Q&A: Exploring how the design of the built environment affects our health and well-being

Making Healthy Places book cover

How does the design of the built environment – such as houses, schools, workplaces, streets, parks, transportation systems, and urban form – affect our health and well-being? To explore these issues, editors Nisha D. Botchwey, Andrew Dannenberg, and Howard Frumkin, recently published the second edition of “Making Healthy Places: Designing and Building for Well-being, Equity, and Sustainability.”

The first edition, published in 2011, was widely used to teach students in public health, urban planning, architecture, and other fields about the impacts of design on human health. In subsequent years there has been increasing focus on how the design of the built environment impacts health in areas such as climate change, sustainability, environmental justice, and the COVID-19 pandemic. There has also been a growing need for more cross-disciplinary training across these fields.

We asked the editors about the importance of this book now.

Why did you want to write this book?

The second edition of Making Healthy Places fills the gap in the education of health and design professionals so they will understand how the design and building of places impacts health and will be prepared to create healthy places. Making Healthy Places includes practical applications, an enhanced emphasis on sustainability, equity, well-being, and examples from urban and rural environments in high-income and low to middle-income countries around the world. The first edition of MHP, published in 2011, has been used widely for teaching in the US, Australia, and elsewhere, and has become out of date.

Why does this book matter? How does it help actually create healthy places that are equitable and sustainable and promote well-being?

As the climate crisis intensifies and recognition of racism and other forms of inequity continues to grow, it is important to study the role of the built environment in addressing such issues. The field is growing and more people are interested in learning about the connection between the built environment and health; this book is valuable for students planning on working at this intersection.
New technologies emerge every day that allow us to study the built environment and develop meaningful ways of creating healthy places.

Please give us an overview of the book. What topics are covered in the second edition of the book? Why did you include these in this new version? What are some key differences between the first edition and the second edition?

This second edition (2022) maintains key messages while expanding treatment of some topics including wellbeing and sustainability, with new chapters on equity and health disparities, issues across the lifespan, climate change, resilience, technological innovations, and impacts from the COVID-19 pandemic.

We were able to review feedback from UW students on the first edition and incorporate that into the new and updated chapters. We also included updated references along with a website. It was important for us to increase diversity of contributors by gender, race, geography, and professional expertise, incorporate global perspectives, and keep sustainability as a main focus.

With an urban planner as the lead editor of the second edition, the book highlights work that can be done by planners and other design professionals in collaboration with public health professionals to promote health, well-being, sustainability, and equity.

Some people may not realize the connection between community design and health, how might you describe or explain that relationship?

Both fields took modern form in the 19th century in response to rapid population growth, industrialization, and urbanization; they eventually evolved to become distinct fields. Today’s leading causes of suffering and death are related to community design and associated behavioral choices. There are numerous opportunities for the two fields to collaborate that would lead to improved health, well-being and sustainability.

How does the book respond to the COVID-19 pandemic? In what ways did shifting COVID-19 policies influence the writing process/direction?

The COVID-19 pandemic began after we started drafting the book. As the pandemic unfolded, we decided to add an entire chapter about COVID-19 and the design of the built environment. We also revised chapters to discuss connections between topics in other chapters and the pandemic.

Aside from COVID-19, are there other things like it over the last 10 years that have had such a profound impact on the built environment?

Climate change and equity and racism have become more prominent issues. The design of the built environment, both redeveloping existing and building new buildings, neighborhoods and cities can have major impacts on these issues.

Who will find this book most useful? Did you have a specific audience in mind during the writing process, or does everyone including the general public have something they can take away from this book?

This book will appeal to anyone interested in making healthy places and improving their own physical environments. In particular, we hope built environment professionals including planners, architects, landscape architects, civil engineers, transportation professionals, real estate developers, public health professionals, and graduate and undergraduate students in public health and in design fields, will find it especially useful.

What do you hope readers take away from this book?

The built environment shapes physical and mental health and well-being over both the short and the long term. Policies and practices can influence the design of the built environment to promote health and equity, minimize adverse health impacts and health disparities, and maintain a sustainable balance between human needs and natural systems.