>> GOOD AFTERNOON, EVERYONE. I THINK WE'RE GOING TO GET STARTED. I'M THE DEPUTY DIRECTOR OF THE OFFICE OF DISEASE PREVENTION AT THE NIH, AND I WANTED TO WELCOME ALL OF YOU HERE TODAY TO OUR SESSION IN COLLABORATION WITH THE OFFICE OF THE SURGEON GENERAL ON TRANSLATING FROM CLINIC TO CURB SIDE. THE MIND GAPT SERIES IS A LECTURE SERIES THAT EXPLORES ISSUES ON THE INTEGRATION OF RESEARCH, EVIDENCE AND CLINICAL PRACTICE. THESE SERIES SEMINARS ARE DESIGNED TO EXPLORE THOSE AREAS WHERE CONVENTIONAL WISDOM MAY BE CONTRADICTED BY RECENT EVIDENCE. WE AIM TO ENGAGE THE NIH COMMUNITY THROUGH THOUGHT PROVOKING DISCUSSIONS TO CHALLENGE WHAT WE THINK, WE KNOW, AND TO THINK CRITICALLY ABOUT OUR ROLE IN TODAY'S RESEARCH ENVIRONMENT. PAST SEMINARS HAVE INCLUDED TOPICS THAT RANGE FROM THE ROLE OF ADVOCACY ORGANIZATIONS, POLICY TO HEALTH, AND POLICY TO HOW THE PUBLIC USES THE INTERNET IN THEIR HEALTHCARE DECISION-MAKING. THOSE ARE JUST SOME OF THE AREAS THAT WE HAVE EXPLORED IN THE PAST, AND TODAY WE'RE GOING TO BE WORKING ON A NEW TOPIC. AS A REMINDER, THERE'S A Q & A SESSION AFTER THE SPEAKERS' PRESENTATIONS. PLEASE SUBMIT YOUR QUESTIONS VIA ODP MAILBOX, AND/OR USE TWITTER AT NIH PREVENTS. WE WOULD REALLY WELCOME OUR ONLINE COMMUNITY TO BE ACTIVE PARTICIPANTS IN THIS DISCUSSION SO PLEASE SEND YOUR QUESTIONS FORWARD. WE'RE PLEASED TO BE WORKING WITH THE OFFICE OF THE SURGEON GENERAL IN THIS MIND THE GAP SEMINAR SERIES. THIS IS THE FIRST IN A SERIES THAT WE'RE PLANNING, AND WE HOPE TO EXPLORE THE SCIENCE OF PREVENTION IN COMMUNITY-BASED SETTINGS. DEVELOPMENT OF THIS PARTNERSHIP STARTED OVER A YEAR AND A HALF AGO, I STARTED WITH ONE OF THE COLLEAGUES WHO'S NOT EVEN THERE ANYMORE BUT HAPPY TO SEE THIS HAS COME TO FRUITION. THE OFFICE OF THE SURGEON GENERAL WAS INTERESTED IN FINDING A WAY TO BETTER CONNECT THE RESEARCH COMMUNITY WITH A NATIONAL PREVENTION STRIKE THAT YEE, ANSTRATEGY ANDTO UNDERSCORE THE IMPOR TANCE OF THESE POLICIES. WE BELIEVE THIS IS AN EXCELLENT FORM TO ADVANCE THESE GOALS. AS MANY OF YOU KNOW, THE ODP RECENTLY COMPLETED ITS FIRST STRATEGIC PLAN WHICH WE'RE VERY PROUD OF. OUR OFFICE PROMOTES THE OBJECTIVES OF A COUPLE OF OUR PRIORITIES, ONE FOCUSING ON THE IDENTIFICATION OF PREVENTION RESEARCH AREAS FOR INVESTMENT OR EXPANDED EFFORT BY THE NIH AND ANOTHER, PRO PROMOTE THE USE OF THE BEST AVAILABLE METHODS IN PREVENTION RESEARCH AND SUPPORT THE DEVELOPMENT OF BETTER METHODS. THESE ARE AREAS WE HOPE AS AN OFFICE WE CAN HELP PROMOTE AT THE NIH AND MORE BROADLY. THE OFFICE IS PLEASED TO HAVE DR. LARRY TABAK WITH US TODAY, PRINCIPAL DEPUTY DIRECTOR OF THE NIH WHO'S JOINED US TO SUPPORT THE ODP IN THIS NEW PARTNERSHIP WITH THE OFFICE OF THE SURGEON GENERAL AND TO HIGHLIGHT THE IMPORTANCE OF COLLABORATION BETWEEN THE NIH AND OUR FEDERAL PARTNERS TO IMPROVE PUBLIC HEALTH. DR. TABAK HAS PROVIDED LEADERSHIP FOR SEVERAL TRANSNIH ACTIVITIES, INCLUDING THE NIH ROAD MAP EFFORT TO SUPPORT TEAM SCIENCE, THE NIH DIRECTOR'S INITIATIVE TO ENHANCE PEER REVIEW, AND NIH'S IMPLEMENTATION OF THE AMERICAN RECOVERY AND REINVESTMENT ACT. HE'S ALSO CO-CHAIRED WORKING GROUPS FOR THE ADVISORY COMMITTEE TO THE DIRECTOR OF THE NIH AND THE DIVERSITY OF THE BIOMEDICAL RESEARCH WORKFORCE AND INFORMATION TECHNOLOGY, AND INFORMATICS. DR. TABAK IS CURRENTLY COORDINATING A TRANSNIH EFFORT TO ENHANCE THE REPRODUCIBILITY OF SCIENTIFIC FINDINGS. DR. TABAK IS AN ELECTED MEMBER OF THE INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMY. WE WELCOME DR. TABAK AND THANK HIM FOR JOINING US TODAY. [APPLAUSE] >> WELL THANK YOU FOR THAT VERY COMPLETE INTRODUCTION. I APPRECIATE IT. SO WE'RE VERY GLAD THAT THE NIH OFFICE OF DISEASE PREVENTION HAS TEAMED UP WITH THE OFFICE OF THE SURGEON GENERAL TO SPONSOR THIS SERIES OF SEMINARS ON THE SCIENCE OF PREVENTION IN COMMUNITY SETTINGS. NOW OF COURSE HERE AT NIH, WE'RE VERY FAMILIAR WITH THE NATIONAL PREVENTION STRATEGY, HAVING PARTICIPATED IN SOME OF THE VERY EARLY DISCUSSIONS TO DEVELOP BOTH THE STRATEGY AND THE SUBSEQUENT NATIONAL PREVENTION COUNCIL ACTION PLAN, AND A NUMBER OF INSTITUTES AND CENTERS' EFFORTS HIGHLIGHTED IN THAT ACTION PLAN. SO JUST THE SAMPLING, NIDA'S RESEARCH ON TOBACCO USE AND EFFECTIVENESS OF TOBACCO CONTROL AND PREVENTIONS, NHLBI'S EFFORTS TO DEVELOP AND DISSEMINATE CLINICAL GUIDELINES AND BEST PRACTICES ON INCREASING PHYSICAL ACTIVITY AND REDUCING THE NUMBER OF OVERWEIGHT AND OBESE INDIVIDUALS, NIMH AND OBSR'S RESEARCH ON POLICIES AND PROGRAMS THAT ENHANCE MENTAL AND EMOTIONAL WELL-BEING, ESPECIALLY FOR VULNERABLE POPULATIONS, AND THEN FINALLY NIEHS AND NCCAM'S CONTRIBUTIONS ARE ALSO REPRESENTED IN THIS PLAN. SO WE ALREADY HAVE A GOOD FOUNDATION FOR THIS SERIES, AND WE ALREADY HAVE ESTABLISHED SOME GOOD PARTNERSHIPS TO BE ABLE TO CO-SPONSOR. SO IT'S NOW MIGRATE PLEASUR MY GREAT PLEAS URE TO INTRODUCE ONE OF THOSE PARTNERS. HE'S BECOME QUITE A FAMILIAR FACE ON OUR CAMPUS THESE DAYS. THE ACTING SURGEON GENERAL OF THE UNITED STATES, REAR ADMIRAL BORIS LIS LUSHNIAK. HE COMPLETED A RESIDENCY IN FAMILY MEDICINE, AS WELL AS DERMATOLOGY, AND IS BOARD CERTIFIED IN PREVENTIVE MEDICINE, AND IS A MEMBER OF THE AMERICAN COLLEGE OF PREVENTIVE MEDICINE. SOME OF YOU KNOW, HE SPENT A NUMBER OF YEARS AT THE CDC AND THE FDA, BEFORE SERVING AS THE DEPUTY SURGEON GENERAL FROM NOVEMBER 2010 UNTIL JULY 2013, WHEN HE ASSUMED THE ROLE OF ACTING SURGEON GENERAL. HE ARTICULATES THE BEST AVAILABLE SCIENTIFIC INFORMATION TO THE PUBLIC REGARDING WAYS TO IMPROVE PERSONAL HEALTH, AND THE HEALTH OF THIS NATION. HE ALSO OVERSEES THE OPERATIONS OF THE UNITED STATES PUBLIC HEALTH SERVICE COMMISSION CORPS THAT CONSISTS OF OVER 6800 UNIFORMED HEALTH OFFICERS WHO SERVE IN LOCATIONS AROUND THE WORLD TO PROMOTE, PROTECT AND ADVANCE THE HEALTH AND SAFETY OF OUR NATION. NIH RECOGNIZES THE COMMITMENT OF THE OFFICE OF THE SURGEON GENERAL TO PREVENTION, WELLNESS, HEALTH PROMOTION, AND APPRECIATES ITS CONTINUED SUPPORT OF THE NIH MISSION AND THE EFFORTS OF PREVENTION RESEARCHERS. WITHOUT FURTHER ADO, PLEASE WELCOME THE ACTING SURGEON GENERAL, ADMIRAL BORIS LUSHNIAK. [APPLAUSE] >> THANK YOU SO MUCH, LARRY. THANK YOU. THANK YOU FOR THAT KIND INTRODUCTION AND THANK YOU FIRST AND FO FOREMOST, WE HAD A BRIEF INTERLUDE BEFORE THIS SESSION BEGAN, AND I'M JUST INTRIGUED WITH WHAT YOU'RE GOING TO HEAR, THAT DOESN'T ALLOW ME TO SIT -- WILL BE MODERATING WILL REPORT BACK. SO WHY DO I LOVE MY JOB? [AUDIO DIFFICULTIES] AND IN OUR OFFICE. MELISSA IS ON DETAIL. IT'S THE TIME OF YOUR LIFE, RIGHT? THE VARIETY -- EVEN TO THE IDEA OF -- LOVE THE NAME OF THE SERIES. MIND THE GAP. WORLD TRAVELERS KNOW IT COMES ACTUALLY FROM A REFERENCE OF THE LONDON TUBE. IT'S A SAFETY THING, RIGHT? WHERE YOU'RE WAITING THERE FOR THE TUBE, IT PULLS IN, AND THERE'S WARNINGS ALL OVER. "MIND THE GAP." MIND THE GAP BECAUSE IF YOU STEP INTO IT, YOU CAN HURT YOURSELF. IT'S A SAFETY, IT'S A PREVENTION ISSUE. BUT IN THIS CONTEXT, IT GOES BEYOND THAT. BECAUSE WHEN IT TALKS ABOUT IS WE HAVE TO MIND THE GAP. WE HAVE TO PAY ATTENTION TO THE GAP BETWEEN THE CLINIC AND THE CURBSIDE, BETWEEN WHAT'S GOING OUT IN THE RESEARCH WORLD AND HOW DO WE GET IT TRANSLATED OUT THERE? BUT AT THE SAME TIME, IT GOES IN THE OPPOSITE DIRECTION, WHICH IS WHAT'S GOING ON IN THE COMMUNITY, IN THE CURB SIDE. IT HAS TO HAVE A DIRECT CONNECTIVITY WITH THE CLINICAL WORLD, WORLD RESEARCH, SO THAT ULTIMATELY, WE CAN ACTUALLY WALK AWAY WITH INFORMATION THAT TELLS US WHAT WORKS. THE IDEA OF BEING ABLE TO SAY -- A MEDICAL GUY, A SCIENTIST. WE STARTED -- WE ALWAYS SAY OH, CASE REPORT, RIGHT, DR. TABAK? A SCIENTIST WILL SAY, THIS REPORT, A STORY OF WHAT MONTGOMERY COUNTY IS IS DOING IS A GREAT STORY, A STORY OF WHAT'S GOING ON IN PHILADELPHIA DEFINITELY YA OR AT THE URBAN LAND INSTITUTE IS A GREAT STORY. YOU HAVE TO ENTER THE NEXT PHASE OF THE 21ST CENTURY LOOKING AT THE IDEA OF EVIDENCE BASE. WE HAVE TO TAKE THOSE STORIES AND SAY OKAY, IF YOU'RE DOING SOMETHING WITH -- IF YOU'RE BUILDING -- IT WOULD BE A GREAT STORY. IT'S GOING TO BE A GREAT STORY, A GREAT DEVELOPMENT, IT'S GOING TO MAKE PEOPLE HAPPY. I ULTIMATELY NEED TO BE ABLE TO PROVE THAT IT MAKES PEOPLE HAPPY, HEALTHY, THAT IT CHANGES THE WORLD, BECAUSE THEN AND ONLY THEN WITH THAT SORT OF DATA WILL WE ACHIEVE WHAT WE WANT TO ACHIEVE, NOT JUST HAPPENING IN ONESIES AND TWOSIES THAT WE CHANGE OUR COMMUNITIES ONE AT A TIME, BUT IN FACT WE SAY THIS IS PART OF THE ANSWER TO MAKE AMERICA A HEALTHIER ENVIRONMENT. I ALWAYS BRING UP AT THIS POINT, LET'S REMEMBER, WE TALK ABOUT HEALTH, HOW DO WE LOOK AT HEALTH, AND I ALWAYS LOVE TO GO BACK TO THE WORLD HEALTH ORGANIZATION DEFINITION OF HEALTH. AND LET'S REMEMBER THAT. I OFTENTIMES AT THIS POINT TELL PEOPLE, CLOSE YOUR EYES, BECAUSE I WANT YOU TO HEAR THE WORDS, BECAUSE HEALTH -- CLOSE YOUR EYES -- HEALTH IS THE COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING AND NOT MERELY THE ABSENCE OF DISEASE OR INFIRMITY. COMPLETE PHYSICAL MENTAL AND SOCIAL WELL-BEING, AND NOT THE FACT THAT I DON'T HAVE A DISEASE. CERTAINLY IN THE WORLD OF THE BUILT ENVIRONMENT THIS, IS AN AREA THAT I'VE ONLY GOTTEN TO KNOW IN THE LAST YEAR OR SO. I'LL TELL YOU THE TRUE STORY, RIGHT? TURN GENERAL, ACTING OR NOT, YOU HAVE A LOT OF GIGS, YOU DO. I FEEL LIKE A ROCK STAR, I CALL THEM GIGS. DAD, WHAT ARE YOU DOING? I GOT THREE GIGS THIS WEEK, YEAH, I'M OUT THERE ON THE ROAD. BUT IT'S THAT WHOLE SENSE OF WE HAVE THE ABILITY IN THIS OFFICE TO PLAY THAT ROLE. SOME PEOPLE CALL IT THE NATION'S DOCTOR, THE BULLY PULPIT, WHATEVER YOU WANT TO CALL IT. ALL OF A SUDDEN THIS IS EARLY ON IN THIS ONE YEAR OF BEING IN THE ACTING POSITION WHERE I LOOK AND I'M TALKING TO THE AMERICAN INSTITUTE OF ARCHITECTS. UNLIKE OKAY, WHO SIGNED US UP FOR THIS ONE, RIGHT? WHAT DO I, A PUBLIC HEALTH PERSON HAVE TO DO AND SAY WITH ARCHITECTS, AND IT WAS THEN THAT THAT NIRVANA MOMENT CAME, WHICH IS THAT IF I STRONGLY BELIEVE IN THE NATIONAL PREVENTION STRATEGY IS TO HAVE SAFE AND HEALTHY COMMUNITY ENVIRONMENTS, RIGHT? IT'S ALL WRITTEN ALL OVER. THEN HOW DARE I NOT EXPAND MY PARTNERSHIPS TO ACTUALLY ACHIEVE THAT. BECAUSE HOW THE HECK AM I GOING TO ACHIEVE SAFE AND HEALTHY COMMUNITY ENVIRONMENTS WHEN I'M NOT TALKING WITH THE RIGHT PEOPLE? IF I DON'T TALK WITH MONTGOMERY COUNTY AND SAY OKAY, LISTEN, WHAT ARE YOU DOING AT WHITE FLINT MALL THAT ULTIMATELY IS GOING TO AFFECT THE HEALTH AND SAFETY OF THAT COMMUNITY, BECAUSE I NEED YOU TO BE IN PARTNERSHIP WITH ME AND I WOULD LOVE TO BE IN PARTNERSHIP WITH YOU, IT'S GOT TO WORK BOTH WAYS, TO ACHIEVE THE GOALS. WE TALK ABOUT THE GOALS WE LOOK AT, WE TALK ABOUT THE CONCEPT OF WALKABLE COMMUNITIES. WE TALK ABOUT CERTAIN INITIATIVES IN THE OFFICE OF THE SURGEON GENERAL TO COME OUT WITH THE CONCEPT OF, YOU KNOW, PUTTING AMERICA BACK INTO ITS SHOES, ITS WALKING SHOES. PARLT OF THISHOES. PART OF THIS IS DEALING WITH THE SOCIETY THE INDIVIDUAL LIVES IN. IF I DON'T HAVE WALKING PATHS, IF I HAVE BUSY STREETS WITHOUT CROSSINGS, I CAN'T EXPECT PEOPLE TO GO AND WALK IF IT'S UNSAFE. FROM A SOCIAL PERSPECTIVE, IF WE HAVE CRIME RIDDEN AREA, IF WE DON'T HAVE POLICE PROTECTION, I CAN'T TELL PEOPLE, OH, LISTEN, THE SURGEON GENERAL SAYS 30 MINUTES, FIVE DAYS A WEEK HAD CHANGE AMERICA. I STRONGLY BELIEVE THAT. I THINK WHEN IT COMES TO PHYSICAL EXERTION, I'VE DONE CRAZY THINGS, RIGHT? MARATHON RUNNING -- I DON'T USE MYSELF AS AN EXAMPLE BECAUSE I THINK SOMETIMES WE'RE OVERSHOOTING. LET'S START SIMPLE AGAIN. LET'S START WALKING. WE HAVE TO HAVE THOSE WALKABLE COMMUNITIES. WE HAVE TO BUILD STRUCTURES THAT, IN FACT, TAKE HEALTH INTO CONSIDERATION. WE'RE DISCUSSING THIS IN OUR SMALL GROUP. AGAIN, IT WAS ONE OF THESE AHA MOMENTS THAT HAPPENED AFTER I SPOKE WITH THE ARCHITECTS, FIVE DAYS LATER IT, I'M SPEAKING WITH THE AMERICAN PLANNING ASSOCIATION, CITY PLANNERS. COUNTY PLANNERS. THEY'RE WORKING AT THIS LEVEL AND THEY'RE DESIGNING THINGS, NOT JUST BUILDINGS, BUT THEY'RE DESIGNING WHOLE COMMUNITIES. BY THEN, I'M ON A ROLE BECAUSE THE ARCHITECTS TAUGHT ME A LESSON. I'M LIKE, DAMNIT, I'M GOING OUT THERE WITH ENTHUSIASM BECAUSE I UNDERSTAND IT. THE DESIGNER OF CENTRAL PARK SAID WHAT -- I HOPE I GOT HIS NAME RIGHT, WHAT DID HE SAY ABOUT THE PARKS, THAT IN ESSENCE, THE PARK IS THE LUNGS OF NEW YORK CITY. THE LUNGS OF NEW YORK CITY. WHAT AN INCREDIBLE SYMBOLISM, RIGHT, FOR US TO SAY THAT WE'RE BUILDING SOMETHING BECAUSE IT ALLOWS THAT COMMUNITY TO FLOURISH, TO BE DIFFERENT. SO AT THE SAME TIME THAT WE TALK ABOUT THE SENSE THAT WHERE THE GREEN MOVEMENT WAS, PERHAPS 20 YEARS AGO, I REMEMBER THE FIRST EARTH DAY, RIGHT? THIS WAS 1972 OR SO, I THINK WE JUST SAW, OR '74, JUST CELEBRATED ITS ANNIVERSARY. AND EARTH DAY WAS THAT FIRST MOVEMENT, I SAY THIS WITH ALL THE LOVE AND RESPECT BECAUSE I'M AN ENVIRONMENTALIST MYSELF, BUT THE FIRST EARTH DAYS WERE PRETTY MUCH FRINGE PEOPLE SITTING IN THE PARK BEATING ON A DRUM, RIGHT? [LAUGHTER] >> IN ESSENCE SAYING, WE HAVE TO LOOK AT THIS ENVIRONMENT, OH, MY GOD. AND NOW YEARS LATER, ALTHOUGH WE'RE STILL BEHIND THE CURVE ON CHERISHING AND LOVING OUR PHYSICAL ENVIRONMENT, OUR NATURAL ENVIRONMENT, WE HAVE MADE INCREDIBLE STRIDES. LOOK BACK AT THE ARCHITECT. IF YOU DON'T HAVE AN ARCHITECT THAT LOOKS AT THE BUILDING AND TAKES THE GREEN CONCEPT FOO CONSIDERATION, ENERGY USAGE, RIGHT, ENERGY CONSERVATION, THAT'S ALREADY EMBEDDED. YOU WANT A GARDEN ON YOUR ROOF? WE'LL PUT A GARDEN ON THE ROOF. THAT'S NO LONGER THOUGHT OF AS BEING SOMEWHERE OUT THERE. IT'S ALMOST MAINSTREAM. AND I'M LOOKING AT THAT SAME APPROACH FOR THE BUILT ENVIRONMENT THAT WE NEED TO ACHIEVE THAT. THAT AT THE SAME TIME THAT WE'RE DESIGNING OUR COMMUNITIES, OUR BUILDINGS, PERHAPS WE'RE DECIDING ON THE COLOR, IS IT THE BLUE MOVEMENT, BLUE DENOTING HEALTH, IS IT THE GOLD MOVEMENT, I DON'T CARE WHAT COLOR WE CHOOSE, WE NEED TO HAVE A COLOR. AND THAT COLOR PUTS IN THE FOREFRONT SAYING, WE NEED TO TAKE HEALTH AS PART OF THE MISSION OF OUR BUILDING OF THINGS, AND THAT IT BECOMES A FACT. IT BECOMES SOMETHING THAT WE NOW SAY, LISTEN, I'M DESIGNING A BUILDING AND IN THE OLD DAYS, THIS IS WHAT WE DID. WE PUT THE ELEVATORS IN THE MIDDLE OF THE BUILDING, WE HAD BANKS AND BANKS OF ELEVATORS, AND THEN WE BUILT STAIRWELLS ONLY TO BE USED RARELY, I'M NOT GOING TO PUT ANY LIGHTING IN THERE, IT'S GOING TO BE REALLY UGLY, AND WE'RE GOING TO PUT THEM SO OUT OF THE WAY THAT NO ONE'S GOING TO USE THEM UNLESS YOU HAVE A FIRE DRILL AND YOU'RE RUNNING DOWN THE STAIRS, RIGHT? THE OPPOSITE OF THAT IS WHAT WE WANT TO ACHIEVE, WHICH IS IN ESSENCE, BUILD YOU SOMETHING WHERE PEOPLE WALK. BUILD ME SOMETHING WHERE PEOPLE STAND AT THEIR DESKS BECAUSE IT'S THE HEALTHY THING TO DO. BUILD SOMETHING WHERE THERE'S LIGHTING, AND I GET NATURAL LIGHT COMING IN. BUILD THINGS THAT HAVE INCREDIBLE AND EFFICIENT CIRCULATION SYSTEMS SO I'M I IN A HEALTHY ENVIRONMENT. BUILD ME A COMMUNITY WHERE I'M ALLOWED TO BIKE AND WALK. BUILD ME A COMMUNITY WHERE I CAN GO TO THE STORE WITHOUT GETTING INTO MY CAR. BUILD ME A COMMUNITY THAT'S NEAR THE METRO STOP. BUILD ME ALL THESE THINGS BECAUSE BEYOND THE FACT THAT THESE ARE ALL ASSOCIATED WITH THE GREEN MOVEMENT, THEY ARE GOOD FOR PEOPLE'S HEALTH. AND IF I'M TRYING TO ACHIEVE COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING, THE BUILT ENVIRONMENT IS SUCH A KEY COMPONENT OF THAT. SO AS I'M GIVEN THE ZERO SIGN HERE, WHICH OFTENTIMES HAPPENS, I'M SORRY, I GET VERY ENTHUSIASTIC AND I'M PROBABLY A MINUTE OR TWO OVER, BUT I JUST WANT TO ENDORSE THE IDEA OF BOTH HERE FOR THE AUDIENCE IN THE ROOM AND THOSE ON THE BIG SCREEN, ON THE WEB, WHEREVER WE'RE BEING BROADCAST, THAT THE 21ST CENTURY CONCEPT TAKES THE BUILT COMMUNITY INTO CONSIDERATION. THAT THE 21ST CENTURY CONCEPT NEEDS TO BE ABLE TO ALIGN OUR MISSIONS, PART OF THE MISSION OF THE OFFICE OF THE CERTAIN GENERAL TO PROTECT, PROMOTE AND ADVANCE THE HEALTH AND SAFETY OF OUR NATION. I CAN DO THAT IN 20TH CENTURY MODES AND I'M BEHIND, I'M NEVER AHEAD OF THE CURVE, RIGHT? WE'RE STILL DEALING WITH CIGARETTES AS AN ISSUE, RIGHT? WE STILL CARRY THAT. WE CERTAINLY DEAL WITH INFECTIOUS DISEASES AS AN ISSUE, AS WE KNOW WHAT'S GOING ON. LARRY AND I WERE DISCUSSING ALL OUR ACTIVITIES THESE PAST FEW WEEKS DEAL WITH THE EBOLA ISSUE. BUT IN THE MIDST OF THAT, WE TAKE ON NEW MISSIONS. WE TAKE ON NEW PARTNERSHIPS. YES, WE SHARE THE BURDEN WITH THE THREE PANELISTS HERE, BASICALLY SAYING YOU ARE NOW DEPUTIZED TO ASSIST US IN THE HEALTH AND WELLNESS OF THE NATION. IT IS ACHIEVABLE, LADIES AND GENTLEMEN, IT IS DOABLE. WE NEED THOSE PARTNERSHIPS, WE NEED TO THINK OUTSIDE OF THE BOX, WE NEED TO MIND THAT GAP. THANK YOU SO MUCH. [APPLAUSE] -- THE CONCEPTS THAT HE'S BEEN DISCUSSING IN THE OPENING. SO I JUST WANT TO TAKE ANOTHER MOMENT TO THANK THE NIH OFFICE OF DISEASE PREVENTION FOR THE PARTNERSHIP, IT'S BEEN GREAT TO KNOW THAT THIS SEMINAR HAD BEEN IN THE PLANNING. I JUST HAVE THE BENEFIT OF COMING IN AT THE TAIL END, WHERE ALL THIS PLANNING HAS BEEN DONE, A SHOUT OUT TO OUR FELLOW ALI, AND PARIS WATSON AT NIH TO REALLY FLESH OUT THIS WORK. I ALSO WANT TO ACKNOWLEDGE FOR FOLKS WHO DON'T KNOW, WE WORK CLOSELY WITH CDC'S OFFICE OF PREVENTION STRATEGY. SO I THINK HER FOLKS ARE ALSO WATCHING THE WEBCAST AND WANT TO KNOW, IT'S BEEN GREAT TO WORK WITH ALL OF YOU BECAUSE THEY HAD THIS IDEA FOR THE SEMINAR SEVERAL MONTHS AGO. SO WE'RE JUST VERY EXCITED TO SEE HOW WE CAN BRING THE STRATEGIC DIRECTION OF REALLY CREATING HEALTHY AND SAFE COMMUNITIES FROM THE PREVENTION STRATEGY TO LIFE THROUGH THE EXAMPLES THAT YOU'LL BE HEARING. SO LET ME START BY INTRODUCING OUR PANELISTS AND HOW WE'VE SET UP THIS SEMINAR IS EACH OF THEM WILL HAVE A CHANCE TO DO THEIR PRESENTATION AND THEN IF YOU COULD SAVE YOUR QUESTIONS FOR THE DISCUSSION PORTION, WE'LL HAVE AN OPPORTUNITY TO ACTIVELY ENGAGE THEM. SO OUR FIRST SPEAKER IS DR. ALLEN GLICKSMAN, DIRECTOR OF RESEARCH AT THE PHILADELPHIA CORPORATION FOR AGING. HE HOLDS FACULTY APPOINTMENTS AT THE SCHOOL OF NURSING AT THE UNIVERSITY OF PENNSYLVANIA AND ALSO THE SCHOOL OF PUBLIC HEALTH AT DREXEL. HE HAS A BACHELOR'S FROM TEMPLE AND A PH.D. IN SOCIOLOGY FROM THE UNIVERSITY OF PENNSYLVANIA. AND HE'S BEEN AT PCA FOR ABOUT 13 YEARS. IT'S THE FEDERALLY FUNDED AREA AGENCY ON AGING, AND I LEARNED THE FOURTH LARGEST ACTUALLY IN THE COUNTRY, WHICH PROVIDES A WIDE RANGE OF PROGRAMS TO HELP OLDER ADULTS MAINTAIN THEIR HEALTH AND REMAIN IN THEIR HOMES AND NEIGHBORHOODS FOR AS LONG AS POSSIBLE. SO WE ARE VERY EXCITED TO HIGHLIGHT THE PHILADELPHIA CORPORATION FOR AGING IN OUR 2014 ANNUAL REPORT FOR THE PREVENTION STRATEGIES. AND I THINK WHAT'S BEEN REALLY GREAT ABOUT LEARNING ABOUT HIS WORK IS HE'S REALLY COMMITTED TO BRIDGING THE RESEARCH TO PRACTICE GAP AND REALLY INCORPORATING THE VIEW POINTS OF PEOPLE WHO ARE THE PRACTITIONERS AND PEOPLE LIVING THE WORK. HE HAS A NUMBER OF NOTABLE ACCOMPLISHMENTS, I'LL JUST MENTION THAT HE HAS SAFED THE RECEIVED THE JAIM A. SHANNON DIRECTOR'S AWARD FROM THE NIH AND HE'LL BE SHARING FINDINGS FROM AN NIH STUDY, WALKABILITY IMPACTS ON SENIOR HEALTH. OUR SECOND SPEAKER IS RACHEL MACCLEERLY, SENIOR VICE PRESIDENT AT THE URBAN LAND INSTITUTE. SHE LEADS THE BUILDING HEALTHY PLACES INITIATIVE, WHICH SHE'LL BE TALKING ABOUT TODAY, AND IT'S REALLY TRYING TO LEVERAGE THE POWER OF ULI'S GLOBAL NETWORKS TO SHAPE PROJECTS AND PLACES IN WAYS THAT IMPROVE THE HEALTH AND PEOPLE IN COMMUNITIES. SO IT'S TRYING TO UNDERSTAND -- THE UNDERSTANDING OF ACTION AND CONNECTION BETWEEN THE BUILT ENVIRONMENT AND HEALTH. SHE BEGAN HER CAREER AS A TRANSPORTATION PLANNER IN D.C., BUT SHE'S ALSO WORKED ON A NUMBER OF INTERNATIONAL PROJECTS IN DIFFERENT COUNTRIES. SHE HAS HER UNDERGRADUATE FROM WILLIAM AND MARY, AND A MASTER'S IN PUBLIC AFFAIRS AND PLANNING FROM THE WOODROW WILSON SCHOOL AT PRINCETON. SO SHE'LL SHARE MORE AS I SAID ABOUT THIS INITIATIVE AND THE TREMENDOUS RESOURCES THAT ARE AVAILABLE AT ULI. AND THEN OUR THIRD SPEAKER WILL REALLY BRING THE LOCAL PERSPECTIVE AROUND PLANNING, MS. GWEN WRIGHT IS THE DIRECTOR OF MONTGOMERY COUNTY'S PLANNING DEPARTMENT, SO SHE OVERSEES A WIDE RANGE OF PROJECTS THAT AIM TO IMPROVE THE QUALITY OF LIFE IN MONTGOMERY COUNTY AND REALLY CONSERVING AND ENHANCING THE NATURAL AND BUILT ENVIRONMENT. SO MONTGOMERY COUNTY FOLKS MAY KNOW WHO ARE WATCHING, BUT IT'S ONE OF THE LARGEST JURISDICTIONS IN M.D. WITH OVER A MILLION RESIDENTS, AND PRIOR TO THIS ROLE, SHE'S HAD A NUMBER OF DIFFERENT POSITIONS, ENVIRONMENTAL PLANNING, SHE ALSO WAS LEADING THE DEVELOPMENT DIVISION AT THE CITY OF ALEXANDRIA. SO SHE HAS DEGREES IN ARCHITECTURE AND ARCHITECTURAL HISTORY FROM YALE UNIVERSITY. SO CLEARLY WE HAVE AN INCREDIBLE PANEL WITH A LOT TO SHARE FROM THE RESEARCH AND PRACTICE, SO IF I COULD JUST INVITE DR. GLICKSMAN, AND HE WILL SHARE WITH YOU HIS FINDINGS. [APPLAUSE] >> THANKS FOR THE INVITATION TO SPEAK. I'M GOING TO TALK ABOUT THE WAYS IN WHICH MY AGENCY -- THE NATIONAL PREVENTION STRATEGY, FINDINGS FROM AN NIH FUNDED RESEARCH PROJECT HAVE BEEN USED TO MOVE THAT PREVENTION STRATEGY FORWARD. AS YOU ALREADY TOLD THEM, A RESEARCH SCIENTIST IN A PRACTICE SETTING WHICH HELPS EXPLAIN THE KIND OF -- WELL, YOU'LL SEE. [LAUGHTER] RETURN LET ME SAY A LITTLE ABOUT OLDER ADULTS IN PHILADELPHIA. WE START AT AGE 60, IT'S A LARGE PROPORTION OF THE CITY'S ELDERLY. ALMOST A QUARTER HAVE INCOMES LESS THAN 100% OF THE FEDERAL POVERTY LEVEL. 43% HAVE INCOMES LESS THAN -- THAT'S THE REAL POVERTY LEVEL. YOU DON'T WANT TO BE POOR, YOU'VE GOT TO BE MAKING 200% OF THE POVERTY LEVEL. 22% OF A FUNCTIONAL IMPAIRMENT INTERFERES WITH INDEPENDENT LIVING. -- THAT SHOULD HELP EX-PALESTINE PLAIN WHY WE ARE INTERESTED IN THE NATIONAL PREVENTION STRATEGY. MY JOB IS TO ASK HOW RESEARCH CAN SUPPORT THAT EFFORT. TO PUT THIS INTO SOME SORT OF CON IT TEXTCONTEXT FOR ALMOST 10 YEARS NOW -- GENERAL FOCUS HAS BEEN TO MODIFY ENVIRONMENTS, ESPECIALLY IN REGARD TO HOUSING AND TRANSPORTATION, HEALTHY FOODS AND INCREASED -- THAT MEANS THE ULTIMATE GOAL IS NOT JUST HEALTHIER OLDER ADULTS BUT HEALTHIER COMMUNITIES. AND YOU CAN SEE THAT BECAUSE OF THAT, AGE FRIENDLY GOALS ARE ALIGNED WITH THE NATIONAL PREVEPTION STRATEGY, WHICH I'LL NOW REFER TO AS THE NPS, BOTH ARE ROOTED IN THE SAME SET OF CONCERNS. IT'S ALSO IMPORTANT BECAUSE OLDER ADULTS AND THEIR NEEDS ARE SOMETIMES NOT ACKNOWLEDGED IN PUBLIC HEALTH EFFORTS. EVEN THOUGH THOSE EFFORTS ARE ENGAGING COMMUNITIES WITH OLDER ADULTS, THEY ENGAGE IN THE SAME HEALTHY BEHAVIORS AND THE SAME RISKY BEHAVIORS AS YOUNGER PERSONS, SO IT'S IMPORTANT THAT OLDER ADULTS BE INTEGRATED AND AGE-FRIENDLY KIND OF ALLOWS THAT. SO WHAT I'M GOING TO DO IS TAKE A QUICK LOOK AT THE WAGE AGE FRIENDLY HAS DEVELOPED AT PCA AND HOW IT TIES INTO THE NATIONAL PREVENTION STRATEGY, BECAUSE OUR AGE FRIENDLY EFFORTS ACROSS THE UNITED STATES, NOT JUST A PHILADELPHIA THING, IT'S UNDER THE EGIS OF THE WORLD HEALTH ORGANIZATION, IT'S ALL OVER THE WORLD, ALL OVER THE UNITED STATES, I'M USING PHILADELPHIA AS AN EXAMPLE BECAUSE IT'S WHAT I KNOW BEST. SO THE STRATEGIC -- HEALTHY AND SAFE COMMUNITIES, AGE FRIENDLY HAS ALREADY BEEN WORKING ON HOUSING AND ACCESS TO HEALTHY FOODS, CLINICAL AND COMMUNITY PREVENTIVE SERVICES, WHILE HEALTH SERVICES ARE NOT OFTEN PART OF AGE FRIENDLY EFFORTS, ACCESS TO HEALTH SERVICES ARE PART OF MOST AGE FRIENDLY EFFORTS. OLDER ADULTS ARE MORE LIKELY TO REPORT HAVING CANCELED A DOCTOR'S APPOINTMENT DUE TO LACK OF HOSPITALIZATION WHERE THE HOSPITALS ARE. OLDER ADULTS ARE FREQUENT USERS OF HOSPITALS, FOR SPECIALTY TESTS AND SO FORTH. WHAT SEEMED TO BE TRUE FROM THE MAP IS DIFFICULTY WITH TRANSPORTATION DOES NOT RELATE TO DISTANCE, IT'S RELATED TO POVERTY. KEEP THAT IN MIND, BECAUSE THAT'S WHERE WE'RE GOING WITH THIS. BACK TO THE NPS EMPOWERING PEOPLE, MOST AGE FRIENDLY EFFORTS INCLUDE ACTIVE PARTICIPATION OF OLDER ADULTS IN THE THE DESIGN AND FOCUS OF THOSE EFFORTS IN ORDER TO CREATE OPPORTUNITIES FOR THEM TO TAKE ROLES IN THEIR COMMUNITIES, AND ELIMINATION OF HEALTH DISPARITIES. THAT'S PART OF MOST AGE-FRIENDLY EFFORTS, BUT EACH EFFORT IS A LITTLE BIT DIFFERENT, WHETHER IT'S NEW YORK OR SEATTLE OR WASHINGTON OR WHEREVER, AND EACH ONE MAY PUT A LITTLE BIT OF A DIFFERENT ACCENT. OUR ACCENT IS VERY MUCH ON DISTRESSED INDIVIDUALS AND DISTRESSED NEIGHBORHOODS. BECAUSE IT'S SO CHARACTERISTIC OF PHILADELPHIA. THE OTHER THING I'M GOING TO SAY AS WE MOVE THROUGH, OUR EFFORTS ARE NOT JUST AROUND PHYSICAL HEALTH, IT'S ABOUT EMOTIONAL WELL-BEING AS WELL. WE'RE CONCERNED ABOUT EMOTIONAL HEALTH AND PHYSICAL HEALTH, THEY INTERACT WITH EACH OTHER, AND BOTH INTERACT WITH THE ENVIRONMENT. IN 2009, PHILADELPHIA INITIATED AN AGE FRIENDLY EFFORT BASED ON A MODEL FROM THE ENVIRONMENTAL PROTECTION AGENCY. YOU CAN SEE HOW THE SAME CONCERNS COME BACK AND COME BACK. THOSE ARE THE FOUR AREAS OF THE APEA MODEL. THE WOMAN IN THE PHOTOGRAPH IS THE GIS SPECIALIST WHO MADE THESE MAPS. IN 2011, PCA WON AN AWARD FROM THE EPA FOR ITS EFFORT, AND BUILDING ON THAT VERY SET OF INITIATIVE, PCA NOW COMMITTED ITSELF TO THE NATIONAL PREVENTION STRATEGY AND PRODUCED THIS DOCUMENT TO TEACH OTHER -- HOW TO INTEGRATE THE NPS INTO THEIR OWN ACTIVITIES. IN ADDITION TO THE OVERLAP YOU ALREADY TALKED ABOUT, THERE'S SOME OTHER OVERLAP IN THAT IN BOTH CASES, WE'RE TRYING TO GET ORGANIZATIONS OUTSIDE OF AGING AND OUTSIDE OF HEALTH, COMMUNITY DEVELOPMENT CORPORATIONS, TRANSPORTATION, GREENING, ALL THOSE PEOPLE INTERESTED IN ISSUES OF OLDER, FRAIL AND DISABLED PERSONS AND THEIR PLANNING, SUPPORTING SPECIFIC EFFORTS LIKE CHANGING THE ZONING CODE, WE'LL COME BACK TO THAT, LINKING THOSE GROUPS AND NETWORKS OF AGENCIES THAT SERVE OLDER ADULTS AND DEVELOPING SUPPORT AMONG THE GENERATIONS OF LEADERS, WE HAVE A GROUP BEING DUPLICATED, PEOPLE IN THEIR 20s AND 30s, ASKING THEM WHAT KIND OF CITY DO YOU WANT TO GROW OLD IN? WE BUILD THESE RELATIONS, WE SHARE MAPS, DATA, WE DO ALL KINDS OF STUFF, BUT IT'S A TWO-WAY STREET. SO WE LEARN WHAT THEIR PRIORITIES ARE AND WHAT THEY THINK THEIRS ARE. SO HOW DOES RESEARCH GET INVOLVED IN THIS? ELICITING, WORKING, SHARING, AND REALLY OUT OF ALL THESE DISCUSSIONS, THREE QUICK QUESTIONS EMERGE. ONE, WHAT TYPE OF AGE-FRIENDLY INTERVENTIONS HAVE THE GREATEST POTENTIAL OF YIELDING SIGNIFICANT IMPROVEMENT IN HEALTH? I MEAN, YOU CAN'T DO THE TRANSPORTATION AND THE HOUSING AND THE FOOD, AND IT COSTS A LOT OF MONEY, A LOT OF RESOURCES, LIMITED RESOURCES, WHERE DO YOU GET YOUR BIGGEST BANG FOR THE BUCK. TWO, WILL NEIGHBORHOODS WITH HIGH RATE OF DISTRESS BENEFIT FROM SUCH EFFORT? ARE SOME OF THOSE NEIGHBORHOODS TOO FAR GONE? THAT NO INTERVENTION IS GOING TO MAKE A DIFFERENCE? AND THREE, HOW DO YOU GAIN SUPPORT ACROSS A DIVERSE GROUP OF STAKEHOLDERS? BECAUSE YOU NEED OLDER ADULTS, YOU NEED COMMUNITY RESIDENTS, YOU NEED COMMUNITY DEVELOPMENT GROUPS, YOU NEED CITY GOVERNMENT AND STATE GOVERNMENT, YOU NEED HEALTH, YOU NEED RESEARCH. HOW DO YOU GET ALL THOSE GROUPS TO WORK TOGETHER? SO I'M GOING TO SAY A FEW WORDS NOW ABOUT OUR STUDY, WALK ABILITIES IMPACT ON SENIOR HEALTH, WHICH WAS FUNDED BY NATIONAL INSTITUTE OF -- RESEARCH OF THE NIH. TALK ABOUT HOW THE FINDINGS FROM THAT HELP DEAL WITH THOSE QUESTIONS AND MOVE THIS AGENDA FORWARD. THE PRIMARY GOAL OF THE STUDY WAS TO DEAL WITH TWO HYPOTHESES. ONE, IN A WALKABLE NEIGHBORHOOD, WHERE A PERSON REASONABLY GOOD HEALTH CAN WALK TO NEIGHBORHOOD AMENITIES AND THERE ARE FEW BARRIERS TO THOSE AMENITIES, AND HYPOTHESIS TWO, THAT THE RELATIONSHIP BETWEEN HEALTH AND NEIGHBORHOOD WOULD BE STRONGER FOR PERSONS AGED 60 AND OLDER, BECAUSE THEY SPEND MORE TIME IN THE NEIGHBORHOOD. AND WE DECIDED WE WOULD DO THIS BY COMBINING DATA FROM OMNIBUS HEALTH SURVEY OF PERSONS 18 OR OLDER, WITH SHAPE FILES CREATED FOR USE IN GIS THAT INCLUDE INFORMATION SUCH AS CRIME AND ABANDONED BUILDINGS, AND MATCH IT TO A CENSUS TRACT LEVEL. WE PLAN ON DOING A WALKABILITY SCALE, AND TAKING THAT SCALE AND APPLYING IT IN EACH NEIGHBORHOOD AND LOOKING AT THE RELATIONSHIP BETWEEN HEALTH OUTCOMES AND THAT SCORE ON THE WALKABILITY SCALE. WELL, GUESS WHAT, COULDN'T DO IT. BECAUSE AS MUCH AS WE TRIED TO CREATE A SINGLE SCALE, WE COULDN'T. THERE WERE THREE SEPARATE FACTORS, THREE SEPARATE DIMENSIONS TO WALKABILITY. OR WHATEVER YOU WANT TO CALL THIS. THE FIRST ONE HAD TO DO WITH AMENITIES. KIND OF PLACES YOU'D WANT TO WALK TO. THE SECOND HAD TO DO WITH IT DISTRESSED NEIGHBORHOODS. AND THE THINGS THAT CREATE -- MAKE A NEIGHBORHOOD DIFFICULT. AND THE THIRD ONE HAS TO DO WITH RESIDENTIAL AREAS. IN THE AMENITY -- AREAS OF HIGH AMENITIES HAD MORE PEOPLE BEING PHYSICALLY ACTIVE, LOWER BMI. IN DISTRESSED NEIGHBORHOODS, WE FOUND LESS ACTIVITY AND HIGHER BMI. AND IN THE RESIDENTIAL NEIGHBORHOODS, THERE WAS LESS CONSUMPTION OF FRUITS AND VEGETABLES. THERE WERE FEWER STORES. IT WAS HARDER TO GET TO. NOW, A GERIATRIC EXPERT TOOK A LOOK AT THIS AND SAID WAIT A MINUTE, SOMETHING BOTHERS ME HERE. ON THE FACTOR THAT HAD DISTRESSED NEIGHBORHOODS, IT ALSO HAD MURALS AND LAND WRECK RECLAMATION. SO WE LOOKED AND FOUND THAT IN VERY DISTRESSED NEIGHBORHOODS, AREAS WITH MURALS, PEOPLE WERE MORE PHYSICALLY ACTIVE. AND PEOPLE -- WHEREAS WITHOUT MURALS, PEOPLE WERE LESS PHYSICALLY ACTIVE. IN THE LESS DISTRESSED NEIGHBORHOODS, THE MURALS DIDN'T MAKE A DIFFERENCE. IT WAS ONLY IN THE MORE DISTRESSED NEIGHBORHOODS. SO I KNOW ALL THESE FINDINGS FURTHER CONFIRMATION. WE'D LIKE TO KNOW THE CITIES' ENVIRONMENTS. THIS IS WHAT WE HAVE AND THIS IS WHAT WE'VE BUILT ON. BEFORE I TALK ABOUT HOW THEY SUPPORT THE NPS, I WANT TO SAY A WORD ABOUT HOW WE SHARED OUR FINDINGS. WE DID WHATEVER ELSE DOES IN RESEARCH WHEN YOU GET MONEY FROM NIH, YOU PUBLISH, YOU DO PRESENTATIONS, INCLUDING THOSE THE AT NIH. BUT WE HAD ALL THOSE OTHER COMMUNITY PEOPLE, SO WE BORROWED AN IDEA FROM PLANNERS, AND THAT IDEA WAS A DESIGN CHARETTE. WE CREATED MAPS, WE WERE WORKING WITH A PARTICULAR COMMUNITY DEVELOPMENT CORPORATION IN A VERY DISTRESSED AREA, WE CREATED MAPS OF THAT EA IDENTIFYING WHERE ITEMS WERE THAT FELL INTO OUR ANALYSES THAT SHOWED SIGNIFICANT RELATION, AND WE BROUGHT TOGETHER COMMUNITY PEOPLE AND OLDER ADULTS AND WE BROUGHT TOGETHER ACADEMICS AND THE GOVERNMENT AND ALL KINDS OF PEOPLE TO LOOK AT THOSE MAPS, TALK ABOUT THE NEIGHBORHOOD, AND TALK ABOUT WHAT MIGHT BE DONE. THAT'S HOW WE SHARED THE FINDINGS. IT WAS ESPECIALLY IMPORTANT IN THAT NEIGHBORHOOD BECAUSE MANY OF THOSE OLDER ADULTS HAVE PROBLEMS WILL LITERACY, SO GIVING THEM LONG WRITTEN TABLES WHICH WOULD MAKE MOST PEOPLE CRAZY, BUT THEY KNEW THE NEIGHBORHOOD AND THEY KNEW THE STREETS. AND IT WAS CREATED AN OPPORTUNITY FOR THEM TO BE ACTIVE PARTICIPANTS. NOW, HOW DOES ALL THIS RELATE TO THESE AGE-FRIENDLY GOALS? WELL, IN THE FIRST PLACE, WITH HEALTH AND SAFE COMMUNITY ENVIRONMENTS, THE HINT -- AND I'M GOING TO CALL EVERYTHING HINTS BECAUSE IT IS ONE STUDY AND I KNOW ALL THE CAVEATS, BUT THE RELATION OF SPECIFIC ENVIRONMENTAL CHARACTERISTICS IS SPECIFIC HEALTH BEHAVIORS. IT'S NOT ONE SIZE FITS ALL. YOU HAVE TO THINK ABOUT WHAT SPECIFICALLY YOU WANT TO CHANGE. AND THEN THINK ABOUT THE THINGS THAT WILL LEAD TO THAT. SO SCARCE RESOURCE, YOU HAVE TO LOOK FIRST AT THE SPECIFIC GOALS. PREVENTIVE SERVICE, YOU'RE NOT GETTING OUT OF THE HOUSE, YOU'RE NOT GETTING A DOCTOR VISIT. ELIMINATION OF HEALTH CAN DISPARITIES. THAT HINT FROM THE MURALS IS THAT THERE ARE WAYS OF INTERVENING EVEN IN VERY DISTRESSED NEIGHBORHOODS, MAYBE IN ADDITION TO BRINGING IN WHAT THEY DON'T HAVE LIKE SUPERMARKETS, THERE'S ALSO SPECIFIC INTERVENTIONS THAT MAY BE EFFICACIOUS IN THOSE NEIGHBORHOODS MAY NOT BE EFFICACIOUS ELSEWHERE. AND IT'S ALSO LESS COSTLY. THERE MAY BE -- THEY HAD A THEORY AS WE GET MORE FRAIL, THE ENVIRONMENT HAS MORE EFFECT ON US BECAUSE WE HAVE LESS ABILITY TO CHANGE THE AVAILABILITY. MAYBE THAT'S TRUE FOR NEIGHBORHOODS TOO, MAYBE IN A FRAILER NEIGHBORHOOD, ATTITUDES CAN CHANGE A LITTLE BIT MORE. THE CHARETTE MODEL TURNED OUT TO BE ONE OF THE BEST IDEAS WE EVER BORROWED. OKAY? BECAUSE RATHER THAN HAVING THE FOCUS GROUP OF THE OLD PEOPLE, THE PLANNERS, THEY'RE SITTING IN THE SAME ROOM AT THE SAME TABLE, THEY'RE TALKING TO EACH OTHER, GETTING TO KNOW EACH OTHER, THEY'RE HEARING EACH OTHER'S CONCERNS, AND THAT'S A HELL OF A WAY TO BUILD BUY-IN. IT'S ONE WAY IT WAS A VERY EFFECTIVE WAY FOR US, WE'RE GOING TO DO THAT AGAIN, WE HAVE TO THINK ABOUT OTHER WAYS OF BUILDING BUY-IN BY BUILDING THOSE KINDS OF LINKS BETWEEN PEOPLE. OKAY. SO WHAT ARE WE UP TO NEXT? FIRST LET ME JUST SAY, THIS IS PROBABLY -- WHAT WE DID WASN'T THE TRADITIONAL TRANSLATIONAL MODEL, BASIC SERVICE SCIENCE TO TEST THE INTERVENTION SHARING WITH THE COMMUNITY. WE KIND OF DID SOME BASIC SCIENCE LOOKING AT VARIATIONS OF VARIABLE, SHARED THAT WITH THE COMMUNITY, NOW WE'RE DEVELOPING AN INTERVENTION, FOR LOW INTERCOM HISPANIC NEIGHBORHOODS. SO MAYBE THERE'S MORE THAN ONE WAY TO DO A TRANSLATIONAL MODEL. WE'LL ALSO DO SOME OF THE MORE TRADITIONAL STUFF WE'RE WAITING TO HEAR FROM A FOUNDATION ABOUT TRYING OUT A MODEL BEING USED IN ISRAEL SUCCESSFULLY TO KEEP OLDER ADULTS IN THEIR HOMES. WE'RE LOOKING AT ANOTHER KIND OF MODEL, ANOTHER KIND OF INTERVENTION, TO WHAT EXTENT DOES THE ENVIRONMENT INTERFERE -- WHAT IS THE ROLE OF SOCIAL WORK. SOCIAL WORK IS THE GREAT ELEPHANT IN THE ROOM WHEN YOU TALK ABOUT AGING AND HEALTH, BECAUSE THEY'RE THE ONES THAT MAKE THE DIFFERENCE MOST OF THE TIME. SOCIAL WORK IN AMEAL YOUR AGENT SOME OF THOSE EFFECTS SO THOSE OLDER ADULTS CAN COMPLETE THEIR PROTOCOLS, AND ANOTHER THING WE'RE LOOKING AT WHICH DOESN'T GET LOOKED AT A WHOLE LOT IS, THINK ABOUT THE THINGS THAT WORK. THINK ABOUT THE THINGS THAT REALLY DO WORK. WHY DO THEY WORK? WE'RE GOING TO LOOK -- THIS IS GARDENING, WE WANTED OLDER ADULTS TO DEN BECAUSE WE WANTED THEM TO EAT FRESH FROOTS AND VEGGIES, WE ASKED THEM WHY THEY GARDEN, THEY DIDN'T MENTION THAT AT ALL. THEY TALKED NUMBER ONE ABOUT THE EMOTIONAL BENEFIT. THESE ARE MOSTLY OLDER ADULTS IN THE SOUTH OR FROM ASIAN COUNTRIES THAT HAD DONE A LOT OF GARDENING. THE OTHER THING THEY SAID WHICH WAS VERY IMPORTANT, THE OVERRULED ADULTS KNEW HOW TO GARDEN, THEY WERE THE MENTORS, THEY WERE THE TEACHERS. BECAUSE THEY WILL TELL US THAT THEY ARE LOVED BUT NOT RESPECTED. AND HERE THEY WERE ALSO RESPECTED FOR THE KNOWLEDGE THEY HAD. THAT CHANGED RELATIONSHIPS TOO AND HOW WE BUILD THOSE RELATIONSHIPS BECOMES VERY IMPORTANT. ONE OTHER EXAMPLE WORKING WITH GOVERNMENT, THEY HAD A NEW ZONING CODE AND A NEW PLANNING DISTRICT, WE'RE WORKING WITH THAT, TURNED OUT WE HAD NIFTY IDEAS FOR THE ZONING CODE, BUT WE RAN UP AGAINST ISSUES THAT HAD NOTHING TO DO WITH AGING, UNDERSTANDING EVERYBODY ELSE'S AGENDA, IT'S NOT NECESSARILY OUR AGENDA. WE WORKED WITH CITY PLANNING, ENVIRONMENT, TRANSPORTATION, AND WE WORKED WITH THE PARKS DEPARTMENT TO MODIFY WHO AGE-FRIENDLY CHECKLISTS IN ORDER TO MAKE IT APPLICABLE TO PHILADELPHIA, PHILADELPHIA HAS A LOT OF PARKS, WE WANT MORE OLDER ADULTS TO USE THEM. SO IN CONCLUSION, WHAT CAN I SAY? ONE, THE BASIC RESEARCH IN SOCIAL SIGH SENSES CAN BE AN IMPORTANT PART OF HEALTH PROMOTION. IT'S NOT JUST THE INTERVENTION. IT'S UNDERSTANDING WHAT THOSE RELATIONSHIPS ARE. TWO, RESEARCH HAS TO BE A DYNAMIC RELATIONSHIP WITH LOCAL AGENTS OF CHANGE IN THE ENVIRONMENT. EVERYTHING CAN'T BE A NATIONAL PROBABILITY STUDY. YOU'VE GOT TO LISTEN TO THE LOCAL PLANNERS, THE LOCAL GOVERNMENT, THE LOCAL AGENCIES, THE PEOPLE THAT ARE RESPONSIBLE, WE HAVE ALL KINDS OF GREAT IDEAS THAT ARE SIMPLY NOT GOING TO WORK IN SOME COMMUNITIES AND WORK WELL IN OTHERS. YOU'VE GOT TO KNOW THE DIFFERENCE, YOU'VE GOT TO BE SURE OF WHAT YOU'RE TRYING TO GET AT. AND FINALLY, THE NEED TO UNDERSTAND THE WIDER ENVIRONMENTAL CONTEXT, AND I MEAN THE PHYSICAL, SOCIAL ENVIRONMENT, BUT I ALSO MEAN THE POLITICAL ENVIRONMENT. BECAUSE YOU'RE TALKING ABOUT THE KINDS OF CHANGES THAT SOONER OR LATER ARE GOING TO INVOLVE LOCAL GOVERNMENT, MUNICIPAL GOVERNMENT, COUNTY GOVERNMENT, STATE GOVERNMENT, AND IF YOU DON'T UNDERSTAND HOW THOSE THINGS WORK, ALL THOSE GOOD IDEAS ARE GOING TO GO ON TO NAUGHT. SOMEBODY WAS AT A CONFERENCE RECENTLY TALKING ABOUT CHANGING NEIGHBORHOODS IN PHILADELPHIA, AND THEY ASKED SOMEBODY FROM CITY GOVERNMENT, WHAT IS THE MOST IMPORTANT THING TO KNOW -- WHAT IS THE MOST IMPORTANT FACTOR IN DECIDING WHETHER CHANGE WILL HAPPEN? AND SHE SAID, WHO'S YOUR CITY COUNCILMEN? SO WITH THAT, I WANT TO THANK YOU FOR LISTENING AND TURN TO OUR NEXT SPEAKER. [APPLAUSE] >> BEFORE THEY COME ON STAGE, I THINK DEFINITELY DR. GLICKSMAN HAS GIVEN US A LOT TO THINK ABOUT AROUND THE RESEARCH QUESTIONS AND THE APPROACH HE'S BEEN USING. NOW WE GET TO HEAR A BIGGER, BROADER POLICY AND PLANNING PERSPECTIVE AND WHAT'S HAPPENING NATIONALLY AS WELL. >> GREAT. THANKS. WONDERFUL. SO I'M RACHEL MACCLEERLY, I'M WITH THE URBAN LAND INSTITUTE, AND I AM JUST DELIGHTED AND HONORED TO BE HERE. SO THANK YOU VERY MUCH TO NIH FOR HAVING ME HERE. SO I'M GOING TO SHARE A LITTLE BIT ABOUT ULI'S BUILDING HEALTHY PLACES WORK, BUT FIRST I WANTED TO GIVE YOU SOME INFORMATION ABOUT THE URBAN LAND INSTITUTE. ANYBODY HERE HEARD OF ULI BEFORE, ANY MEMBERS? GREAT. SO ULI IS A RESEARCH AND EDUCATION NON-PROFIT. OUR MISSION IS PROVIDE LEADERSHIP IN THE RESPONSIBLE USE OF LAND AND IN CREATING AND SUSTAINING THRIVING COMMUNITIES WORLDWIDE. WE DO THAT IN A VARIETY OF WAYS, THROUGH CONVENINGS AND RESEARCH, BEST PRACTICES, EDUCATION, BUT PRIMARILY THROUGH OUR ENIMAIJMENENGAGEMENTWITH OUR MEMBERS. GLOBALLY ULI HAS 33,000 MEMBERS. MANY OF THOSE ARE LOCATED HERE IN THE UNITED STATES, BUT WE HAVE A GROWING PRESENCE IN ASIA AND EUROPE AND LATIN AMERICA, AND OUR MEMBERS ARE INVOLVED IN VARIOUS FACETS OF THE REAL ESTATE INDUSTRY AND LAND USE FIELD. SO OUR MEMBERS ARE DEVELOPERS, REAL ESTATE DEVELOPERS, PEOPLE WHO BRING PROJECTS OUT OF THE GROUND, ARCHITECTS, PLANNERS, PUBLIC SECTOR PEOPLE, AND OUR MEMBERSHIP, WE HAVE SOME PUBLIC SECTOR MEMBERS BUT A LOT OF OUR MEMBERS ARE IN THE PRIVATE SECTOR. SO I THINK THAT'S A LITTLE BIT OF A UNIQUE NICHE FOR US IN THIS CONVERSATION, ULI IS REALLY THINKING ABOUT HOW DO WE ENGAGE PEOPLE WITH A PRIVATE SECTOR SPER SPECULATIVPERSPECTIVE IN CONVERSATION S ABOUT HEALTH. THE BUILDING HEALTHY PLACES INITIATIVE WAS LAUNCHED BY THE ULI BOARD OF DIRECTORS ABOUT TWO YEARS AGO, AND THE INITIATIVE IS WORKING TO LEVERAGE THE POWER OF ULI' I'S GLOBAL NETWORKS TO SHAPE PROJECTS AND PLACES IN WAYS THAT IMPROVE THE HEALTH OF PEOPLE AND COMMUNITIES. THE BOARD OF DIRECTORS CHOSE HEALTH AS A CENTRAL FOCUS FOR THE ORGANIZATION BECAUSE THEY LOOKED AT SOME TROUBLING HEALTH TRENDS THAT I'LL EXA EXAMINE IN A MINUTE AND REALIZED THAT ULI AND ITS MEMBERS NEEDED TO DO MORE. WE NEEDED TO BE A BIGGER PART OF THE SOLUTION AND OUR MEMBERS REALLY NEEDED TO FOCUS ON HEALTH AND EXERCISE LEADERSHIP ON HEALTH. IN ORDER TO DO THAT, WE REALLY UNITED OUR PROGRAM OF WORK AND HAVE DONE A VARIETY OF THINGS TO TRY TO ENGAGE OUR MEMBERS AND BRING THEM ALONG IN UNDERSTANDING ABOUT HEALTH. SOME OF OUR MEMBERS ARE LEADERS IN THE FIELDS AND HAVE DONE A LOT OF WORK, AND TO SOME OF THEM, HEALTH WAS REALLY A NEW CONSIDERATION. IT WASN'T SOMETHING THAT THEY HAD THOUGHT ABOUT. AND AS ADMIRA THE GOAL IN 10, 20 YEARS, HEALTH COULD BE AS MAINSTREAM AND GREEN FOCUSES ARE. HEALTH IS ONE OF THE TRENDS I'M SURE YOU'RE VERY AWARE OF, THE FACT THAT AMERICAN CHILDREN TODAY MAY HAVE A SHORTER LIFE EXPECTANCY THAN THEIR PARENTS FOR THE FIRST TIME IN HISTORY AS A RESULT OF GROWING INACTIVITY AND OBESITY. THE GROWING FRACTION OF GDP THAT'S BEING TAKEN UP BY HEALTHCARE SPENDING. AND WE KNOW THAT THERE'S A LOT OF DIFFERENT THINGS THAT ARE GOING ON WHEN IT COMES TO THE HEALTH PICTURE. MANY DIFFERENT THINGS ARE AT PLAY. MEDICAL CARE A KEY COMPONENT, PERSONAL BEHAVIOR, GENES, ACCESS TO ECONOMIC OPPORTUNITY, BUT LIVING AND WORKING CONDITIONS IN HOMES AND COMMUNITIES, WHAT WE CALL THE BUILT ENVIRONMENT, IS A KEY FACTOR IN THAT. IT'S NOT THE ONLY THING AT PLAY, BUT IT'S SOMETHING THAT OUR MEMBERS KNOW ABOUT, THEY CARE ABOUT AND THEY CAN DO SOMETHING ABOUT. AND SO THAT'S WHERE WE'VE BEEN FOCUSING OUR ATTENTION. THE PURSUIT OF WEALTH AND COMFORT, WE HAVE MANAGED TO DESIGN PHYSICAL ACTIVITY OUT OF EVERYDAY LIFE. YOU CAN GET AROUND TODAY IN AMERICA WITHOUT A WHOLE LOT OF PHYSICAL EFFORT. IT'S JUST ONE PLACE WHERE THE SHAPE OF THE BUILT ENVIRONMENT IMPACTS HEALTH. OPPORTUNITIES FOR SOCIAL ENGAGEMENT, ACCESS TO HEALTHY FOOD, DRINKING WATER, AIR QUALITY, ALL OF THOSE THINGS ARE INFLUENCED AND AFFECTED BY THE WAY THAT OUR COMMUNITIES ARE BUILT. AND DESPITE THE WAY THAT MANY PLACES HAVE BEEN BUILT RECENTLY, WE KNOW HOW TO DO THINGS BETTER. WE KNOW THAT COMMUNITIES CAN BE BUILT WITH A HEALTH FOCUS OR A HEALTH CENTER FACILITY IT AT THE CORE. THAT HOMES, AFFORDABLE HOUSING, CAN BE BUILT IN WAYS THAT ADDRESS ASTHMA SYMPTOMS IN CHILDREN, AND THESE ARE BREATHE EASY HOMES IN SEATTLE THAT WERE BUILT WITH CAREFUL ATTENTION TO VENTILATION AND BUILDING MATERIALS AND HAVE HAD A DEMONSTRATED IMPACT ON ACUTE ASTHMA SYMPTOMS AMONG THE LOW INCOME CHILDREN THAT LIVE THERE. WE CAN BUILD MULTIFAMILY HOUSING AND APARTMENTS IN WAYS THAT PROMOTE RECREATION AND ACCESS TO NATURE AND THAT PROMOTE SOCIAL ENGAGEMENT AND COMMUNITY GATHERING, AND WE CAN BUILD MASTER PLAN COMMUNITIES LIKE MUELLER AND AUSTIN, TEXAS IN WAYS THAT PROVIDE A RANGE OF DIFFERENT TRANSPORTATION OPTIONS FOR PEOPLE, SO YOU DON'T JUST HAVE TO GET IN THE CAR TO GET AROUND. ALL OF THESE PRODUCTS HAVE BEEN FEATURED IN ULI'S VARIOUS PUBLICATIONS IF YOU'D LIKE TO READ MORE ABOUT THEM. SO THROUGH THE BUILDING HEALTHY PLACES INITIATIVE, WHICH AS I MENTIONED WE LAUNCHED ABOUT TWO YEARS AGO, WE ARE FOCUSING ON FOUR BROAD AREAS OF IMPACT. WE'RE WORKING TO RAISE AWARENESS AMONG OUR MEMBERSHIP ABOUT CONNECTIONS BETWEEN HEALTH AND THE BUILT ENVIRONMENT, HELPING THEM TO UNDERSTAND HOW THEY MIGHT CHANGE PRACTICE IN ORDER TO IMPROVE HEALTH OUTCOMES FOR THE PEOPLE THAT LIVE, WORK AND VISIT IN OUR COMMUNITIES AND PROJECTS. EXPLORING THE VALUE PROPOSITION AND MAKING THE MARKET CASE SO PEOPLE UNDERSTAND WHAT BENEFITS CAN ACCRUE BOTH TO THE PRIVATE SECTOR AND THE COMMUNITY AT LARGE, THE COMMUNITIES WHEN WE'RE SPENDING LESS MONEY CARING FOR ACUTE DISEASES AND CHRONIC DISEASE. AND OVERALL ADVANCING THE STATE OF POLICY AND PRACTICE. WE'VE BEEN FORTUNATE IN THIS WORK TO HAVE THE PARTNERSHIP OF A COUPLE OF IMPORTANT FOUNDATIONS, THE COLORADO HEALTH FOUNDATION HAS BEEN AN IMPORTANT PARTNER WITH US, AND MORE RECENTLY WE'RE PARTNERING WITH THE ROBERT WOOD JOHNSON FOUNDATION ON A PROJECT THAT I'LL TALK ABOUT A LITTLE BIT LATER. WE REALLY SEE OUR MEMBERS AS THE LEVER FOR CHANGE. OUR MEMBERS AS I TALKED ABOUT ARE INVOLVE THE IN DESIGNING, SHAPING, INVESTING IN REAL WILL STATREALESTATE INVESTMENT PROJECTS. WE SEE THREE OPPORTUNITIES FOR ULI MEMBERS TO LEAD. ONE IS THROUGH LEADERSHIP OF THEIR ORGANIZATIONS AND COMPANIES, THINKING ABOUT WORK-LIFE BALANCE, TRANSPORTATION POLICIES AND OTHER THINGS. THE AMENITIES THAT THEY PROVIDE FOR EMPLOYEES ON SITE. THROUGH THEIR INVESTMENT IN PROJECT DECISIONS, WE'VE DONE A LOT OF WORK ON THIS SIDE AND I'LL SHARE A LITTLE BIT ABOUT AN EXAMPLE OF HOW THAT'S PLAYING OUT. SO HELPING THEM TO UNDERSTAND WHAT THEY CAN DO WHEN THEY'RE DESIGNING A PROJECT AS THE ADMIRAL MENTIONED, YOU CAN PUT A STAIRWELL, FOR EXAMPLE, IN A PROMINENT PLACE AND NOT HIDE IT IN THE BACK, SO THAT PEOPLE CAN GET INTO PHYSICAL ACTIVITY. ALSO THROUGH THEIR INFLUENCING COMMUNITIES. A LOT OF OUR ULI MEMBERS ARE LEADERS AT THE CITY SCALE, AND THEY CAN BRING AWARENESS OF HEALTH ISSUES AND HEALTH OPPORTUNITIES TO THEIR COMMUNITY ENGAGEMENT AND ADVOCACY WORK. I JUST WANT TO SHARE A STORY OF HOW THIS IS PLAYING OUT IN AN APPLIED WAY WITH ONE OF OUR MEMBERS. SUSAN POWERS IS THE PRESIDENT OF A PRIVATE DEVELOPMENT COMPANY IN DENVER, COLORADO CALLED URBAN VENTURES, AND SHE PARTNERED WITH THE DENVER HOUSING AUTHORITY, WHICH HAS BEEN A KEY LEADER HAD THIS FIELD, AND SHE HELPS WITH A PROJECT THEY WERE WORKING ON CALLED MAYOR POE I MARIPOSA, A VERY AMBITIOUS PROJECT THAT PROBABLY SOME FOLKS ARE AWARE OF, HAS HAD A VERY DEEP AND DELIBERATE FOCUS ON HEALTH AND IMPROVING HEALTH OUTCOMES FOR THOSE PEOPLE. AND THROUGH THAT ENGAGEMENT WITH MA RCHT IPOSA AND THE DENVER HOUSING AUTHORITY, SHE REALLY HAD HER EYES OPEN TO THE IMPORTANCE OF HEALTH. NOW HEALTH HAS BECOME A KEY PART OF HOW SHE THINKS ABOUT HER DEVELOPMENT WORK, AND AS I MENTIONED, SHE'S A FOR-PROFIT PRIVATE DEVELOPER, BUT SHE DOES AFFORDABLE HOUSING PROJECTS AS WELL. AREA IS A PLACE WHERE A LOT OF THOSE IDEAS ARE SORT OF COMING INTO PLAY, SO DEVELOPMENT PROJECT, A 17-ACRE SITE IN SOUTHWEST DENVER, IT'S BEING DEVELOPED ON THE SITE OF A CONVENT SO SHE'S WORKING WITH NUNS THERE, AND THE VALUES OF THE NUNS HAVE REALLY BEEN REFLECTED IN THE DEVELOPMENT PLAN THAT THEY'VE PUT TOGETHER. IT'S HARD TO READ, BUT THERE'S A COMPREHENSIVE FOCUS ON HEALTH IN THIS PROJECT. SO THERE'S AN EMPHASIS ON FOOD, THERE WILL BE A PRODUCTION GARDEN, IN PARTNERSHIP WITH REGIS UNIVERSITY, SO SOME OF THE FOOD WILL BE FOR SALE AT REGIS' CAFETERIA. THERE ARE ADULT FITNESS EQUIPMENT FACILITIES THAT ARE BEING SET UP, AND AN INTERESTING THING WITH AREA IS THAT SUSAN -- THIS IS KIND OF A WEIRD SOUND. SHOULD I USE ONE OR THE OTHER? OKAY. SO THE ADULT FITNESS EQUIPMENT. THE IMPORTANT THING HERE IS THAT SUSAN DOESN'T JUST THINK ABOUT HER PROJECT'S FOOTPRINT. SHE'S ALSO THINKING ABOUT HOW SHE CAN BENEFIT THE HEALTH OF THE NEIGHBORING COMMUNITY WHICH IS A VERY MODEST INCOME COMMUNITY IN DENVER. SO A LOT OF THIS INVESTMENT IS GOING ON NOT JUST IN THE 17 ACRES OF ARE BUT OUTSIDE, SO THERE'S A PARK THAT'S BEING BUILT ADJACENT TO -- THAT THEY'RE HELPING TO UPGRADE ADJACENT TO THE SITE. THERE WILL BE A CLINIC THAT HELPS TO ANCHOR THE FACILITY, ANCHOR THE CAMPUS, AND THAT CLINIC WILL PROVIDE OPPORTUNITIES FOR REGIS UNIVERSITY STUDENTS TO PRACTICE, TO GET TRAINING. THERE WILL BE NUTRITION AND FIT NENESS CLASSES, BICYCLE INFRASTRUCTURE, AND WAY FINDING. THIS WAY FINDING IS THE NOT JUST ON THE 17-ACRE CAMPUS BUT ALSO OUTSIDE OF THE SITE. SUSAN HAS ALSO PARTNERED WITH THE COLORADO HEALTH FOUNDATION, WHICH IS HELPING TO PROVIDE FUNDING FOR SOME OF THE ELEMENTS OF THIS PROJECT. SO HERE'S SOME PICTURES. ARIA IS RIGHT NOW UNDER KOND STRUX. SO WE HAVE A COUPLE PUBLICATIONS WE'LL TALK WITH LATER, IT'S NOT IN ANY OF THOSE BUT IT'S AN AMAZING PROJECT AND WE'LL BE SURE TO DOCUMENT IT AS WE GO FORWARD. SO THESE ARE THE PRODUCTION GARDENS ON THE GROUND OF ARIA. ARIA HAS A STRONG AFFORDABLE HOUSING COMPONENT, SO THERE ARE INCOME RESTRICTED HOUSING THAT'S BEING ALLOCATED BY LOTTERY, AND THESE ARE APARTMENTS. HERE'S ANOTHER VIEW OF THE AFFORDABLE HOUSING. IF THERE'S ANYTHING THAT WE'VE LEARNED IN ALL OF THESE YEARS OF BUILDING COMMUNITIES, IT'S THAT MIXED INCOME COMMUNITIES FUNCTION AND WORK BEST, SO THERE'S ALSO FOR SALE MARKET RATE HOUSING ON THE SITE. THIS IS A PICTURE OF THE TOWNHOUSE UNITS THAT ARE FOR SALE. AND THE MARKET RESPONSE TO THESE THESE -- FOR THESE UNITS HAS BEEN VERY STRONG AND HAS EXCEEDED SUSAN'S EXPECTATIONS, SO IN THE D.C. AREA, THESE WOULD NOT BE A HIGH PRICEPOINT, BUT FOR THIS MARKET, THEY'RE SELLING FOR ABOUT 300 OR $350,000, WHICH IS A GOOD -- AT THE TOP OF WHAT SUSAN COULD HAVE EXPECTED, AND FOR HER, I THINK THAT AI AFFIRMS DEMAND FOR THESE KINDS OF PLACES AND THE DESIRE THAT PEOPLE HAVE TO LIVE IN PLACES THAT REFLECT THEIR VALUES AND THAT RESPOND TO THE WHOLE PERSON. BY LIVING HERE, PEOPLE CAN PARTICIPATE IN ALL OF THESE AMAZING AMENITIES THAT THEY'VE DELIVERED. SUSAN IS ALSO ON THE BOARD OF DENVER HEALTH, SO SHE BRINGS THE HEALTH P PERSPECTIVE THAT SHE GETS FROM BEING ON THE BOARD TO HER DEVELOPMENT WORK AND VICE VERSA. THIS IS JUST -- ARIA IS AN AMAZING PROJECT, SUSAN IS AN AMAZING DEVELOPER, AND WE SHARE THE STORIES OF OTHER PEOPLE THAT ARE DOING INCREDIBLE WORK AT THE NEXUS OF REAL ESTATE DEVELOPMENT AND HEALTH IN SOME OF OUR RECENT PUBLICATIONS. THERE ARE SOME COPIES HERE AND A FLYER FOR FOLKS THAT WANT TO GET MORE INFORMATION ABOUT THEM. THIS SORT OF LAYS OUT SOME OF THE GENERAL CONNECTIONS BETWEEN HEALTH AND COMMUNITY, 10 PRINCIPLES FOR BUILDING HEALTHY PLACES. AGAIGWEN IS GOING TO TALK A LITTLE MORE ABOUT THAT ONE. BUILDING FOR WELLNESS INCLUDES PROJECT PROFILES, REAL ESTATE PROJECTS, WHAT THEY DID TO PROMOTE HEALTH AND WHAT THE MARKET RESPONSE HAS BEEN, AND HOUSING IN AMERICA LOOKS AT CONNECTIONS BETWEEN HEALTH RYE RESILIENCE IN AMERICA. WE'VE ALSO PARTNERED WITH OTHER ORGANIZATIONS INCLUDING THE AMERICAN INSTITUTE OF ARK ARCHITECTS ARCHITECTS. AIA AND MCGRAW-HILL DID A STUDY OF MARKET DRIVERS, SO THIS IS LOOKING AT PARTICULAR BUILDINGS, WHAT ARE THE DEMOGRAPHIC TRENDS THAT ARE DRIVING THAT FORWARD. AND ONE OF THE KEY FINDINGS HERE IS THAT PHYSICIANS ARE NOT FOCUSED ON BUILDINGS, AND THE IMPACT OF BUILDINGS ON HEALTH. SO ONLY ABOUT HALF OF PEDIATRICIANS AND A THIRD OF GENERAL PRACTITIONERS WERE CONVINCED THAT BUILDINGS HAD AN INFLUENCE ON THE HEALTH OF BUILDING OCCUPANTS. AND THAT'S IMPORTANT BECAUSE THE STUDY ALSO FOUND THAT HOMEOWNERS ARE NOT LIKELY TO TURN TO REAL ESTATE PROFESSIONALS, PLANNERS, DEVELOPERS, ARCHITECTS, FOR INFORMATION ABOUT HEALTH AND HOMES. THEY ARE LIKELY TO TURN TO FRIENDS AND PEERS AND TO THE MEDICAL PROFESSIONAL. SO I THINK THAT POINTS OUT THE NEED FOR INCREASED AWARENESS ABOUT CONNECTIONS BETWEEN HEALTH AND THE BUILT ENVIRONMENT. DR. JACKSON, WHO IS A LEADER IN THIS FIELD, HE SERVES US ON OUR BUILDING HEALTHY PLACES ADVISORY GROUP AT ULI. HE HAS MADE THE YOU A DAITION STATEMENT THAT DEVELOPERS CAN BE MORE EFFECTIVE IN ACHIEVING PUBLIC HEALTH AND THAT DOCTORS IN WHITE COATS. I DON'T KNOW IF THE DOCTORS IN THE ROOM AGREE WITH THAT OR NOT. BUT I WANTED TO PUT THAT UP THERE BECAUSE I THINK, YOU KNOW, THIS IS PART OF OUR TASK AT ULI, IS TO GET DEVELOPERS TO THINK ABOUT THE ROLE THAT THEY PLAY IN PROMOTING HEALTH ON A DAY-TO-DAY BASIS IN THEIR PROJECTS. I'D LIKE TO CHALLENGE THE PUBLIC HEALTH PRACTITIONERS TO THINK OF THEMSELVES AS STEWARDS OF THE BUILT ENVIRONMENT. ALL OF US HAVE A ROLE TO PLAY IN MAKING SURE THAT THE COMMUNITIES THAT PEOPLE LIVE IN, THE BUILDINGS THAT WE CALL HOME ARE AS HEALTH PROMOTING AND HEALTH CONDUCIVE AS POSSIBLE. WE ALL HAVE A RESPONSIBILITY TO MAKE THE HEALTHY CHOICE, THE EASY CHOICE, AND WE SHOULD ALL BE APPALLED AT CONDITIONS LIKE THIS. IT SHOULD NOT BE DANGEROUS AND UNSAFE FOR PEOPLE TO CROSS THE STREET, TO GET THEIR DAILY NEEDS MET, OR TO ACCOMPLISH PHYSICAL ACTIVITY AND EXERCISE. WE CAN DO BETTER. WE CAN HAVE COMMUNITIES THAT ARE CONDUCIVE TO A LOT OF DIFFERENT TRANSPORTATION OPTIONS, AND ULI HAS ENDORSED THE URBAN STREET DESIGN GUIDE BY THE NATIONAL ASSOCIATION OF CITY TRANSPORTATION OFFICIALS THAT LAYS OUT VERY SPECIFIC STRATEGIES FOR MAKING SURE THAT TRANSPORTATION STREETS AND NETWORKS ARE SAFE AND HEALTHY FOR ALL USERS. TOGETHER, WE CAN BUILD PLAY SPACES FOR CHILDREN THAT ACCOMMODATE ALL KINDS OF USERS. WE CAN BUILD CITIES THAT FACILITATE SOCIAL ENGAGEMENT AND THAT BRING PEOPLE TOGETHER THAT LEVERAGE NATURAL ASSETS, AND WE CAN BUILD PLACES THAT PROVIDE ACCESS TO HEALTHY FOOD, REGARDLESS OF INCOME LEVELS. ADMIRAL LUSHNIAK REMINDED US THAT HEALTH, AS THE WORLD HEALTH ORGANIZATION SAYS, IS NOT THE ABSENCE OF DISEASE OR INFIRMITY BUT A COMPLETE STATE OF PHYSICAL, SOCIAL AND MENTAL WELL-BEING. THAT'S DEFINITELY WHERE ULI IS FOCUSED WITH THE INITIATIVE AND I LOOK FORWARD TO THE DISCUSSION LATER ON. THANKS. [APPLAUSE] >> THANK YOU SO MUCH. CERTAINLY A LOT TO THINK ABOUT AND EXCITING TO SEE ALL THE DIFFERENT PLACES ACROSS THE CAN COUNTRY THAT ARE STARTING TO REALLY EMBRACE THIS APPROACH. SO WE'RE REALLY FORTUNATE TO HAVE GWEN WRIGHT HERE TO SHARE WHAT'S HAPPENING LOCALLY IN MONTGOMERY COUNTY AND HOW THEY'RE REALLY PROMOTING THESE POLICIES AS WELL. >> THANK YOU. I'M WITH THE M.D. NATIONAL CAPITAL PARK AND PLANNING COMMISSION IN THE MONTGOMERY COUNTY PLANNING DEPARTMENT, AND THIS SERIES IS CALLED "FROM CLINIC TO CURBSIDE." I'M THE CURBSIDE. I AM WHERE THE RUBBER MEETS THE ROAD, SO TO SPEAK, AND WE ARE WORKING TO PUT A LOT OF THE IDEAS THAT HAVE BEEN DISCUSSED TODAY INTO EFFECT. FOR THOSE OF YOU WHO DON'T KNOW A LOT ABOUT MONTGOMERY COUNTY, IT'S OVER A MILLION PEOPLE IN POPULATION, IT'S OVER 300,000 ACRES IN SIZE, IT HAS PORTIONS OF THE COUNTY THAT ARE VERY, VERY URBAN AND IT HAS PORTIONS OF THE COUNTY THAT ARE VERY RURAL. OUR PLANNING DEPARTMENT IS NATIONALLY RECOGNIZED WITH OVER 140 PLANNING PROFESSIONALS IN THE FIELDS OF ARCHITECTURE, LANDSCAPE ARCHITECTURE, RESEARCH, TRANSPORTATION PLANNING, ENVIRONMENTAL PLANNING. WE SORT OF TOUCH A LOT OF DIFFERENT TOPICS. SO AS WE'VE HEARD, HEALTH IS NOT JUST A BYPRODUCT OF HOW WE LIVE, IT'S ALSO RELATED TO WHERE WE LIVE. AND THE HEALTHY ENVIRONMENT MAKES IT EASY FOR RESIDENTS TO ADOPT A HEALTHY LIFESTYLE. THINKING ABOUT THE RELATIONSHIP BETWEEN HEALTH AND THE BUILT ENVIRONMENT IS NOT NEW. IN THE 19THTH AND 20TH CENTURIES, ARCHITECTS AND PLANNERS IN LONDON, NEW YORK, AND PARIS JOINED WITH PUBLIC HEALTH OFFICIALS AND SOCIAL REFORMERS TO REDUCE INFECTIOUS DISEASES BY DESIGNING BUILDINGS, STREETS, PARKS, NEIGHBORHOODS AND CLEAN WATER SYSTEMS TO IMPROVE HEALTH. NOW THE BUILT ENVIRONMENT AND HOW WE PLAN IT IS ONCE AGAIN CONSIDERED AN IMPORTANT PART OF THE SOLUTION TO TODAY'S PUBLIC HEALTH CHALLENGES SUCH AS THE OBESITY EPIDEMIC. I LOVE THE URBAN LAND INSTITUTE. I'M A MEMBER, AND I THINK THAT THEIR WORK ON HEALTHY PLACES IS FANTASTIC. THEY'VE DEVELOPED, AS RACHEL MENTIONED, 10 PRINCIPLES FOR BUILDING HEALTHY PLACES, AND THESE ARE THE PRINCIPLES. I THINK THEY ARE SPOT-ON, AND THEY GUIDE US IN A LOT OF OUR PLANNING ACTIVITIES. WHAT WE FIND IS WHEN WE THINK ABOUT PUTTING PEOPLE FIRST IN PLANNING, IT RELATES NOT ONLY TO HOW WE LAY OUT COMMUNITIES, BUT REALLY THE ACTUAL STRUCTURE OF OUR STREETS CREATING COMPLETE STREETS THAT ARE NOT JUST TO ACCOMMODATE VEHICLES BUT REALLY ACCOMMODATE PEDESTRIANS AND BICYCLISTS. IT RECOGNIZES THE ECONOMIC VALUE OF HEALTHY PLACES WITH LOTS OF PEDESTRIANS, YOU ENLIVEN STREETS, AND THAT SUPPORTS RETAIL. IN FACT WE FOUND HOMES IN WALKABLE NEIGHBORHOODS EXPERIENCED LESS THAN ONE HALF THE AVERAGE DECLINE IN PRICE FROM THE HOUSING PEAK IN THE MID 2,000s. WE EMPOWER CHAMPIONS FOR HEALTH AND PARTNERSHIPS WITH GROUPS LIKE NIH ARE VERY IMPORTANT PART OF THIS. ENERGIZING SHARED SPACES. TAKING BACK THE STREET, CREATING GREAT PUBLIC SPACES. MAKING HEALTHY CHOICES EASY AND ENSURING EQUITABLE ACCESS, DESIGNING FOR ALL AGES. WHAT WE FOUND IS THAT MILLENNIALS AND SENIORS ACTUALLY HAVE A LOT OF COMMON GOALS. THEY WANT PLACES TO BE SAFE, ACCESSIBLE, FUN AND EASY TO USE. MIXING IT UP, HAVING A MIX OF USES AND FORMS, EMBRACING THE UNIQUE CHARACTER AND HISTORY OF COMMUNITIES, PROMOTING ACCESS TO HEALTHY FOOD AND MAKING IT ACTIVE. SO SPECIFICALLY THE THINGS THAT MONTGOMERY COUNTY IS DOING, BASED ON THESE HEALTHY PLACE PRINCIPLES, WE'RE CREATING WALKABLE TRANSIT-ORIENTED MIXED USE COMMUNITIES. I'M GOING TO GIVE YOU A COUPLE EXAMPLES OF THOSE. WE'RE ASSURING THERE ARE WORLD CLASS PARKS AND TRAILS WITH PLENTIFUL RECREATIONAL OPPORTUNITIES. AS I MENTIONED, WE'RE THE PARK AND PLANNING COMMISSION, THAT IS WHAT THE PLANNING DEPARTMENT IS A PART OF. AND WE'RE PRESERVING FARMLAND IN CLOSE PROXIMITY TO URBAN AREAS SO AS TO ENSURE ACCESS TO NUTRITION FOODS. ONE OF MY FAVORITE PLACES IS THE BETHESDA FARM WOMEN'S MARKET, WHICH IS IN THE LOWER RIGHT-HAND CORNER. THAT HAS BEEN A PLACE FOR FARM WOMEN IN MONTGOMERY COUNTY TO SELL THEIR PRODUCE SINCE THE 1930s, AND IT CONTINUES TO BE OPERATED AS A PRIVATE NON-PROFIT GROUP, AND IT IS OPERATED BY MONTGOMERY COUNTY'S FARM WOMEN. SO WHAT IS A HEALTHY PLACE? WELL, HEALTHY PLACE MAKES HEALTHY CHOICE THE EASY CHOICE. I LIKE TO CALL IT 10-MINUTE LIVING. WHERE WITHIN 10 MINUTES, YOU CAN GET TO ALMOST ANYTHING YOU NEED EASILY AND ACCESSIBLY. YOU CAN WALK TO SCHOOLS, YOU CAN WALK TO JOBS, YOU CAN WALK TO SHOPPING, TO ENTERTAINMENT, YOU CAN WALK TO HEALTHCARE, YOU CAN WALK TO PUBLIC AMENITIES LIKE LIBRARIES AND CIVIC CENTERS. IT PROVIDES CONVENIENT TRANSPORTATION CHOICES TO PROMOTE WALKING, IT SUPPLIES ACCESS TO HEALTHY FOODS, TO PARKS, TO TRANSIT AND TO AMENITIES, AND CREATES NEIGHBORHOODS WITH A REAL MIX OF USES. PLANNING HAS A POWERFUL IMPACT IN MAKING THIS ALL HAPPEN. WE LAY OUT COMMUNITIES, WE LAY OUT RHOADES, WE LAY OUT TRANSIT STOPS, AND WE HAVE A GREAT INFLUENCE ON THE ROOTS FOR DRIVING, WALKING, BIKING, WHERE PUBLIC TRANSIT IS AND HOW CONVENIENT IT IS, WHERE THERE ARE PLACES TO EXERCISE, TO SHOP, AND THE OVERALL SAFETY AND ATTRACTIVENESS OF NEIGHBORHOODS. WHAT HAS BEEN THE BIG FOCUS IN THE LAST DECADE OR SO IS WHAT'S CALLED TRANSIT-ORIENTED DESIGN, OR TOD. AND THE CONCEPT OF TOD IS TO CLUSTER USES AND TO REDUCE DRIVING, TRAFFIC CONGESTION, AIR POLLUTION, STRESS, BY PUTTING EVERYONE TOGETHER IN WALKABLE COMMUNITIES. THAT INCLUDE BOTH HOUSING AND OTHER KINDS OF USES LIKE RETAIL AND OFFICES. THE OLD UNHEALTHY SUBBUSH WAS AUTO DEPENDENT, ENCOURAGED A SEDENTARY LIFESTYLE. THERE WERE VERY FEW OPPORTUNITIES TO BE PHYSICALLY ACTIVE. IT SEPARATED LAND USES, WHICH IS AN IMPORTANT POINT. IT USED TO BE IF YOUR PROPERTY WAS ZONED COMMERCIAL, YOU COULD NOT BUILD A HOUSE IN THAT AREA. OR IF YOUR PROPERTY WAS ZONED RESIDENTIAL, YOU COULD NOT BUILD A BUSINESS OR A RETAIL SHOP IN THAT AREA. WE'RE LOOKING TO CHANGE THAT. WE HAVE -- WE HAD LOW DENSITY DEVELOPMENT, NO CONNECTIVITY, A FEW SIDEWALKS, POOR ACCESS TO PUBLIC TRANSPORTATION. THE NEW HEALTHY SUBURB THAT WE'RE WORKING ON PROMOTES A MIX OF USES THAT ALLOWS YOU TO WALK AND TO BE ACTIVE. IT IS ORIENTED TO TRAN SIPT, GETS PEOPLE OUT OF THEIR CARS. VERY COMPACT DOWNTOWN CENTERS, LOTS OF TRAILS, BIKE PATHS AND SIDEWALKS, ACCESSIBLE PUBLIC TRANSIT, PARKS, RECREATION AND OPEN SPACE ARE ALL INTEGRATED INTO THE NEW DEVELOPMENTS. THE MASTER PLANS I'M GOING TO JUST TOUCH ON BRIEFLY THAT WE'RE WORKING ON NOW AND THAT HELP US TRANSFORM OUR OLDER SUBURBS INTO TOD COMMUNITIES INCLUDE WHITE FLINT, OUR CAPITAL BIKE SHARE PROGRAM IN MONTGOMERY COUNTY, AND THE GREATER LITTONSVILLE SECTOR PLAN. TODAY WHITE FLINT HAS OVER 400 ACRES OF SURFACE PARKING LOTS. OUR VISION IS TO CHANGE THAT, TO CREATE A CORE FOCUSED ON MOBILITY NEAR THE WHITE FLINT METRO STATION, TO CLUSTER BUILDINGS THERE, TO CREATE COMPATIBILITY CERTAINLY WITH THE SURROUNDING AREA BUT TO REALLY MAKE -- TO MAKE EVERYTHING MUCH DENSER, AND MORE SUSTAINABLE, AND TO CREATE SOME GREAT PUBLIC OPEN SPACES. THE GOAL IS TO REALLY INTENSIFY LAND USE AROUND METRO AND EXPAND THE MIXED USE DEVELOPMENT, THE LITTLE MAP ON THE LEFT SHOWS WHERE WHEN WE STARTED, THERE WAS LITERALLY ABOUT ONE BLOCK WHERE THERE WAS FAIRLY INTENSE DEVELOPMENT NEAR THE METRO, AND THAT WAS A FEDERAL FACILITY. WHAT WE'RE LOOKING AT IS WHAT YOU SEE ON THE RIGHT, WITH THE AREA IN RED ALL BECOMING MUCH, MUCH HIGHER DENSITY FOCUSED ON THAT CORE AREA. AND IT'S UNDER CONSTRUCTION. THOSE OF YOU WHO HAVE BEEN UP TO THE WHITE FLINT AREA SEE THE NEW DEVELOPMENT THAT'S CALLED PIKE AND ROSE, WHICH IS JUST OPENING, THAT'S A SKETCH OF WHAT IT WILL LOOK LIKE IN THE LOWER RIGHT. AND IT'S GOING TO HAVE RESIDENCES, OFFICES, A MOVIE THEATER, SHOPS, AND A GRID SYSTEM OF STREETS SO THAT PEOPLE CAN WALK FROM ONE BUILDING TO ANOTHER RATHER THAN HAVING TO GET INTO THEIR CARS. WE ALSO ALREADY HAVE A COUPLE OF THE NEW HIGH RISE BUILDINGS INCLUDING THE ONE SHOWN IN THE IMAGE ON THE RIGHT, WHICH HAS A LOT OF RETAIL INCLUDING A WHOLE FOODS GROCERY STORE ON THE GROUND FLOOR, AND 15 STORIES OF RESIDENTIAL ABOVE. WE'RE LOOKING AT NEW WAYS OF GETTING AROUND WITH PET STREEN FOCUSED STREETS AND BIKEWAYS. ON THE LEFT, EVERYTHING YOU SEE IN THE SORT OF PURPLE COLOR ARE NEW STREETS THAT ARE BEING INTRODUCED TO ESSENTIALLY APPLY A GRID SYSTEM OF STREETS IN AN AREA THAT WAS TRADITIONALLY SUBURBAN. AND ON THE RIGHT, YOU SEE NEW BIKEWAYS THAT WE'RE LOOKING AT WITH THE AREA SHOWN IN THE BROWN. THAT'S A GOOD SEGUE INTO TALKING ABOUT BIKES IN GENERAL, AND INTRODUCING THE CAPITAL BIKE SHARE PROGRAM NOOR MONTH GM RECOUNTY HAS BEEN ANOTHER MAJOR PROJECT OF OURS THAT WE THINK IS PROMOTING HEALTHY LIVING. THERE ARE 300 STATIONS ACROSS MONTGOMERY COUNTY, D.C., ARLINGTON AND ALEXANDRIA. THERE ARE 2,671 BIKES NOW IN THE SYSTEM, AND IT'S BEING USED MORE AND MORE. THERE'S BEEN A HUGE SUCCESS. THE ACTIVE USE OF THE CAPITAL BIKE SHARE SYSTEM IS ACTUALLY REDUCING CARBON DIOXIDE OUTPUT DRAMATICALLY IN 2013, IT WAS BY NEARLY 3 MILLION POUNDS, AND BIKE SHARE USERS BURNED AN ESTIMATED 186 MILLION-CALORIES OVER 4.3 MILLION MILES. SO GET OUT THERE ON YOUR BIKES. IT'S A GREAT THING FOR THE ENVIRONMENT AND IT'S A GREAT THING FOR YOUR HEALTH. AND WE ARE SEEING MORE AND MORE PEOPLE COMMUTING, WHETHER USING THEIR PRIVATE BIKES OR USING CAPITAL BIKE SHARE, BUT COMMUTING BY BIKE. IT'S NOT JUST A RECREATIONAL OPPORTUNITY ANY LONGER. THE THIRD PLAN I WANTED TO JUST MENTION IS THE GREATER LITTONSVILLE PLAN, I WANTED TO MENTION THIS BECAUSE IT WAS A COMMUNITY THAT WAS HISTORICALLY AFRICAN-AMERICAN. IT IS BECOMING A TRANSIT-ORIENTED DEVELOPMENT COMMUNITY. HISTORICALLY IT WAS CAR-DEPENDENT, BUT THERE ARE TWO NEW PURPLE LINE STATIONS PLANNED FOR THIS COMMUNITY, AND WE ARE DOING A MASTER PLAN TO HELP THINK ABOUT HOW THE COMMUNITY CAN RESPOND TO THAT NEW TRANSIT INFRASTRUCTURE THAT'S BEING INTRODUCED WHILE STILL MAINTAINING MUCH OF THE SINGLE-FAMILY NEIGHBORHOOD, BUT CREATING ADDITIONAL OPPORTUNITIES FOR SOME NEW DEVELOPMENT NEAR THE PURPLE METRO LINE STOPS, AND ACCESS FOR THE RESIDENTS TO THOSE STOPS AND ALSO TO THE SILVER SPRING STATION. THE GENTLEMAN HOLDING UP THE SIGN, WE DID A LITTLE SELF EE WALL AT ONE OF OUR EVENTS, HE WAS SAYING WHAT HE LIKED ABOUT HIS COMMUNITY WAS IF HE HAD EASY ACCESS TO DOWNTOWN SILVER SPRING, AND WE WANT TO MAKE SURE TO KEEP THOSE CONNECTIONS IN PLACE. THE OTHER THING THAT WE'RE DOING IN ADDITION TO ALL OF THE PLANNING WORK THAT I'VE BEEN MENTIONING IS OUR PARKS. AND WE DEFINITELY BELIEVE THAT PARKS EQUAL WELLNESS. WE HAVE A VERY ROBUST PARK SYSTEM. IN MONTGOMERY COUNTY WITH OVER 400 PARKS, 200 MILES OF TRAILS, WE DO A LOT OF PROGRAMS LIKE HEART SMART TRAILS AND WE ALSO -- GOING TO TALK A LITTLE MORE, WE HAVE A PARK PRESCRIPTIONS PARTNERSHIP WITH SOME LOCAL DOCTORS TO ENCOURAGE HEALTHY LIVING. WE HAVE PLAYGROUNDS AND WE HAVE COMMUNITY GARDENS FOR PEOPLE TO PRODUCE THEIR OWN NUTRITIOUS FOODS. THE ONE NICE THING THAT HAS BEEN MENTIONED, WE'RE ALSO TALKING ABOUT MENTAL HEALTH, AND THERE IS A LOT OF RESEARCH THAT REALLY SAYS THAT BEING OUTDOORS PROMOTES A BETTER STATE OF MIND. WHEN COMPARING A WALK IN A NATURAL SETTING, LIKE A PARK, A WALK IN AN URBAN SETTING AND RELAXING IN A COMFORTABLE CHAIR, RESEARCHERS FOUND THAT MENTAL STRESS AND FATIGUE WAS MOST SUCCESSFULLY RELIEVED BY A WALK IN THE PARK. I THINK THIS IS VERY TIED IN WITH SOME OF THE COMMENTS THAT ADMIRAL LUSHNIAK MADE NOT ONLY ABOUT PHYSICAL HEALTH BUT ALSO MENTAL WELLNESS. ANOTHER IMAGE, AGAIN, BASED ON SOME RESEARCH IS THAT COMPARED TO PATIENTS WITH AN URBAN VIEW, SOME GALLBLADDER PATIENTS RECOVERING FROM SURGERY WHO HAD A VIEW OF NATURE WERE ACTUALLY FOUND TO RECOVER FASTER, SPEND LESS TIME IN THE HOSPITAL, HAD A BETTER EVALUATION FROM THE NURSES, AND REQUIRED FEWER PAINKILLERS. THAT'S, AGAIN, AN INTERESTING STUDY THAT WAS DONE THAT PROMOTES THE IDEA THAT NATURE IS ACTUALLY NOT ONLY GOOD FOR YOUR HEALTH, BUT IT'S GOOD FOR YOUR MENTAL STATE AS WELL. THERE IS A GENTLEMAN MAN, MICHAEL POSNER, WITH THE UNIVERSITY OF OREGON, THAT ALSO TALKS ABOUT HOW BEING IN A NATURAL SETTING AND BEING IN A PARK CAN ACTUALLY BOOST YOUR PERFORMANCE ON TASKS THAT CALL FOR SUSTAINED FOCUS. SO AGAIN ALL THESE ARE EXAMPLES OF HOW OUR PARKS THAT WE WORK SO HARD TO PROMOTE IN MONTGOMERY COUNTY CAN HELP WITH BOTH PHYSICAL WELL-BEING AND MENTAL WELL-BEING. I DO WANT TO MENTION OUR PARK PRESCRIPTION PROGRAM, WHICH IS CURRENTLY IN PLACE. IT'S A PARTNERSHIP WITH SOME LOCAL PHYSICIANS. THEY PROVIDE LINKS TO PARK LOCATIONS AND AMENITIES AND A WEBSITE WITH ADDITIONAL RESOURCES, AND WHAT THE GOAL IS IS REALLY TO CREATE A NEW PARADIGM. PEOPLE RECONNECTING WITH NATURE FOR THE HEALTH OF THEIR MINDS AND BODIES. WE THINK IT HAS A LOT OF POTENTIAL. THE LAST THING I WANTED TO MENTION WE DO AS A COUNTY IS WE HAVE CREATED AN AGRICULTURAL RESERVE. IT'S ACTUALLY ABOUT ONE-THIRD OF THE TOTAL ACREAGE IN THE COUNTY, OVER 90,000 ACRES IN MONTGOMERY COUNTY IS PRESERVED FOR FARMLAND AND OPEN SPACE. IN THIS 90,000 ACRES, THERE ARE OVER 10,000 PEOPLE EMPLOYED, AND THEIR EMPLOYMENT ON FARMS THAT SORT OF AVERAGE IN SIZE OF BEING ABOUT 58 ACRES CONTRIBUTE OVER $250 MILLION ANNUALLY TO OUR ECONOMY. THIS PROGRAM STARTED IN 1980 AND HAS BEEN IN PLACE FOR ALL THESE YEARS. IT IS A GREAT WAY OF AGAIN PRESERVING OPEN SPACE FOR ENVIRONMENTAL PURPOSES, BUT ALSO ACTUALLY PRODUCING FOOD. AND IT ALLOWS RESIDENTS IN THE DENSELY POPULATED D.C. AREA TO VISIT AND RECHARGE IN THE COUNTRYSIDE TO BUY FRESH PRODUCE, YOU HAVE TO PICK YOUR OWN FARM, SOME OF THAT PRODUCE IS ALSO THEN TRUCKED IN FOR FARM MARKETS IN DIFFERENT NEIGHBORHOODS THROUGHOUT THE WASHINGTON REGION. AND THEY SUPPLY A LOT OF FOOD TO LOCAL GROCERY STORES AND RESTAURANTS AS WELL. SO IT'S A GREAT SORT OF FARM TO TABLE OPERATION. SOME OF OUR UPCOMING HEALTH PROMOTING PROJECTS INCLUDE WORK WE'RE GOING TO BE DOING ON SUBDIVISION STAGING, WHICH IS A FANCY NAME FOR OUR GROWTH POLICY IN MONTGOMERY COUNTY THAT WILL CONTINUE TO FOCUS DEVELOPMENT IN OUR TRANSIT-ORIENTED NEIGHBORHOODS. WE'RE GOING TO BE UPDATING OUR RECREATION GUIDELINES. WE ARE -- WE DO HAVE CURRENTLY A REQUIREMENT FOR NEW DEVELOPMENTS TO PROVIDE DIFFERENT TYPES OF ACTIVE RECREATION, BUT WE REALLY HAD LOOKED AT THAT MORE IN A SUBURBAN CONTEXT, AND WE'RE GOING TO SPEND SOME TIME THINKING ABOUT THE RIGHT WAY TO INTEGRATE MORE ACTIVE RECREATION INTO URBAN CONTEXT AS WELL. WE'RE WORKING ON OUR DOWNTOWN BETHESDA PLAN RIGHT NOW, AND ON OUR PLAN FOR WESTBARRED, WHICH IS GOING TO TAKE A SUBURBAN VERY LOW DENSITY SHOPPING CENTER WITH A LARGE SURFACE PARKING LOT AND HOPEFULLY RECREATED AS A MUCH MORE MIXED USE TRANSIT-ORIENTED NEIGHBORHOOD. SO THANKS FOR HAVING ME. I DO ENCOURAGE YOU TO FOLLOW US EITHER ON OUR WEBSITE, ON TWITTER OR ON FACEBOOK. WE HAVE A LOT OF EDUCATIONAL OPPORTUNITIES AND EVENTS FOR THOSE OF YOU WHO LIVE HERE IN THE WASHINGTON AREA THAT YOU MAY WANT TO PARTICIPATE IN AND I'M VERY GLAD TO HAVE BEEN HERE TODAY. THANKS. [APPLAUSE] >> GREAT. IT'S MAKING ME A LITTLE JEALOUS. I LIVE IN ARLINGTON, WHICH WE HAVE PRETTY NICE PLANNING BUT MONTGOMERY COUNTY DEFINITELY SOUNDS LIKE A GREAT PLACE TO LIVE AS WELL. NOW I WANT TO REMIND FOLKS WHO ARE WATCHES US THAT YOU ALSO HAVE AN OPPORTUNITY TO JOIN IN THIS DISCUSSION. IF YOU SUBMIT YOUR QUESTIONS. I HAVE A SET OF QUESTIONS THAT WE'VE TALKED ABOUT THAT I WOULD BE POSING BUT ALSO WELCOME FOLKS IN THE ROOM HERE TO ASK AS WELL. CLEARLY WE'VE GOTTEN A VERY COMPREHENSIVE LOOK AT THE RESEARCH AROUND THE BUILT ENVIRONMENT, WHAT'S HAPPENING NATIONALLY, WHAT'S HAPPENING LOCALLY, VERY COMPREHENSIVE MODELS. I'M REALLY CURIOUS ABOUT -- THE FIRST QUESTION IS HOW EACH OF YOU WOULD MEASURE SUCCESS IN TERMS OF THE PLANNING YOU'RE DOING, THE DEVELOPMENT IN THE COMMUNITIES, AND WHAT ARE SOME KEY MEASURES THAT YOU WOULD RECOMMEND PEOPLE TO THINK ABOUT. SO I DON'T KNOW WHO WANTS TO START FIRST. >> ONE OF THE BIGGEST THINGS THAT WE MEASURE IS HOW WELL WE'RE DOING AT GETTING PEOPLE OUT OF THEIR CARS. AND SO MANY OF OUR TRANSIT-ORIENTED DEVELOPMENT AREAS, WE HAVE DEVELOPERS COMMIT TO TRANSPORTATION MANAGEMENT PLANS WHERE THEY PROVIDE ANNUAL SURVEYS AND WE CAN SEE WHAT IS THE ACTUAL PERCENTAGE OF PEOPLE WHO ARE COMMUTING IN MODES OTHER THAN BY SINGLE OCCUPANCY VEHICLES. SO IN THE WHITE FLINT EXAMPLE I GAVE, WHEN WE STARTED, WE WERE AT ABOUT 25% OF THE PEOPLE WHO COMMUTED IN WAYS OTHER THAN BY SINGLE OCCUPANCY VEHICLE. WE'RE HOPING TO GET TO 50%. BUT THAT'S A REAL QUANTIFIABLE KIND OF NUMBER THAT WE MEASURE TO SEE IF WE'RE SUCCEEDING. >> WE THINK ABOUT HOW WE MEASURE SUCCESS IN A VARIETY OF WAYS. FOR THE INITIATIVE OVERALL, WE HAVE DONE SOME SURVEYS OF OUR MEMBERSHIP TO TRY TO GET A SENSE FROM THEM ABOUT WHAT DO THEY SEE THEMSELVES AS HEALTHCARE PROVIDERS, DO THEY SEE THEMSELVES IN A ROLE OF -- DO THEY THINK ABOUT HEALTH WHEN THEY APPROACH THEIR PROJECTS OR IN THEIR PROFESSIONAL WORK, AND SO WE'VE DONE A BASELINE SURVEY OF THAT AND THEN WE'LL CONTINUE TO REPEAT THAT TO SEE IF WE'VE BEEN ABLE TO MOVE THOSE NUMBERS AT ALL. AND I THINK, YOU KNOW, THE HOLY GRAIL OF METRICS WOULD BE TO TRY TO UNDERSTAND BETTER IF THESE INTERVENTIONS THAT ARE BEING USED OR RECOMMENDED ARE ACTUALLY HAVING OUT -- HAVING AN IMPACT ON PEOPLE'S HEALTH OUTCOMES, AND SO THAT'S SOMETHING THAT WE'RE INTERESTED IN PROMOTING AMONG OUR MEMBERS AND GETTING THEM TO THINK ABOUT. THERE'S A LOT OF ANECDOTAL EVIDENCE, THERE'S A PROJECT IN ONE OF OUR REPORTS CALLED ECO MODERN FLATS WHERE THE DEVELOPER HAD ASTHMA AS A CHILD AND HAS DONE A LOT TO REALLY MAKE SURE THAT THE INDOOR AIR QUALITY FOR HIS APARTMENT BUILDINGS ARE -- IS VERY CLEAN, AND HE HAS MADE A LOT OF EFFORT AND INVESTMENT INTO THAT. AND HE'S VERY DISTINCT ABOUT HOW YOU HE MIGHT BE MORE -- WHETHER OR NOT THAT'S HAD AN IMPACT ON THE PEOPLE WHO LIVE THERE, HE HAS ANECDOTAL DATA, BUT CLEARLY THAT'S A VERY COMPLICATED ISSUE AND REQUIRES PARTNERSHIPS THAT ARE A LITTLE BIT NON-TRADITIONAL, BUT IT'S DEFINITELY SOMETHING THAT WE'D LIKE TO SEE MORE OF. MUELLER, WHICH IS A PROJECT THAT I MENTIONED, THROUGH A PARTNERSHIP BETWEEN THE DEVELOPER AND TEXAS A & M UNIVERSITY HAS STARTED -- HAS BEEN DOING SURVEYS OF THE RESIDENTS TO REALLY SEE BEFORE YOU MOVED IN HERE AND AFTER YOU MOVED IN HERE, HAS YOUR BEHAVIOR CHANGED, ARE YOU INTERACTING WITH YOUR NEIGHBORS ANY DIFFERENTLY, ARE YOU CHOOSING THE ACTIVE MOBILITY CHOICE, THAT KIND OF THING. I THINK THERE'S A LOT OF POTENTIAL TO DO MORE OF THAT. BUT WE HAVEN'T SEEN A LOT OF IT YET. THEN OF COURSE A LOT OF OUR MEMBERS THINK ABOUT OUTCAN COMES INCLUDING WHAT'S THE MARKET RESPONSE OR MARKET RETURN AND HOW DOES THAT STACK UP AGAINST THE SORT OF EXTRA INCREMENT THAT THEY HAD TO PUT IN, EXTRA INVESTMENT THEY HAD TO PUT IN FOR THE HEALTH PROMOTING ELEMENTS. IN BUILDING FOR WELLNESS, IT WAS A SMALL FRACTION OF THE OVERALL BUDGETS THAT WENT INTO THE SORT OF EXTRA HEALTH PROMOTING PIECE AND THE MARKET RESPONSE HAS BEEN VERY STRONG, SO THAT'S SOMETHING THAT WE -- THAT I THINK OUR MEMBERS WILL PAY ATTENTION TO GOING FORWARD. >> I THINK IT GOES BACK TO THE QUESTION OF WHAT'S YOUR GOAL. I COULD THINK OF HALF A DOZEN THINGS WE COULD DO. WHAT YOU'D DO WOULD DEPEND ON THE PROJECT. ONE WOULD BE IF IF YOU'RE TRYING TO INCREASE ACCESS IN A NEIGHBORHOOD, WE'D GO AND TALK TO THE BUSINESSES AND SEE IF THEY'RE GETTING MORE FOOT TRAFFIC. THEY'RE NOT GOING TO MAKE MONEY, THEY'RE NOT GOING TO STAY THERE. SO LOOK AT WHAT'S GOING ON IN THE NEIGHBORHOOD BUSINESSES, NEIGHBORHOOD ORGANIZATIONS. LOOKING AT THE POPULATION LEVEL, DOING SURVEYS, OBSERVATION, WHETHER THERE ARE CHANGES IN BEHAVIOR AS A GROUP, AND THEN TALKING TO PEOPLE AND FINDING OUT IF THEY DID CHANGE THEIR BEHAVIOR, IF SO, WA REALLY MADE THEM CHANGE THEIR BEHAVIORS? SOMETIMES IT'S BECAUSE IT'S -- I NOW CAN WALK TO X, AND SOMETIMES IT'S NOT I CAN WALK TO X, BUT MY FRIEND, MRS. SO-AND-SO, WALKS TO X AND SHE WALKS WITH ME. AND THAT'S REALLY IMPORTANT BECAUSE WE'RE GOING TOGETHER. RYE LE I STILL DON'T FEEL THAT MORE COMFORTABLE WALKING TO X. YOU COULD DO ALL OF THOSE IF YOU GOT THE MONEY, BUT YOU USUALLY DON'T HAVE THE MONEY. SO AGAIN, WHAT IS THE GOAL OF THE PROJECT, AND THEN FROM THAT COLLECTION OF POSSIBLE INTERVENTION, INCLUDING MUCH MORE MEDICAL TRADITIONAL, YOU KNOW, LET'S SEE IF THEY'RE HEALTHY OR MEASURE THEM ALL KINDS OF WAYS WOULD DETERMINE WHICH OF THOSE WE'D USE. >> [INAUDIBLE] >> OLDER ADULTS, THERE'S ONE REAL GOOD EXAMPLE OF THAT. IF YOU TOOK A POLL OF OLDER ADULTS IN THE CITY OF PHILADELPHIA RIGHT NOW, A SIGNIFICANT NUMBER OF THEM WOULD SAY GET RID OF THE GOD DAMN BIKES. [LAUGHTER] BECAUSE IT SCARES THE HELL OUT OF THEM, THEY'RE UP ON THE STREET AND THEY'R THERE ARE REAL CHALLENGES. SO SOMETHING LIKE THAT NEEDS TO BE BROUGHT IN IN A WAY THAT RECOGNIZES THAT IT HAS INDIVIDUAL LEVEL BENEFITS BUT THEY'RE ALSO -- AT THE SOCIAL, AT THE CIVIC LEVEL, AND UNFORTUNATELY IN MY BUSINESS, WE CARRY A BIAS. OUR BIAS IS WE LIKE TO MEASURE INDIVIDUALS, I LOVE TO MEASURE YOUR BLOOD PRESSURE IN YOUR BLOODSTREAM, YOUR THIS AND YOUR THAT. THAT'S INDIVIDUAL VIRTUE, SO I GET YOU ALL BIKING, I SEE IF YOUR BLOOD PRESSURE IS BETTER, IT'S WONDERFUL AND I GET FUNDED. BUT HOW YOU INTEGRATE THAT SOCIAL LEVEL, HOW YOU ASK THOSE SOCIAL QUESTIONS WHERE YOU DON'T HAVE THE SAME KIND OF PRECISION BUT YOU HAVE A MUCH MORE -- BECAUSE YOU HAVE A MUCH MORE COMPLEX UNIT OF ANALYSIS, SO I'M NOT EXACTLY ANSWERING YOUR QUESTION BUT FROM A RESEARCH POINT OF VIEW, IT POSTS A CHALLENGE TOO, AND PART OF OUR CHALLENGE IS TO GET THE BIKERS DRK SOME OF THOSE PEOPLE RUNNING DOWN THE OLD PEOPLE ON THE STREETS, THEY'RE OLD THEMSELVES. DOESN'T MATTER, I'M OLD, I'M VIRTUOUS, TO HELL WITH THOSE OTHER OLD PEOPLE. SO IT'S A REAL CHALLENGE, AND NEGOTIATING SOME OF THOSE IS PART OF WHAT NEEDS TO GO ON. >> IF I COULD JUST ADD, I THINK ONE OF THE THINGS ABOUT PLACES AS BIG AS MONTGOMERY COUNTY IS THERE ISN'T ONE SIZE FITS ALL KIND OF AN ANSWER. THERE ARE RURAL AREAS THAT PROBABLY JUST NOT GOING TO BE PEDESTRIAN FRIENDLY BECAUSE THE CAN DISTANCES BETWEEN BUILDINGS AND BETWEEN HOMES IS TOO GREAT. AND THERE ARE INTUR INTA SUBURBAN AREAS WHERE CUL DE SACS ARE APPROPRIATE AND GREAT PLACES FOR KIDS TO BE, AND THEN THERE ARE THE MORE DOWNTOWN AREAS WHERE I THINK WE'VE BEEN TALKING ABOUT OPPORTUNITIES FOR DIFFERENT KINDS OF TRANSIT-ORIENTED DEVELOPMENT, BUT IT'S NOT THAT THE ENTIRE COUNTY NEEDS TO BE PAVED OVER AND TURNED INTO ONE GIANT URBAN AREA. I THINK THAT THE GOAL REALLY IS TO HAVE THE BEST URBAN AREAS, THE BEST SUBURBAN AREAS, AND THE BEST RURAL AREAS. >> HELLO. MY QUESTION IS MORE OF A GENERAL OVERALL QUESTION. WE HAVE DEVELOPMENTS THAT ARE BEING BUILT TODAY, PRAN SIT ORIENTED DEVELOPMENTS, WE WANT TO MAKE THEM HEALTHY, WE WANT TO MAKE THEM WALKABLE. BUT HOW DO WE MAKE THESE DEVELOPMENTS AND MAKE THEM AFFORDABLE? >> WELL, ONE THING THAT WE DO HAVE I MONTGOMERY COUNTY THAT WE'RE VERY PROUD OF IS THAT WE HAVE INCLUSIONARY ZONING. SO EVERY NEW DEVELOPMENT OVER 20 UNITS IN SIZE HAS TO INCLUDE 12.5% MODERATELY PRICED DWELLING UNITS. BUT THAT'S NOT ENOUGH. WE NEED TO HAVE MORE OPPORTUNITIES AND WAYS TO GET AFFORDABLE HOUSING, AND WE ARE IN THE MIDST ACTUALLY OF BEGINNING A RENTAL HOUSING STUDY WHERE WE'RE GOING TO LOOK AT HOW CAN WE PERHAPS THROUGH TRANSFERRING DENSITY OR OTHER KINDS OF INCENTIVES, HOW CAN WE PRESERVE SOME OF OUR NATURALLY OCCURRING PERHAPS LOWER DENSITY GARDEN APARTMENT TYPE AFFORDABLE HOUSING BY TRANSFERRING DENSITY OFF OF THOSE PROPERTIES AND PUTTING DENSITY PERHAPS SOMEWHERE ELSE, EVEN CLOSER TO A TRANSIT STOP. SO THERE ARE A VARIETY OF TOOLS THAT CAN BE USED BUT I ABSOLUTELY AGREE WITH YOU, IT'S A MAJOR CONCERN. >> ULI HAS A WHOLE CENTER FOR HOUSING THAT'S FOCUSED ON ISSUES OF AFFORDABLE AND WORKFORCE HOUSING, AND AFFORDABLE HOUSING IS A KEY CONCERN ALL OVER THE COUNTRY, AND REALLY IS A GLOBAL ISSUE TOO IN CHINA AND OTHER PLACES. I WOULD SAY PART OF THE ANSWER ARE THESE POLICIES AND INCENTIVES, AND THEN PART OF THE ANSWER IS GOING TO HAVE TO BE ABOUT SUPPLY, INCREASING SUPPLY. I THINK WHAT WE SEE RIGHT NOW IS THAT THERE'S A MISMATCH BETWEEN WHAT DEMAND IS FOR THESE KINDS OF WALKABLE COMPACT PLACES AND THE AMOUNT OF OPPORTUNITY, THE DEVELOPMENT THAT'S OUT THERE NOW, SO FIGURING OUT HOW TO SPEED UP PRODUCTION, HOW TO PRESERVE THE AFFORDABILITY OF THE LEGACY OF SOME OF THESE APARTMENT COMPLEXES IS GOING TO HAVE TO BE PART OF THE MIX. >> YOU ALSO NEED HOUSING AT EVERY AGE. WHEN WE TALK TO OLDER ADULTS, MANY OF THEM SAY THEY WANT TO REMAIN IN THEIR HOME NOT BECAUSE THEY'RE ATTACHED TO THE HOME BUT THEY'RE ATTACHED TO THE NEIGHBORHOOD AND THERE'S NO ALTERNATIVE IN THE NEIGHBORHOOD. THERE'S LOW INCOME SENIOR HOUSING IN THAT NEIGHBORHOOD, THAT'S WHERE THEY'D WANT TO GO BECAUSE IT'S EASY TO MAINTAIN THAT HOME, MAYBE THAT COULD GO TO A YOUNGER COUPLE. A LOT OF THE HOUSING IN PHILADELPHIA ISN'T REALLY WORTH THE MONEY, THEY COULD BE CLEANED UP, FIXED UP, IF A YOUNGER COUPLE MOVED IN IF THERE WAS AN ALTERNATIVE FOR THAT OLDER ADULT. >> GREAT. THANK YOU. DID YOU HAVE A QUESTION? >> FIRST THANK YOU FOR THE PRESENTATIONS, THEY WERE EXCELLENT, DIVERSION GROUP OF PEOPLE AND DIFFERENT PERSPECTIVES. I CAME THIS MORNING FROM A MEETING AT THE IOM FOCUSED ON A PARTICULAR PRESENGS TOPIC. THEY HAVE ALL THESE WONDERFUL PROGRAMS THAT ARE OF USE BUT PART OF THE PROBLEM IS GETTING PEOPLE TO SUPPORT FINANCIALLY OR THE DECISION MAKERS TO SAY YES, LET'S SPEND OUR MONEY HERE RATHER THAN SOMEWHERE ELSE. AND I'M INTERESTED FROM YOUR PERSPECTIVE ABOUT LESSONS LEARNED AND HOW TO SELL YOUR RESEARCH, DR. GLICKSMAN, FOR EXAMPLE, TO DECISION MAKERS IN THE COMMUNITY. YOU TALKED ABOUT THE WIDER ENVIRONMENT IN WHICH WE OPERATE IN, SO PART OF THAT IS GOVERNMENT, AND PEOPLE WHO HAND OUT FUNDS FOR DIFFERENT PROJECTS, AND GWEN PROBABLY HAS EXPERIENCE BECAUSE THERE ARE LOTS OF THINGS HAPPENING IN MONTGOMERY COUNTY BUT THEY HAD TO START SOMEWHERE. AND I'M GUESSING THEY'VE GONE THROUGH LOTS OF ITERATIONS BEFORE WE GET TO WHAT WE SEE NOW IN A VERY BALANCED APPROACH TO HOPEFULLY INTEGRATE THESE PUBLIC HEALTH ISSUES. SO I'M INTERESTED IN HEARING FROM YOU YOUR LESSONS LEARNED IN SELLING THESE PUBLIC HEALTH ADVANTAGES TO BUILT ENVIRONMENTS TO DECISION MAKERS THAT ARE LETTING YOU IN THE COMMUNITY TO DO RESEARCH OR SUPPORTING YOUR PROJECTS. >> CHANGE IS ALWAYS HARD, ESPECIALLY WHEN YOU'RE DEALING WITH COMMUNITIES WHERE PEOPLE LIVE AND WORK AND WHERE THEY HAVE A LOT OF BOTH FINANCIAL AND EMOTIONAL ATTACHMENT TO THOSE COMMUNITIES. I ALWAYS SAY CHANGE IS HARD BUT CHANGE IS INEVITABLE, AND OUR TBOAL IS TO FIGURE OUT WAYS TO MANAGE THAT CHANGE AND TO MANAGE IT IN WAYS THAT ARE MOST PRODUCTIVE BUT ALSO MOST -- OF GREATEST PUBLIC BENEFIT. THAT SORT OF CONCEPT OF PUBLIC BENEFIT, I THINK IS A VERY IMPORTANT ONE. I TRULY BELIEVE THAT DEVELOPING AROUND TRANSIT IS OF GREAT PUBLIC BENEFIT IN THAT IT'S MAKING USE OF INFRASTRUCTURE AND NOT WASTING THE INVESTMENT THAT'S ALREADY BEEN MADE -- HEALTHIER LIVING AND THAT IT ACTUALLY CREATES SOCIALLY AND ENVIRONMENTALLY SUSTAINABLE PLACES, I THINK WE ALL WANT TO BE -- [INAUDIBLE] ALSO THAT WE GET TO KNOW OUR -- [INAUDIBLE] SIDEWALKS AND WALKABILITY AND LAND USE MIX THAT SUPPORT THOSE KINDS OF DESIRES OF THE MARKETPLACE. >> FOR US, THE KEY IS THEN LISTENING. LISTENING NOT JUST TO THE STAKEHOLDERS, BUT THE PEOPLE WHO INFLUENCE THE STAKEHOLDERS. ONE OF THE REASONS SOME ORGANIZATIONS SIGNED UP WITH US IS ALL OF A SUDDEN THEY THOUGHT ABOUT IT, THEIR DONORS ARE ALL OLDER, THE BOARD IS ALL OLDER, A LOT OF THE VOLUNTEERS ARE ALL OLDER. AT THE SAME TIME, SOMETIMES CONSTITUENCIES HAVE OTHER INTERESTS. I MENTIONED THE ZONING CODE. WE WANTED ACCESSORY DWELLING UNITS. TURN IT INTO A SEPARATE ENTRANCE, THEY'RE OFTEN CALLED GRANNY FLATS. OR A YOUNGER PERSON COULD MOVE IN, WATCHING THE THIRD FLOOR, SOMETIMES THE OLDER ADULTS ARE NEVER WALKING UP THERE. SO WHEN THE CITY DECIDED TO CHANGE THE ZONING CODE AND WE WANTED ADUs ADDED, THEY HAD HEARINGS ALL OVER THE CITY. I WENT TO THE HEARINGS ALONG WITH MY PLANNER COLLEAGUE TO LISTEN TO WHAT OTHER PEOPLE THINK. THEY HATED THE IDEA. THEY HATED IT AND WHY DID THEY HATE IT? BECAUSE THE ASSUMPTION, I DID NOT KNOW THIS UNTIL I SAT AND LISTENED, AMONG MANY IN PHILADELPHIA, IS THAT ALL THE MAJOR UNIVERSITIES ARE INVOLVED IN ONE PIECE OF RESEARCH WHICH IS HOW MANY UNDERGRADUATES CAN YOU STICK IN A SINGLE BEDROOM. [LAUGHTER] THEY WERE GOING TO USE THIS TO RUN ROUGH ROD OVER ALL THEIR NEIGHBORHOODS, ALTHOUGH IT'S SUPPOSEDLY OWNER OCCUPIED, NOBODY BELIEVED LICENSE AND INSPECTION IN PHILADELPHIA COULD DO ANYTHING ABOUT IT, AND WE'VE HAD A MAJOR TRAGEDY SINCE THOSE HEARINGS BECAUSE L & I HASN'T BEEN DOING THEIR JOB, SO THEY FELT THE UNIVERSITY WOULD SIMPLY USE THIS TO DRIVE MORE OF THE LOCAL RESIDENTS OUT. NOW WE CAN DID EVENTUALLY GET ADUs INTO THE ZONING CODE IN A MORE MOD FIGHT FORM, BUT WE HAD TO LISTEN TO THEM BECAUSE THE CITY COUNCILMEN WERE LISTENING TO THEM. SO WHEN WE MEANT AND MADE THE ARGUMENT, WE DID THE BEST JOB WE COULD TO UNDERSTAND THAT THEIR CONSTITUENTS HAD LEGITIMATE CONCERNS, BECAUSE THEY'RE RIGHT, UNIVERSITY IS ALL JUST BURSTING AT THE SEAMS IN TERMS OF SPACE, BUT WORKING WITH THOSE GROUPS, NOT ASSUMING BECAUSE WE KNOW THIS THING ABOUT HEALTH OR ABOUT AGING THAT, A, WE KNOW BETTER, OR EVERYBODY LIKES OLD PEOPLE, OR EVERYBODY LIKES SCIENCE. IT'S A NEGOTIATION. ALL THESE HAVE TO BE NEGOTIATED, THERE ARE MULTIPLE CONSTITUENCIES, AND WE HAVEN'T BEEN SUCCESSFUL EVERYWHERE, BUT WHERE WE HAVE BEEN, IT'S BEEN THROUGH THAT KIND OF LISTENING. >> GREAT, THANKS. I WONDER ON THAT LINE, WHAT WOULD YOU SAY HAVE BEEN THE GREATEST CHALLENGES IN TRYING TO CONDUCT RESEARCH AND PROMOTE POLICY FOR THE BUILT ENVIRONMENT AND HEALTH? YOU ALL COULD REFLECT ON THAT. >> THE GREATEST CHALLENGES FOR US ARE TWO, ONE IS RESEARCH, ONE IS PRIVATE FUNDING. THIS IS NOT ANYBODY'S TOP AGENDA ITEM. WE WERE LUCKY TO GET ONE GRANT, WE'RE LOOKING FOR OTHERS, BUT FINDING THE RESEARCH FUNDING. THE OTHER THING IS, ALL THE PROBLEMS WE SEE ARE EITHER CAUSED BY OR EXACERBATED BY POVERTY, AND ALL OUR PROGRAMS ARE AROUND AMELIORATING SOME OF THOSE EFFECTS IN OLDER ADULTS, THE QUESTION OF HOW TO DEAL WITH THE ROOT PROBLEM IS NOT SOMETHING THAT WE'RE GOING TO FIX WITH RESEARCH. AND WHERE THE ELDERLY ARE -- THE OUTCOME OF YEARS OF LIVING IN POVERTY, SO HOW DO YOU BUILD THOSE RELATIONSHIPS, HOW DO WE BEST SUPPORT THE COMMUNITY DEVELOPMENT CORPORATIONS WHICH ARE THE BEST THING GOING? PEOPLE ON THE GROUND IN THE NEIGHBORHOOD, WE'RE TRYING TO WORK AT THE ROOT OF THE PROBLEM IN ORDER TO MAKE OUR LIFE A LITTLE BIT EASIER. >> SO WE HAVE AN ONLINE QUESTION QUESTION. HAS -- AVAILABILITY BEEN TAKEN INTO CONSIDERATION IN THE STUDIES LOOKING INTO ENVIRONMENTAL CONSIDERATIONS TO INCREASING PHYSICAL ACTIVITY LEVEL OF COMMUNITIES? THIS IS PARTICULARLY IMPORTANT IN OLDER PERSONS BUT IS AN ISSUE FOR YOUNGER PERSONS AS WELL. >> BATHROOMS -- SAFETY IN BATHROOMS. WE DID PARKS, TWO THINGS WE WANT IN PARKS WERE SAFETY AND BATHROOMS. AND WE'RE TALKING ABOUT ACCESSIBLE BATHROOMS. NOT BATHROOMS THAT ARE AT THE BOTTOM -- NO, THEY'RE DOWN IN DUNGEONS. YOU WALK DOWN A STEEP SET OF 27 STEPS. BATHROOMS ARE CRITICAL, CLEAN, SAFE, USABLE, SOMEBODY HAS A SOLUTION TO THAT ONE, PUBLICLY ACCESSIBLE, I WANT TO HEAR ABOUT IT. >> I WOULD JUST ADD THAT THAT IS AN IMPORTANT ISSUE FOR US IN OUR AREAS WHERE WE HAVE PUBLIC GATHERING PLACES, PARK FACILITIES, AND IT IS A CHALLENGE BECAUSE SOME OF THOSE FACILITIES ARE NOT HIGHLY TRAFFICKED. YOU DON'T SEE PEOPLE CONSTANTLY WALKING DOWN CERTAIN TRAILS, AND SO EVEN IF YOU WERE ABLE TO PUT EVEN A PORTABLE FACILITY THERE, I THINK THERE ENDS UP BEING SOME SECURITY CONCERNS. SO I THINK IT'S A CHALLENGE, BUT I THINK IN RESPONSE TO THE EARLIER QUESTION ABOUT WHAT OUR GREATEST CHALLENGES ARE, EVERYTHING IS A BALANCE OF DIFFERENT INTERESTS, OF DIFFERENT PUBLIC INTERESTS. AND THAT'S BOTH OUR GREATEST CHALLENGE ON A DAY-TO-DAY BASIS, BUT IT'S ACTUALLY MOST FUN PART OF MY JOB, BECAUSE IT REALLY REQUIRES YOU TO DELVE IN TO LISTEN, AS WAS MENTIONED, AND TO REALLY THINK ABOUT THESE ISSUES IN A VERY SORT OF CREATIVE WAY. >> HI. EACH OF YOU REPRESENT AN IMPORTANT BUT DIFFERENT SECTOR IN BUILDING HEALTHY AND SAFE ENVIRONMENTS. I WAS HOPING YOU COULD TALK ABOUT SOME OF THE SUCCESSES AND CHALLENGES YOU'VE FACED WORKING TOGETHER AND WORKING IN CROSS SECTOR COALITIONS. >> I WOULD JUST SAY THAT WE WORK WITH ULI A LOT BUT THIS IS MY FIRST OPPORTUNITY TO TALK TO A GROUP LIKE NIH, AND I'M VERY EXCITED ABOUT THE IDEA THAT THIS IS A GREAT FUTURE DIALOGUE THAT WE CAN HAVE. I THINK DR. GLICKSMAN MENTIONED IT WAS A SORT OF REVELATION FOR HIM TO ENGAGE URBAN PLANNERS AND TO USE THE CHARETTE PROCESS IN SOME OF HIS RESEARCH, AND I WAS THINKING WOW, WE NEED TO BRING SOME SCIENTISTS IN TO HELP US A LITTLE BIT MORE ON SOME OF OUR URBAN PLANNING PROJECTS. I THINK THAT TODAY HAS BEEN A GREAT LEARNING EXPERIENCE FOR ME AND HAS GIVEN ME LOTS OF IDEAS ABOUT HOW WE CAN MAYBE MOVE FORWARD IN THE FUTURE. >> SO ULI MEMBERS, WE HAVE A LOT OF PRIVATE SECTOR FOLKS THAT DO WORK IN AN ONGOING WAY WITH PUBLIC SECTOR LEADERS TO TRY TO COME UP WITH THOSE SORT OF WIN-WIN SOLUTIONS, AND THEN ALSO LEVERAGE THESE PUBLIC INVESTMENTS SO A GOOD EXAMPLE OF THAT, MONTGOMERY COUNTY HAS SOME GOOD ONES AROUND WHITE FLINT AND ROCKVILLE PIKE, BUT -- THERE'S ANOTHER VERY AMBITIOUS TRAIL PROJECT AROUND THE CITY THAT'S UTILIZING OLD RAILROAD LINES AND AS A CONSEQUENCE OF A LOT OF PUBLIC INVESTMENT THERE, IT'S ALSO CATALYZED A LOT OF PRIVATE REAL ESTATE DEVELOPMENT AS WELL AND APARTMENT BUILDINGS. LOTS OF EXAMPLES LIKE THAT WHERE THE PRIVATE AND THE PUBLIC SECTOR COME TOGETHER. YOU KNOW, AS PART OF THE BUILDING HEALTHY PLACES WORK, I'VE HAD THE OPPORTUNITY TO WORK WITH PEOPLE THAT THINK ABOUT HEALTH ON AN ONGOING BASIS, WHICH WAS A NEW PERSPECTIVE FOR ME AND THE CHANCE TO WORK WITH THE COLORADO HEALTH FOUNDATION, THE ROBERT WOOD JOHNSON FOUNDATION, OTHER PUBLIC HEALTH PRACTITIONERS. I THINK IT ADDS JUST A NEW DIMENSION TO THINKING ABOUT SOME OF ULI'S WORK OVERALL. I AM EXCITED AND THINK THERE'S A REAL OPPORTUNITY ON THE METRICS AND THE OUTCOME SIDE. I DON'T KNOW WHAT THAT LOOKS LIKE, BUT WE HAVE THE CHANCE TO REALLY BRING THE CONVERSATION TO THE NEXT LEM AND TRY TO UNDERSTAND THE SORT OF -- THE CHANGE CAUSALITY AND TRY TO UNDERSTAND HOW THINGS HAPPEN FOR PEOPLE AND FOR COMMUNITIES, AND I THINK THAT'S A PROMISING AVENUE THAT DESERVES FURTHER EXPLORATION. >> THE REASON I HAVE THE JOB I DO IS BECAUSE MY AGENCY NEEDED RESEARCH DONE THAT NO UNIVERSITY RESEARCHER WOULD TOUCH. BECAUSE IT'S NOT FUNDABLE. -- INSTITUTIONS IN THESE COMMUNITIES HAVE TO THINK -- WE ALSO -- MOST TERRIFYING WORDS, TENURE TRACK -- ACADEMIC IS UNFUNDED RESEARCH. THERE IS NO MORE TERRIFYING NAME THAN THAT. UNIVERSITIES HAD AN INCENTIVE FROM, SAY, NIH TO ALSO SHOW THEY'RE SUPPORTING UNFUNDED COMMUNITY RESEARCH, IT WOULD MAKE ONE HELL OF A DIFFERENCE, BECAUSE ACADEMICS ARE OFTEN NOT TRANSPARENT WITH COMMUNITY PEOPLE ABOUT THEIR IMPERATIVES, THEIR FINANCIAL SITUATION AND THEIR CAREER ISSUES, AND HOW THAT MUCH DRIVES AND SHAPES WHAT THEY WILL DO AND WILL NOT DO. THERE'S GOT TO BE TRANSPARENCY ON BOTH SIDES. I GENERALLY HAVE FOUND MORE TRANSPARENCY ON THE PLANNER AND EVEN SOME GOVERNMENT OFFICIAL SIDE TO HAVE -- SOME GOVERNMENT OFFICIALS ARE FINE, SOME ARE PROTECTING OTHER INTERESTS AND THAT'S ABOUT THE END OF IT, BUT WE CAN STILL WORK WITH THEIR INTERESTS, WE CAN WORK WITH THEM. WITH THE UNIVERSITIES, IT HAS TO BE THE INSTITUTION MAKING REAL COMMITMENTS TO THEIR COMMUNITIES COMMUNITIES. >> THERE ARE ALREADY A LOT OF AMENITIES OUT THERE, BUT THERE ARE A LOT OF PEOPLE WHO EITHER DON'T KNOW ABOUT THEM OR EVEN MORE IMPORTANT, DON'T CONSIDER THEM AS SOMETHING RELEVANT TO THEIR LIVES. HOW DO YOU INFORM PEOPLE ABOUT WHAT'S AVAILABLE AND HOW IT WOULD BE USEFUL TO THEM IN A WAY THAT CONVINCES THEM TO ACTUALLY MAKE USE OF IT? >> WE SEE THAT A LOT. YOU KNOW, ONE OF THE THINGS THAT HAS STRUCK ME, AND I SHOULD HAVE MENTIONED THIS DURING MY PRESENTATION, IS THAT WE THINK A LOT ABOUT THE SORT OF PHYSICAL DESIGN AND THE INFRASTRUCTURE, THEN YOU SORT OF MAKE AN ASSUMPTION THAT PEOPLE WILL USE IT, BUT ON THE DEVELOPMENT PROJECT LEVEL, WHAT THE FINDING IS IS THAT IT ACTUALLY TAKES A LOT OF SOFT PROGRAMMING FOR LACK OF A BETTER TERM, SOFT INFRASTRUCTURE, ONGOING CLASSES, AND OTHER CLUBS, EVENTS, FESTIVITIES, PROGRAMS, OTHER THINGS TO REALLY GET PEOPLE TO COME OUT AND TO TAKE ADVANTAGE OF THE PARK OR THE ASSET THAT'S THERE. I WAS JUST AT ULI'S FALL MEETING IN NEW YORK, AND THERE WAS A PRESENTATION BY SOMEBODY WHO HAS BEEN INVOLVED IN REINVENTING THE ERIE CANAL PARK IN BUFFALO, AND THEY HAVE AN EVENT ALMOST EVERY SINGLE DAY, SO WHAT THEY ARE TRYING TO DO IS TO SAY IF YOU COME DOWN TO THE ERIE CANAL PARK, THERE WILL BE SOMETHING GOING ON AND THINGS THAT APPEAL TO OLDER PEOPLE AND YOUNGER PEOPLE AND MIDDLE AGED PEOPLE, AND THAT HAPPENS AT THE PRIVATE DEVELOPMENT SCALE TOO. THERE'S A DEVELOPMENT IN ARIZONA THAT DOES EVENTS AND PROGRAMMING IN CLUBS AND ALL SORTS OF THINGS TO GET PEOPLE MOVING AND ENGAGED AND ALSO SORT OF -- THE PRIVATE SECTOR, EVEN FOR CITIES, THAT'S ABOUT GENERATING A FEELING -- AN AFFINITY FOR A PARTICULAR PLACE THAT ADDS IT TO THAT SORT OF STICKINESS AND LOYALTY AND GETS PEOPLE TO FEEL INVOLVED WITH THEIR COMMUNITY. THE OTHER THING I WOULD SAY IS THAT I THINK WE'RE SEEING MORE AND MORE OF THAT GO DIGITAL TOO, SO WITH APPS AND OTHER THINGS THAT CAN BRING PEOPLE TOGETHER AND ENGAGE. SO IT DEFINITELY IS NOT JUST ABOUT THE UP FRONT INVESTMENT IN A TRAIL OR A PARK OR AN ASSET, ALSO ABOUT GETTING PEOPLE TO USE IT ON AN ONGOING BASIS. >> I WOULD ONLY ADD THAT I THINK THERE IS A DESIGN COMPONENT TO IT. YOU CAN BUILD THE MOST BEAUTIFUL OPEN SPACE OR -- FACILITY, BUT IF PEOPLE DON'T KNOW IT'S THERE, IT'S NOT GOING TO GET USED. SO I DON'T KNOW HOW MANY OF YOU ARE FROM THIS AREA OR IF YOU REMEMBER THAT IN DOWNTOWN BETHESDA, FOR MANY YEARS THERE ACTUALLY WAS AN ICE SKATING RINK RIGHT AT THE METRO CENTER. IT WAS CUT, THOUGH, WAY BACK, SORT OF BEHIND THE HYATT HOTEL THAT'S THERE RIGHT ON WISCONSIN AVENUE. NO ONE KNEW IT WAS THERE, AND NO ONE USED IT. AND IT ENDED UP BEING TAKEN OUT AND JUST THIS GREEN SPACE NOW. BUT THAT WAS ACTUALLY AN ICE SKATING RINK. THE ICE SKATING RINK, HOWEVER, THAT THEY BUILT IN SILVER SPRING RIGHT IN THE CIVIC CENTER IS RIGHT THERE. YOU CAN'T MISS IT. NOT ONLY DO YOU SEE IT BUT THEY PUT THIS BIG, VERY ELABORATE SORT OF ROOF OVER IT, AND IT'S MOBBED. I THINK THEY'VE EVEN OPENED IT ALREADY FOR THE SEASON. I'VE SEEN PEOPLE OUT THERE ICE SKATING ON A FRIDAY NIGHT OR A SATURDAY NIGHT. AND SO I THINK THAT THERE'S ALSO A DESIGN COMPONENT TO IT. IF YOU HIDE IT AND DON'T MAKE IT REALLY ACCESSIBLE AND VISIBLE AND EASY TO GET TO, YOU CAN PROGRAM IT, YOU CAN DO ALL SORTS OF OPERATIONAL THINGS BUT NO ONE IS GOING TO USE IT. >> GOOD AFTERNOON. WILL YOU PLEASE ADDRESS DISPLACEMENT AND THE ROLE IT PLAYS IN HOUSING, DEVELOPMENT, OR RESIDENTIAL OR COMMERCIAL DEVELOPMENT SINCE THIS PLACEMENT OF RESIDENTS AFFECTS HEALTH OF THE INDIVIDUALS AS WELL AS THE COMMUNITIES, WOULD YOU ADDRESS HOW DISPLACEMENT IS A PART OF THE PLANNING PROCESS, AND HOW THAT IS CONSIDERED WHEN LARGE SCALE REDEVELOPMENT IS PLANNED FOR AN AREA. I THINK USUALLY HOMEOWNERS CAN BE REIMBURSED SOME WAY, THEY MAY BE GIVEN SOME INCENTIVE FOR MOVING, BUT IN RESIDENTIAL NEIGHBORHOODS WHERE YOU HAVE A HIGH PERCENTAGE OF INDIVIDUALS WHO ARE RENTING, HOW DO DEVELOPERS TAKE UNDER CONSIDERATION DISPLACEMENT OF INDIVIDUALS WHEN A NEW PROJECT IS DEVELOPED THAT MIGHT BE COMMERCIAL? >> THIS IS VERY CONNECTED WITH THE AFFORDABLE HOUSING ISSUE, AND LUCKILY, IN SOME OF THE TRANSIT-ORIENTED PROJECTS THAT I HIGHLIGHTED, LIKE WHITE FLINT, THERE HASN'T BEEN A LARGE DEGREE OF DISPLACEMENT BECAUSE MOST OF THE DEVELOPMENT IS HAPPENING ON THE AREAS THAT WERE SURFACE PARKING LOTS FOR EXISTING SHOPPING CENTERS. BUT YOU ARE EXACTLY RIGHT THAT WHEN PROJECTS GO FORWARD THAT AFFECT EXISTING PERHAPS LOW SCALE NATURALLY OCCURRING AFFORDABLE HOUSING, DISPLACEMENT IS A MAJOR ISSUE. IN MONTGOMERY COUNTY, OUR COUNTY COUNCIL HAS STRUGGLED WITH THAT. THEY'VE ACTUALLY ACTIVELY DECIDED NOT TO IN CERTAIN NEIGHBORHOODS PROMOTE REDEVELOPMENT OF THOSE GARDEN APARTMENTS, EVEN IF THEY'RE VERY CLOSE TO TRANSIT, BECAUSE OF THEIR CONCERN ABOUT DISPLACEMENT. HOWEVER, I THINK THAT THERE ARE TOOLS, THERE ARE THINGS THAT CAN WORK. WHEN I WAS IN ALEXANDRIA, VIRGINIA FOR FIVE YEARS, AS CHIEF OF THE DEVELOPMENT DIVISION, WE HAD A VERY INNOVATIVE PROJECT THAT WE DID IN COORDINATION WITH THE ALEXANDRIA REDEVELOPMENT AND HOUSING AUTHORITY, WHICH IS ACTUALLY THE PUBLIC HOUSING AUTHORITY IN ALEXANDRIA. AND THAT COMMUNITY HAS A POLICY THAT IF YOU'RE GOING TO DO ANY DEVELOPMENT OF PUBLIC HOUSING, THERE MUST BE A ONE FOR ONE REPLACEMENT. YOU CANNOT ACTUALLY DIMINISH THE NUMBER OF PUBLIC HOUSING UNITS. WITHIN THE CITY. SO WE DID A VERY INNOVATIVE PROJECT THAT INCLUDED REDEVELOPMENT OF FIVE BLOCKS OF PUBLIC HOUSING VERY CLOSE TO THE BRADDOCK METRO STATION THAT HAD ABOUT 150 UNITS OF PUBLIC HOUSING ON THOSE BLOCKS, BUT IT WAS AT A VERY LOW SCALE, VERY OLD STRUCTURES BUILT AROUND AT THE TIME OF THE SECOND WORLD WAR. WE WORKED WITH THE HOUSING AUTHORITY AND WITH A DEVELOPER TO PRETTY MUCH TRIPLE THE DENSITY ON THOSE FIVE BLOCKS, AND TO DEVELOP THEM COMPREHENSIVELY, BUT TO INTEGRATE ALL OF THE PUBLIC HOUSING UNITS BACK IN TO THE MORE DENSE DEVELOPMENT. SO YOU MIGHT SEE A BLOCK OF TOWNHOUSES THAT LOOK LIKE TRADITIONAL NEW TOWNHOUSES, BUT AT EACH CORNER, THE TOWNHOUSE IS ACTUALLY THREE SEPARATE PUBLIC HOUSING UNITS. BUT IT LOOKS EXACTLY LIKE ALL OF THE OTHER UNITS IN THAT DEVELOPMENT. AND THROUGH THAT, THEY WERE ABLE TO MAKE SURE THAT ALL 150 PUBLIC HOUSING UNITS WERE PRESERVED ON SITE, PUT BACK THROUGH REDEVELOPMENT, AND IT REALLY CREATED A MIXED INCOME COMMUNITY. SO IT DIDN'T FEEL LIKE A PUBLIC HOUSING BLOCK. IT FELT LIKE JUST A REALLY NICE MIXED INCOME COMMUNITY. AND WE GOT A PUBLIC PARK IN THE MIDDLE OF IT AS A BONUS. SO I THINK THERE ARE TOOLS OUT THERE, THERE ARE WAYS THAT IT CAN BE DONE, BUT IT IS SOMETHING THAT IS AN ONGOING CHALLENGE IN MONTGOMERY COUNTY, AND WE'RE WORKING ON IT. >> I WOULD JUST ADD TO THAT, I THINK IT'S A CHALLENGE EVERYWHERE, AND IT'S ALSO AN ISSUE WHEN IT COMES TO BIG INFRASTRUCTURE INVESTMENT PROJECTS, WE HAVE A RELATIVELY WELL BUILT TRANSIT SYSTEM HERE, ALTHOUGH WE'RE INVESTING IN THE SILVER LINE, BUT IN OTHER PARTS OF THE COUNTRY AND MANY OTHER CITIES IN THE COUNTRY ARE BUILDING OUT THEIR TRANSIT SYSTEMS, AND THAT HAS HAD SOME GENTRIFICATION EFFECTS, AND I THINK THAT CITIES REALLY NEED TO BE MORE PROACTIVE WHEN THEY THINK ABOUT MAKING THOSE PUBLIC INVESTMENTS TO ENSURE THAT THE BENEFITS ARE EQUITABLY DISTRIBUTED AND THERE AREN'T THESE EFFECTS ON VULNERABLE PEOPLE. I WOULD SAY THERE'S TWO GOOD EXAMPLES FROM OUTSIDE OF THIS REGION THAT I THINK HAVE BEEN PRETTY SUCCESSFUL. ONE IS WITH THE CORRIDORS IN MINNEAPOLIS, THE PHILANTHROPIC COMMUNITY WAS VERY INVOLVED IN WORKING WITH LOCAL RESIDENTS AND RETAILERS, NOT JUST HOMEOWNERS BUT PEOPLE WHO ARE RENTING SHOPS AND LEASING LAND, AND THEY HAVE BEEN VERY ENGAGED IN GETTING THE COMMUNITY INVOLVED IN MAKING SURE THAT TRANSIT STOPS ARE GOING TO BENEFIT ALL OF THE DIFFERENT PEOPLE ALONG THE LINES, AND PROACTIVELY DOING TRAPEING AND OTHER THINGS T -- TRAINING AN D GETTING PEOPLE READY FOR THE ECONOMIC CHANGES AND HELPING THEM MAKE INVESTMENTS SO THEY CAN STAY THERE AND NOT BE DISPLACED. THE OTHER ONE IS AN APPROACH IN COLORADO, WHERE A NON-PROFIT COMES IN AND DOES LAND BANKING ALONG WHERE A TRANSIT LINE WILL GO IN ANTICIPATION OF THE LINE AND HELPS TO PURCHASE THAT LAND AT A LOWER COST AND KEEP IT AND REDEVELOP IT AS AFFORDABLE HOUSING. BUT I THINK THAT IT'S A REAL ISSUE, AND YOU KNOW, ULI, I THINK WE HAVE CONCERNS THAT CITIES, IN ORDER FOR THEM TO BE VIBRANT AND TO STAY EXCITE, THERE REALLY HAS TO BE A PLACE IN THEM FOR EVERYONE. IT CAN'T JUST BE THE WEALTHY. THAT'S NOT JUST ABOUT INCOME LEVEL, IT'S ABOUT PERSPECTIVES AND THE TYPES OF JOBS THAT PEOPLE CAN UNDERTAKE, SO YOU SEE IN PLACES LIKE SAN FRANCISCO WHERE IT'S JUST BECOME UNAFFORDABLE FOR LARGE PORTIONS OF THE POPULATION. THAT'S NOT A VISION THAT ANYBODY SHOULD HAVE FOR HOW CITIES PROCEED IN THE FUTURE, AND I THINK WE REALLY HAVE TO GET SERIOUS ABOUT MAKING SURE CITIES REMAIN INCLUSIVE, AVAILABLE AND ACCESSIBLE TO EVERYONE WHO WANTS TO BE A PART OF THAT COMMUNITY. >> GREAT. THANK YOU SO MUCH. AND ON THAT NOTE, I KNOW WE'RE RUNNING CLOSE TO TIME SO I JUST REALLY WANT TO THANK THE PANEL, CLEARLY THERE WERE A LOT OF REALLY IMPORTANT QUESTIONS ASKED, THERE MAY BE MORE ONLINE THAT WE'LL TRY TO CONNECT WITH THE PANELISTS, BUT I JUST WANTED TO GIVE IT BACK TO WILMA. >> THANK YOU SO MUCH. SO FIRST OF ALL ANOTHER THANK YOU TO OUR PANEL. IT WAS EXCELLENT. WE REALLY APPRECIATE YOU JOINING US TODAY. A SPECIAL THANK YOU TO MELISSA FOR BEING OUR PANEL MODERATOR. AND TO THE STAFF AT THE OFFICE OF THE SURGEON GENERAL FOR HELPING US PLAN THIS EVENT. TO ADMIRAL LUSHNIAK FOR JOINING US AND TO DR. TABAK, OF COURSE. I WANT TO EXTEND A SPECIA THANKS TO OUR COMMUNICATIONS STAFF AS A WHOLE BUT PARTICULARLY ELIZABETH NELSON AND DEBL FOR THEIR WORK ON THIS PROJECT TO MAKE SURE EVERYTHING GETS DONE. AND I CAN'T FINISH WITHOUT SAYING THANK YOU TO PARIS WATSON, WHO HATES THANK YOUS BUT I'M DOING IT ANYWAY FOR THE COORDINATION OF THE EVENT. AND TO ALL OF YOU ONLINE AND IN THE ROOM, DON'T FORGET, THERE ARE MORE PANELS LIKE THIS TO COME ON OVERTOP IX FOCUSED ON AREAS WITHIN THE NATIONAL PREVENTION STRATEGY THAT WE PLAN TO COORDINATE IN PARTNERSHIP WITH THE OFFICE OF THE SURGEON GENERAL, SO WE'RE VERY MUCH LOOKING FORWARD TO THAT. IF YOU HAVE TOPIC IDEAS THAT YOU'D LIKE TO SHARE WITH US, PREVENTION@MAY OWE.FIF.GOV, SEND THEM OUR WAY. THIS IS YOUR FORUM, ADDRESSING TOPICS OF MOST INTEREST TO YOU. SO THANKS AGAIN TO ALL OF YOU, TO OUR PANEL, AND HAVE A GOOD AFTERNOON. [APPLAUSE]