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Institute of Medicine (US) Roundtable on Environmental Health Sciences, Research, and Medicine. Green Healthcare Institutions: Health, Environment, and Economics: Workshop Summary. Washington (DC): National Academies Press (US); 2007.

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Green Healthcare Institutions: Health, Environment, and Economics: Workshop Summary.

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This workshop is the ninth in a series of workshops sponsored by the Roundtable on Environmental Health Sciences, Research, and Medicine since the roundtable began meeting in 1998. When choosing workshops and activities, the roundtable looks for areas of mutual concern and also areas that need further research to develop a strong environmental science background.

When the Roundtable on Environmental Health Sciences, Research, and Medicine began its discussions, the roundtable members suggested that a broader concept of environmental public health needed to be established. The roundtable has built on other definitions of environmental health to include the natural, built, and social environments. Prior to these initial discussions, many roundtable members felt that there had been a focus on the toxicological effects of individual environmental agents to the detriment of understanding the larger picture of how environmental conditions impact health.

The roundtable members acknowledged that the built environment—where and how communities and transportation systems are built—is very important and relevant to health. The roundtable’s first workshop, Rebuilding the Unity of Health and the Environment: A New Vision of Environmental Health for the 21st Century, examined and explored a broader definition of the environment as a very integral part of health. Where people live, work, and play impacts their health, and environmental policies must consider this relationship.

In the past six years, the role of the built environment has received more attention in public health. Roundtable members Howard Frumkin, Lynn Goldman, Richard Jackson, Samuel Wilson, and others helped to shape the roundtable’s thinking on the built environment, bringing this issue to the forefront in public health leadership and planning communities.

This workshop focused on the environmental and health impacts related to the design, construction, and operation of healthcare facilities, which are part of one of the largest service industries in the United States. Healthcare institutions are major employers with a considerable role in the community, and it is important to analyze this significant industry. The environment of healthcare facilities is unique. It has multiple stakeholders on both sides, as the givers and the receivers of care. There are ill and injured individuals, their families and friends, and the employees that deliver care to them. Many of the most vulnerable individuals pass through the doors of healthcare facilities each day.

In order to provide optimal care, more research is needed to determine the impacts of the built environment on human health. The scientific evidence for embarking on a green building agenda is not complete, and at present, scientists have limited information. There is general information that pleasant places that emit low levels of chemical materials are good for the environment and good for health, but, at best, science can make only vague statements. For example, there is no guideline to determine how much use of natural daylight as a source of illumination is necessary to realize benefits. Overall, the major point that I took away from the workshop is that the scientific community needs to think strategically about its funding in this area. There is an opportunity of great promise, yet more information about the complexities involved in building a green facility is needed. A number of speakers pointed out that hospitals, which regularly collect information on patient outcomes, are ideal living laboratories to advance knowledge as the United States embarks on replacing many facilities from the early postwar era. Through implementation of controlled studies, investigators can address the research gaps and discern the complexities of building green on human health. The challenge will be to conduct meaningful research in this area that examines the interplay of the built environment and health. Finally, the workshop participants discussed research directions that will help promote an environment for overall health.

This workshop summary captures the discussions and presentations by the speakers and participants; they identified the areas in which additional research is needed, the processes by which change can occur, and the gaps in knowledge. The views expressed here do not necessarily reflect those of the Institute of Medicine, the roundtable, or their sponsors.

Paul G. Rogers, Chair

Roundtable on Environmental Health Sciences, Research, and Medicine

Copyright © 2007, National Academy of Sciences.
Bookshelf ID: NBK54154
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