical school, the young pediatrician shifted toward public health; it has been a means for making an impact on large numbers of people, including the most vulnerable.

Urbanists and smart-growth advocates should be aware of the book he co-authored in 2004, Urban Sprawl and Public Health, and another he co-authored last year, Making Healthy Communities. Now he has still another, Designing Healthy Communities. Though intended as a companion to a four-part TV series he is hosting on PBS stations this January, the book stands on its own very well.

The obesity epidemic

Assessing the epidemic of obesity-related diseases that disproportionately afflicts children living where there is no reasonable way to walk to school, where cafeteria food is often less than healthy, and where there are pollutants in the environment, Dr. Jackson warns, “The cumulative impact of this injustice, if it not remedied, will crush the United States.” Children need to grow up in environments “where they can have increased physical activity and autonomy,” asserts a policy statement that Dr. Jackson was instrumental in getting the American Academy of Pediatrics to promulgate.

Designing Healthy Communities underscores the cost of inaction: “if we do nothing, about a third of our children will become diabetic at some time in their lives, with a reduction of their average life span of fifteen years and a reduction in their quality of life of about twenty years.” What to do? Part of the answer is, build homes and communities that alleviate loneliness, encourage activity, and recognize the importance of extended families. “Schools need to be in town, near where people work and where elder care facilities might be located, and not isolated in boxes on distant land,” he says.

A community should create “a sense of both connection and stimulation in us,” Dr. Jackson says. He is alert not just to elementary matters such as whether there are safe sidewalks but also to whether a community’s buildings are beautiful and human-scale. He asks: “Do you like the way your built environment looks — the choice of building materials, the shapes and size of the buildings, the other architectural choices, the preservation of historic structures or the modern design of the landscape?”

This is the voice of a man who appreciates life and human culture in all its dimensions.

The book consists of three parts. Part One describes the characteristics of healthy communities, and looks at “why caring, love, and caritas are important.” Part Two examines communities that are working to transform themselves into healthful physical environments. These include two developments with strong New Urban characteristics: the Belmar town center, near Denver, and Prairie Crossing, north of Chicago. Also examined are Charleston, South Carolina, where the author tells about Mayor Joseph Riley’s wise stewardship; Boulder, Colorado, which has created conditions that favor walking and biking; Elgin, Illinois, an old industrial city striving for a better future; Oakland, California, where degraded air quality has been an issue; and Detroit, where urban homesteading and agriculture are being promoted.

Part Three investigates ways in which average citizens can have a voice. Interviews conducted by Harry Wiland, Dale Bell, Stacy Sinclair, and the author add to the book’s liveliness and detail. Though professionals of many stripes can learn from Designing Healthy Communities, its greatest strength is likely to lie in energizing and educating a broad public — readers described by Dr. Jackson as “those of us who are concerned about our communities and the world we are giving to our children.”