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Absiract This Book Presents Nine Papersreviewing Factors In DOCUMENT RESUME ED 155 020 SE 024 274 AUTHOR Hinkle, Lawrence E., Jr., Ed.; Loring, William C., Ed. .TITLE The Effect of the Man-Made Environment on Health and INSTITUTION Center for Disease control (DHEW/PHS), Atlanta, . Ga. FEPORT 40> DHEW-CDC-77-8318 TUB DATE 07) . v MpTE. 360P. , AVAILABLE FROM Superintendentof Documents, O.S. Government Printing Office, Washington, D.C. 20402 '(Stock Number, 017-023-00110-8, $3.25) e.%, BIAS PRICE. MF-$0:83 HC=$19.41 Plus Postage. DESCRIPTORS Accident Prevention; Commuticalle,Diseases; *Diseafes; *Environment; Injuries; *Medical Education; *Preventive Medicite; *Public Health; Research; *Urban Environment ABSiRACT This book presents nine papersreviewing factors in the'residen ial environment whichftay offer alternativepoints for , intervention to reduce and control disease and injury. ,Recommendations are presented for,further research'and.for, practice of preventive programs fcir epidemiologists; other health professionals; designers, developers, and 'managers ofresidential environments; public recreation professionals; andsocial workers., (SL) *********************************************************************** * Reproductions 'supplied by EDRS are the best that can be'made * . * . from the original document... * *********************************************************************** , ,; . U S DEPARTMENT OF HEALTH. EDUCATION &WELFARE .,. NATIONAL INSTITUTE OF EDUCATION the r THIS DOCUMENT HAS BEEN REPRO- DUcED EXACTLY AS RECEIVED FROM me PERSON OR ORGANIZATION.OR IGIN AXING IT POINTS OF VIEW OR OPINIONS effect STATED DONOT NECESSARILY REPXL:. SENT OFFICIAL NATIONAL INSTITUTE OF of the EDUCATION POSIJION OR POLICY .I an-ade. environ ent .4 o health i ,and. behavior. ti '4,4:n`1,41" ),s-,tg," bitstr"-. ).,e r 4 - *Carr ?. I .1t 5 Li? 7113 . \ tt -46 I/1 IN fie IV- -f- DEPARTMEir T OF HEALTH, EDUCATION':AND WELFARE. Public Health Service Center for Disease Control THE EFFECT OF THE MANMADEENVIRONMENT . ON . HEALTH AND BEHAVIOR .s.V. LAWRENCE E. HINKLE, JR., M.D. AND WILLIAM C. LORING, PH.D. I Editors 4 Aileport of the Inter-University Boaid of Collaborators USPHS Contract CPE-R-69-30' # Center for Disease Control, Public Health*Service U.S.-ei3artinent of Health, Education, and Welfare Atlanta, Geozglia 30333 3, t . , a .. Collaborating Abthors. Robert P. Burden, Ph.B. , Lawrence E. Hinkle, Jr., ,M.D. Assistant to the Dean for Environmental Professorof Medicine, Professor of 'Affairs, and Director, Environmental Medicine in Psychiatry, and Director, Systems Program Division of Human Ecology Division of engineeringand Applied Department of 'Medicine andPsychiatry .Physics . Cornell University Mkdicat-College Harvard University New York, NY 10021 Cambridge, MA 02138 Stanislav V. Kasi, Ph.D. (Psychology) John C. Cassel, M.D.,-MIP.H. Professor of Epidemiology and Professor and Chairman, Psychology. , Department 'of Epidemiology and Department "Of Epidemiology Public, Healc -. 'The School of Public Health Yale School of Medicine University of 'North Carolina Yale University ... Chapel Hill, NC 27514 New Haven, CT 06510 Albert Damon. M.D., Ph.D.,'(PhysicalDonald 'A. Kennedy, Ph.D. (Social Anthropology) Anthropology) Lecturer and Senior Research . Associate,Associate Professor, Director ofResearch Department of. Anthropology Department of Family and Community Harvard University,' ... Medicine )4ershey Medical Center Robert L. Geddes, M. Arch. Pennsyl'ania State University Professor of Architecture andDean, Hershey, PA 17035, School of Architecture and Urban Planning William C. Loring, Ph.D. (Urban Princeton University Sociology) , Science Advisor Princeton, NJ 08540. Environmental*. Health Services Division, BSS, Center fob Disease Control Robert Gutman, Ph.D. U.S. Public Health Service, DHEW Professor of Sociology Atlanta, GA 30333 Department of Sociology Rutgers . University Kermit K. Schooler, Ph.D.(Social New Brunswick, NJ 08903 Psychology) (also Lecturer itt Architecture, Dean and Prof. of Social Research Princeton, University. a School of Social Work Syracuse University Deceased. - Syracuse, NY 13210 DHEW Publication No. (CDC) i 77-83181 For sale by the Superintendent of Documents. U.S. Government Printing. Office Washington, D.C. 20402 - Price $3.25, Stook No. 017-023-0011078 4 Preface The papers published in this'book represent .an. endeavor bythe Public Health Service to gairi:Vetterunderstanding of the factors in the "residenlial environment whichmay offer alternative points for intervention to gain reduction of disease and injury. The strategy of ,* controlling disease and injuryby environmental changes madeunder the- guidance of the local publichealth officer has ,long been accepta_ practice in community hygiene. The research reviewed and pre" d . by the authors, however, points up that the traditionaldefinition cif environment, relating only tykephysical surroundings, istoo narrow for today in a mobile, i4liersonal urban community. Theirrecom- imendations for further research jand for practice of preventivepro- grams may be of interest to epidemiologists;other health profegsionals; practitioners` of design,. developmett,and management of residential environments; and professionals inpublic recreation and socialwork. David J. Sencer, M.D. j Assistant Surgeon General- Director, Center for DiseaseControl int iii 4 Acknowledgements The\Center for Disease Control wishes to express its appreciatiOn of the-work done by the ,authors, and by Professor Lawrence E. Hinkle, Jr., M.Das principal invstigator. For his interest andericduragement the iuth rs thank Mr. Robert E. Novick, (now of the Environmental ealth Djivision, World Health Organization, Geneva), then Director,' Co pity Environgental Management, '(Predecessor to for i:hTsease Control's Environmenkal Health Services -Divi- r wlioSt direction the contract for thii- work was initiated 1 anour apterl'1 drafted. The authors wish to acinoWledge their ,gran itude to Missarol Webster for her Untiring adMinistrativeffort hhmaded eliberation possible. The helpful contributions of r. Richard efield, Center for Studies of Metropolitan Prob- ms, National Insti ute of-Meintal Health, during all the meetings; and .Richard C. .S., noi with the Health Resources Administra- n, are also ac novel dged. Mrs. Mildred W. Hershberg also is thanked fo \her work inroo eading and in preparation of- the author index. \ \ / ) .. \ k .1 . et Sr Table OfContents . ; Preface 'Page AcknowledgementS iii Introduction William. C. Loring iv, Chapter I ti vii The Background andPtirpose of This Work , Lawree E. Hinkle, Jr. 1 kChapter II Community Health and theUrban Environment Donald A. Kennedy Chapter jII The Forgotten Enviroriinene 45 Robert P. Burdei Chapter W The Effects of theResidential Environmezivon Health and Behaviox:, A Review 65 Stanislav V. Kas1 CI__The-Relation---of-the-Urban---Environmentto Toward a ConceptualFrame and a Research Strategy 129 John Cassel `Chapter VI The Assessment of theBu'ilt-Environment for Safety: Research and PrZctice 143 Robeit Geddes andRobert Gutman C hapterVII. Measurement of the Effects of the Environment Upon the Health.and Behavior of People.... 197 Lawrence E. Hikle,' Jr. Chapter VIII The Residential vironment; Health,and Behavior: Sim ple ResearchOpportunitiei, Strat- egies, and Some Findingsin the Solomon Islands and Boston, Massachusetts 241 ,Albert Damqn Chapter IX Residential Eliviroikmentand Health ofthe Elderly: Use of ResearchResults for Policyand' Planning S 263 Kermit K. Schoolerand Neal Bejlos Chapter X Some Implication* OfThese Papers E. Hinkle, Jr Appendix' Epidemiological Contiibutionsto Environmental Health k'olicy: Housing and Health 805 Rodney R. Beard - Authorndex tdChapter Bibliographies xxxvii t List of Figures and Schema .0 Page Schema of Human Ecosysteni Processes in Injciry and Disease: The Two Subsystems: ;I. Environmental Components, II. Human Physiological Organism (s) xvii Schema of Human Ethsystem Piqcesses: Alternative Points to Intervene for Safety and Health xxi Basic Steps in Use of Paretq-Admissable Decision Vectofs 58-59 A Diagrammatic Presefitation of Major Classes Variables in the Study of Effectsof.. the Resillent`ial Env ronment on Health and Behavior 107 Psychosocial Factors Potentially Related to Health Status 138 Man-Made Physical Environment Classification System Rele- vant to Social Behavior (ECSB) 151-152 Chart'A. An Example of ECSB 178-181 Behavioral Classification System (BCS) 161-162 Chart B. An illustration of BCS 182 Schema for Measuring the Effects of Environment on Health and Behavior .c 210,218 odest- udget, field resdich suggestions for ethnographers and applied anthropologists 258-259 A Comments on one causal model for path analysis of links be; % . tween pairs of variables , , 358,, Comments on an example of the process krrXhich environ- , mental factors mediate each other as they effect level of health ` pi.. 269-271 1 . r. S e 4 Intradction. 4c WILLIAM C. LORING I. Public Health and the Residential Environment This book grew out ofan endeavor of the Public Health 'Service (PHS) to identify factors in the physical andsocial components of the residential environment of urban residentsthat. relate to health and diseaie or to safety and injury. Thisresidential or living envirorns went is defined as excluding the occupationalstructures and areas devoted solely to work, but including dwellings,neighborhood, recre- ation areas, the siting of shcipping andother pertinent service facilities (including those for health care, daycare, schooling). It is the physical environment
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