I interviewed Dr. Richard Jackson for Inside the Outbreaks, my history of the Epidemic Intelligence Service. He was a valuable resource for City on the Verge as well. Here I describe his epiphany as he saw an elderly woman walking about Buford Highway in 1999, on his way to a CDC meeting about the major causes of death:

As he drove, Jackson saw a stooped older woman, clearly suffering from osteoporosis, walking along the side of the road with heavy plastic shopping bags in each hand. She paused and looked across the road, searching for a good time to cross. “She had red hair and looked like my mother,” Jackson recalled. At his meeting, Jackson’s thoughts kept going back to the woman. “If she were to collapse,” he thought, “the cause of death would be listed as heat stroke, and there would be no mention of the upstream causes – the absence of trees, a black tar road, too many cars, too much air pollution, and lack of public transport.” And if she were hit by a truck, the cause of death would be motor vehicle trauma, not lack of sidewalks and inadequate pedestrian crossings.

That incident served as an epiphany for Jackson, who subsequently became an ardent proponent for rethinking and restructuring the “built environment,” recognizing that the way we build our cities, transportation systems, and infrastructure has a profound public health impact. In his 2012 four-part public television documentary and accompanying book, Designing Healthy Communities, he preached a New Urbanist health mantra. Children should be able to walk or ride bikes to school. A public park (as opposed to impervious blacktop) “captures rainwater, reduces pollution, raises property values, and improves physical, mental, and social well-being.” In his program, he singled out the Atlanta BeltLine as the “largest redevelopment project in the United States,” a visionary effort that would “forever change the face of Atlanta.”

Jackson sounded a near-apocalyptic alarm about the importance of such transformative projects. “Sixty-eight percent of Americans over age twenty are overweight or obese,” he wrote, “and obesity in U. S. children and adolescents has tripled in just over a generation. One in three American children is overweight.” Many developed type 2 diabetes. “If current trends are not reversed,” Jackson prophesied, “this could be the first generation of American children to have shorter life spans than their parents.”

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