CP 8882KL: Healthy Cities: Built Environment and Public Health - City and Regional Planning Program,

Georgia Institute of Technology

EOH 584: Built Environment and Public Health - Environmental and Occupational Health, Rollins School
of Public Health, Emory University

Tuesdays, 6:05 to 7:55 p.m.

INSTRUCTORS

Ben Gerhardstein, MPH Karen Leone de Nie, AICP

Emory University, adjunct faculty Georgia Tech, adjunct faculty
bgerhar@sph.emory.edu karen.leonedenie@coa.gatech.edu
Phone: 770.488.3646 Phone: 404.217.1458
OFFICE HOURS: by appointment OFFICE HOURS: by appointment

Judy Kruger, PhD

Emory University, adjunct faculty
jkruger@emory.edu
Phone: 404.386.3029
OFFICE HOURS: by appointment

This interdisciplinary course, offered jointly by Georgia Tech and Emory University’s School of Public
Health, examines how cities and neighborhoods can have both positive and adverse effects on human
health. The course begins by providing a brief history of theories and practices of public health and city
planning to give students from different disciplines a foundation for further study. We then consider
how decisions about land use, urban design, transportation, public facilities, and housing are made,
followed by an examination of the associated health consequences of these decisions. The course
considers built environment impacts on physical activity, obesity, air quality, and the health of
vulnerable populations, among other issues. Attention is paid to the wide array of actors who are
responsible for making the places where we live, work, play and learn. Through lectures, seminar
discussions, guest speakers, and field exercises, students will interact with individuals from a variety of
disciplines to investigate the broad range of elements necessary to foster healthy places.

CLASS MEETING PLACES

Classes will alternate between the Georgia Tech and Emory University Campuses. All students will
attend classes at both locations. Students are expected to make their own arrangements for travel to
the course locations.

At Georgia Tech: Klaus Computing Building, 266 Ferst Drive, Room 2447
Campus Map: http://gtalumni.org/map/

At Emory University: Grace Crum Building, Rollins School of Public Health, 1518 Clifton Rd. NE, Room
P41
Campus Map: http://map.emory.edu/

Google Map for both locations with parking information:

http://maps.google.com/maps/ms?hl=en&ie=UTF8&msa=0&msid=118409960646750483651.00045553
2e7f4838104b5&z=14

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COURSE OBJECTIVES
This course is intended to utilize a transdisciplinary approach to understanding the relationship between
public health and the built environment. The objectives of this course are:
1) To expose students to the multiple perspectives on public health and the built environment
through the use of the socio-ecological model, lectures by planning and public health experts,
and readings;
2) To examine the relationships between built environment components, such as
transportation, land use, community and economic development, urban design, and
architecture and specific health issues, such as transmission of infectious diseases and
incidences of chronic disease; and,
3) To develop a working knowledge of various methods used to assess the built environment
and its impact on public health; and
4) To prepare students to perform professionally in an interdisciplinary environment.

By engaging in lectures, readings, and in-class discussions and by completing class assignments, students
will be able:
1) To understand the relationship between public health and the built environment,
emphasizing what we know and do not know;
2) To examine built environment and public health issues at multiple scales from local to
regional to national;
3) To develop an understanding of the fields of public health and planning and their
contributions to built environment literature; and,
4) To gain familiarity with the methods involved in assessing the relationship between public
health and the built environment and the strengths and limitations of these methods.

REQUIRED WORK
Due to the interactive nature of the course and the large number of invited guests into this course,
attendance is mandatory and promptness is critical. Please be on time for class so that you do not
interrupt our guests.

Students will be conducting a variety of assignments throughout the course. Some of these will be field-
based assignments and others will require written work, summarizing information from readings and
lectures. Students will also be required to work in interdisciplinary teams on a capstone project. Details
about this project, written and oral presentation requirements, and team members will be provided in a
separate handout.

All work must be completed on time. Work that is submitted late will receive substantially reduced
credit, except in highly unusual instances. Usually, 10 percent of the total possible points will be
deducted for every 24 hours that an assignment is late. All written work is expected to be polished and
professional. Clarity of expression, organization of materials, absence of typographical errors,
correctness of grammar and spelling, and other communication skills are considered in evaluating
written assignments. Oral presentations are expected to be professional, clear, well-structured, and use
appropriate graphical tools, as necessary.

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A final aspect of required work consists of a student's attendance and participation in the course. This
measure includes a student's preparation for class, understanding of the course readings, and
participation in discussions with guest speakers and student presentation groups.

Speak with an instructor if you require course adaptations or accommodations due to a disability, if you
have any emergency medical information about which instructors should know, or if you need special
arrangements in the event the building must be evacuated.

PRIMARY TEXT
Frumkin, H., Frank, L., Jackson, R. 2004. Urban Sprawl and Public Health. Island Press: Washington D.C.

Additional readings from journals and reports (see course schedule).

The readings are available via the URL in the schedule or they are posted on Emory’s Blackboard at
https://classes.emory.edu/webapps/portal/frameset.jsp. Georgia Tech students will receive a username
and password to access the site.

REFERENCE MATERIAL
LEED-ND Core Committee. Understanding the Relationship between Public Health and the Built
Environment [online]. 2006. Available at:
https://www.usgbc.org/ShowFile.aspx?DocumentID=1480
Robert Wood Johnson Foundation Active Living Research Website:
http://www.activelivingresearch.org/
University of Minnesota, Cornell University and the University of Colorado Design for Health
Website: http://www.designforhealth.net/

GRADING
25% Walkability Assignment
25% Participation and Attendance
50% Capstone Project
10% Part I: Land Use/Urban Design & Health
10% Part II: Infrastructure & Health
10% Part III: Buildings & Health
10% Part IV: Recommendations
10% Final Report and Presentation

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COURSE SCHEDULE
NOTE: due to the large number of guest presenters it may be necessary to make schedule alternations
during the semester. You will be notified by email of changes.

I. Foundations and History of Public Health and City Planning

Aug. 18 : Class 1 : Georgia Tech

Topic: Course Overview and Introduction to Public Health
Lecturers: Judy Kruger and Ben Gerhardstein

Aug. 25 : Class 2 : Georgia Tech

Topic: Foundations and History of Public Health
Lecturers: Judy Kruger and Ben Gerhardstein

Frumkin, H., Frank, L., Jackson, R. 2004. Urban Sprawl and Public Health. Island Press: Washington D.C.
Chapter 3 "The Evolution of Urban Health".

Contra Costa Health Services. Planning Communities: What health has to do with it. 2007. Available at:
www.cchealth.org/groups/injury_prevention/pdf/planning_healthy_communities.pdf

Sept. 1 : Class 3 : Emory University

Topic: Course Overview and Introduction to City Planning (optional for Georgia Tech and Georgia State
students)
Lecturer: Karen Leone de Nie

Malizia EE. City and regional planning: a primer for public health officials. American Journal of Health
Promotion 2005;19 Suppl 5:1-13.

WALK SCORE DUE BY NOON ON SEPTEMBER 7. Go to http://www.walkscore.com/, enter the address

where you currently live, and record the resulting Walk Score. Send your name, zip code where you live,
and Walk Score to karen.leonedenie@coa.gatech.edu.

II. Determinants of Health and Health Assessment Tools

Sept. 8 : Class 4 : Georgia Tech

Topic: Understanding the Health and Planning Intersection; & Determinants of Health and Health
Disparities; Discuss Walkability Assignment
View and discuss: "Place Matters" episode of PBS documentary Unnatural Causes (see
http://www.unnaturalcauses.org/episode_descriptions.php?page=5)

Lee, J. 2009. To Improve Public Health, City Urges Use of Stairs. New York Times. Available at:
http://cityroom.blogs.nytimes.com/2009/06/10/to-improve-public-health-city-urges-use-of-stairs/

Frumkin, H., Frank, L., Jackson, R. 2004. Urban Sprawl and Public Health. Island Press: Washington D.C.,
Chapter 10 (Emory students read Chapter 3).

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Lopez, RP. 2009 Jul 16. Public Health, the APHA, and Urban Renewal, Am J Public Health. [Epub ahead of
print]

Sallis JF, Owen N. 2002. Ecological models of health behavior. In, Glanz K, Rimer BK, Lewis, FM, editors.
Health behavior and health education: theory, practice, research. 3rd Ed. San Francisco (CA): Jossey-
Bass. pp. 462-484.

Assignment: Walkability, DUE SEPTEMBER 22

Students work in pairs to conduct a walkability assessment. Each group will assess several road
segments to identify the most common safety hazards and inconveniences that can keep people from
walking. Students will discuss their findings in a response paper.

Sept. 15 : Class 5 : Emory University

Topic: Common Principles, Methodologies, and Approaches to Health Impact Assessments
Guest Lecturer: Sarah Heaton, MPH, Centers for Disease Control and Prevention [invited]

Cole BL, Fielding JE. 2007. Health impact assessment: A tool to help policy makers understand health
beyond health care. Annual Review of Public Health. 28:393-412.

Dannenberg AL, Bhatia R, Cole BL, Heaton SK, Feldman JD, Rutt CD. 2008. Use of health impact
assessment in the U.S.: 27 case studies, 1999–2007. Am J Prev Med; 34(3):241–56.

For review:
Georgia Tech, Center for Quality Growth and Regional Development, with the Centers for Disease Control and
Prevention. 2007. Atlanta Beltline HIA, available at
http://www.cqgrd.gatech.edu/PDFs/BLHIA_report2007updated.pdf.

Bhatia R. 2006. Oak to Ninth Avenue Waterfront Development Project Health Impact Assessment [online].
Available at: http://sites.google.com/site/ucbhia/projects-and-research

III. Built Environment and Health Outcomes

Sept. 22 : Class 6 : Georgia Tech

Topic: Land Use and Urban Design; Discuss Capstone Project and Debrief Walkability Assignment
Lecturer: Karen Leone de Nie

Frumkin, H., Frank, L., Jackson, R. 2004. Urban Sprawl and Public Health. Island Press: Washington D.C.
Chapter 2.

Hoch, C., Dalton, L.C. So, FS. (Eds). 2000. The practice of local government planning. International
City/County Management Association (ICMA): Washington, DC. Chapters 13 and 14.

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Assignment: Capstone Project, Part I, DUE OCTOBER 13
Components of the Capstone Project will be completed throughout the semester. For this project
students will work in small groups to assess the health impacts of a development or redevelopment
project in the Atlanta metro. Using Health Impact Assessment methods, empirical evidence discussed in
class and found through independent research, and background information on the development or
redevelopment project, students will explore how public health may be affected and will culminate their
work in a final report and presentation that includes recommendations to improve health outcomes.

Sept. 29 : Class 7 : Emory University

Topic: Land Use and Urban Design Health Outcomes
Lecturers: Judy Kruger and Ben Gerhardstein

Frumkin, H., Frank, L., Jackson, R. 2004. Urban Sprawl and Public Health. Island Press: Washington D.C.
Chapter 5.

Kahn et al. 2009. Recommended Community Strategies and Measurements to Prevent Obesity in the
United States. Morbidity and Mortality Weekly Report. Vol. 58, No. RR-7. Available at:
http://www.cdc.gov/mmwr/PDF/rr/rr5807.pdf [Pages 1-7, 16-23]

Oct. 6 : Class 8 : FIELD TRIP (meet at Emory)

Guided walking tour of Pittsburgh Community discussion of redevelopment plans.

Oct. 13 : Class 9 : Georgia Tech

Topic: Infrastructure: transportation; Discuss Capstone Project, Part II
Lecturer: Karen Leone de Nie
Guest Lecturer: Catherine Ross, PhD, Georgia Tech [invited]

Hoch, C., Dalton, L., So, F. 2000. The Practice of Local Government Planning. ICMA: Washington D.C.
Chapter 9.

Jacobs, A. 1995. Great Streets. MIT Press. Part III: Street and City Patterns: Settings for Streets and
People.

Assignment: Capstone Project, Part II, DUE NOVEMBER 10

Oct. 20 : Class 10 : Emory University

Topic: Transportation-related Health Outcomes
Guest Lecturer: Andrew Dannenberg, MD, MPH, Centers for Disease Control and Prevention [invited]

Frumkin, H., Frank, L., Jackson, R. 2004. Urban Sprawl and Public Health. Island Press: Washington D.C.
Chapters 4 and 6.

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Oct. 27 : Class 11 : Georgia Tech
Topic: Infrastructure: Green Space and Urban Heat Islands
Guest Lecturer: Brian Stone, Ph.D., Georgia Tech

Stone, B, Rodgers, M. Spring 2001. Urban Form and Thermal Efficiency. Journal of the American Planning
Association. Vol 67. No. 2. -
http://www.coa.gatech.edu/~stone/Publications%20folder/UrbanFormandThermalEfficiency.pdf

Penny Gordon-Larsen, Melissa C. Nelson, Phil Page and Barry M. Popkin. 2006. Inequality in the Built
Environment Underlies Key Health Disparities in Physical Activity and Obesity. Pediatrics. 117. -
http://pediatrics.aappublications.org/cgi/reprint/117/2/417

Lackey, KJ. and Kaczynski, AT. 2009. Correspondence of perceived vs. objective proximity to parks and
their relationship to park-based physical activity. International Journal of Behavioral Nutrition and
Physical Activity Volume 6, Issue 53.

Nov. 3 : Class 12 : Emory University

Topic: Green and Food System Related Health Outcomes; Discussion Capstone Project, Parts III, IV and
Final Presentation
Guest Lecturer: Christa Essig, CDC

McCann, Barbara. 2006. Community Design for Healthy Eating: How land use and transportation
solutions can help. - http://www.rwjf.org/files/publications/other/communitydesignhealthyeating.pdf

Larson, N. 2009. Neighborhood Environments: Disparities in Access to Healthy Foods in the U.S.
American Journal of Preventive Medicine. 36(1).

Gottlieb, R. 2009. Where We Live, Work, and Play… and Eat: Expanding the Environmental Justice
Agenda. Environmental Justice. 2(1): 7-8

Assignment: Capstone Project, Part III, DUE NOVEMBER 17, Part IV and Final Presentation, DUE
DECEMBER 1

Nov. 10 : Class 13 : Georgia Tech

Topic: Building and Building-related Health Outcomes
Lecturer: Karen Leone De Nie
Guest Lecturer: Rick Duke, Georgia Tech

Krieger, James and Donna L. Higgins. 2002. Housing and Health: Time Again for Public Health Action.
American Journal of Public Health 92(5): 758-768. - http://www.ajph.org/cgi/reprint/92/5/758.pdf

Newman, Sandra. 2008. Does housing matter for poor families? A critical summary of research and
issues still to be resolved. Journal of Policy Analysis and Management, Volume 27. Issue 4.

Krieger, J., et al. 2007. Breathe Easy in Seattle: Addressing Asthma Disparities Through Healthier Housing,
in Eliminating Healthcare Disparities in America (Ed. Richard Williams). Springer-Verlag New York, LLC.

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National Healthy Housing Policy Summit Proceedings. May 2009. Washington, DC -
http://www.nchh.org/LinkClick.aspx?fileticket=CUgvlZBYLQY%3D&tabid=340

Reference: Center for Housing Policy - http://www.nhc.org/housing/intersections

III. Climate Change and the Built Environment

Nov. 17 : Class 14 : Emory University

Topic: The Built Environment, Public Health & Climate Change
Guest Lecturers: Howard Frumkin, MD, DrPH

Younger M, Morrow-Almeida H, Vindigni S, Dannenberg, A. 2008. The Built Environment, Climate Change,
and Health Opportunities for Co-Benefits. American Journal of Preventive Medicine. 35(5):517-26.

Assignment: Class evaluations

IV. Public Engagement for Healthy Places

Nov. 24 : Class 15 : Georgia Tech

Topic: Strategies to Engage the Public
Guest Lecturer: Melissa Conrad, Georgia StandUp [invited]

Frumkin, H., Frank, L., Jackson, R. 2004. Urban Sprawl and Public Health. Island Press: Washington D.C.
Chapter 11.

Jayne Parry and John Wright. 2003. Community Participation in HIA. Bulletin of the WHO -
http://www.apho.org.uk/resource/item.aspx?RID=44855

Background Information:
Chloe Chadderton, Eva Elliott, Gareth Williams. ND. Involving the Public in HIA, Cardiff University -
http://www.apho.org.uk/resource/item.aspx?RID=54457

Alizon Draper and Diana Hawdon. 2000. Improving Health through Community Participation: concepts to
commitment. Health Development Agency, London –
http://www.nice.org.uk/nicemedia/documents/improvhealth_comm.pdf

B. Rifkin, G. Lewando-Hundt, A.K. Draper. 2000. Participatory Approaches to Health Promotion and Health
Planning: a literature review, S Health Development Agency, London –
http://www.nice.org.uk/niceMedia/documents/partapproach_hp2.pdf

Wright, J, Parry, J, Mathers, J. 2005. Participation in HIA: objectives, methods and core values. Bulletin of the
World Health Organization. 83 (1) - http://www.scielosp.org/scielo.php?pid=S0042-
96862005000100015&script=sci_arttext&tlng=en

Dec. 1 : Class 16 : to be determined : Final Presentations