Sustainable Health Care, Part 1 - The Way We Eat

This week's newspaper column - first in a two-part series on sustainable health care reform.

The national debate on health care reform is raging. On the left, the buzz is about universal coverage and pubic options; on the right - tort reform and the free market. Everyone is concerned about the increasingly high price tag.

You may be asking, “What does sustainability have to do with health care?”

Surprisingly, sustainable practices – or more to the point, the lack of sustainable practices - have a great deal to do with how much Americans pay for health care. Regardless of where you fall in the political spectrum, or whether you are fully insured or not at all, unsustainable practices jack up the price you pay.

Consider the issue of what we eat and how we grow our food.

Perhaps the most costly contributor to what we pay for health care is America’s obesity epidemic. Americans are getting fatter and fatter each passing year. Diabetes, heart disease, respiratory ailments and other expensive-to-treat maladies are exacerbated and sometimes completely brought on by obesity.

Juvenile diabetes is on the rise as kids take in almost a third of their calories from sugary soft drinks. The sweetener of choice – high fructose corn syrup – is cheap because government subsidies over the past half century have encouraged farmers to abandon sustainable practices of rotating crops and livestock and move to single-crop farming. That strategy has been good for production yields, but bad for the diversity of local farming and the availability of locally grown produce.

Crop rotation has been used for millennia as a sustainable practice to self-fertilize and to keep pests away naturally. Without that cultivated diversity, farmers now use more fertilizer and more insecticide to produce the food we eat. Thankfully, farmers cannot spray with DDT any more - a chemical proven to have extreme adverse side effects – but the jury is still out on the long-term effects of currently-used chemicals when it comes to contracting various types of cancer.

When you think about sustainability, think “natural. One of the keys to good health is eating a diverse selection of fresh fruits and vegetables. Processed foods contain extra chemicals for the sake of shelf life and preservation of natural coloration, but some of the nutritional value in processed foods is lost in the process of, well, being processed.

At some point, we began using hydrogenated oils to extend expiration dates of various packaged foods – good news for retailers, but turns out too much hydrogenated oil in the diet leads to heart disease and resulting high-cost treatments.

It’s simple: Americans are eating too many empty calories from processed sugars and fats and we’re paying a high price to treat the consequences. If we do not change the way we eat, Americans will continue to pay “too much” for health care no matter how we change system.

Obama's Health Care Plan

Many people from across the political spectrum are asking "What's in Obama's health care plan?"

Certain factions (seemingly motivated by fear of change or a visceral hatred for President Obama) have mis-characterized the Administration's health care plan so loudly that honest information-seekers are genuinely confused.

You can read the full plan at Whitehouse.gov; here are the bullet highlights.

If You Have Health Insurance

• Ends discrimination against people with pre-existing conditions.
• Limits premium discrimination based on gender and age.
• Prevents insurance companies from dropping coverage when people are sick and need it most.
• Caps out-of pocket expenses so people don’t go broke when they get sick.
• Eliminates extra charges for preventive care like mammograms, flu shots and diabetes tests to improve health and save money.
• Protects Medicare for seniors.
• Eliminates the "donut-hole" gap in coverage for prescription drugs.

If You Don't Have Insurance

• Creates a new insurance marketplace – the Exchange – that allows people without insurance and small businesses to compare plans and buy insurance at competitive prices.
• Provides new tax credits to help people buy insurance.
• Provides small businesses tax credits and affordable options for covering employees.
• Offers a public health insurance option to provide the uninsured and those who can’t find affordable coverage with a real choice.
• Immediately offers new, low-cost coverage through a national "high risk" pool to protect people with preexisting conditions from financial ruin until the new Exchange is created.

For All Americans

• Won’t add a dime to the deficit and is paid for upfront.
• Requires additional cuts if savings are not realized.
• Implements a number of delivery system reforms that begin to rein in health care costs and align incentives for hospitals, physicians, and others to improve quality.
• Creates an independent commission of doctors and medical experts to identify waste, fraud and abuse in the health care system.
• Orders immediate medical malpractice reform projects that could help doctors focus on putting their patients first, not on practicing defensive medicine.
• Requires large employers to cover their employees and individuals who can afford it to buy insurance so everyone shares in the responsibility of reform.

LEED Rating System: Panacea or Smoke Screen?

New LEED Silver university dormitories

Over the past few years, the LEED (Leadership in Energy and Environmental Design) rating system by the USGBC (US Green Building Council) has become the most recognized public symbol of green building in the US.

Since its inception in 1993, the USGBC has contributed monumentally to public awareness of green building issues, and the LEED rating system is a good-faith attempt to certify the level of sustainability in a building, but LEED - as is - has some fatal flaws. Did you know that a building can be awarded a LEED Silver Certification while using more energy than the average building or without addressing any of the local climatic conditions? A building in Alaska would not be disqualified for being a carbon copy of a building in Florida - as long as the credits add up.

Problem is, LEED is a checklist, and a clever designer can find enough check marks to gain a certification without really making a fundamental change in the way buildings are designed. (A contractor representative of a local LEED Silver project recently came by my sustainability class and presented the building. The visit got them a point on the checklist necessary to make Silver. Great! But does it make the building any greener? Turns out, the building in question looks conspicuously just like the last conventional energy-hog-of-a-building designed by that architect.)

LEED is a rating system, and no substitute for a thorough understanding of the "principles" of Sustainability. LEED should reflect sustainability, not the other way around.

Here's a good article from New York Times about LEED rating shortfalls.

Transformative Ideas of Van Jones

Image: YouTube still

Want to know the real reason Van Jones was targeted by the noise machine?

Watch this speech he delivered in Philadelphia a couple of years ago explaining the philosophy of lifting people out of poverty by matching up America's fastest growing economic sector - the green economy - with those who need jobs most.

Powerful ideas draw powerful enemies. Pick it up at the 22:40 mark if you want to skip over a rather lengthy intro.

UPDATE: Arianna Huffington's take - Thank You, Glenn Beck.

BeauSoleil: Put a Lid On It !

Solar Decathlon Update: Every two years 20 university teams are chosen, based on proposals, to design an all-solar home and assemble it on the National Mall in Washington DC for public viewing and judging. Check back each Wednesday as the NAV Blog reports on the process of the design and construction of BeauSoleil, the University of Louisiana at Lafayette's entry. For more info about the project, visit their website. And check out a short film about the project.

Report from the field:

Why do we as designers like the challenge of a competition like the Solar Decathlon? Why do we work and think so hard about very specific problems? Is it because the solutions we develop give us gratification/ satisfaction? Are we not challenged enough in a typical design project whether hypothetical or real? Is it the desire to triumph over others working on similar design problems/solutions?

It seems to me that it is the fear of the unknown, the possibility of failure and the risk in general, that is the allure also. I've often compared the struggle of the Decathlon with the Moon Launch and the assault on Normandy in WWII. Obviously, there is really no comparison with the scale of the projects or the sacrifices made - but for those who have competed in the Decathlon there is some truth the rings true.

So why do we drive ourselves to such extreme for 10 days on the mall in DC? It is not really about those ten days... but it is... but is also really about a personal challenge for each of the TEAM members. Can I handle it? The Decathlon is really a vehicle for testing ourselves and our ideas while producing something of lasting significance.

W. Geoff Gjertson, AIA
Assoc. Professor of Architecture
UL Lafayette
TEAM BeauSoleil Faculty Advisor

Obama Administration Cans Van Jones

Late-breaking news:

In a sad and tragic turn of events, the Obama administration just threw Van Jones, and with him the heart and soul of the green movement, under the bus after refusing to defend Jones from viscous partisan attacks. Around midnight last night, Jones submitted his resignation along with this statement.

In the early days of the administration, advocates for greening the American economy (including this one) were ecstatic over the appointment of Van Jones to the new position of "Green Jobs Czar." Finally, after years of rudderless inattention, we had the hope and promise of proactive efforts to promote green jobs in all sectors of the economy. At long last, all Americans stood to benefit from brainpower inside the federal government dedicated to expanding the green economy.

Jones' crime - wearing his heart on his sleeve. Jones lives and breathes the ethic of empowering ALL of our citizens through education, training, and the creation of green jobs with special emphasis on those who do not have the means to lobby Washington for just that. Equipped with a Yale law degree, Jones could have chosen a path in corporate America or on Wall Street with the accompanying personal enrichment. He didn't. Instead he has devoted his professional life to lifting the disenfranchised out of poverty by equipping eager-to-learn individuals with skills that (ironically considering right-wing cries of "Marxist!") allow them to compete in our capitalist economy.

Over the past several months, I have attempted in vain to find out what green jobs initiatives were in the works. In the age of the Internet, that should not have been a very hard task. Seems, in retrospect, that Van Jones has been kept under wraps by this administration, and never had the respect or solid backing of the president.

Jones' ideas on greening the American economy are not only defendable, they are a moral imperative. Why not, instead of sacrificing the good, demand that opponents defend their positions, which have turned out to be disastrous.

It's hard to imagine how Jones' resignation will do anything but enable and empower those who are hell-bent on killing the green movement. (The Luddites have already started celebrating and now they're looking for more scalps.)

This is a sad day for America, and a telling move from an administration that - until now - this green Architect has doggedly defended in the face of lies and slander by those who despise progressive values.

Katrina Cottages

Images: Mississippi Development Authority

Immediately after Hurricane Katrina, hundreds of designers descended on the Mississippi Gulf Coast and New Orleans. Chief among them were purveyors of the New Urbanism movement. The Katrina Cottage design was born out of those efforts.

New Urbanists lean heavily on borrowing historical examples of "traditional neighborhoods" in creating master plan layouts and in establishing the stylistic appearance of buildings and spaces.

(Before firing off hate mail to the author, please be aware that, admittedly, this is somewhat of a broad and over-simplistic explanation of New Urbanism. Somewhat. There are variations on the theme, but the "looking back" quality seems to be a common tenant. You can learn more about New Urbanism from pioneer Andres Duany and associates in the very informative book Suburban Nation.)

My critique of New Urbanism is that it tends to be forced, overly regimented, lacking in unpredictable creativity, and unnecessarily nostalgic - all qualities, when overly weighted - result in sacrificing environmental compatibility for the sake of "what it looks like." Having said that, I think the New Urbanists are spot on in their analysis of what's wrong with America's suburbs.

Take for example this proposed layout (above) included in Mississippi's grant application - Mississippi calls them Mississippi Cottages, not Katrina Cottages - for alternative hurricane relief housing. The explanation claims that this plan is based on a "Roman Camp" model. Just between you and me, I think it more closely resembles the layout of a stockade or a modern-day penitentiary.

Where's the life? Where are the unexpected delightful spaces. And what happened to Nature? (Here's a clue: think about bulldozers lined up blade to blade scraping Mother Nature's silt-soft skin.)



Earlier in the year, a coast developer who was considering buying out a few hundred of the excess cottages hired me to design a layout for said cottages a few miles north of the gulf. The density requirement was a challenge on this project, but here's the organic solution I came up with.

Notice the variety of spaces (carved out of the natural landforms) and the periodic relief between units and shared vistas into natural wetlands.

Quite a contrast. Same Katrina Cottages but with a very different feel. A more natural feel. What a difference it makes to the senses (and the human spirit) when sensitive coexistence with the natural environment trumps "historical" remedies.

Update: Since this post, a couple of people have mentioned that the site plan of the New Urbanist-generated Katrina Cottage layout looked curiously like 1) a concentration camp or 2) the hull of a slave ship. You be the judge.

GreenMobile: Eco Prefab

Image by Michael Berk (double click image for higher resolution)


In response to the Katrina toxic trailer debacle, the federal government appropriated $400 million for alternative temporary housing.

Mississippi's Katrina Cottage concept got the lion's share of the money, but a respectable thin sliver - almost $6 million - went to fund the production of a lesser known concept - Michael Berk's GreenMobile.

The GreenMobile, pronounced like the oil company, not the auto-, is a factory-produced, transportable, expandable, affordable green home that can serve as a "port after the storm" or as permanent domicile. This prototype ties into existing infrastructure or can be equipped to go it alone as self-sustaining living quarters.

Though Katrina Cottages are in abundance - the State of Mississippi is now selling off the excess units - I have to say I'm having some trouble finding a constructed GreenMobile anywhere in Mississippi. (Can somebody help me out here?)

I asked Michael Berk recently about the status of the funded GreenMobile and he said he didn't know. Seems that after consulting early on, he's out of the loop on any resulting construction. Sounding like someone talking about an estranged former lover, Berk commented about the design : "It's changed." I could hear him shaking his head over the phone.

Nevertheless, the final proposal for funding that I saw two years ago was far deeper shade of green than anything else out there. The wording in the appropriation announcement contained the disclaimer "up to" before funding amounts. It would be a shame if this progressive prototype died a premature death with money on the table.

Check out Professor/Architect Michael Berk's website for more images of the GreenMobile.

The Legacy of FEMA Trailers: Meet "Little Wierdo"

Image: still from Becky Gillette interview with Katrina survivor Jennifer Donelson

My friend Becky Gillette is a real American hero. We've all heard about the hazardous levels of formaldehyde that were found in Katrina FEMA trailers; well, you can thank Becky for bringing this explosive story to the world's attention.

Here's what happened.

Shortly after Katrina's homeless population started occupying the FEMA-supplied manufactured homes - an industry euphemism for "house trailers" - rumors started to circulate that people who lived in the trailers were getting sick. Very sick.

Scratchy eyes, sore throat, couching, nausea, vomiting - the symptoms seemed to be universal. When people inquired into the coincidental nature of all the sudden ill health, they were told, in so many words, to go back in their trailers and shut up. 'Be glad to have any home at all' was the prevailing sentiment from the federal government officials who were sent down to smooth things over.

(You can read my FEMA Trailer post from last year: Wake Up and Smell the Formaldehyde.)

One of the very few environmentalists living on the coast at the time, Becky caught wind of the situation and doggedly pursued the story through the press and, with the Sierra Club, through the courts until the federal government was forced to admit that the trailers were not fit for human habitation. They subsequently forbade any government employees from entering the trailers on "safety" grounds, and measures were taken to move people into alternative housing.

In her interview with Katrina survivor Jennifer Donelson, the consequences of living in a toxic environment are revealed. Sitting on her couch and holding her Katrina baby, she tells about the excitement of when her family first moved in to their new trailer. "It had that great brand-new smell. I thought that was good! Of course," she says sadly, "it ended up not being good."

Jennifer goes on to tell how living with formaldehyde affected her child.

"We just called him Little Wierdo. We didn't know there was something really wrong with him." Shortly after birth, she noticed that her baby was turning blue. Then he stopped breathing.

I'll spare you the rest of the details; you can watch the interview here.

For her work, Becky was awarded a 2008 Sierra Club Special Achievement award. USA Today called her "Gulf Coast's Erin Brockovich." We need more people like Becky in this world.

Green Homes for New Orleans' Ninth Ward

Image by William McDonough + Partners


In New Orleans, Brad Pitt's initiative - Make It Right Homes - is refitting the devastated 9th Ward with an interesting collection of affordable green homes. Four years after the storm, several units are finished and occupied, more are under construction, and still more are on the way.

Pitt's organization managed to obtain the services of some of the country's leading green architects to design MIR prototypes including this one by architect William McDonough.

McDonough seems to have come out of the womb thinking green. His influential book Cradle to Cradle has proven to be somewhat of a manifesto for sustainable design. In the book, he and coauthor Michael Braungart promote the idea that "waste equals food" introducing to a wide audience the concept that products can be designed for infinite uses in a closed loop life cycle.

His early claim to fame was the design of a solar house built in Ireland in 1977. New Orleans has considerably more sun than Ireland; you guessed it - this home is equipped with a rooftop of PV panels.

Some very nice work is going on here, but given the huge demand for affordable housing in the Katrina affected zone, it's just a drop in the proverbial bucket. But the ideas generated in the process - many experimental - are the real power of this initiative. How this plays out will influence far more than the Ninth Ward, I predict.

Click on this link for detailed renderings and plans of William McDonough's green duplex prototype.

And for some "on the ground" reporting on the new MIR homes, check out this link from Lira Luis' blog. Lira is a former Taliesin apprentice and uber-creative architect in her own right.