Zoning trade-off: privacy vs. adverse effects

The conclusion of Sonia Hirt’s book Zoned in the USA sums up the advantages and disadvantages of a zoning system that privileges the single-family home:

Arguably, zoning – the kind of zoning that makes explicitly private space the formative compositional element of America’s settlements – does deliver the gift of privacy to American families. But put all the other arguments mentioned in the previous paragraphs together, and one begins to wonder whether the original promises of zoning were either highly suspect from the beginning or have since been turned on their heads. Paradoxically (from the viewpoint of zoning’s founders), we may not have more pollution and worse public health with our current zoning that we would have if we had modified our land-use laws more substantially over the last hundred years.

As Hirt discusses, residents can have their own private homes – the largest new single-family homes in the world – but that comes at a cost of traffic and commuting, worse pollution and using more land, and worse health as well as some unrealized dreams of zoning including reduced crime. Some would argue that the privacy is overrated as well: compared to many other countries, Americans have given up on public life.

While it is easier to imagine mixed uses in dense urban neighborhoods – imagine Jane Jacobs’ vision of a bustling mixed use New York neighborhood – it is harder to imagine mixed use or zoning throughout the vast expanses of American suburbs. Even New Urbanists have tended to design neighborhoods or shopping centers dropped into suburban settings rather than the whole fabric of suburban communities. From the beginning of American suburbs, there was the idea that the urban dweller was escaping to a cottage in nature. The home out there offered refuge from people, dirt, and bustle. Today, this legacy lives on when suburban residents oppose certain land uses near their homes for fear of a lower quality of life and subsequently reduced property values.

Ultimately, would the American suburbs even exist without the fundamental desire for privacy?

In one decade, major suburban areas go from lowest drug overdose rates to highest

A new report details the rise of drug overdose deaths in suburbs:

Released Wednesday, the Robert Wood Johnson Foundation’s 2017 County Health Rankings and an accompanying report analyze county-level data from all 50 states on more than 30 public health outcomes and behaviors. The report finds there’s been a clear flip in the geography of addiction: One decade ago, large suburban areas experienced the lowest rates of premature deaths due to drug overdoses. In 2015, they had the highest.

The Johnson Foundation’s analysis doesn’t pinpoint which counties experienced the most dramatic gains in drug-induced death. What it does is rank every county in the U.S., by state, using data that reflects local health conditions, such as diabetes and obesity, as well as measures that can predict health outcomes, including teen birth, smoking rates, and grocery store access…

Comparing those numbers to the Johnson Foundation report, I found startling disconnects between deadly drug problems and places that have an otherwise fairly “healthy” facade. For example, Essex County ranks sixth out of the 14 counties in the Bay State by the new report—middle-of-the-road when it comes to the chronic health conditions that normally wave red flags for public health researchers. Yet it’s increasingly afflicted by drug-related deaths.

On the fringes of Cincinnati, Boone County, Kentucky, ranks first out of 120 across its state on all other health rankings. As in Essex County, rates of diabetes, smoking, and teen births are relatively low; poverty is suppressed, and employment is solid. Yet a look at CDC data shows county saw its drug-related death rate leap from 26 in 2010 to nearly 46 in 2015. Ranked smack in the middle of Ohio’s 88 counties and also included in the Cincinnati metro area, Clermont County saw a similar leap. Another example: Clay County, part of the Jacksonville, Florida, metro area, is 11th of the Sunshine State’s 67 counties. But drug-related deaths increased from 14 in 2010 to 23 in 2015.

It has been interesting thus far and it will continue to be interesting to observe how this is treated by the media, government, and public. This would be a good case for studying how a social problem develops: American society is so large that not everything can receive the attention it deserves. For example, how do the reactions to suburban drugs differ to how Americans treat drug use in cities (or rural areas which rarely get any attention)? How is the drug use explained: as part of criminal activity, irresponsibility, broken down homes and/or neighborhoods, wealth, or addiction? Because these deaths are happening to suburbanites – who as this article notes, are supposed to be healthier and often are – the story will be different.

Selling “wellness real estate”

Connect health and real estate in nice locations and you have a joint product to sell:

Chopra has been selling our body antidotes to life for two decades, and he has taken on most ingestible platforms. Now he is striking out into the booming domain of “wellness real estate”—building living spaces ostensibly designed to optimize bodily functioning. In collaboration with the design firm Delos and real-estate firm Property Markets Group (PMG), he is finishing construction of a 68-unit luxury tower in Sunny Isles Beach, on the barrier island abutting North Miami Beach. Two angular penthouse units resembling white glass-marble sky mausoleums are listed for $18.5 and $19.5 million…

The trend in Florida real estate, Maloney continued, is pairing with lifestyle brands. “We couldn’t figure out what we were going to do with our new project. When someone brought up Chopra, my ears perked up,” he said. “We’re not going with a car company or a clothing designer. When this concept came up, we thought, ‘wow, wellness.’”…

The Delos press release for these new “exclusive wellness residences” explains that they “will focus on three core wellness principles: air, water, light and sleep.” My guess there is light and sleep are meant to count as one. The Delos building in Manhattan where Chopra lives also features a “posture-supportive flooring system” and a surface coating “which destroys bacteria,” but I don’t know if these are wellness principles.

It then takes the author a while to figure out exactly what Chopra and his company will be doing to promote wellness. Additionally, an academic expert in this field offers a different approach:

The key to these technologies is that unlike the multimillion-dollar properties of Delos, Colistra and his colleagues are primarily concerned with scale—how to deploy mass-produced housing units that are equipped without creating huge disparities in who has access. “This is probably the antithesis of what they’re doing,” he said of Chopra and company. “What we’re looking at are population-health strategies in which health and wellness is accessible to everyone. When you’re talking about $15 million condos, it very quickly devolves into social inequities. Health is divided between the haves and have-nots.”

And that same expert suggests the answer is not really technology but social connectivity. So how about selling small town northern Minnesota as the ultimate wellness property?

If only wellness were not just a tagline that could sell more products…

“Move to a leafy suburb to cut cancer risk”

A new Harvard study suggests the risk of getting cancer decreases when people live around more greenery – such as in suburbs:

People whose homes are surrounded by the most greenery are 13 per cent less likely to die of cancer. Their risk of dying from respiratory disease also drops by 34 per cent, the biggest ever study into green spaces and health has shown.

Overall mortality was 12 per cent less for people who had the most greenery within 250 metres of their homes during the eight year follow-up period.

It is thought that being surrounded by vegetation improves mental health and lowers depression. It also allows people to get out and about more, giving more opportunities for exercise and social engagement, both of which are known to be protective against disease. The lack of air pollution in green areas also plays an important role…

More than 100,000 women enrolled in the Nurses’ Health Survey were followed between 200-2008. Scientists used satellite imagery from different seasons and years to monitor how much greenery surrounded their homes.

The early suburbs of England and the United States were popular in part because of their health benefits compared to the growing dirty industrial cities. The suburbs then featured much more greenery and the idea of having a small house in the midst of nature. I’m not sure today’s suburbs can truly compare, particularly those closer to the central city. I’m reminded of James Howard Kunstler’s commentary in this TED Talk about the “nature band-aid” that is often applied in suburbs today. But, this study suggests that a greener setting – even if it is heavily modified by humans in suburban settings – can help.

The negative effect of loneliness on health

Loneliness is not just a social or emotional condition; it affects physical health.

The scourge of loneliness has been with us since time immemorial, but only in recent years has its toll on human health gained appreciation. New research shows that feeling lonely or socially isolated bumps up a person’s average risk for coronary heart disease and stroke — two of the developed world’s most prolific killers — by 50%.

As a risk factor for heart attack, clogged arteries or stroke, those statistics put loneliness on a par with light smoking, anxiety and occupational stress. And they make social isolation a more powerful predictor of such vascular diseases than are either high blood pressure or obesity…

The new research, published Tuesday in the British Medical Journal’s publication, Heart, aggregated the findings of 23 separate studies that asked people to characterize their level of social engagement. Each of those studies then tracked participants for periods ranging from 3 to 21 years and noted whether they had a first stroke or were newly diagnosed with, or died from, coronary heart disease…

As a result, it’s hard to know whether loneliness is a contributor to, the result of, or just another symptom of poor health. And for the same reason, it’s hard to know whether programs aimed at getting the socially isolated to re-engage will improve their health, and how.

Social relationships matter, not just for using weak ties to get a job but also to improve your health.

The article hints at interventions at the end, primarily suggesting that doctors can ask about social networks and relationships. However, how possible is it for doctors to incorporate more social factors into their analysis, whether that involves asking people about social behaviors or recommending treatment? Doesn’t a finding like this suggest we need a more holistic approach to health that would incorporate physical conditions as well as emotional and social conditions? Perhaps we need more of the biopsychosocial approach. Maybe this requires having multiple professionals – doctors, social workers, psychologists – working together as units to address conditions.

More than ten year gap in life span among rich and poor

New data shows that the difference in life spans between richer and poorer Americans continues to grow:

The poor are losing ground not only in income, but also in years of life, the most basic measure of well-being. In the early 1970s, a 60-year-old man in the top half of the earnings ladder could expect to live 1.2 years longer than a man of the same age in the bottom half, according to an analysis by the Social Security Administration. Fast-forward to 2001, and he could expect to live 5.8 years longer than his poorer counterpart.

New research released on Friday contains even more jarring numbers. Looking at the extreme ends of the income spectrum, economists at the Brookings Institution found that for men born in 1920, there was a six-year difference in life expectancy between the top 10 percent of earners and the bottom 10 percent. For men born in 1950, that difference had more than doubled, to 14 years.

For women, the gap grew to 13 years, from 4.7 years…

It is hard to point to one overriding cause, but public health researchers have a few answers. In recent decades, smoking, the single biggest cause of preventable death, has helped drive the disparity, said Andrew Fenelon, a researcher at the Centers for Disease Control and Prevention. As the rich and educated began to drop the habit, its deadly effects fell increasingly on poorer, uneducated people. Mr. Fenelon has calculated that smoking accounted for a third to a fifth of the gap in life expectancy between men with college degrees and men with only high school degrees. For women it was as much as a quarter.

In the set of the right to life, liberty, and pursuit of happiness, you can’t have as much of the second and third if the first is not the same. While we often discuss inequality of opportunities or outcomes, we spend less time focusing on the body though commentators like Ta-Nehisi Coates have recently drawn more attention to the role of bodies in racial differences.

The article does suggest that evidence shows access to healthcare is not a big driver of this gap.

Wearable fitness devices might not be very reliable

The FDA uses different criteria for consumer fitness devices compared to medical devices:

Sehgal should know: he and his colleagues at the Center for Digital Health Innovation have compared the data reported by consumer wearable devices to relevant clinical gold standards in multiple studies over the past two years. They’ve found that very few devices currently on the market perform with the reliability one would expect from a medical-grade device.

And in fact wearable devices such as the Fitbit haven’t been clinically validated to perform at the same standards for reliability that the U.S. Food and Drug Administration uses for medical devices, such as the traditional blood-pressure cuff in a doctor’s office. Consumer wearables are marketed under the FDA’s less rigorous “wellness-focused” rubric.

Trister says that rather than tracking general activity, the most promising wearables target a specific thing. He cites startup Empatica’s Embrace wristband, which measures skin conductance—a signal that tends to rise as you get stressed—to detect an oncoming seizure (see “A Sleek Wristband That Can Track Seizures”). And Sehgal also points to devices being used in research labs that similarly measure the conductivity of the skin to help determine the severity of post-traumatic stress disorder among soldiers returning from war.

The end of this article suggests we’ll need time to see whether these devices can actually be used to help treat certain conditions. In the meantime, it would be interesting to know two things.

  1. What would it take to upgrade wearable devices for the masses: is it an issue of cost (all the testing an0d regulations would drive up the average price too much) or technology (these devices can’t yet be always reliable)?
  2. How would the average user know whether their particular device is unreliable? And if they could figure it out, do they have grounds for financial recourse?