Architecture & The Nations Health: Design Matters ASLA Conference Washington, DC May 7, 2003 Jamie Bussel, MPH

RWJF Mission To improve the health and health care of all Americans.

RWJF Grantmaking Goals To assure access to basic health care To assure access to basic health care To improve care for people with chronic health conditions To improve care for people with chronic health conditions To reduce the harm caused by substance abuse To reduce the harm caused by substance abuse To promote healthy lifestyles and communities To promote healthy lifestyles and communities

Health Care Determinants of Health Environmental Behavioral Social Genetic

Improvements in Health Status Only 10%-15% of preventable mortality could be avoided by improved medical care Only 10%-15% of preventable mortality could be avoided by improved medical care Increase of 7 years in Life expectancy Increase of 7 years in Life expectancy 4 years from prevention 4 years from prevention 3 years from medicine 3 years from medicine

WHY Focus on Behavior Actual Causes of Death, United States Diet/Inactivity Alcohol Microbial Agents Toxic Agents Firearms Sexual Behavior Motor Vehicles Illicit Drugs Drugs Tobacco

Physical Inactivity and Diet Account for almost 300,000 deaths or 14% of deaths per year Account for almost 300,000 deaths or 14% of deaths per year It is estimated that we save almost $77 billion dollars in health care cost by increasing physical activity levels It is estimated that we save almost $77 billion dollars in health care cost by increasing physical activity levels

Physical Inactivity is Associated With: Obesity and Overweight Obesity and Overweight Stroke and High Blood pressure Stroke and High Blood pressure Cardiovascular diseases Cardiovascular diseases Diabetes Diabetes Colon Cancer Colon Cancer