Abstract: The built environment has direct and indirect effects on mental health. High-rise housing is inimical to the psychological well-being of women with young children. Poor-quality housing appears to increase psychological distress, but methodological issues make it difficult to draw clear conclusions. Mental health of psychiatric patients has been linked to design elements that affect their ability to regulate social interaction (e.g., furniture configuration, privacy). Alzheimer's patients adjust better to small-scale, homier facilities that also have lower levels of stimulation. They are also better adjusted in buildings that accommodate physical wandering. Residential crowding (number of people per room) and loud exterior noise sources (e.g., airports) elevate psychological distress but do not produce serious mental illness. Malodorous air pollutants heighten negative affect, and some toxins (e.g., lead, solvents) cause behavioral disturbances (e.g., self-regulatory ability, aggression). Insufficient daylight is reliably associated with increased depressive symptoms. Indirectly, the physical environment may influence mental health by altering psychosocial processes with known mental health sequelae. Personal control, socially supportive relationships, and restoration from stress and fatigue are all affected by properties of the built environment. More prospective, longitudinal studies and, where feasible, randomized experiments are needed to examine the potential role of the physical environment in mental health. Even more challenging is the task of developing underlying models of how the built environment can affect mental health. It is also likely that some individuals may be more vulnerable to mental health impacts of the built environment. Because exposure to poor environmental conditions is not randomly distributed and tends to concentrate among the poor and ethnic minorities, we also need to focus more attention on the health implications of multiple environmental risk exposure.

Abstract: Mounting evidence suggests physical and mental health problems relate to the built environment, including human-modified places such as homes, schools, workplaces, parks, industrial areas, farms, roads and highways. The public health relevance of the built environment requires examination. Preliminary research demonstrates the health benefits of sustainable communities. However, the impact of mediating and moderating factors within the built environment on health must be explored further. Given the complexity of the built environment, understanding its influence on human health requires a community-based, multilevel, interdisciplinary research approach. The authors offer recommendations, based upon a recent conference sponsored by the National Institute of Environmental Health Sciences (NIEHS), for research and policy approaches, and suggest interagency research alliances for greater public health impact.

Abstract: Health and Community Design is a comprehensive examination of how the built environment encourages or discourages physical activity, drawing together insights from a range of research on the relationships between urban form and public health. It provides important information about the factors that influence decisions about physical activity and modes of travel, and about how land use patterns can be changed to help overcome barriers to physical activity. Chapters examine: the historical relationship between health and urban form in the United States; why urban and suburban development should be designed to promote moderate types of physical activity; the divergent needs and requirements of different groups of people and the role of those needs in setting policy; how different settings make it easier or more difficult to incorporate walking and bicycling into everyday activities; A concluding chapter reviews the arguments presented and sketches a research agenda for the future.

Abstract: The overarching goal of this article is to make explicit the multiple pathways through which the built environment may potentially affect health and well-being. The loss of close collaboration between urban planning and pulic health professionals that characterized the post-World War II era has limited the design and implementation of effective intervention and policies that might translate into improved health for urban populatons. First, we present a conceptual model that developed out of previous research called Social Determinants of Health and Environmental Health Promotion. Second, we review empirical research from both the urban planning and public health literature regarding the health effects of housing and housing interventions. And third, we wrestle with key challenges in conducting sound scientific research on connections between the built environment and health, namely: (1) the necessity of dealing with the possible health consequences of myriad public and private sector activities; (2) the lack of valid and reliable indicators of the built environment to monitor the health effects of urban planning and policy decisions, especially with regard to land use mix; and (3) the growth of the “megalopolis” or “super urban region” that requires analysis of health effects across state lines and in circumscribed areas within multiple states. We contend that to plan for healthy cities, we need to reinvigorate the historic link between urban planning and public health, and thereby conduct informed science to better guide effective public policy.

Abstract: “Sense of place” is a widely discussed concept in fields as diverse as geography, environmental psychology, and art, but it has little traction in the field of public health. The health impact of place includes physical, psychological, social, spiritual, and aesthetic outcomes. In this article, the author introduces sense of place as a public health construct. While many recommendations for “good places” are available, few are based on empirical evidence, and thus they are incompatible with current public health practice. Evidence-based recommendations for healthy place making could have important public health implications. Four aspects of the built environment, at different spatial scales—nature contact, buildings, public spaces, and urban form—are identified as offering promising opportunities for public health research, and potential research agendas for each are discussed.

Abstract: The drive from my office to my suburban Atlanta home is all too familiar: it begins with a scary 7-lane thoroughfare, infamous for its strip malls, lack of sidewalks, and high pedestrian fatality rates; progresses to a jumble of connecting interstate highways packed with rush-hour traffic despite 12 or more roadway lanes; and ends with clusters of new, low-density, single-family residential developments lacking public parks, playgrounds, libraries, nearby stores or cafes, sidewalks, bicycle trails, and public transit. Adults and children in my neighborhood travel by private automobile to virtually all of their destinations, because they have no practical transportation alternatives. We humans often assume that what is, had to be that way. In reality, virtually everything in our built environment is the way it is because someone designed it that way. Central Park is beautiful and appears “natural” precisely because Frederick Law Olmsted designed and built it that way. Roadside signs advertising fast food restaurants strike the eye because they are designed to catch the attention of someone rushing by at high speed. Because children cannot buy homes or vote for parks, bicycle trails, small local schools, or nearby ball fields, many new residential areas in America are built without such community assets. Despite the fact that many humans accept the world as it is, we have a remarkable capacity to plan ahead, shape the future, and adapt to new settings. This capacity serves us well when we are trying to build new societies or solve public health dilemmas. Our parents and grandparents helped extend our life expectancy and build great cities such as New York and San Francisco that became hubs for culture and diversity. Our predecessors left us an economically strong and well-educated nation with a high standard of living seen as a model for many around the world. The current generation now faces its own challenges. One challenge is to better understand the broad impact of our built environment on health and then to build future communities that promote physical and mental health. Public health has traditionally addressed the built environment to tackle specific health issues such as sanitation, lead paint, workplace safety, fire codes, and access for persons with disabilities. We now realize that how we design the built environment may hold tremendous potential for addressing many of the nation’s greatest current public health concerns, including obesity, cardiovascular disease, diabetes, asthma, injury, depression, violence, and social inequities. Some of our current zoning laws that block high-density, live–work–play developments derive from interventions that helped prevent the spread of tuberculosis and other infectious diseases in the 19th century. Public health–based zoning laws were also instrumental in separating homes and schools from the odors and toxic emissions of abattoirs and tanneries. In the 20th century, the automobile and accompanying highway construction enabled the growth of suburbs and the vast expansion of metropolitan areas. Rail and trolley lines declined, and by the late 1960s, the cores of most major cities were sapped of economic vitality and left with failing schools and rising crime rates. Government incentives that subsidized mortgages and highways encouraged home-building further out from urban areas. As the US population grew and density dropped, vast stretches of forests and farmland were lost in the creation of roadways, megamalls, megaschools, and megasubdivisions. Even our environmental policies exacerbated the flow. In urban areas with extensive preexisting infrastructure, the past contamination of land presents future investors with real or potential liability risks, so many of these urban “brownfields” go unsalvaged. Despite the availability of over 10 000 vacant land parcels in New York City,1 some city workers there have chosen to face commutes of 4 or more hours per day to subdivisions that replaced forests in northern Pennsylvania. This commuting pattern has led to the paving of vast quantities of landscape for roadways, cloverleaf intersections, and parking lots. At this point, the United States has paved a land area equivalent in size to the state of Georgia.2,3 Typical American families earn in real dollars roughly what they earned in the 1970s,4 but we spend much more now on motorized transportation. From 1969 to 1995, the number of private vehicles per household rose more than 50% to roughly one vehicle per licensed driver.5 Cars are such a necessity for work and other daily activities in American life that most adults manage to find the $7000 or more per year to own, maintain, insure, and drive a car,6 even if faced with choosing between health insurance and a car. Since 1970, the US population has increased 37%,7,8 but the distance traveled by the nation’s fleet of cars, motorcycles, sport-utility vehicles, and small trucks increased 143%.9 From 1982 to 2000, the annual hours of highway traffic delay per person in urban areas increased from 16 hours to 62 hours per year.10 And Americans now work more hours than people in any other major industrial nation in the world.11 With rising private vehicle costs, long commutes, increasing traffic delays, and long work hours, it is easy to understand why parents may feel overwhelmed by time and financial demands. Private motor vehicle transportation made necessary by extensive low-density land use has important implications for health: people are less active because they walk less, vehicle exhaust degrades air quality, motor vehicle injuries increase, and mental health and social capital are adversely affected. Decreased opportunities for children to incorporate physical activity into their daily lives, such as the inability to walk to school because of hazardous streets and long distances,12 have contributed to a threefold increase in the prevalence of overweight children over the last 3 decades.13 America’s aging population faces its own challenges. In this country, the number of people aged older than 65 will double by the year 2020.14 Communities that are adequately designed for a young adult with fast reflexes can be unnavigable for an elderly person. As chronic diseases such as arthritis, obesity, and diabetes increase in prevalence, the need becomes paramount for communities where elderly and disabled persons (and young persons with few resources) can function well and contribute to society without needing to own an automobile. As Hippocrates, the Romans, and Jung knew, our physical environment affects our physical and mental health. We physicians focus well on our patients as individuals with health problems, but when so many of our patients have the same problems, such as cardiovascular disease, diabetes, and depression, we must realize that their poor health is not caused only by a lack of discipline but may be the result of the built environments in which we live. It is time for a shift to communities intentionally designed to facilitate physical and mental well-being. To effect this change, we need to draw upon the unique ability of humans to plan creatively for healthy communities. The first step is to understand better the elements of the built environment that promote health. From the limited research to date, the public health community knows that some environments encourage walking, biking, and social interaction more than others do15,16; that many traffic injuries can be prevented17; that increasing motor vehicle exhaust exacerbates pulmonary disease18; and that the presence of neighborhood liquor stores increases alcohol consumption and associated adverse health consequences.19 But overall, there is still much to learn about the effects of the built environment on health. To address the multitude of questions, public health professionals must work closely with experts in other fields: architects, planners, policymakers, social scientists, traffic engineers, developers, law enforcement officers, economists, social marketers, and others. With its focus on the built environment and health, this issue of the Journal strives to promote this emerging field of research. Bringing together experts from many disciplines, this issue includes research on the relationship between the way we build our communities and walking/biking (Cervero, Powell, Saelens, Pucher, Bonnefoy), mental health (Kaplan, Leventhal), traffic safety (Evans, Retting, Egan, Ewing, Lucy), children’s health (Everett), minority health (Duran), affordable housing (Garb, Saegert), crime (Carter), government policies and law (Perdue, Buzbee, Ashe, Librett), economics (Burchell), air quality (Samet, Kunzli), and water quality (Greenberg, Gaffield). Other articles examine the effects of local community interventions (Dickerson, Staunton, Semenza, Wilson), the connection between the Smart Growth movement and health (Geller), the “sense of place” as a public health construct (Frumkin), and key questions for future research (Dannenberg, Srinivasan). Many aspects of the built environment will resist rapid change, even when research has adequately revealed key aspects of healthy communities. Efforts to improve pedestrian facilities, preserve green space, and upgrade public transportation are under way in many communities. Whereas our generation may reap some benefits from the new field of the built environment and health, with a little vision and a lot of good science and hard work, our children and grandchildren will be able to walk or bicycle home from their workplaces through attractive communities designed to promote the physical and mental health of all people.

Abstract: Purpose. This paper reviews existing environmental audit instruments used to capture the walkability and bikability of environments. The review inventories and evaluates individual measures of environmental factors used in these instruments. It synthesizes the current state of knowledge in quantifying the built environment. The paper provides health promotion professionals an understanding of the essential aspects of environments influencing walking and bicycling for both recreational and transportation purposes. It serves as a basis to develop valid and efficient tools to create activityfriendly communities. Data Sources. Keyword searches identified journal articles from the computer-based Academic Citation Databases, including the National Transportation Library, the Web of Science Citation Database, and MEDLINE. Governmental publications and conference proceedings were also searched. Study Inclusion and Exclusion Criteria. All instruments to audit physical environments have been included in this review, considering both recreation- and transportation-related walking and bicycling. Excluded are general methods devised to estimate walking and cycling trips, those used in empirical studies on land use and transportation, and research on walking inside buildings. Data Extraction Methods. Data have been extracted from each instrument using a template of key items developed for this review. The data were examined for quality assurance among three experienced researchers. Data Synthesis. A behavioral model of the built environment guides the synthesis according to three components: the origin and destination of the walk or bike trip, the characteristics of the road traveled, and the characteristics of the areas surrounding the trip’s origin and destination. These components, combined with the characteristics of the instruments themselves, lead to a classification of the instruments into the four categories of inventory, route quality assessment, area quality assessment, and approaches to estimating latent demand for walking and bicycling. Furthermore, individual variables used in each instrument to measure the environment are grouped into four classes: spatiophysical, spatiobehavioral, spatiopsychosocial, and policy-based. Major Conclusions. Individually, existing instruments rely on selective classes of variables and therefore assess only parts of built environments that affect walking and bicycling. Most of the instruments and individual measures have not been rigorously tested because of a lack of available data on walking and bicycling and because of limited research budgets. Future instrument development will depend on the acquisition of empirical data on walking and bicycling, on inclusion of all three components of the behavioral model, and on consideration of all classes of variables identified. (Am J

Abstract: In this article, the authors examine whether subjective perceptions of community safety are informed by the built environment. They posit that the built environment serves as a heuristic device, providing cues about likely levels of neighborhood crime, independent of the effects of neighborhood crime itself. Using data on 4,456individuals nested within 100 census tracts, the authors estimate hierarchical logistic models of perceived community crime risk. They focus on the role of the neighborhood built environment in the form of aggregated perceptions of nonresidential land use, while controlling for individual-level criminal opportunity, community-level social structural antecedents, and community-level objective crime. The findings indicate that the neighborhood-level presence of businesses and parks and playgrounds increases individual perceptions of community danger, but these effects disappear once neighborhood crime rates are controlled. The presence of schools has no effect on subjective interpreta...

Abstract: The quality of our indoor environments affects well-being and productivity, and risks for diverse diseases are increased by indoor air pollutants, surface contamination with toxins and microbes, and contact among people at home, at work, in transportation, and in many other public and private places. We offer an overview of nearly a century of research directed at understanding indoor environments and health, consider current research needs, and set out policy matters that need to be addressed if we are to have the healthiest possible built environments. The policy context for built environments extends beyond health considerations to include energy use for air-conditioning, selection of materials for sustainability, and design for safety, security, and productivity.

Abstract: In the British colonial city of Singapore, municipal authorities and Asian communities faced off over numerous issues. As the city expanded, various disputes concerning issues such as sanitation, housing and street names arose. This volume details these conflicts and how they shaped the city.

Abstract: The built environment, defined by the facilities and civil infrastructure systems that people use, is the fundamental foundation upon which a society exists, develops, and survives. As the main provider and the life cycle custodian of the built environment, the Architecture, Engineering, and Construction (AEC) industry plays a critical role in determining the quality, integrity, and longevity of this foundation. In the execution of these two roles, provider and custodian, the AEC industry has had a major direct and indirect impact on the natural environment, contributing both directly and indirectly to natural resource depletion and degradation, waste generation and accumulation, and environmental impact and degradation. These impacts are not unique to the AEC industry. Other industries face similar challenges, and for many years, a wide range of constituencies within them have been attempting the implementation of the concept of sustainability within what these industries do, how they do it, and with what as a possible mechanism to slow, reduce, eliminate these impacts, and even restore conditions to a better state. In the pursuit of sustainability, the AEC industry faces challenges posed by the unique attributes and characteristics nature of facilities and civil infrastructure systems, the complexities of the current processes for their delivery and use, and the diverse set of resources required for both their delivery and their use. This paper offers a road map and an initial set of principles to implement built environment sustainability as a starting point for an ongoing, industry-wide dialogue and debate.

Abstract: Although most older people prefer to age in place, nonetheless many do relocate, with a small proportion moving to retirement villages, which provide a purpose designed and built residen- tial and lifestyle environment. Using factor analyses, path analyses, and a push^pull framework, the authors model the decision process of retirees in Australia in order to identify relationships between push^pull factors and predictor variables, using data from a national survey of retirement village residents. The push factors relate to change in lifestyle, home maintenance, social isolation, and health and mobility, whereas the pull factors relate to built environment and affordability, the loca- tional attributes of villages, and the desire to maintain an existing lifestyle. The survey data also identify village attributes considered desirable or undesirable, or important or unimportant. Overall, resident satisfaction with moving is high.

Abstract: Although the seemingly apocalyptic scale of the World Trade Center disaster continues to haunt people across the globe, it is only the most recent example of a city tragically wounded. Cities are, in fact, perpetually caught up in cycles of degeneration and renewal. As with the WTC, from time to time these cycles are severely ruptured by a sudden, unpredictable event. In the wake of recent terrorist activities, this timely book explores how urban populations are affected by wounds inflicted through violence, civil wars, overbuilding, drug trafficking, and the collapse of infrastructures, as well as natural disasters such as earthquakes. Mexico City, New York, Beirut, Belfast, Bangkok and Baghdad are just a few examples of cities riddled with problems that undermine, on a daily basis, the quality of urban life. What does it mean for urban dwellers when the infrastructure of a city collapses transport, communication grids, heat, light, roads, water, and sanitation? What are the effects of foreign investment and huge construction projects on urban populations and how does this change the look and character of a city? How does drug trafficking intersect with class, race, and gender, and what impact does it have on vulnerable urban communities? How do political corruption and mafia networks distort the built environment? Drawing on in-depth case studies from across the globe, this book answers these intriguing questions through its rigorous consideration of changing global and national contexts, social movements, and corrosive urban events. Adopting a grass roots up approach, it places emphasis on peoples experiences of uneven development and inequality, their engagement with memory in the face of continual change, and the relevance of political activism to bettering their lives. It is especially attentive to the historical interaction of particular cities with wider political and economic forces, as these interactions have shaped local governance over time. Imagining e

Abstract: The authors invoke a population health perspective to assess the distribution of environmental hazards according to race/ethnicity, social class, age, gender, and sexuality and the implications of these hazards for health. The unequal burden of environmental hazards borne by African American, Native American, Latino, and Asian American/Pacific Islander communities and their relationship to well-documented racial/ethnic disparities in health have not been critically examined across all population groups, regions of the United States, and ages. The determinants of existing environmental inequities also require critical research attention. To ensure inclusiveness and fill important gaps, scientific evidence is needed on the health effects of the built environment as well as the natural environment, cities and suburbs as well as rural areas, and indoor as well as outdoor pollutants.

Abstract: A joint urban planning and public health perspective is articulated here for use, in health impact assessment. Absent a blueprint for a coherent and supportive structure on which to test our thinking, we are bound to fall flat. Such a perspective is made necessary by the sheer number of people living in cities throughout the world, the need for explicit attention to land use and transportation systems as determinants of population health, and the dearth of useful indicators of the built environment for monitoring progress. If explicit attention is not paid to the overarching goals of equality and democracy, they have little if any chance of being realized in projects, programs, and policies that shape the built environment and therefore the public's health.

Abstract: Written with the non-Muslim reader in mind, this book analyses the principles and values established by Islamic tradition to govern the social and physical environments of Muslims.The picture of Islam that emerges from this work is of a way of life with social ideals. Relying on the Qur'an and Sunna, the basic sources of Islamic law, and using examples of the built environment of early Muslims in North Africa, the Middle East, Europe and Central Asia, the author explains how following these ideals can create an urban environment that responds to social and environmental variables.Islamic views on the controversial issue of modernisation are also examined.This book will be of interest to people in the fields of urban planning, architecture, sociology, anthropology, housing and built environment, as well as Islamic studies.

Abstract: Healthcare organization performance is a function of many variables. This study measured relationships among culture, the built environment, and outcome variables in a healthcare provider organization. A culture survey composed of existing scales and custom scales was used as the principal measurement instrument. Results supported culture strength’s links with higher performance levels and identified the built environment’s role as a moderating variable that can lead to improved processes and outcomes. Job satisfaction and patient satisfaction were found to be significantly and positively correlated with culture strength and with ratings of the built environment.

Abstract: US studies of land-use and travel have focused on three issues relating to the built environment: density, diversity and design. Travel demands were compared among two similar neighbourhoods: Rockridge and Lafayette in California. A criticism of matched-pair comparisons of neighbourhood prototypes is that dimensions of built environment are commingled. Studies have attempted to separate these dimensions are reviewed. Studies investigating the effects of road network designs on travel choice are described. The relevancy of empirical findings to contemporary urban transportation policy themes in the USA is considered with reference to implementation tools and travel model refinements.

Abstract: Why do authorities in post-colonial African states continue to employ European or Western planning models? What are the implications for different societal groups of adopting such models? Several decades following independence, this outstanding volume provides in-depth empirical research to uncover the answers to such questions. The book focuses in particular on Cameroon, the only African country to have been colonized by three different European powers: Germany, Britain and France. It discusses the nature of the state in peripheral capitalist countries and sets current planning and land use policies in their historical, colonial and post-colonial contexts. The author then proceeds to examine key planning issues such as housing, land ownership, sustainable development, environmental and waste management, transportation, infrastructure and gender. In addition to analyzing the impact of colonialism and imperialism on the built environment in Cameroon in particular and sub-Saharan Africa in general, the book also addresses global issues about urbanism and will be particularly relevant to those interested in planning, regional studies and development, and development geography.

Abstract: This paper provides an overview of the Norwegian climate policy and of the practical implications of preparing Norway for climate change, with special emphasis on the challenges confronting the built environment. Although the Norwegian government has been relatively proactive in instituting measures aimed at halting global climate change, less attention has been paid to the challenge of adapting to climate change. The global climate system is likely to undergo changes, regardless of the implementation of abatement policies under the Kyoto Protocol or other regimes. The full range of impacts resulting from these changes is still uncertain; however, it is becoming increasingly clear that adaptation to climate change is necessary and inevitable within several sectors. The potential impacts of climate change in the built environment are now being addressed. Both the functionality of the existing built environment and the design of future buildings are likely to be altered by climate change impacts, and the ex...

Abstract: This special issue of the American Journal of Health Promotion on ‘‘Health Promoting Community Design’’ highlights the most recent research into how the built environment affects health. This emerging research provides another chapter in the rich history of public health and its quest to overcome obstacles to health through shaping the environment in which people live. The role of public health in community design has traditionally been to improve sanitation and personal hygiene. Now attention is shifting to how design affects other important elements of health, especially physical activity. The 13 articles in this special issue provide a fundamental overview of the relationship between community design and health and what needs to be done to promote physical activity and improve health through affecting social circumstances and environmental conditions.

Abstract: People with disabilities are just one of the groups designated for special attention in relation to equity in postsecondary education. This paper explores the way in which policies that provide academic accommodation for students disabled by chronic illness unfold in practice. As part of the administrative regime of the university, these policies are typically designed to reconcile the interests and relevances of the law with the interests and relevances of the academy. When a disabled student "activates" the policy, regardless of whether or not services and assistance are provided or are useful, the student becomes situated within social relations that make disabled students' "needs" manageable in the organizational context. As applicants for the institution's privileges and services, students actively participate in the accomplishment of the institutional order of the university, i.e., they fulfil the university's legal obligation not to discriminate against students with disabilities. This, I will argue, constitutes an exercise of power and preserves the existing social organization of the university, although it is normally understood as the university acting "in the interests of students with disabilities." Specifically, I show how the individualization of accommodation--ostensibly to meet each student's unique needs--shifts the obligation for change to individual students and instructors and forecloses opportunities for the university to become more genuinely accessible and inclusive. ********** People with disabilities are just one of the designated groups that have been targeted for special attention in relation to educational equity (Fortin, 1987). At academic institutions across Canada this has entailed the creation of a social "disabilities apparatus" organized around the concepts of accessibility and accommodation. In postsecondary education, accessibility refers to the institution's legal obligation to create genuine opportunities for people with disabilities to participate in all aspects of university life. The duty to accommodate, as one aspect of the duty not to discriminate, requires the institution to take an active part in modifying those practices, facilities, or services that prevent the inclusion and participation of otherwise qualified students who are disabled (BCEADS, 1996). Improving accessibility includes making changes in the built environment and providing specialized adaptive equipment to disabled students. Accommodation usually involves procedural changes and modifications in teaching and academic evaluation practices that are individualized according to each disabled student's unique needs. Exactly what constitutes an accommodation is a matter of law: courts have the ultimate authority in Canada to define the meaning of the term and the extent of the responsibility of the institution to provide it (BCEADS, 1996). In this paper, I use an institutional ethnographic approach (Smith, 1987, 1999) to explore the more difficult procedures entailed by providing academic accommodation, especially in relation to students disabled by chronic illness. While chronic illness does not fit the more taken for granted understanding of disability--usually because it is less visible, or "invisible"--it still complies with the criteria set out by the United Nations definition of disability (Allbrecht, 1992; Wendell, 1996; Williams, 1998). In fact, people with chronic illnesses constitute a significant proportion of people with disabilities (Russell, 1989; Zola, 1994). And although many are reluctant to identify themselves as "disabled"(Charmaz, 1999; Gadacz, 1994; Gordon and Feldman, 1998; Linton, 1998; Russell, 1989; Wendell, 1996), most students with chronic illnesses depend on disability policies in order to take advantage of postsecondary educational opportunities. In this paper, I challenge the assertion that academic accommodation fulfils the university's moral and legal obligation to ensure the full inclusion of students disabled by chronic illness. …

Abstract: (2003). Design quality, its measurement and management in the built environment. Building Research & Information: Vol. 31, Design quality, pp. 314-317.

Abstract: While an ever increasing number of clients and professionals are committed to achieving high levels of energy and environmental standards in new and retrofit projects, the investment community still has not moved beyond first cost decisionmaking. The need for life cycle decisionmaking will depend on multiple national and international efforts to develop the financial algorithms and collect the databases demonstrating the link between high performance buildings and energy, environmental, health and productivity benefits. This paper introduces eBIDS™, a web-based life cycle decision support tool under development for the cost-benefit analysis of the DOE data base of high performance building components, systems and whole building projects. This DOE interactive tool is linked to BIDS™ - the building investment decision support tool that has been developed by the NSF/IUCRC Center for Building Performance at Carnegie Mellon University, with the support of the Advanced Building Systems Integration Consortium (ABSIC). The cost-benefit decision support tool presents the results of field case studies, laboratory studies, simulation, and other research, clearly demonstrating the relationship of quality building investments for workstation, central system and whole building/ LEED design approaches to multiple cost benefit factors. The BIDS™ tool is more fully described in “Building Investment Decision Support (BIDS)” published in the Austin Papers – the Best of the 2002 International Green Building Conference (Loftness and Hartkopf 2002). 1. CONFLICTS BETWEEN COST, ENERGY AND ENVIRONMENTAL QUALITY? There are two debates that consistently hamper the drive to improve indoor environmental quality in U.S. buildings. First, many environmentalists argue that improving indoor environmental quality does not cost more (Figure 1a), while many building owners argue that the increased first costs for high performance buildings cannot be considered in today’s market.

Abstract: The value of involving patients’ and family members’ voices in the dialogue about healthcare facility environments is immense if society’s goal is to meet people’s needs. Reports from these ultimate end consumers about what matters to them in the built environment, and about what supports their healthcare experience will provide important information for healthcare planners, managers, architects, and interior designers who strive to create caring and supportive healthcare environments. The Picker Institute and The Center for Health Design conducted a multiyear project to identify what end consumers of healthcare seek in the built environment and what supports or detracts from their healthcare experience. Through focus groups with patients and family members, we have learned that the built environment does affect the quality of their experience. Patients and family members told us that they want a built environment that: 1) facilitates connection to staff, 2) is conducive to well-being, 3) is convenient and accessible, 4) is caring for family, 5) is confidential and private, 6) is considerate of impairments, 7) facilitates connection to the outside world, and 8) is safe and secure. From these research results, we developed a patient satisfaction survey and a patient-centered environmental checklist. These assessment tools will help healthcare facility designers and healthcare organizations collect information about consumers’ needs, measure satisfaction, and provide facility comparisons for modeling the industry’s best practices. Journal of Architectural and Planning Research 20:1 (Spring, 2003) 16

Abstract: In the last decade of the 20th century a wide variety of deployment strategies and dissemination programmes for grid-connected PV systems in the built environment has been launched by quite different organizations and institutions. Governmental bodies on national and local levels have launched strategies, as have electric utilities and NGOs. The core objective of this paper is to document and evaluate the most important past and current market deployment strategies for the broader dissemination of grid-connected PV systems in the built environment.

Abstract: The roots of the Healthy Cities concept may be traced back to 1844, when the Health of Towns Association was formed in the United Kingdom to deliberate on Edwin Chadwick's reports about poor living conditions in towns and cities. The revival of those concerns in the "new public health" era dates from the Healthy Toronto 2000 convention in 1984 and, subsequently, the enthusiasm of the World Health Organization (WHO) Regional Office for Europe to translate its principles into a tangible global programme of action to promote health. WHO defines a Healthy City as "one that is continually developing those public policies and creating those physical and social environments which enable its people to mutually support each other in carrying out all functions of life and achieving their full potential". This philosophy seeks to enhance the holistic well-being of people who live and work in cities, based on four criteria: (a) explicit political commitment at the highest levels to the principles and strategies of a Healthy Cities project; (b) establishment of new organizational structures to manage change; (c) commitment to developing a shared vision for the city, with a healthy plan and work on specific themes; and (d) investment in formal and informal networking and cooperation. The concept is founded on the moral and political beliefs that inequalities in social conditions (and therefore health) are unjustified and that their reduction should be an overriding public health objective. While the entry point of the Healthy Cities approach is health, its underlying rationale has always been based on a model of good urban governance, which includes broad political commitment, intersectoral planning, citywide partnerships, community participation, and monitoring and evaluation. The Healthy Cities principles draw on various work on the social determinants of health, notably studies initiated by Thomas McKeown. However, its proponents rightly diverged from McKeown's overemphasis on the "invisible hand" of improved nutrition at the expense of various types of important social interventions, such as improvements in living and working conditions, public education, medical science, democratic governance, public health practices, and human rights. The International Healthy Cities Foundation partners are drawn from leaders in these sectors. The strategy also takes account of the increasing recognition of the complex effects of urbanization on health. Rapidly growing cities in Africa, Asia, and the Americas constitute the majority of the 300 cities with over one million inhabitants. While poor people in urban cities operate under the most life-threatening living and working conditions, their high concentration nevertheless provides opportunities for improving health: economies of proximity greatly reduce unit costs for provision of piped water, sewers, rubbish collection, immunization services, schools and public transport. Recent United Nations statistics estimate that, by 2007, more than half of the world's population will live in urban areas. Thus, Healthy Cities may be viewed as a set of public health strategies of potential benefit to more than half the people in the world. Now in its second decade, a number of important achievements have been attributed to this approach. For example, California's Healthy Cities and Communities programme, which began in 1987, has contributed significantly to improving the state's health profile through a multitiered strategy that includes technical assistance, funding, promotion, coordination and collaboration, systems reform, programme evaluation, and recognition. However, the effectiveness of Healthy Cities has largely been confined to industrialized countries, for a number of reasons. First, although its proponents acknowledge that conventional public health projects for the prevention or treatment of diseases did not adequately take account of health risks such as poverty, urban violence and terrorism, the predominantly functionalist health promotion framework within which the Healthy Cities approach operates makes it less likely to focus effectively on these underpinnings of "unhealthy" cities. …