So I mean, you've really done a lot of thinking about interconnections between public health and city planning, and urban development. How do you teach urban planning students, who perhaps have never thought about public health being implicated in there teachings and work that they hope to do in their careers? How do you teach them to think about public health in your courses? Yeah. Well there's a few things to consider there, one is, most city planners have never really thought about public health, other than in the most vague terms, right? There's a sense for instance, that Zoning laws are rooted in promoting public health and safety. There's a sense that, environmental sustainability movements will improve health and well-being. But other than that most sort of superficial reference, city planners have never really thought through all the different implications, of different projects. So for instance, one misconception that a number of city planning students have is that the environmental sustainability movement, essentially solves all health problems. That as long as the environment is safe and healthy for frogs, that it's going to be safe and healthy for people as well, right? There's some truth to that, right? If we have cleaner air, cleaner water, if we do some things to reduce the risks associated with climate change, yes, that is likely to have some public health benefits for people as well. But that also leaves a whole lot of public health issues unaddressed. So for instance, if we think about the health risks that people face in housing, right? If we think about housing that starts to become dilapidated, and then there's sort of maybe or people get exposed to mold, or different kinds of rodents and it triggers asthma, right? The environmental sustainability movement isn't necessarily going to address something like that. If we think about people encountering disabling environments, so you work with elderly folks for instance, right? If you have sidewalks that don't have curb cuts, and so you can't step down, that's a disabling environment, that as you say prevents makes it more likely that seniors will simply not go out, or might become more socially isolated, or might not be getting, they're not in a walkable environment, they're not getting the physical activity that might help promote their wellness, their bone density, their cognitive functioning. The environmental sustainability movement is not going to identify that curb cut as a problem, right? So that's I think the first thing is helping city planning students distinguish between environmental sustainability and the implicit health benefits there, from all of the other aspects of public health. Another goal that I have is to help city planners, not just think about the things they can do to contribute to public health improvements, but also the way some of those projects might simultaneously create public health liabilities at the same time. So cycling and walking for instance, which we discussed earlier, if we can create compact mixed-use developments, so that people are much more likely to be walking and cycling, and therefore getting more physical activity, that's great. But it also increases the risk of people getting hit by cars, right? So if we're aware of that risk, we can design infrastructure to protect people as they're walking and cycling. But if we're not paying attention to the risk, then we're unlikely to put that protective infrastructure in place and we say, "Oh look it's compact mixed-use development like problem-solved, right?" Instead of paying attention to both the opportunity that we've created and the risk that was created with the same project. Right. Another example, air pollution. So we know that from an environmental sustainability perspective, many city planners want compact mixed-use development, because it reduces the amount of driving society-wide. Which can help bring down aggregate levels of air pollution and can help mitigate against climate change. But the problem is, even if total emissions dropped 20 percent, by concentrating everyone in the same space, and by encouraging people to be outside walking and cycling, we've actually increased or there's a risk that we have actually decreased air pollution overall. But we've increased exposure to these hotspots where air pollution is concentrated, and we've asked people to go outside, and be physically active. Which means outside, they're more exposed to that air, physically active, they're breathing in a lot more of that air. So we've reduced the risks of climate change, but we've increased risks of air pollution. Again, there are things that we can do to protect against that especially if we're aware of certain high-risk needs or high-risk groups, for instance. We could say, okay if you're going to be near senior center or near a school, we need a different transportation plan there that will help that not to become a hotspot, right? Whereas someone, you or I, are probably going to be fine with that change in exposure. But I think just some examples of what I mean when I say city planners need to not just say, oh I've done this thing and there's a public health benefit. We also have to pay attention to the new risk we might have also accidentally created, and address that at the same time, so that the gain of one doesn't simply offset, isn't simply offset by the other, right? That makes sense. So I'm going to flip it now. What advice and tips do you have for public health professionals to collaborate successfully with urban planners? Yeah, that's a good question. So the fields are starting to come back together, but I would say that public health awareness of environmental determinants is growing at a faster rate than city planners or architect's awareness of public health. So there's still a lot of opportunity for education and institutional reforms that can help city planners and architects to become better partners with public health projects. So one thing that makes it easier to overcome some of those barriers is by meeting city planners where they already are, and taking existing city planning tools and existing city planning goals, and folding public health into it, rather than necessarily trying to say, you're person who's involved in city planning and knows nothing about public health, overnight, you have to suddenly become an entirely different person or an entirely different professional. Luckily, there are some ways to do this. For example, city planners have certain working methods that they use, architects as well. We might use a lot of checklists if you want to meet everything on a building code. Have you done this? You can overlay onto that health considerations. I'm thinking about the environmental movement which did this for sustainability issues. Public health can do the same thing. In the environmental movement, the LEAD, I can't remember what it stands what it stands for. But the LEAD certification that is about encouraging architects and city planners to develop buildings and neighborhoods that reduce energy consumption, that reduce excessive transportation, that increase use of renewable resources. One way they did that was by creating a set of checklists that break environmental sustainability into really small actionable nuggets. Do you have a front door that faces the sidewalk? Do you have a place where someone who has cycled can store their bicycle while they're at work? These are very long lists, but each little nugget is really clear and easy to understand, so I don't have to go get another degree to think about it. So this then became an educational tool for architects and city planners to learn how to incorporate environmental ideas into their plans in a way that already fit the professional norms. As a result of that, we have seen a significant increase in the amount of green buildings and green neighborhoods that are being built. Not because people have become experts in environmental science, but because they'd been given some tools that are easy to use. I think we are already seeing some similar movements in public health with the development of healthy places checklists. Essentially, we create that same structure. Or if we think about New York City, a few years ago came out with a document on building physically active cities. They had another one on nutrition. They had a few different examples. A part of the educational document that explained what is the relationship between the built environment and physical activity, for instance. But then they also had a series of checklists. Does your plaza have a place to sit, a shade? Do you have protective bollards for the cyclists so they won't get hit. It was a very easy to follow checklist. That makes it very easy for city planners to incorporate health principles into designs without having to go back and get that extra degree, or without having to go back and do a continuing education course. So that removes one barrier. So another change is helping city planners understand how they can partner with public health folks to accomplish their goals that they already care about. So city planning here at the University of Michigan, the students learn a lot about social justice and they learn a lot about environmental sustainability. So if public health officials or public health folks can come to city planners and say you're interested in social justice, if we're thinking about gentrification, housing displacement, or if we're thinking about environmental sustainability, and wanting to have non-greenhouse based modes of mobility, well, here, let me tell you how I can help advance your goal of safe and carbon-neutral mobility in a way that also meets this public health goal. Or if you're interested in social justice and I want to do a project on healthy housing, how can I bring this to you in a way where you see that this healthy housing goal is a social justice goal, and then we're moving in the same direction rather than asking you to stop doing something and just start doing something else. So infusing health into the already existing actions being taken. Right. Yeah. Well, this was so fantastic and informative and helpful. Thank you so much for being here today and talking to us about this. I really appreciate it. Yeah, this was fun.
