From the Dean

This issue of Northwest Public Health addresses the important role that public health plays in decision making about the built environment. We are increasingly aware that the structures and infrastructure of our communities—the places where we live, work, and play and how we travel among them-have a profound effect on our health.

We need look no further than the well-documented obesity epidemic to see how the built environment can affect the health of the public. Although a lack of healthy, affordable food is an obvious factor, a shortage of safe, accessible venues for physical activity in many communities also contributes to this epidemic. Obesity has become one of the chronic diseases of the twenty-first century and a major risk factor for heart disease and diabetes. Adequate exercise is among the most effective strategies for treating those diseases, but it requires a physical environment conducive to walking, jogging, and bicycling.

Asthma, too, is increasing in this country. We have long known that air quality is degraded by our reliance on the automobile and a highway system that necessitated the wholesale removal of trees. Dense, low-income housing also contributes to asthma, especially in children, when allergens and irritants such as dust mites, mold, cockroaches, rodents, and toxic chemicals may be present in the home.

Our architects and builders need to practice prevention by design to create healthier spaces, but public health professionals and our allies in other fields also must seize opportunities for intervention in existing unhealthy environments. Our first step, already well under way, is to broaden our concept of the environment. A too-narrow definition, although it includes air and water quality, leaves out considerations such as sidewalks and safe places to walk, bike paths and green space, natural lighting in buildings, and the availability of healthy food.

The cross-cutting nature of the many factors comprising the built environment points to the partnerships needed to improve health outcomes in our society. As members of an inherently interdisciplinary field concerned with preventing disease and injury and promoting health, public health professionals have much to offer city planners, architects, builders, transportation designers, and policy makers when environmental decisions are made. Members of our School's faculty are involved on many fronts. Examples include:

• Research in the Department of Environmental and Occupational Health Sciences on air and noise pollution, asthma, asbestos, and housing and health
• Collaboration between our Center for Public Health Nutrition, government agencies, and communities to improve physical activity and promote environmental change, such as the Center's involvement in the Moses Lake Healthy Communities Project
• Efforts by our Center for Health Promotion, through the Healthy Aging Network, to encourage wider sidewalks and more convenient public transportation for elders

In April the School co-sponsored (with the UW College of Architecture and Urban Planning) a second visit to campus and lecture by Dr. Richard Jackson. Jackson is state public health officer for the California Department of Health Services and former director of CDC's National Center for Environmental Health. He and Dr. Howard Frumkin, who is interviewed in this issue of Northwest Public Health, are leaders in research on the relationship between the built environment and health.

Although we live in a region of exceptional natural beauty and recreational opportunities, our scenery does not guarantee healthy living conditions, especially for our most at-risk populations. Public health can encourage healthy behaviors and reduce health disparities by playing a central role in designing healthy communities and altering unhealthful environments.

Patricia Wahl, Dean
School of Public Health and Community Medicine