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ABSTRACT VAN BAKERGEM, MARGARET ANNE. Exploring Health and Well-Being Considerations in Multifamily Real Estate Development

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ABSTRACT VAN BAKERGEM, MARGARET ANNE. Exploring Health and Well-Being Considerations in Multifamily Real Estate Development ABSTRACT VAN BAKERGEM, MARGARET ANNE. Exploring Health and Well-Being Considerations in Multifamily Real Estate Development (Under the direction of Dr. James Aaron Hipp). The real estate industry has largely been left out of discussions among built environment and public health stakeholders about how to create healthy communities. Considering the rising rates of urbanization and the increased demand for multifamily housing, multifamily real estate developers are well-positioned to integrate healthy community and building principles into their decision-making. Multifamily developers’ decisions around health and well-being (HWB) strategies may holistically contribute to curbing rising rates of chronic disease and enhance feelings of well-being While most multifamily developers do not adopt a health lens in their approach to development, several early adopters are intentionally targeting health promotion in their projects. It is an emerging consideration and little is known about how these multifamily developers think and talk about health. Moreover, due to its nascence, limited literature is available within the real estate discipline, potentially delaying awareness of the benefits a health and well- being perspective can bring to how built environments are formed. This dissertation aimed to explore the emergence of HWB constructs in real estate literature and practice. The three-article dissertation was guided by grounded theory principles. The first article explored the emergence of HWB in real estate literature using a descriptive keyword approach. The second article used multiple case studies of three multifamily developers deemed early adopters for pursuing health to gain insights into how HWB is conceptualized. Finally, the third article proposes a framework outlining the overarching principles of a HWB vision for real estate development. Together, the articles provide a foundation for how HWB is an emerging and worthwhile consideration in the multifamily development arena. Findings from this exploration highlight how multifamily developers can become integral participants among multidisciplinary groups that actively attempt to plan, modify, develop, and program built environments to promote healthy behaviors and outcomes for communities at large. © Copyright 2020 by Margaret Anne van Bakergem All Rights Reserved Exploring health and well-being considerations in multifamily real estate development by Margaret Anne van Bakergem A dissertation submitted to the Graduate Faculty of North Carolina State University in partial fulfillment of the requirements for the degree of Doctor of Philosophy Parks, Recreation and Tourism Management Raleigh, North Carolina 2020 APPROVED BY: _______________________________ _______________________________ Dr. J. Aaron Hipp Dr. Traci R. Rider Committee Chair __ Dr. Michael B. Edwards Dr. Kyle S. Bunds DEDICATION To my parents, Kathy and Dave. ii BIOGRAPHY Margaret earned a bachelor’s degree in Psychology with an emphasis in neuroscience from the College of Charleston in South Carolina in 2007, and a master’s degree in Public Health with an emphasis in chronic disease prevention and the built environment from Washington University in St. Louis in 2011. Whether studying human behavior via the brain or the built environment, Margaret has dedicated her academic and professional careers to researching health and well-being. Her nearly ten-year tenure as a Washington University School of Medicine employee shaped her affinity to high quality clinical research. Specifically, her time spent working on the Contraceptive Choice Project as a data analyst in the Division of Clinical Research in the Department of Obstetrics and Gynecology served as a turning point as she was introduced to the realm of public health and geographic information systems (GIS). Growing up in the City of St. Louis, surrounded by architects and urban designers, she merged her appreciation for city form with health. After completing her master’s degree, she spent a year working for the Prevention Research Center on various public health and built environment research projects. In 2012, she moved to Nashville, TN to work as a data and GIS analyst for the Growing Right Onto Wellness (GROW) project – a longitudinal randomized control trial aimed to test the efficacy of family-centered, community based intervention to prevent childhood obesity. She worked closely with built environment project stakeholders, including Nashville Metro Parks and Recreation. Since 2009, Margaret has been a founder and board member of the Yantaló International Volunteer Organization, a non-profit organization based in Yantaló, Peru. With a mission to design and build a volunteer house in close proximity to a newly constructed medical clinic, her role on the board introduced her to sustainable property development. Her experiences on the iii board of this international housing project guided her to better understand local development in Nashville. It was during this time that she realized that real estate developers play a tremendous role in making decisions about the built environment. This piqued her curiosity and eventually landed her in Raleigh, NC to pursue a Doctor of Philosophy degree in the Department of Parks, Recreation, and Tourism Management (PRTM) at North Carolina State University. After spending the entirety of her career in the realm of quantitative and spatial research, she entered the world of qualitative research as she explored how real estate developers think and talk about health. Her research was funded by the Robert Wood Johnson Foundation. iv ACKNOWLEDGMENTS I want to give a heartfelt and grateful nod to my family and crew. v TABLE OF CONTENTS LIST OF TABLES ...................................................................................................................... viii LIST OF FIGURES ...................................................................................................................... ix Chapter 1: INTRODUCTION .................................................................................................... 1 Overview ........................................................................................................................................ 1 Health Concepts ............................................................................................................................. 1 Real Estate Concepts ...................................................................................................................... 5 Health and Real Estate Concepts ................................................................................................... 7 Dissertation Focus .......................................................................................................................... 9 Research Objectives and Questions ............................................................................................. 10 References .................................................................................................................................... 11 Chapter 2: THEORETICAL APPROACHES TO THE RESEARCH PROCESS Theoretical Overview................................................................................................................... 16 Grounded Theory ...................................................................................................................... 17 Sensitizing Concepts ................................................................................................................. 19 Theory of Organizational Change ............................................................................................. 20 Theory of Diffusion of Innovation ............................................................................................ 21 Research Objectives ..................................................................................................................... 23 References .................................................................................................................................... 25 Chapter 3: FROM GREEN TO HEALTH: KEYWORD INDICATORS IN THE ADOPTION OF INNOVATIVE CONCEPTS IN REAL ESTATE LITERATURE Introduction .................................................................................................................................. 28 Background .................................................................................................................................. 28 Green Building Precedent: Tracking the Transformation of an Industry .................................... 32 Exploring Early Stages of Health and Well-Being in Real Estate Development ........................ 35 Methods........................................................................................................................................ 38 Data Gathering, Management, and Processing ...................................................................... 40 Keyword Analyses ................................................................................................................. 45 Results .......................................................................................................................................... 46 Descriptive Results ................................................................................................................ 49 Green Building and Active Living Keyword Growth in Real Estate Literature Domain ...... 50 Green Building and Active Living Keyword Appearances
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