By Scott Carlson
Researchers can have revelatory moments in remarkable places—the African savannah, an ancient library, or the ruins of a lost civilization. But Richard J. Jackson’s epiphany occurred in 1999 in a banal American landscape: a dismal stretch of the car-choked Buford Highway, near the Centers for Disease Control and Prevention in Atlanta.
Dr. Jackson, who was then the head of the National Center for Environmental Health at the CDC, was rushing to a meeting where leading epidemiologists would discuss the major health threats of the 21st century. On the side of the road he saw an elderly woman walking, bent with a load of shopping bags. It was a blisteringly hot day, and there was little hope that she would find public transportation.
At that moment, Dr. Jackson says, “I realized that the major threat was how we had built America.” His center had already been dealing with problems that he suspected had origins in the built environment—asthma caused by particulates from cars and trucks, water contamination from excessive runoff, lead poisoning from contaminated houses and soil, and obesity, heart conditions, and depression exacerbated by stressful living conditions, long commutes, lack of access to fresh food, and isolating, car-oriented communities.
Treatments could come in the form of pills, inhalers, and insulin shots, but real solutions had bigger implications. “More and more, I came to the conclusion that this is about how we build the world that we live in,” he recalls, speaking over the phone from San Francisco.