Designing Healthy Communities by Jackson, Richard J. and Sinclair, Stacy

Abstract

Children, Youth and Environments Vol. 22 No. 2 (Winter 2012) ISSN: 1546-2250 Designing Healthy Communities Jackson, Richard J. and Sinclair, Stacy (2012). San Francisco: Jossey-Bass; 230 pages. ISBN 978111803366. This book is a fitting milestone in Richard Jackson’s long career as a leader in public health. A pediatrician, Jackson helped establish the California Birth Defects Monitoring Program while he served with the California Department of Public Health, and the Childhood Lead Poisoning Prevention Program in his position as Director of the Centers for Disease Control and Prevention’s National Center for Environmental Health. From his early focus on the microcosm of children’s health—the toxic chemicals and particulates associated with birth defects, cancers, neurological disorders and asthma—he turned his attention to the macrocosm of the built environment that forms the upstream source of these problems, sometimes literally as well as figuratively. More recently, his concern includes the epidemic of obesity in the United States population, including children. He currently chairs the Department of Environmental Health Sciences in the School of Public Health at the University of California, Los Angeles. Jackson helped the profession of public health recognize that the built environment impacts major health concerns of our day. With Howard Frumkin and Lawrence Frank, he coauthored Urban Sprawl and Public Health (2004), a book that explores connections between our automobile-dependent way of life and health problems like obesity, depression, and exposure to air and water pollution. With Howard Frumkin and Andrew Dannenberg, he edited Making Healthy Places(2011). In Designing Healthy Communities, he and Sinclair emphasize the importance of community as a means to health, arguing that places that promote health and happiness are public goods that people create together. The book is an accessible analysis of relationships between the built environment and 296 health, featuring seven urban initiatives to create livable, walkable cities and towns. It culminates in guidelines for action, explaining how engaged citizens can conduct environmental audits, organize, develop action plans, and move to the implementation of local land use policies and infrastructures that promote health. Throughout the book, Jackson and Sinclair give attention to the well-being of children and their families. Many of the issues they discuss are intergenerational: affordable homes that are free of mold, asbestos and lead-based paints; adequate open spaces for play and exercise; nearby nature; complete streets that accommodate cyclists and pedestrians as well as cars; human-scaled streets; access to shops and public services by walking, biking or public transit; access to fresh foods and farmers’ markets; protection from pollution. While these resources benefit all ages, they are critical for children’s development, and the authors identify these links. They also discuss more child-specific issues, such as neighborhood schools, bike-to-school programs, and after-school programs. They recognize that more livable communities are desirable locations, resulting in high real estate prices in some of the cities that they discuss—such as Boulder, Colorado and Charleston, South Carolina—so that they identify affordable housing programs as critical for equitable access to healthy places. They also feature initiatives to improve working-class and decaying cities through the examples of Elgin in Illinois, Oakland, California and Detroit, Michigan. Jackson and Sinclair note repeatedly that environmental choices impact children for better or for worse, with long-term consequences for them and for society. They treat children and youth primarily as a vulnerable population that adults need to protect and provide for: the traditional view of children in Jackson’s fields of public health and pediatrics. This is an essential beginning: young people do need adult protection from toxins, air pollution, fast traffic, and dangerous neighborhoods that keep them indoors under conditions similar to house arrest. It is time for pediatrics and public health, 297 however, to catch up with the United Nations Convention on the Rights of the Child, ratified by the UN in 1989, which asserts that children have three kinds of rights: rights to protection from harm, rights to have their basic needs provided, and rights to participation in decisions that impact their lives, to the extent of their capabilities. The United Nations Committee on the Rights of the Child has specified that...