Architecture & The Nation’s Health: Architecture & The Nation’s Health:

Design Matters Design Matters

ASLA ASLA ConferenceConference

Washington, Washington, DCDC

May 7, 2003May 7, 2003Jamie Bussel, MPH

RWJF Mission

To improve the health To improve the health and health care of all and health care of all

Americans.Americans.

RWJF Grantmaking Goals

To assure access to basic health care To assure access to basic health care To improve care for people with chronic To improve care for people with chronic

health conditionshealth conditions To reduce the harm caused by substance To reduce the harm caused by substance

abuse abuse To promote healthy lifestyles and To promote healthy lifestyles and

communitiescommunities

Health Care

DeterminantsDeterminants ofof HealthHealth

EnvironmentalBehavioral

Social

Genetic

Improvements in Health Status

Only 10%-15% of preventable mortality Only 10%-15% of preventable mortality could be avoided by improved medical carecould be avoided by improved medical care

Increase of 7 years in Life expectancyIncrease of 7 years in Life expectancy 4 years from prevention4 years from prevention 3 years from medicine3 years from medicine

WHY Focus on BehaviorActual Causes of Death, United States

Diet/Inactivity Alcohol

Microbial Agents

Toxic Agents

Firearms

Sexual Behavior

Motor Vehicles

Illicit DrugsDrugs

Tobacco

Physical Inactivity and Diet

Account for almost 300,000 deaths or 14% Account for almost 300,000 deaths or 14% of deaths per yearof deaths per year

It is estimated that we save almost $77 It is estimated that we save almost $77 billion dollars in health care cost by billion dollars in health care cost by increasing physical activity levelsincreasing physical activity levels

Physical Inactivity is Associated With: Obesity and OverweightObesity and Overweight Stroke and High Blood pressureStroke and High Blood pressure Cardiovascular diseasesCardiovascular diseases DiabetesDiabetes Colon CancerColon Cancer