Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109341

Deborah A. Cohen, MD, MPH, Health, RAND Corporation, 1700 Main Street, Santa Monica, CA 90405 and Thomas A. Farley, MD, MPH, Community Health Sciences, Tulane School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, 504 588-5391, tfarley@tulane.edu.

While many recognize the influence of the built environment on health-related behaviors and health, there is much skepticism about whether the built environment can actually be changed in ways to promote health and scant discussion of practical approaches to changing the built environment. This presentation demonstrates that the environment can be changed, by making the following points: First, the built environment is constantly changing, and decisions about the structure of the built environment are made frequently, providing opportunities to modify the structure. Second, while we tend to assume that government regulation of the environment will be resisted, in fact opinion polls indicate that the general public is in favor of more regulation. Third, the resistance to environmental change stems more from industry than the general public, and industry has successfully framed health issues as individual-level problems to be solved only by individual responsibility. And fourth, we have examples from smoking prevention and injury prevention of how advocates have successfully reframed prevention to place some responsibility on industry and on society collectively. In doing so, these advocates have enacted policy-based changes to the built environment that have promoted health. The session ends with a discussion of the political barriers to environmental change today and the type of advocacy needed to achieve environmental changes.

Learning Objectives:

• 1) Describe examples of how the built environment has been changed to improve health
• 2) Identify political forces that must be addressed to produce health-promoting environmental changes

Keywords: Primary Prevention, Public Health Policy

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commertial supporters WITH THE EXCEPTION OF In the talk I will mention a book that I wrote, named "Prescription for a Healthy Nation".