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1 Introduction1 On November 10, 2014, the National Academies of Sciences, Engineering, and Medicineâs Roundtable on Environmental Health Sciences, Research, and Medicine held a workshop titled Bringing Public Health into Urban Revitalization. This workshop represents the Roundtable membersâ long-standing interest in and growing appreciation of the ways in which the urban environment, conceived broadly from factors such as air quality and walkability to factors such as access to fresh foods and social support systems, can affect health. Individuals and organizations are investigating and experimenting with ways to improve public health by influencing such factors in cities across the United States. This can be a broad, multidisciplinary undertaking involving not only public health professionals but also experts from such areas as architecture, business, economics, marketing, sociology and social work, and urban design. A particularly valuable opportunity to improve public health arises when an urban area is being redesigned and rebuilt following some type of serious disruption, whether it is caused by a sudden physical event, such as a hurricane or earthquake, or steady economic and social decline that may have occurred over decades. The purpose of the workshop was to explore the various opportunities to reimagine the built environment in a city and to increase the role of health promotion and protection during the process of urban revitalization. The workshop focused on case studies from three U.S. cities: Washington, DC; Detroit, Michigan; and New York City. Each of these urban areas recently engaged in rebuilding and revitalization efforts, 1 The planning committeeâs role was limited to planning the workshop, and the workshop summary has been prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of the individual presenters and participants and are not necessarily endorsed or verified by the National Academies of Sciences, Engineering, and Medicine, and they should not be construed as reflecting any group consensus. 1
2 BRINGING PUBLIC HEALTH INTO URBAN REVITALIZATION the impetus for which was unique to the specific city. These three cities face not only similar but also different challenges, and the rebuilding and revitalization efforts are in different stages of implementation. By examining and comparing the role of public health in these different revitalization efforts, it is possible to gain a broad sense of where the various challenges and opportunities lie in this area. The workshop statement of task is provided in Box 1-1. ORGANIZATION OF THE SUMMARY The following is a summary and synthesis of the presentations and discussions that took place during the workshop. When reading the summary, it is important to keep in mind that the opinions expressed and any recommendations made are those of the individual speakers themselves and do not represent the position of the Institute of Medicine or the National Academies of Sciences, Engineering and Medicine. The purpose of the Roundtable on Environmental Health Sciences, Research, and Medicine is to provide a mechanism for interested parties to meet and discuss sensitive and difficult environmental issues in a neutral setting. The Roundtable fosters dialogue about these issues, but it does not provide recommendations or try to find a consensus. BOX 1-1 Statement of Task An ad hoc committee will plan and conduct a 1-day, public workshop exploring issues related to the redesign of major American cities. The workshop will use two to four case studies of cities in decline currently undergoing major revitalization or reimagining of the built environment. The workshop will explore different causes of urban decay, the environmental health impact of that decay, and potential strategies to improve the built environment to protect and promote human health. The committee will identify specific topics to be addressed, develop the agenda, select and invite speakers and other participants, and moderate the discussions. An individually authored full-length workshop summary and a brief workshop summary will be prepared by a designated rapporteur in accordance with institutional guidelines.
INTRODUCTION 3 The organization of this summary follows the structure of the workshop agenda. Chapter 2 includes the presentations regarding the efforts in Washington, DC, to improve health by making Washington, DC, a green city. Chapter 3 addresses the challenges faced by Detroit. Chapter 4 includes a presentation on Rebuild by Design, focusing on a winning project on rebuilding Hunts Point in New York City after Hurricane Sandy. Chapter 5 includes a discussion of cross-cutting issues. The workshop presenters included many photos and one video during the day. The interested reader is encouraged to access these via the Roundtable website.2 The workshop agenda is found in Appendix A, and biographical sketches of the workshop speakers are included in Appendix B. OVERVIEW: A TALE OF THREE CITIES Lynn Goldman, dean of the Milken Institute School of Public Health at George Washington University, opened the workshop by noting that for many decades many U.S. cities, particularly older industrial cities, have been undergoing population loss but that in recent years both younger and older people have become interested in living in cities again. She noted that young people, many of whom grew up in suburbs, prefer not to live far from where they work and want to be in neighborhoods that are walkable and bikable and that offer places to congregate and interact with people from different cultures and backgrounds. At the same time, older people have become more interested in living in cities, which has led to a global movement of cities becoming more aging friendly. She stated that there is a growing recognition that living in the suburbs in not necessarily the best option for older people in terms of access to services and social environments and the opportunity to move on to second careers or new lives. There is currently much focus on urban living and urban environments, which provides an opportunity to create healthier urban communities. That is the context in which the workshop should be seen, she said. The three cities highlighted during the workshopâWashington, DC, Detroit, and New York Cityâall went through rebuilding efforts that were done quite differently. Goldman noted that the workshop presenters were asked to outline the unique approaches and ideas that were utilized, the creative energy that was stimulated, and the many opportunities for public health 2 See http://iom.nationalacademies.org/Activities/Environment/Environmental HealthRT/2014-NOV-10.aspx.
4 BRINGING PUBLIC HEALTH INTO URBAN REVITALIZATION that were present in the context of urban revitalization. She also suggested that speakers devote particular attention to efforts taken to ensure the health of children and minorities, to increase the role of public health departments and health systems, to increase a sense of community, and to utilize green technologies to increase livability and sustainability.
