Urban Design and a Healthy Mind and Body

Introduction

The origin and the subsequent development of urban design and human health demonstrate a clear line of a strong relationship that exists between metropolitan development and its well-being. Evidence gathered on urban designs and its relationship to improving human conditions is very striking. Many of these studies have concluded that urban designs are influenced by population density.

Drawing primarily on research gathered by Laura, modern society is increasingly becoming exposed to environmental degradation brought about by increased urbanization¹. Based on literature on human health, social and cultural vibrancy, our research analysis begs the question: At which stage can be centralized and decentralized cities meet to create a design that is essential in maintaining a healthy mind and body? To answer this question, however, my research was designed in the qualitative and quantitative genre of data collection as I believe this approach will allow us to obtain a more comprehensive understanding of health issues surrounding urban designs.

Our research methodology of using participant observation and interviewing helped us gain a better understanding of the complexities of social, economic and cultural factors impacting on them. Qualitative approaches were believed to be appropriate as they are likely to yield more honest opinions in obtaining an in-depth understanding of the meanings and events by obtaining raw data from participants. To affirm this analysis, researchers linked various responses to research from the related areas and concluded with references for future research on the health and urban design dimensions. Thus, the reason for this research is to generate more knowledge and improve understanding on aspects of nature and human health on the concept of urbanization.

Literature Review

The ever-increasing population in the cities is currently attributed to decentralization and differences in spatial structure exposing human nature to illnesses from dispersed and synergistic causes. The rise of chronic illnesses such as asthmas, allergies, airborne diseases, obesity and depression are linked to inadequacy in urban planning and health-conscious. Laura argues that “joined with deforestation, wetland destruction, stream degradation and concomitant loss of native species and detrimental contribution, human health and well being is increasingly being threatened by urbanisation”¹. The relationship between forest destruction and loss of biodiversity with the expansion of urbanization extends our understanding of the relationship between nature and culture.

On the other hand, however, the revolution in information processing and telecommunication has accelerated the growth and dispersion of economic activities and population, possibly moving to a point where urban design and a healthy mind and by is relevant. Many planners, including policymakers, in contrast to the realities of increasingly spread out metropolitan development.

Transport

Urban planners have been criticised for not taking into consideration socioeconomic factors, disregarding the influences of travellers’ attitudes and lifestyles. Transport affects wider social values and social economic variables such as income levels, age, leisure interests, and household structures should be highly considered. From the fields of psychology, environmental health, transportation, public health, medicine, city planning and natural resource management, the cross-disciplinary collaboration in urban planning and design, and the participation of residents in shaping their environment is very important.

Laura states that “methods and patters of human settlement have increased landscape modification causing potential adverse effects on human beings and the environment”¹. Against the backdrop of increasing concerns about the environmental consequences of urban transport, in particular car travel, a growing number of research studies have addressed the relationship between spatial characteristics of cities and the inhabitants’ travel behaviour¹. The relationship has been particularly attributed to high concentration of facilities areas such as shopping malls and libraries. The results of such congestion problems have commonly been interpreted as a foundation for recommendations, public transport improvement rather than urban road construction ¹.

Research to strengthen the relationship between design and health argues that neighbourhoods should be embedded in existing infrastructure to provide larger cultural and business opportunities and reduce reliance on automobile. Laura also adds that strong relationship between health practitioners, city planners and their clients must be included to explore policy strategies that can be promoted in order to move towards sustainable development.

In consideration of technological, fiscal and regulatory measures, new approaches that prioritise healthy mind and body should be adopted. Here, it’s argued that no single solution can be adopted in all cities. It’s therefore important to mix all measures across different disciplines to achieve a mutually supportive packages¹.

Essentially, the development and transport strategy in urban centres is a continuous process that requires the involvement all stakeholders. There is a strong argument that collective responsibility improves efficiency. It is also argued that technological innovations should be encouraged so that substantial savings in co-efficiency can be achieved¹. It’s essentially important to note that land-use characteristics affect travel patterns². Naess was quoted arguing that “ planning policies can influence the location of new developments, regional policies size and shape of buildings and type of land use, while urban planning policies influences the level and land use-mixing”².

On settlement aspect however, population size and distance from homes have contributed to increased number of cars in metropolitan areas³. Laura replicates this analysis by adding that Population density linked to travel patterns¹.

Laura recommends implementing new patterns of retailing to ensure accessibility to all and allow multiple purpose trips to take place so as to reduce travel distances. He argues that neo-traditional developments that consider the quality of environment should be prioritised to encourage people to get out and walk to local facilities and jobs. Open spaces, narrow streets with side walks and alleys running behind homes, grid street patterns that provide multiple paths for drivers and pedestrians should also be included in city planning to lessen car use.

Naess demonstrates a strong correlation between urban structures and travel behaviours². According to Kitamura and his colleagues, proximity of transport networks such as road and rail networks influences travel patterns⁴. In this regard, parking provision and sound planning policies that have particular impacts on transport demands should be carefully looked into. They evidence that trip frequency and modal choice are influenced by parking availability and people with more likely parking spaces make fewer journeys as opposed to people with fewer parking spaces⁴.

Greenery, Buildings and Grounds

On urban design scale, greenery and access to it’s visually is very important to human health. This approach draws on Laura’s medical and social science research that focus on visual and physical access of the outdoors¹. These findings concluded that most healthful architecture exposes inhabitants to natural light and ventilation. Laura was quotes in that “..experiencing and simply viewing nature reduces the stress of daily urban life” ¹. Arguably, parks and gardens have long been credited for their restoration effects on both mental and physical health. Frumkin on the other hand coins the term biophilia to express innate human reaction to nature⁵. He argues that park-like setting to prehistorical sites for water and shelter.

Sullivan and Kuo research on urban designs and a healthy mind and vody states that “the presence of trees near public housing associate to decreased levels of domestic violence”^4. On the other hand, Sullivan and Kuo add that “window view onto green vegetation, rather than dirt pavements, with increased function in low-income households”⁶. Ulrich studies on the other hand provide that “a patient recuperation from surgery with window view of greenery heal faster as opposed those looking onto brick walls”⁷.

Research findings from Lindheim and Syme also add that artificial lighting impairs the body’s use of calcium⁸. Wells summarised this findings by adding that homes on higher floors associated with lower physical activity are likely to experience bodily dysfunctions⁹. Wells replicates this analysis by stating that “restricted access to outdoors is the key factor to these adverse health effects. He emphasises that mothers of children under 5 years of age are mostly affected by high-rise buildings, while young adults on the other hand would prefer”⁷.

Most research gathered by Laura advocate greenery as a way of improving health and social welfare. Her findings reports overwhelming beneficial of greenery to human health and provides overwhelming choice of lawn cover for homes, schools and businesses¹. Ecological survey reports gathered by Laura stated that “lawn-care pesticides can lead to cancer in wildlife and humans, prolonged periods of tracked indoors”¹. His findings concluded that emissions from lawn mowers surpass emissions from cars and cause ozone formation.

Neighbourhoods

Neighbourhoods introduce the critical issue of social capital. Laura states that “gregarious species, people benefit both emotionally and physically from interpersonal relationships”¹. Community volunteerism, informal sociability and social trust are collectively intertwined to promote healthy mind and body. Using existing survey data, Laura relates these measures to numerous aspects of human health and welfare. These studies demonstrate that poor social capital weakens the social fabric of a society. Lindheim and Syme (1983) analysis add that “increment in suicide incidents, pregnancy complications and alcoholism add to the list of adverse health effects associated with weak social ties”⁸.

He argues that social capital begins in the neighbourhood. Laura adds that where neighbours meet to configure information contact among residents, street crimes is reduced, and people express greater happiness with their physical surroundings¹. He demonstrates that providing green space increases informal contact. While studying on low-income residents Laura argues that presence of trees and grass represents strong social ties among neighbours. Lyle findings demonstrated that residents in Berlin apartments displayed more social cohesion that people who lived in apartments¹⁰.

High densities and Mixed use

Substantiated by formal research, high densities and mixed land use have been reported to increase pedestrian and bicycle activity. Clearly, Laura demonstrates that “mixed land use confers health benefits on residents by concentrating development on high densities and encouraging mixed land use while preserving open space”¹.She adds that “mixed use enables shared parking between daytime and evening drivers, further minimising paved areas”¹.

Laura studies further evidences that non-motorised travel from these design features reduce automobile trips. Laura was further quoted stating that “In Seaside, FL, the original neo-traditional development, residents have allowed shrubbery to obscure windows and porches so as to block views from the street”¹. Her analysis also adds to survey results indicating that “people prefer loop and cul-de-sac street designs to grids, even though grid residents report the highest sense of community, neighbour friends friendliness, and convenience to shopping and schools” ¹.

Laura suggests that social and environmental goals of neo-traditional design are more likely to be met through collaborations. Citing Multiple studies, Lindheim and Syme report that crowding often result to high urban densities making the goal for neo traditional inherently stressful⁶. They add that culturally integrated settings increase participation in the urban setting, a measure for social capital. However, Steingraber warns against their toxic emissions by stating that “small businesses are unsuitable for mixed land-use design and they should instead he wiped out and replaced with new technology”¹¹.

Patterns and landmarks on public buildings

Kaplan and his colleagues have written extensively on this subject by stating that¹² “visual landmarks and logical transit pathways assist in providing direction. Kaplan adds that “the presence of orienting landmarks provides a sense of ease and comfort and decreases recidivism in de-institutionalized mental health patients. These civic amenities serve as havens from urban noise and traffic, while providing a sense of belonging in society”¹⁰. Kunstler further states that “psychological benefits of human scale neighbourhoods lie in the design and presence of public buildings as they are important to social capital”¹³.

Conducive walkways

CDC reports states that “physical inactivity accounts for 23% of all US deaths from major chronic illnesses”¹⁴. He re-emphasises the important of physical activity to human well being. CDC findings add that urban residents and low-income women report low participation in leisure-time exercise. Laura adds that poor lightning, excessive noise, lack of public transport and heavy traffic are associated with loss of physical dysfunction. She urges environmental planners to discourage neighbourhood excursions. Kreyling links most pedestrian traffic fatalities to new urban areas, where sprawl is the predominant design¹⁵. Citing multiple studies, Kreyling argues that suburban residents are actually healthier than people living in cities as they are more likely to engage in leasure-time activities.

Ewing argues that sprawls are undesirable since clustering of housing have negative effects on residents’ health through unstructured exercise and does not enhance sense of place and community¹⁶. Ewing reasons that out of home activities, poor residential and destination accessibility encourages healthy mind and body as opposed to scattered or leap frog developments unavailable for public uses fail to provide functional open spaces. Ewing links causes of sprawling to be associated with businesses preferring locations where land is inexpensive and congested. He however argues that low cost of auto travel should be encouraged to enable people to live far from their places of work and shopping since decentralised settlement patterns are economically efficient¹.

Laura argues that low-density settlements are the most preferred residential living. A related argument from Gordon and Harry add that developers are prevented by land use regulations as majority prefer building at higher densities that would yield more profits, and more attractive to consumers. However, the problem is that, such regulations are not ubiquitous. Industries are cyclical as residential constructions and many would not risk building an unacceptable product is very high¹⁷.

Towns/Regions

Road networks should be carefully considered in designing urban buildings. Kunstler‘s research has associated automobile emissions to increased cases of asthma, pollutants released by idling and moving cars are on the rise. Laura published important reports of significant mobility and mortality, proven persuasive in changing transportation behaviours¹.

Commuting

Evidently, the relationship between transport and urban forms has long been recognised as unfriendly. It’s argued that cars generate more air pollution. A number of studies on environmental reporting have documented an increase on environmental pollution and the concerns on the detrimental effects of the urbanisation on the natural environment. Thematic suggestions on nature and culture reinforce the need for substantial efforts of many fronts in copying with the challenges of increased pollution.

Accelerated by urban constructions and increased population, activities such as hill clearing, open burning, toxic waste dumping are once again detriments of natural environment strain signalling the distance between humanity and nature. According to Costa and his colleagues, long distance commuters experience higher absenteeism and accidents at work¹⁸.STPP reports conclude that “road usage is a factor in 56% of all fatal crashes”¹⁹. Conclusively, road accidents are directly linked to traffic congestion in urban cities. ,

Impervious surfaces

Research by Booth and Reinelt states that “paved surfaces impede rainwater infiltration and groundwater recharge, facilitate movement of toxics into water ways and increase erosion, sedimentation and flooding degrading the natural community composition of fish and aquatic insect species”²⁰. Hydrological impacts due to urbanisation have compromised water quality such as sedimentation, habitant changes, loss of fish and increased temperatures. Most hydrological impacts are caused by runoff volumes and velocities of trying to urbanise cities causing major strain to the water streams.

Hydrologic impacts on water streams due to increased impervious include activities such as construction of dams, parking lots, rooftops and roads. In this regard, environmental guidelines to decongest developments and preserve open spaces should be encouraged. Booth and Reinelt add that urbanisation and increased watershed has had intense hydrologic impacts on water streams by affecting their natural course compromising quality of water. These problems are also attributed by heavy reliance on engineered approaches and runoff management such a construction of pavement channels, storm water pipes and bank stabilisation¹⁸.

Booth and Reinelt research on location inflexibility offered by automobile and the associated road networks argue that development styles across major cities adversely affect human health and social well being. They add that congestion takes ambulances and fire tracks longer to reach homes on fringes and low density areas can expose residents to greater risks from emergencies. Kunstler studies add that sprawl leads to social inequity and lack of pedestrians activity. He also adds that wildlife-transmitted diseases and spread of previously localised diseases. CDC on the other hand states that “side effects of sprawl to include joint pain, facial paralysis, severe headaches and memory loss”²¹.

These findings strongly suggests what Cromley and his colleagues states as “residential developments that invades forest and creates edge habitant exposes residents to deer ticks (Ixodes scapularis), which transmit the disease to humans (housing adjacent to forest tracts”²². Biodiversity Project also adds that “decreases in suitable habitat for fish, replies and even bats contribute to increased mosquito-borne malaria and encephalitis”²³.

The relationship between nature and culture has brought about tremendous changes, not only in bringing about huge opportunities, but also important challenges. In several countries, most notably Australia, the rapid development of urban cities has led to increased environmental pollution. The standards of living are inextricably tied to the quality of the natural environment. As it is becoming increasingly clear just how far-reaching the implications of pollution are far more devastating. The potential linkage between forest destruction and loss of biodiversity with the expansion of cities extends our understanding of the relationship between nature and culture.

Description of Outcomes

• Health issues in regard to urban designs in Australia has not been adequately addressed, despite best efforts of number of researchers dedicated to the health and welfare issues of these people.
• Since health issues in respect of car pollution, lack of greenery, parking lots and natural lightning are increasing at an alarming rate, Biodiversity project suggests that studying the problem more closely with the affected people of the relevant communities is likely to address the problem adequately.

Task and timeline table of feasibility of research

Conclusion

Greeneries, natural light and visual and open space in homes and streets are very important to healthy being of human health and mind. Urban planners should collectively work together to construct buildings that consider realities of increasingly spread out metropolitan development. Since causes of sprawling are said to be associated with businesses preferring locations where land is inexpensive and congested, urban planners should price urban buildings at higher prices as a strategy to decongest the city. Low cost of auto travel should be encouraged to enable people to live far from their places of work and shopping since decentralised settlement patterns are economically efficient.

Since research recommends close proximity to outdoor green space and views of greenery healthy to human mind and body, residents should be encouraged to grow lawn and even store artificial plants in their homes as a way of relaxation. There is need to provide reconcilable urbanisation design practices in the aspects of environmental conservation when balancing nature and culture while ensuring healthy mind and.

Industrial-waste disposal find their may be toxic to natural waterways. In this regard, selecting suitable place for disposing waste will ensure waste remains isolated from the ground water aquifers and biosphere. Conclusively, urban design is particularly situated to convey indispensable adjunct of new technologies, factors that essentially focus on the well being of human mind and body. Other activities such as building reservoirs for holding floods said to lessened erosion have been highly criticised for increasing erosion since the bulk of erosions are evidenced to occur above dams. Deforestation activities are also considered to encourage floods and promote erosion by interfering with natural circulation of air and water. Man’s activities that interfere with natural agents by causing abrasion and removing weathered and un-weathered rocks should be discouraged.

Bibliography

Biodiversity Project. “Making the Biodiversity-Sprawl Connection: Human Health Threats at a Glance”. 2010. Web.

Booth, Benard.,& Reinelt, Edward. “Consequences of urbanization on aquatic Systems-measured effects, degradation thresholds, and corrective strategies.” National Conference on Watershed Management 31(1993): 545–550.

Centers for Disease Control (CDC). “Self-Reported Physical Inactivity by Degree of Urbanization.” Morb. Mortal. Wkly. Rep. 47 (1998): 1097–1100.

Centers for Disease Control (CDC). “Lyme Disease.” Morb. Mortal. Wkly. Rep. 50 (2001): 181–185.

Costa, Gerald., Pickup, Leonard.,& Di Martino, Velentino. “Commuting—a further stress factor for working people: evidence from the European community.” Int. Arch. Occup. Environ. Health 60 (1988): 371–376.

Cromley, Kelvins., Cartter, Lindsey., Mrozinski, Donell. “Residential setting as a risk factor for lyme disease in a hyperendemic region.” Am. J. Epidemiol. 147, no.5 (1998): 472–477.

Curtis, Corey. “The windscreen world of landuse transport integration”. TPR 76 (2005): 1-32.

Ewing, Reid. “Is Los Angels style sprawl desirable?” Journal of American Association 63, no.1 (1997): 1-20.

Frumkin, Howard. “Beyond toxicity: human health and the natural environment.” Am. J. Prev. Med. 20 (2001), 234–240.

Gordon, Petter and Harry, Richardson. “Are Compact cities a desirable planning goal?” Journal of American Planning Association 63 (1997): 1-12.

Kaplan, Sullivan.,& Ryan, Lindsey. With People in Mind: Design and Management of Everyday Nature. Washington, DC: Island Press, 1998.

Kreyling, Franklin. “Fat City: Are We Building Sick Communities?” Planning 4 (2001): 9.

Kunstler, Henson. Home from Nowhere: Remaking our Everyday World for the Twenty-first Century. New York: Simon and Schuster, 1996.

Laura, Jackson. “The relationship of urban design to human health and condition.” Landscape and Urban Planning 64 (2002): 1-10.

Lindheim, Richard., & Syme, Lindsey. “Environments, people, and health.” Annu. Rev. Public Health 4 (1983),335–359.

Lyle, Timoth. Regenerative Design for Sustainable Development. New York: Wiley, 1994.

Mees, Paul. “Toronto: Paradigm Reexamined.” Urban Policy and Research 12 (1994): 1-18.

Naess, Petter. “Residential location affects travel behaviour-but how and why? The case of Copenhagen metropolitan area.” Progress in Planning 63 (2005),1-91.

Santana, Paula, Santos, Rita., & Nogeuira, Helena. “The link between local environment and obesity: A multilevel analysis in the Lisbon Metropolitan Area, Portugal”. Social Science and Medicine 68 (2009): 1-9.

Stanton, Richard. “Who will take responsibility for obesity in Australia?” Public Health 123 (2009): 1-3.

Short, Stephanie. “Fat is a fairness issue”. Medicine and Culture 4 (2004): 1-6.

Steingraber, Simon. Exquisite communion: the body, landscape, and toxic exposures. In: Johnson, B.R., Hill, K. (Eds.), Ecology and Design: Frameworks for Learning. Washington, DC: Island Press, 2002.

Sullivan, William., & Kuo, Edwin. “Do Trees Strengthen Urban Communities, Reduce Domestic Violence? Urban and Community Forestry Assistance Program Technology Bulletin.” USDA Forest Service 4 (1996), 1.

Surface Transportation Policy Project (STPP). “Aggressive Driving: Are You at Risk?” Web.

Ulrich, Sullivan. “View from a window may influence recovery from surgery.” Science, 224 (1984), 420–421.

Wells, Moses. “At home with nature: effects of ‘greenness’ on children’s cognitive functioning.” Environ. Behav. 32, no. 6 (2000): 775–795.

Footnotes

• 1 Laura, E. Jackson. “The relationship of urban design to human health and condition.” Landscape and Urban Planning 64 (2002): 1-10.
• 2¹ Laura, E. Jackson. “The relationship of urban design to human health and condition.” Landscape and Urban Planning 64 (2002): 1-10.
• ^? Naess, Petter. “Residential location affects travel behaviour-but how and why? The case of Copenhagen metropolitan area.” Progress in Planning 63 (2005): 1-91.
• 3 Mees, Paul.”Toronto: Paradigm Reexamined.” Urban Policy and Research 12 (1994): p.6.
• 4¹ Ibid, pp.6.
• ^? Curtis, Corey. “The windscreen world of landuse transport integration.” TPR 76 (2005): 1-32.
• 5 Frumkin, H. “Beyond toxicity: human health and the natural environment.” Am. J. Prev. Med. 20 (2001): 234–240.
• 6 Sullivan, William., & Kuo, Edwin. “Do Trees Strengthen Urban Communities, Reduce Domestic Violence? Urban and Community Forestry Assistance Program Technology Bulletin.” USDA Forest Service 4 (1996): 1.
• 7¹ Laura, E. Jackson. “The relationship of urban design to human health and condition.” Landscape and Urban Planning 64 (2002): pp.3.
• ^? Ulrich, R. Sullivan.“View from a window may influence recovery from surgery.” Science 224 (1984): 420–421.
• 8 Lindheim, Richard., & Syme, S.Lindsey. “Environments, people, and health.” Annu. Rev. Public Health 4 (1983): 335–359.
• 9. Wells, N. Moses. “At home with nature: effects of ‘greenness’ on children’s cognitive functioning.” Environ. Behav. 32, no. 6 (2000): 775–795.
• 101. Ibid, pp.4,5.
• ⁶ Lindheim, Richard., & Syme, S.Lindsey. “Environments, people, and health.” Annu. Rev. Public Health 4 (1983): 335–359.
• ^? Lyle, J.Timoth. Regenerative Design for Sustainable Development. New York: Wiley, 1994.
• 11 Steingraber, Simon. Exquisite communion: the body, landscape, and toxic exposures. In: Johnson, B.R., Hill, K. (Eds.), Ecology and Design: Frameworks for Learning. (Washington, DC: Island Press, 2002) pp. 192–202.
• 12 Kaplan, R. Sullivan., & Ryan, R.Lindsey. With People in Mind: Design and Management of Everyday Nature. Washington, DC: Island Press, 1998.
• 13¹ Ibid, pp.4,6.
• ¹¹ Kunstler, J.Henson. Home from Nowhere: Remaking our Everyday World for the Twenty-first Century. New York: Simon and Schuster, 1996.
• ^? Kunstler, J.Henson. Home from Nowhere: Remaking our Everyday World for the Twenty-first Century. New York: Simon and Schuster, 1996.
• 14 Centers for Disease Control (CDC). “Self-Reported Physical Inactivity by Degree of Urbanization.” Morb. Mortal. Wkly. Rep. 47 (1998): 1097–1100.
• 15 Kreyling, Franklin. “Fat City: Are We Building Sick Communities?” Planning 4 (2001) :9.
• 16 Ewing, Reid. “Is Los Angels style sprawl desirable?” Journal of American Association 63, no.1 (1997): 1-20.
• 17 Gordon, Petter and Harry, W. Richardson. “Are Compact cities a desirable planning goal?” Journal of American Planning Association 63 (1997): p.3.
• 18¹ Ibid.
• ^? Costa, Gerald., Pickup, Leonard.,& Di Martino, Velentino. “Commuting—a further stress factor for working people: evidence from the European community.” Int. Arch. Occup. Environ. Health 60 (1988): 371–376.
• 19 Surface Transportation Policy Project (STPP). “Aggressive Driving: Are You at Risk?”. Web.
• 20 Booth, D.Benard., Reinelt, L.Edward. “Consequences of urbanization on aquatic systems—measured effects, degradation thresholds, and corrective strategies.” National Conference on Watershed Management 31(1993): 545–550.
• 21¹³ Ibid.
• ^? Centers for Disease Control (CDC). “Lyme Disease.” Morb. Mortal. Wkly. Rep. 50 (2001): 181–185.
• 22 Cromley, E.Kelvins., Cartter, M.Lindsey., Mrozinski, R.Donell. “Residential setting as a risk factor for lyme disease in a hyperendemic region.” Am. J. Epidemiol. 147, no.5 (1998): 472–477.
• 23 Biodiversity Project. “Making the Biodiversity—Sprawl Connection: Human Health Threats at a Glance.”. Web.
• 24 Santana, Paula, Santos, Rita., & Nogeuira, Helena. “The link between local environment and obesity: A multilevel analysis in the Lisbon Metropolitan Area, Portugal”. Social Science and Medicine 68 (2009): p.1.
• 25 Stanton, Richard. “Who will take responsibility for obesity in Australia?” Public Health 123 (2009): 1-3.
• 26 Short, Stephanie. “Fat is a fairness issue”. Medicine and Culture 4 (2004): 1-6.