Housing Opportunity 2014 - In Pursuit of the Good Life: The Role of Housing in Health and Wellbeing, Jonathan F.P. Rose
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  • These findings are not compatible with the usual idea that people smoke because of the evils of cigarette advertising. The patient you just saw speaks forcefully about the antidepressant, anti-anxiety, and anger-suppressant benefits of nicotine. The world medical literature documents this extensively, but we have comfortably forgotten that in our public health onslaught against smoking. Maybe that is why there has been no net decrease in smoking in the US in the past thirteen years: we are only looking at half the equation. The risks of smoking are very real, but far in the future whereas the psychoactive benefits occur within seconds of inhalation.
  • This is self-acknowledged alcoholism, so it may UNDERSTATE the case a bit. “Sit down, have a drink. Relax.” Some people need a lot of relaxing and it appears commonly to be related to the level of adverse childhood experiences.
  • Self-acknowledged injection drug use. At ACE Score 6 or more, we are wildly off the scale because the likelihood of THAT individual becoming an injection drug user is 4,600% greater than that of an ACE Score 0 individual. Rare in Epi. In America the most common street drug is methamphetamine, ‘crystal meth’. No one seems to recall that the first antidepressant introduced in 1940 for prescription sale in the US was methamphetamine. Does it MEAN anything that the most commonly sold street drug is an acknowledged, potent antidepressant? Isn’t it dangerous? Yes, but no more so than 30 Aspirin in one dose, or digitalis if it were sold on the street with unknown purity and concentration.
  • Here we look at the prevalence of self-acknowledged depression in over 17,000 middle-class adults, and its relation to experiences in childhood. Remember, we are matching depression against events 4 or 5 decades earlier.
  • And here we compare the use of antidepressant medications a half-century after childhood. It would appear that depression has deep roots, often extending back into childhood.
  • Intercourse by 15, Teen PG, Teen paternity.

Transcript

  • 1. ULI In Pursuit of the Good Life: The Role of Housing in Health and Well-Being
  • 2. Jonathan Rose Companies Prosperity The 10 Keys to Urban PROSPERITY are… 1. Connectivity 2. Productivity 3. Economic Diversity 4. Social Diversity 5. Knowledge and Innovation 6. Cultural Flexibility 7. Trust/Security 8: Infrastructure 9. Density 10. Regional Integration
  • 3. Jonathan Rose Companies OECD Wellbeing The 10 Keys to Urban WELLBEING are… 1. Income/Wealth 2. Jobs and Earnings 3. Housing Conditions 4. Health Status 5. Work/ Life Balance 6. Education and Skills 7. Social Connections 8. Civic Engagement 9. Environmental Quality 10. Personal Security
  • 4. The ACE Study • Vincent J. Felitti, MD and Robert J. Anda, MD, MS • Asked 26,000 adults at Kaiser, San Diego’s Dept of Preventive Medicine. • 17,421 participated in the study. • Participants completed a questionnaire.
  • 5. Updated Mechanism
  • 6. Adverse Childhood Experiences vs. Smoking as an Adult 0 2 4 6 8 10 12 14 16 18 20 0 1 2 3 4-5 6 or more ACE Score % p< .001
  • 7. Childhood Experiences vs. Adult Alcoholism 0 2 4 6 8 10 12 14 16 18 %Alcoholic ACE Score 0 1 2 3 4+
  • 8. ACE Score vs Intravenous Drug Use 0 0.5 1 1.5 2 2.5 3 3.5 %HaveInjectedDrugs 0 1 2 3 4 or more ACE Score p<0.001
  • 9. Chronic Depression 0 10 20 30 40 50 60 70 80 %WithaLifetimeHistoryof Depression 0 1 2 3 >=4 ACE Score Women Men
  • 10. ACE Score and Rates of Antidepressant Prescriptions 0 10 20 30 40 50 60 70 80 90 100 Prescriptionrate per100person-years) 0 1 2 3 4 5 or more ACE Score
  • 11. ACE Score and Teen Sexual Behaviors 0 5 10 15 20 25 30 35 40 45 PercentWithHealthProblem(%) 0 1 2 3 4 or more ACE Score Intercourse by 15 Teen Pregnancy Teen Paternity
  • 12. Jonathan Rose Companies Via Verde
  • 13. Jonathan Rose Companies Via Verde
  • 14. Jonathan Rose Companies Via Verde
  • 15. Jonathan Rose Companies Via Verde
  • 16. Jonathan Rose Companies Via Verde
  • 17. Jonathan Rose Companies Via Verde
  • 18. Jonathan Rose Companies The Green Future Portland Source: Portland Sustainability Institute
  • 19. Jonathan Rose Companies Social Connectivity: HGV Community Gardens
  • 20. Jonathan Rose Companies Brooklyn Bridge Park
  • 21. Jonathan Rose Companies Overview In the 21st century, city makers must plan and design to enhance urban prosperity not for itself, but as the engine of human and natural systems well being.