(Unedited) Podcast Transcript 551: Architectural Epidemiology
October 2, 2025
This week we’re joined by Adele Houghton of the Harvard School of Public Health and Carlos Castillo-Salgado of the Johns Hopkins Bloomberg School of Public Health to discuss their new book Architectural Epidemiology: Architecture as a Mechanism for Designing a Healthier, More Sustainable, and Resilient World. We chat about how to connect the social and architectural determinants of health before projects get off the ground in order to create more healthy neighborhoods.
To listen to this episode, visit Streetsblog USA or find it in our hosting archive.
Below is a full AI generated unedited transcript of the episode for those who like to read:
[00:00:00] Jeff Wood: Adele Houghton and Carlos Castillo-Salgado, welcome to the Talking Headways podcast. Thank you very much.
[00:02:17] Adele Houghton: Yeah, thanks for inviting us.
[00:02:19] Jeff Wood: Yeah, thanks for being here. Before we get started, can you tell us a little bit about yourselves?
[00:02:22] So we’ll start with Adele and then go with Carlos.
[00:02:24] Adele Houghton: Sure. My name’s Adele. I am from Houston, Texas, so we have a,
[00:02:29] Jeff Wood: I’m from Kingwood. Yeah. Yeah.
[00:02:30] Adele Houghton: remember hearing that on the episode. I listened to and my sister lives in Austin, very close to UT. So Nice. We’re from the same part of the world and I’m an architect and started out in green building back, I graduated from my master’s in architecture at Rice in Houston in 2003 and started working on.
[00:02:51] Kind of early on in the green building movement and realized pretty quickly on that even that far back, a lot of the work that we were doing [00:03:00] around green building seemed like it was focusing a lot of its effort on marketing and less on impact. And so pretty quickly, about two years in, I switched over to running a nonprofit called The Green Guide for Healthcare, which was.
[00:03:15] The first best practices green building toolkit in the US that really emphasized health benefits, and that’s how I learned about public health was through epidemiologists that worked with us. At the time, this is back in 2005, so around the time you were taking your class about the work that had been happening at the intersection of public health and planning, trying to kind of trace the environmental determinants of health and how land use, planning and built infrastructure could influence health outcomes.
[00:03:49] So then I started a fellowship at the CDC and learned more about public health and eventually went to Johns Hopkins to get my Master’s of public health where I met Carlos. So I’ll just let you take over from there.
[00:04:02] Carlos Castillo-Salgado: My name is Carlos Castillo-Salgado. I always put both last names because in most of the institutions that I have been working there is another Carlos cast that takes my checks.
[00:04:13] That is important for everyone know that that’s not right. I start my professional career as a lawyer. I study and finish law in Mexico and work as a lawyer for the uh, field and the camps.
[00:04:33] In Mexico. And with that I, my medical studies. And then I moved from Guadalajara that I was working as a lawyer in Mexico City and I enjoy very much the community medicine. And I become the director of, uh, five of the most relevant south of the Mexico City Health Centers. Thousand interns and 25 residents working in the community.
[00:05:05] And after that, I moved to United States to have my master in epi and in public health at Hopkins. After that, I received several invitations to work for the worker organization and I become the regional advisor for communicable. America such. I developed some strategies for malaria and I 22 years and public in the I to Hopkins.
[00:05:43] I was the.
[00:05:52] I still have as director of the Global Public Health Observatory, I’m full professor of [00:06:00] epidemiology dealing with Apply epidemiology, and that’s something that is relevant for the architectural epidemiology. Epidemiology is uh uh, we call professional epidemiology. Professional epidemiology at Hopkins become the combination of apply epidemiology.
[00:06:21] And analytical epidemiology, and that was something that we discussed with Adele to incorporate in architectural vision and framework.
[00:06:33] Jeff Wood: So how did you all get connected so that you talked about the architectural side and then the epidemiological side. That
[00:06:39] Carlos Castillo-Salgado: was one of the best MPH student, and I was a capstone advisor that received a lot of recognition and awards at Hopkins.
[00:06:50] And then we continue doing some research about the environment and the importance of heat and uh, blood and epidemiology. Recommended for her to public health and that very having.
[00:07:17] Adele Houghton: Well, and I think the other thing, just from my perspective, yes, Carlos was my advisor, but we met because I took his class on GIS and spatial analysis in public health. And the reason why I went back to school, you know, I already had a master’s in a architecture. I was a registered architect and I had been working in green building for, at that point over 10 years.
[00:07:41] Was because I felt like I was doing public health work and practicing epidemiology, but I felt a bit of a imposter syndrome because I was sort of doing it without ever really having been trained. And what I really wanted to learn about was the methods from an epidemiological perspective of how do you look at both environmental conditions and also populations, the demographics as well as.
[00:08:07] The relationship between environmental exposures and health outcomes. And so I took this class in GIS and I will say, frankly, that I came into the program already an expert in green building as an architect, and also having worked at the intersection of climate change and health for about 10 years and didn’t find courses that would sort of further that knowledge.
[00:08:33] And so what I would end up having to do is take. Public health courses and then apply my knowledge to them. And Carlos was one of the only professors and absolutely the most influential for me who really encouraged that and was the one who encouraged me, you know, said, Hey, I think you’re filling a gap here that nobody else has noticed this gap of what’s the bridge between architectural design and planning?
[00:08:59] [00:09:00] Because you can have the best plan in the world, but if the architect and the developer. Decide they’re going to ignore that plan, which I’ll just tell you from my experiences, the norm, then you might as well not have the plan. So what we’ve been trying to do is use epidemiological methods to demonstrate the value both to the design team and to the community and to public officials about that bridge.
[00:09:27] Why is it important? Where the work gets done, that work is actually paying attention to how it fits into these larger systems.
[00:09:36] Jeff Wood: Then you all put this into the book, right? Basically you created this book, architectural Epidemiology because of the issues that you were seeing from architects and, and developers not paying public health any mind.
[00:09:46] And so what was the process for like putting this together and making it into this textbook that folks can use if there are developers, if there are architects, if they’re public health professionals, planners, and others can use it too. There’s so much really good information in here.
[00:09:59] Carlos Castillo-Salgado: Yeah, I think it’s important to, with context of, uh, there is a tremendous amount of knowledge that is placed in different silos that has not been very useful for the transformation and to respond to the needs of the society in this century, uh, we call the knowledge do gap.
[00:10:23] We have tons of for knowledge, but we don’t apply particularly in public health or even architectural. Then we decided that was important to bring all these connections together to recognize that the silos of climate change, of the air quality, all of those need to be bridging. Apply methodology that is offered by epi we call problem solving.
[00:10:55] It’s not an academic per se, but is for transformation of reality and thus the nature of the book, providing all these assessments and methodology, these steps to start bringing quality of life and equity into the building environment.
[00:11:18] Adele Houghton: Yeah, and I think just to add to that, the way that the conversation started really was through my capstone where I looked at.
[00:11:25] So I had been doing work with the health department in the city of Austin and Travis County through my fellowship at the CDC, looking at developing environmental public health indicators. That combine the vulnerability of people and the vulnerability of infrastructure and natural environments to extreme heat and flooding.
[00:11:48] And we created an index that was both social and infrastructure vulnerability to sort of understand where were the hot spots in the city, and then identify policies within the city of [00:12:00] Austin and pockets of money so that they could prioritize. Funding. Funding in areas that were a combination of both vulnerable populations and high vulnerability to extreme heat or flooding.
[00:12:12] And so I did that work before I came to Hopkins, and then what Carlos and I did was look at Lead and say, okay, lead is in the green building rating system, which is highly used in Austin to see projects who were identifying themselves as green. Were they choosing to use. The strategies in lead that would bring the greatest co-benefits to extreme heat and flooding in neighborhoods that were highly vulnerable.
[00:12:42] And what we found was it was the exact opposite. So in fact, not only were they not emphasizing those strategies in the highly vulnerable neighborhoods, they weren’t even located in those neighborhoods. They were mostly focused in the lowest vulnerability neighborhoods. We use the same approach in Chicago and found the same results.
[00:13:02] And I think for me, like the genesis of the book in a sense was. I started presenting this work to my colleagues because I still very much identified only as an architect and a green building consultant because of the imposter syndrome I was talking about earlier. And so I was going to all these, you know, green building and architecture and planning conferences back in 2012, 2013, around then, and presenting this.
[00:13:30] And people would literally gasp when I would show them the results because. They thought that what they were doing just by following the lead checklist, which doesn’t require you to do any real kind of like substantive, holistic interpretation or analysis of your neighborhood, and you know what is going to be the ripple effect of this project, whether environmentally or socially or economically, it doesn’t ask you to do that.
[00:13:54] And so people just think, oh, well, if I just get more points in this menu of options, I will automatically have an impact. And I think. Just that reaction that was so visceral, I kind of woke up and thought, you know, maybe people haven’t realized that this is actually something they need to pay attention to.
[00:14:13] And fast forward to today, I still talk to architects all the time. It is very unusual for an architecture project to pay any attention at all outside of. Property. They really focus their efforts inside the property line and pretend like they’re building a spaceship that’s going to land on some sort of launchpad on the moon or something, and is not gonna have any kind of impact on its surroundings.
[00:14:39] So the idea behind the book was, okay, let’s give people. A method like Carlos was saying, that would be flexible and problem solving in nature, and use tools that they’re already familiar with, like the lead rating system or the well rating system, or fit well and make use of those strategies.
[00:14:59] [00:15:00] Just be more strategic about it so that you’re paying attention to what those ripple effects will be.
[00:15:06] Jeff Wood: I appreciate specifically the combination of the social determinants of health and the built environment determinants of health. In one mashup, we talk about these things, and Carlos, you mentioned silos earlier.
[00:15:15] I mean that that tracks because. We can talk about the shortcomings of these rating systems all day. LEED being one of them. There’s LEED for buildings, there’s LEED ND, there’s all kinds. But oftentimes when we were doing projects at my old work where we were talking about transit oriented development, you know, you’d plop this lead building in the middle of nowhere and then people have to drive there.
[00:15:32] And so you have this other impact. And so I’m fascinated by this connection between. Inside the property line and outside the property as well as the social aspects of it, but also the design aspects of things. So can you talk a little bit about those connections between those two separate but very connected methods?
[00:15:48] Carlos Castillo-Salgado: Yeah. They’re very, very important the framework that we follow and thus, perhaps one of the benefits of the book is, uh, to be very explicit in coordinating. The social determinant as not only the proximal, but also the main drivers of the inequalities. And if we don’t bring that into the design, we actually will not be able to increase the quality of life.
[00:16:20] Then the idea here is that the Mod Society, uh, determinants need to be included. And not only the, uh, proximal that is the usual, uh, research projects that they forgot how to deal actually with the main inequalities. And the application of the epi problem solving approaches will follow also the framework of the social determinants, but not only in the philosophical, but in the applied characterization of what are the main drivers that we need to take into account that will be different in one neighbor to other neighbors.
[00:17:01] And that’s now our vision that we need to recognize what is happening at the neighborhood level. Because we also think about or abstract national level that we lost the determinant that are affecting the specific neighborhoods that are essential for the problem solving. And now with the polarization of the policies and the politics, we have also the polarization of the problems of chronic diseases and infectious diseases.
[00:17:36] A theory that we already had in an state in which infectious diseases are gone. What COVID-19 epidemic demonstrated that that’s not the case. We have the polarization of both the same importance, the chronic diseases and the, and this is very important [00:18:00] in dealing with. Build environment and understanding the characteristics of the population that are essentially to deal with the more policies and strategies that will improve.
[00:18:19] Jeff Wood: I’ll give you a specific example. There’s a lot in the book, obviously, but I like to hear specific example because I think folks will understand why the outside parts matter for the inside parts. So if you’re thinking about, say, chronic diseases like heart disease or diabetes or things like that, how does the built environment affect that?
[00:18:34] How can you get to a point where the building that you’re building or the neighborhood that you’re cultivating is going to help people resolve some of those issues, or at least manage them?
[00:18:45] Adele Houghton: So before I answer that question, I just wanna add onto what Carlos was saying about how it’s important to notice that the combination of people in place changes neighborhood by neighborhood.
[00:18:57] And so we have 25 case studies in the book. And if you’re just flipping through the book, or I guess clicking through, if you get the PDF version, there are a whole bunch of diagrams and they all look the same. They are diagrams of the neighborhood assessment and then the environmental health priorities coming out of that neighborhood assessment.
[00:19:19] And then the design strategies that go into that case study that respond in an evidence-based fashion to those requirements. So the idea behind having that diagram was that you could flip through and you could visually see. What we’re talking about that you can see that the left hand column of that diagram changes.
[00:19:41] Some neighborhoods have high incidents of cardiovascular disease. Some neighborhoods have high incidence of asthma. Some neighborhoods have high exposure to air pollution, outdoor air pollution, indoor air pollution, and so you’ll see as those. Criteria, the priorities on the left hand side, which are kind of the way that we’re assessing the neighborhood, how those kind of flow through the diagram, you’ll see different design strategies coming outta it, and to me as an architect and a green building consultant, that’s the really big difference.
[00:20:12] We’re basically turning the design process on. Its. A lot of times when you bring health into the conversation and the design process, it comes in at the end and it’s used to justify design decisions that have been made for other reasons. What we’re suggesting is that you pay attention to the neighborhood needs and the occupant needs, and use that information to help inform which design strategies you’re gonna prioritize.
[00:20:41] And I’ll give you two quick examples. One. Is the family health Center on Virginia, which is a community, a federally qualified health clinic outside of Dallas, Texas. And that’s a project that was geared towards low income residents in that part of McKinney, Texas. But [00:21:00] as they started learning more about the characteristics of the patients that they were hoping to attract.
[00:21:06] To the clinic, they realized that it was going to be a lot of women with young children, and so they changed both the types of services that they were gonna provide in the clinic as well as the architecture. So you’ll see that they started providing services for children, not just adults, that there’s, um, more of an emphasis on maternal care than there was going to be previously.
[00:21:33] It was just gonna be like your regular everyday clinic. They’ve started offering wellness services, yoga classes and food prep classes and things like that in a different part of the building. They’ve got different hours than they would’ve had. They open parts of the building to the public after hours, and then they set it up architecturally as more of a, like a domestic looking building.
[00:21:55] It looks kind of like a school or like a kind of. Old fashion apartment building sort of with like gable roof and stuff. And so it’s meant to be welcoming and domestic in scale. So that’s just one example. Another example that’s also kind of related to kids, but answers your question specifically about like how does the population, how question inform the design is.
[00:22:19] There’s a school, Buckingham County primary and elementary school, which is in rural Virginia. Where this is an, a county that has very high obesity rates, both for adults and children. And so when this, it’s like two schools that were right next to each other, they, we’ve developed the entire property and decided that because it’s a rural area and it’s hard to get easy access to fresh and healthy food, and also just physical activity that they were going to make the entire theme of the campus.
[00:22:50] Physical activity and access to fresh and healthy food, and that is integrated into the architectural design, into kind of active movement in chairs and tables and things like that. They’ve got a open food prep kitchen in the middle of the complex. Children get to like learn how to cook with the shelves.
[00:23:09] They’ve got an onsite garden. The children then go outside and bring food in from the garden and then prep it there. It’s integrated into the curriculum. And then the children are asked to bring that curriculum home to their parents. And then they also, like the other example, they open on the weekends and things like that.
[00:23:25] So they’re trying to bring this idea of. Expression, healthy food and physical activity as a positive kind of nurturing community, building cultural shift through the design, and then also through the way that the building is operated. And I’d say that’s another kind of difference between architectural epidemiology and the way a lot of architectural projects work is we don’t stop at the moment that you turn the key over to the client, which is normally when the contract ends for an architect.
[00:23:56] We pay attention to what would need [00:24:00] to happen in the operations and life of that building once it’s occupied, in order for the kinds of health benefits that would be optimal for that place in order for them to actually happen.
[00:24:12] Jeff Wood: So the book lays out the process for all this. Basically thinking ahead of time, figuring out what the needs are, surveying the community and doing data analysis and things like that to figure out are there high rates of obesity, are there high rates of this or that?
[00:24:22] And the other thing. And thinking about that from that first perspective, and then also going through the process of designing with. The architects and the developer in each step of the way, which I think is a really good way to go about it because every part of the process, you can insert the ideas and the lessons that you’ve learned into the process, which allows you to come up with those examples that you just gave.
[00:24:43] Carlos Castillo-Salgado: Yeah, it’s important to Epidemiology Center in three main concepts, the concepts for people, and the concept of time and place. For the first time now, we could combine everything, even using GIS since we are very interested in the interaction between people, time and place. And in that sense, the context is very important.
[00:25:09] We have been working in some of the cities of Sao Paulo about the food desert that is important for the obesity. Different neighborhoods of one of the cities there, but also it’s, it’s important to recognize about the heat islands and the lack of the three canopies that is affecting that tremendous amount of populations that live in areas that is also very unsafe.
[00:25:41] Of these considerations are important in the assessment with the different steps that we propose to be used for problem solving.
[00:25:50] Jeff Wood: Do you all get frustrated by having to solve problems that other projects and infrastructure? Cause I’m thinking specifically of like Houston and the highways that are being expanded.
[00:26:01] I 10 obviously is, and I 45 are being expanded through downtown, and that’s a big thing. But basically a lot of the work that needs to be done is have to do with what you all call trap, which is transportation related air pollution, the particulate matter, things like that. But you’re also solving for things like office spaces and indoor air quality.
[00:26:17] Which are caused by people sitting inside all day on their computers. Or not caused by, but like people have to go to work and they have to subject themselves to those faces. So does it get frustrating to like, have to solve for problems that are created in other ways that could be solved through your method earlier on?
[00:26:35] Carlos Castillo-Salgado: I think what we relies is the importance of collaboration. I think the silos has been for ages and if we don’t expose. That there are different dimensions and components that are needed in order to address the needs of the society. The society now has so many even more challenges that in the [00:27:00] previous century.
[00:27:01] And in that sense we start thinking importance of the collaboration and that is one of the main objectives of architectural epidemiology to building this type of collaborative from even scientists, but also the policy makers and the civil society leaders. And for us is quite relevant. Obviously we are frustrated, but what is more frustrated that the current trend.
[00:27:31] At the political level, eliminating the rational and all the knowledge that has been produced by millions of people. This is something that is quite frustration because what is for the planet now? That’s the concept of planetary health. Important because, uh, the lack of utilization of all the knowledge that is available to us is almost criminal.
[00:28:03] Adele Houghton: Yeah. And that’s another conversation that I’d love to pick up in a minute, but I wanted to just follow up on the idea of silos and kind of professional scope and where the scope of one profession they begins. The problem that you’re talking about, Jeff? When we were pretty far along with the book, I read a book called Green Swans by John Elkington.
[00:28:30] He is kind of a big sustainability thinker from the uk and I think he said that he coined the phrase ESG, either that or the previous one. And he’s an economist and he, he has this idea that if the market within which you’re working is broken. One way to fix that market is to expand its boundaries, and that is literally what we’ve done.
[00:28:58] And so my dissertation, we validated, well, I and my colleagues, not with Carlos, he was my advisor. But, um, we validated the approach of architectural epidemiology with three real real estate projects across the country. And the real kind of nuts and bolts question for the developer was. Would we be able to convince the developer to expand their proforma, which is the calculation that they do to decide whether or not a project is gonna pencil out and they’ll make money.
[00:29:29] Would they be willing to expand that calculation to incorporate neighborhood benefits? Because the way that it’s written out right now tends to require, if you’re going to add one thing, let’s say more installation, then that’s a cost. What’s gonna be the one benefit of that? It’s going to reduce energy use after you’ve sold the building.
[00:29:54] And so you as a developer are not going to actually recoup that money. So you have to find a [00:30:00] way to say that’s going to be incorporated into either an increased sell fee or maybe you get paid for it by the government through tax incentives or something like that, right? That’s the way things are done right now.
[00:30:14] It’s. It fragments everything. Every single, literally every single material product that goes into a building is put into a spreadsheet like that and it’s like one-to-one. And that doesn’t pay attention to the fact that there are kind of groupings of strategies and products and materials and design decisions, frankly, that together can have an exponential benefit or can cause a lot of trouble if you looked at them as a group.
[00:30:42] And so one of the ways that we’ve suggested doing that. By monetizing, demonstrating, quantifying what are going to be the community benefits of this project, right? How is this project going to tangibly benefit either neighborhood health, reduce traffic related air pollution, as you mentioned, or contribute to say, a key performance indicator on the climate action plan or the transportation plan or something like that.
[00:31:09] And then integrate into the proforma, the conversation, the negotiation that happens around what’s called entitlements, which is the process of getting your permit. And through that conversation you end up with, uh, horse trading that happens between the city and the developer. Right? And so if we can incorporate health benefits or environmental health benefits or social equity benefits into that entitlements conversation, you could actually.
[00:31:37] Create a system where the proforma expands out to incorporate community benefit. And what we discovered through the alignment process, which was what the name of my dissertation was, that we surveyed three different stakeholder groups, the community that was gonna be impacted by the project, the proponents of the project.
[00:31:56] That’s the developer, the architect, and this local officials to say, if we expand the performa in this way, did that bring more value to you? Based on the way that you define value and the timeframe within which you’re gonna get that value. And, um, they all said yes, that it did. And so to me, there’s an aspect of this that is trying to break down mental models about kind of where I, as an architect.
[00:32:24] Why can’t I be an architect and also an epidemiologist, right? Like what’s that fuzzy line between you as a planner and me as an architect, right? Or between me as an architect and the facilities manager who’s gonna take over the building once I’ve turned over the keys, right? And how do we find opportunities to collaborate earlier on so that we’re all working at together, maybe not all the same amount of effort, but that we’re contributing.
[00:32:49] Knowingly to this project. And so it’s successful and you’ll see that in the book we actually called out where different disciplines can have their [00:33:00] moment in the spotlight as you walk through the architectural epidemiology process. So there’s not one individual or one discipline that’s in charge the whole time.
[00:33:09] It’s a group that kind of shares responsibility and has their moment of, this is where I’m in control right now, and then I’ll step back. Somebody else will kind of take on the mantle.
[00:33:22] Carlos Castillo-Salgado: I fully agree that it’s important to start again recognizing the concept of problem solving because the exercise is not only something that is scientific, obviously, it’s but is how to put together all these variables, indicators from different disciplines.
[00:33:42] Become useful for addressing the lack of equity and improving the quality of the community life. I think that will require changes in the collaboration and in the policies.
[00:33:59] Jeff Wood: I wanna ask you all about data because I think that that’s, you know, a big part of this is collecting data before collecting data.
[00:34:04] After, in 2012, I built an equity atlas for Los Angeles, and like county level data does not help me at the block level or anything closer, right? And so I’m wondering like the advancement of data and how that’s helped, but also how you produce data from the process that allows you to give the wins to the developer afterwards so that they can actually keep doing these projects over and over and over again.
[00:34:27] Carlos Castillo-Salgado: This is a very important question and actually I had been discussing with the warfare organization to start changing the vision of how to present the information. There have been many initiatives that are quite relevant. One is place matters in which the idea is to start aggregating the information at the neighborhood level.
[00:34:51] For instance, in uh, Baltimore City. Is 55 different neighborhoods that a consortium or different groups provide the main, uh, what we call core indicators that allow us to measure in the level of inequalities and many other characterization of the needs of the different neighborhoods. We applied that also in the, uh, observatory of London.
[00:35:19] In which the characterization allow us to see that the life expectancy, even in London, there is a 20 year of difference between some boroughs and other borders in Boston since, uh, the organization during the COVID-19 and the United Nation United asked me to be part of the measuring. The excess of COVID mortality at the local level.
[00:35:48] We start doing that in different cities at the neighborhood level, and we demonstrated that the main drivers of the excess of mortality for COVID actually was [00:36:00] the inequalities. And this is quite important, your question because in general, the aggregation of the data is at the national level, but you see even in the United States with the life expectancy going down, there is a main difference between Hawaii and the South states that there is 12 years of difference in the life expectancy in the last year.
[00:36:27] If we don’t de the information where the inequalities are, we never will be targeting better intervention and problem solving. Then data is important and fortunately now we have different methods. Even in India, we start using satellite imaging. Deed at a very small areas. What are some proxy indicators that allow us to see the characteristics of the inequalities?
[00:36:59] For instance, in Africa we use lighting in, uh, by night in Central America we use Alex and the roof. That they have then there is many now innovation, even in measuring not only the traditional indicators,
[00:37:19] Adele Houghton: and I just wanna say that the international perspective that Carlos is offering here is reflected throughout the book.
[00:37:26] So we tried with every example in the text and also in the boxes that are sort of highlighted to pair a US example with. Example, so it’s not a book that’s focused exclusively on the us. Having said that, a lot of my work has been focused in the US and President Obama signed an executive order early on in his first term, requiring all federal agencies to make publicly available as much data as possible.
[00:37:58] And that executive order was really. In this kind of fire hose of data that has become more and more prevalent until the past eight months when it’s all been shut off. If we pretend we’re still working in 2024, um, which this book does, because it was published before, or at least it was almost published before, there was a growing amount and variety of data sets that were.
[00:38:30] At the census tracked level for every census tracted in the us. And so when you look at the diagrams in the book, I also in the alignment process.org website have a bunch of demos of projects that I’ve worked on since writing the book that share the actual data itself and compares the census tract where the project’s located with the same data for the city, the county, the state.
[00:38:58] Us for as many of the [00:39:00] datasets as we can, and we’re able to, because of this executive order and sort of what came after, we’re able to compare demographic data with health status data, so prevalence of asthma, cardiovascular disease, cancer, mental health, et cetera, and climate vulnerability. That’s a combination of social vulnerability and infrastructure vulnerability through the FEMA Hazard Risk Index.
[00:39:25] Again, down to the census track level. And so with architectural epidemiology as an approach, we can look at, like Carlos was saying, look at the proximal and distal determinants of health. How they relate to each other through a literature review of the evidence. And it’s through that combination of analyzing what are the built-in natural environmental determinants of health and who’s there in that place and are they sensitive to that?
[00:39:54] Right? So if you are in a place that has a very extensive urban heat island. You’re also maybe a nursing home with an elderly population that’s two kind of marks of sensitivity that would make hopefully a designer think, oh, well we really need to focus on making sure that this is a building that will not warm up quickly when the power goes out during an extreme heat event.
[00:40:20] And so it’s that data at the neighborhood scale that allows us to begin to do a more. Holistic assessment of how an individual project is going to have that ripple effect on the surrounding neighborhood. I mean, I’ll just say I’m very concerned about what’s happened to our data sets, our open source data sets, because I’m not the only person that’s beginning to use them in these innovative ways and.
[00:40:48] It’s really gonna set us back. Having said that, I’ve begun to start looking outside the US frankly, because there are other countries, like Carlos was saying, that are beginning to think in the same way. Like how can we model variability at the neighborhood scale and then use that kind of combination of environmental exposures and population sensitivities to make decisions whether they’re policy decisions or design decisions.
[00:41:13] Carlos Castillo-Salgado: I think countries like the Brazil or even Catalonia in Spain, they have a very complete vision of the importance at the local determinants of health. Not only at the national level, but at at the local level. Brazil has been investing a lot of public health. Economics, but also in the demographics. They have like three epidemiological intelligence centers that are developing data at the local level and try to provide the civil society opportunities for changing the environment, but also recognizing that if they don’t address the inequalities, they’ll not solve the main problems [00:42:00] of the population.
[00:42:02] Jeff Wood: Who should pick up this book and where can they get a copy?
[00:42:05] Adele Houghton: They can get a copy at Johns Hopkins University Press website. And who should use this book? Well, we designed it, um, we actually list in the introduction. Something like 15 disciplines that would find it useful. It’s called architectural epidemiology.
[00:42:24] So I think I would say probably number one would be built environment trades, including green and healthy building consultants, but also architects and engineers. Urban planners, as you pointed out earlier, and public health folks, people who work in climate change and health and have been getting frustrated about those exact same questions about like, we keep noticing that there are all these problems with climate change and nobody is fixing them.
[00:42:47] Well, the people who I argue, the people who are like on the ground doing the work probably are the ones that are, haven’t gotten the message, and that’s the goal here is to kind of bridge. The conversations have been happening at larger scales, at the policy scale in particular, down to the project scale.
[00:43:03] And then I would say I’ve been working a lot with local communities and um, environmental justice groups. To use this data as an opportunity to begin making their case about how do they get their vision made reality, right. Well, one way to do that is to start using data and language that the developers and maybe city council are using when, like not at a community meeting.
[00:43:31] Right. And so we’ve been working through the alignment process to develop kind of talking points. Strategies, strateg, that community members can use to essentially make use of the data for their own advocacy.
[00:43:44] Jeff Wood: And where can folks find you if you wish to be found, Carlos? I am located at the Bloomberg School of Public Health in the Department of Epi.
[00:43:53] Carlos Castillo-Salgado: I am a full professor, uh, my name, it can be found in the website in Dell.
[00:44:01] Adele Houghton: Well, you can find me in a variety of places. There’s a website called architectural epidemiology.org where you can learn more about the book as well, and you can find me there. My company is called Bio Biocom. There’s the alignment process.org, which has a playbook for.
[00:44:18] Kind of a condensed version of the book that you can download for free and you can find me there. And I also teach at the Harvard School of Public Health, so you can find me on their website and at LinkedIn. And we are developing curricula based on the book for both professionals in all of those fields we mentioned, as well as academics.
[00:44:35] So if anybody listening to the podcast wants to reach out and talk about helping in that effort, would be really excited to talk to you.
[00:44:41] Jeff Wood: Awesome. Buy the book. Page 168, print it out. It’s the toolbox crosswalk. Put it on your wall.
[00:44:48] Adele Houghton: Glad you like that.
[00:44:49] Jeff Wood: Put it on your wall. It’s really important. There’s all kinds of like, really cool graphics and things in here.
[00:44:54] So I hope folks buy the book. And Carlos, Adele, thanks for joining us. We really appreciate your time.
[00:44:59] Adele Houghton: Thank you. Thank you very [00:45:00] much for inviting us. Thank you, Jeff.
