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3
HUMAN CAPITAL
Winnie Hamilton, director of environmental health at Baylor
College of Medicine, opened the Human Capital session by talking
briefly about three separate parts or “pillars” of sustainability– social,
environmental, and economic. She added to this definition noting that
sustainable communities are healthy communities where natural and
historic resources are preserved. This “human capital” consists of jobs,
homes, education, health care, and opportunities for citizens to improve
their quality of life; this is a more people-oriented definition of
sustainability. Human capital, along with the built and natural
environment, provides the infrastructure for metropolitan regions like
Houston. To have a healthy, happy, and prosperous city, stated Dr.
Hamilton, this infrastructure needs to be created in a sustainable way.
Stephen Klineberg, professor and co-director of the Kinder Institute
for Urban Research at Rice University, described the demographic
changes that have occurred in Houston and how the region might be
transformed in the future. When Dr. Klineberg first started collecting
survey data in 1982, one million people had moved into Harris County
during the previous decade, in large part due to the booming oil refining
sector and related businesses resulting from dramatic increases in oil
prices—rising from $3.20 a barrel in 1978 to $32.50 a barrel in 1982. At
that time, 82 percent of Houston jobs were in that sector.
Despite the economic boom, a range of social and environmental
challenges, such as traffic congestion, emerging pollution problems, and
growing crime rates faced the growing city. Dr. Klineberg and his group
conducted what they intended to be a one-time survey in 1982 to
measure how people were dealing with the social costs of growth while
at the same time reveling in the benefits of a rapidly expanding economy.
Two months after the survey, oil prices dropped and continued to fall to
$28 a barrel by the end of 1983, resulting in a loss of 100,000 jobs. Dr.
Klineberg and his group decided to repeat the survey that year in light of
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16 PATHWAYS TO URBAN SUSTAINABILITY-HOUSTON
the loss in jobs and kept repeating it every year after that for the past 30
years. The survey, a representative random sample of Harris County
residents who are asked identical questions, has resulted in a valuable
dataset on the demographics and reflections of residents in the region.
Dr. Klineberg noted that historically, economic prosperity in the
region has not been based on education or human capital, but rather from
land and commodities, cotton, timber, cattle, and oil. He noted that this is
likely to change in the future, when the source of wealth will have less to
do with natural resources and more to do with human capital. Many of
the blue collar jobs from the 1970s have left Houston, and future
employment will require higher levels of education.
FIGURE 3-1 Increase in incomes from 1949-1979 compared to 1979-2003.
SOURCE: Stephen Klineberg presentation, January 18, 2012.
Not only has the economic structure of Houston changed, but the
national economy has also changed with increasing income disparity. Dr.
Klineberg presented data comparing the increase in income in the United
States from 1949 to 1979 to the increase in income from 1979 to 2003
(Figure 3-1). From 1949 to 1979, the poorest 20 percent of Americans
more than doubled their income. The era also saw the emergence of the
baby boom generation, as the average American woman gave birth to 3.6
children. In contrast, increases in income from 1979 to 2003 were
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HUMAN CAPITAL 17
concentrated in the top one percent, and mostly in the top one-tenth of
that one percent.
Equalizing institutions, noted Dr. Klineberg, need to be established
to assure that all Americans are able to share in the prosperity of the
country. Accelerating economic growth without any changes is not the
way forward. The only way to improve is to invest in the skills of the
American worker. Education has become the critical determinant of a
person’s ability to earn enough money to have a quality life and support
a family. Houston is a good example of social and economic divisions
inherent in much of the United States. Houston has one of the greatest
medical complexes in the country—the Texas Medical Center—but it
also has one of the highest percentages of children without health
insurance of any major city in the United States. The gap between rich
and poor has become a central political challenge, and new strategies are
needed to replace older ones that worked in the past but no longer meet
the needs of today’s economy.
Dr. Klineberg described some of the sectors where job growth is
most likely. For example, the biotechnology and nanotechnology sectors
are expanding with research being conducted at the Texas Medical
Center and Rice University. Houston’s economy will move toward more
of a knowledge economy, and the city will need to compete to attract the
best and brightest people working at the cutting edge and put that
knowledge into commercial ventures. This makes quality-of-life issues
more important. A striking example is the attitude of business to air
quality regulations. Through most of the 1990s, the business community
in Houston pushed back against regulations EPA promulgated under the
Clean Air Act, insisting that industry would not survive if it had to
comply with more stringent standards. Then, in June 1999, newspaper
headlines announced that Houston had surpassed Los Angeles in the
number of dangerously polluted days (Institute for Health Policy, 2006).
Now, Dr. Klineberg commented, the business community sees
environmental regulations as far from being anti-growth or anti-business,
but rather essential to Houston’s economic prosperity in the 21st century.
The business community understands that the city will not continue to
prosper if it is perceived as hot, flat, and dangerously polluted.
Another example of progress can be seen in the desire for the
revitalization of downtown Houston. In 2010, Dr. Klineberg’s survey
asked residents which type of home they would prefer to live in, and 41
percent of all adults in Harris County – one of the most automobile
dependent areas in America – responded that they would prefer to live in
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18 PATHWAYS TO URBAN SUSTAINABILITY-HOUSTON
a more urbanized area within walking distance of shops and work places
(Figure 3-2). And when the 2011 survey asked about the kind of
neighborhood people would prefer to live in, 45 percent of Harris County
residents expressed a preference for an area with a mix of developments
including shops, restaurants, and work places.
The changing demographics of the Houston area, Dr. Klineberg,
reflect the changing demographics of the nation in general. Until 1965,
82 percent of all U.S. immigrants came from Europe, another 12 percent
were Africans originally brought here as slaves to serve the Europeans,
and the remaining were mostly Asian farm workers and laborers. In
1924, Congress enacted the National Origins Quota Act, which limited
the number of immigrants allowed into the United States using a national
origins quota. The quota provided immigration visas to two percent of
the total number of people of each nationality in the United States as of
the 1890 national census, and excluded all immigrants from Asia (U.S.
Department of State, 2012).
FIGURE 3-2 Select responses from survey of residents in Harris County, TX.
SOURCE: Stephen Klineberg presentation, January 18, 2012.
Following the act, 86 percent of all immigration came from
Northern Europe, mostly Germany, Britain, and Ireland (Koven and
Götzke, 2010). The act, however, did not survive the shift in
consciousness that came with the Civil Rights Movement, and in 1965
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HUMAN CAPITAL 19
Congress changed the law, enacting the Immigration and Nationality Act
of 1965 (Hart-Cellar Act). This act abolished the national origins quota
system and replaced it with a preference system focusing on immigrants'
skills and family relationships with citizens or U.S. residents. Since the
passage of this act, millions of people have emigrated to the United
States from Asia, Latin America, Africa, and the Caribbean. The United
States became a microcosm of the world as the U.S. economy became
more fully integrated into a single global economic system.
Dr. Klineberg commented that no other city has been transformed as
fundamentally, suddenly, and irreversibly as Houston. In the space of
just 30 years, Houston has become one of the most ethnically and
culturally diverse cities in the country. Whereas the city was
predominately Anglos in the 1980s, by the 2000s, no ethnic group held a
majority. In the 2010 survey, the population of Houston was 7.7 percent
Asian, 18.4 percent African American, 33 percent Anglos, and 40.8
percent Hispanic (Figure 3-3). The changing demographics of Houston
have been one of the key drivers to keeping the city a vibrant
metropolitan area. Other cities in the United States have been losing
population. Dr. Klineberg also discussed the changing age distribution in
Houston and the rest of the country; 76 million babies were born in the
United States between 1946 and 1964, and the leading edge of those
baby boomers turned 65 in 2011. The number of Americans over the age
of 65 will double in the next 25 years, a trend that will have major effects
on Social Security and Medicare benefits. Anglos are overrepresented
among the baby boomers with young people disproportionately non-
Anglo. Nowhere is that more obvious than in Houston, Dr. Klineberg
noted. Of all the people currently living in Harris County aged 65 and
older, 69 percent are Anglo, 18 percent are African American, 11 percent
are Hispanic, and 2 percent are Asian. In the age group 18 to 29, the
percentage of African American, Asian, and above all Hispanic surges –
22 percent are African American, 45 percent are Hispanic, and 10
percent are Asian (Figure 3-4).
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20 PATHWAYS TO URBAN SUSTAINABILITY-HOUSTON
FIGURE 3-3 Change in demographics in Texas from 1960 - 2010.
SOURCE: Stephen Klineberg presentation, January 18, 2012.
FIGURE 3-4 Change in demographics in Texas across age groups.
SOURCE: Stephen Klineberg presentation, January 18, 2012.
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HUMAN CAPITAL 21
One of the biggest assets that Houston could have, stated Dr.
Klineberg, is the ability to contribute to a multi-ethnic economy for the
21st century. To prosper in a new high-technology, knowledge-based,
world-wide economy, Houston and the nation as a whole will need to
nurture a far more educated workforce and fashion policies to reduce
inequalities and prevent the rise of a new urban underclass. The Houston
metropolitan region will need to grow into a more aesthetically and
environmentally appealing destination in order to attract the most
innovative companies and talented individuals. Houston will also need to
develop the research centers that will fuel the growth of this new
economy. And in order to have an economy that flourishes, stated Dr.
Klineberg, it will need to develop into a more united and inclusive
multiethnic society, where equality of opportunity is truly made available
to all residents and where all communities are empowered to participate
as full partners in shaping the future.
Sustainable and Healthy Communities
Winifred Hamilton said that the World Health Organization
definition of environmental health encompasses “those aspects of human
health including quality of life that are determined by physical, chemical,
biologic, social, and psychological factors in the environment”. These
factors in the environment affect the ability of people in metropolitan
regions to build healthy lifestyles, develop personal and neighborhood
resilience during disasters, and foster sustainable futures. Dr. Hamilton
added that we need to have a resilient and healthy population capable of
facing future challenges and improving the quality of life for coming
generations. The role of the public health sector is to tie together these
many facets of a healthy lifestyle.
Brenda Reyes, chief of the Bureau of Community and Children
Environmental Health at the Houston Department of Health and Human
Services, explained that sustainability and resilience start at the home
with families. The lack of clean and affordable housing is a national
problem that is increasing economic stress on families and communities.
It is vital for Houston to build and maintain healthy, sustainable, and
affordable housing for its citizens, because housing is at the heart of the
community. Additionally, she noted, healthy housing and improvements
in energy efficiency generate higher resale value and equity for
homeowners, and the communities they form will see lower crime rates
and greater neighborhood involvement. Studies show that children
growing up in healthy housing are less likely to suffer from respiratory
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22 PATHWAYS TO URBAN SUSTAINABILITY-HOUSTON
problems, and are more likely to succeed in schools and society. Homes
built prior to 1978 are most likely to be the ones that put children’s
health at risk due to lead-based paint, mold, leaking water, and other
environmental hazards (Figure 3-5). Dr. Reyes emphasized that
sustainable housing includes both personal dwellings and office
buildings. These should be located in neighborhoods that are close to
jobs, walkways and bikeways, public transport, and community centers.
Neighborhoods such as these promote personal health and safety,
community engagement, prosperous local business, and local economies
and jobs. Community engagement is key, Dr. Reyes noted. For example,
property that is not maintained well becomes infested with pests, making
a single property a neighborhood-scale issue and responsibility.
Seven Principles of Healthy Housing
• Dry
• Clean
• Pest-Free
• Safe
• Contaminant-Free
• Ventilated
• Maintained
Brenda Reyes, Houston Department of Health and Human
Services, January 18, 2012
Healthy and sustainable housing also reduces the environmental
impact of that housing. Sustainable homes have a smaller carbon
footprint, conserve more resources and raw materials, and have lower
utility and water bills, Dr. Reyes commented. Lower bills provide
financial rewards to homeowners and help them recoup the upfront costs
of renovating to install higher efficiency systems. Sustainable homes are
also healthy homes with better air quality, resulting in less exposure to
mold and chemical toxins, as well as greater durability and reduced
maintenance. These high-performing homes require less upkeep and
fewer repairs, saving money and time, which contributes to more quality
family time, comfort, and increased home values. The most important
factor in making communities more resilient and sustainable is the
human component, Dr. Reyes said, and in order to have buy-in and make
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HUMAN CAPITAL 23
further progress, communities need to believe that they can and should
be healthy.
FIGURE 3-5 Eliminating or reducing environmental toxins shown in the
overlapping section of the Venn diagram is key to healthy housing.
SOURCE: Brenda Reyes, presentation, January 18, 2012
Herminia Palacio, director of Harris County Public Health and
Environmental Services, discussed the concept of “community capital”.
Capital, from a business case perspective, can be thought of as the cash
or goods to generate income either by investing in a business or in a
different income-generating property; the net worth of a business – the
amount by which its assets exceed its liabilities; or the money, property,
and other valuables which collectively represent the wealth of an
individual or business. The economist Gary Becker defined human
capital as investments in education, expenditures in health care, and other
activities that raise earnings, improve health, and add to a person’s assets
over time. Using this definition, Palacio stated that expenditures on
education, training, and medical care, for example, can be considered
investments in human capital.
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24 PATHWAYS TO URBAN SUSTAINABILITY-HOUSTON
Dr. Palacio described community capital as using sound policy and
funding strategies to generate sustainable and healthy communities by
investing in quality education, sustainable environmental planning, and
equitable economic development opportunities. Instead of the net worth
of a business, the amount by which a community’s health assets
sustainably and equitably exceed its health liabilities is equivalent to the
“net health” of that community. Instead of money or property and other
valuables that collectively represent the wealth of an individual or a
business, the health of a community is represented by its educational and
economic opportunities.
Dr. Palacio noted that from a planning and environmental health
perspective, developing sustainable communities is really about
protecting public health and developing healthy communities. The
Obesity Prevention Collaborative, funded by the Houston Endowment, is
a good example of a health policy program providing a pathway to urban
sustainability. The collaborative is a two-year community planning
process with the ultimate goal of developing a robust, comprehensive
plan to address obesity, diseases associated with obesity, and chronic
diseases more broadly in Harris County.
There are two well-established tools that make this community
planning process possible, Dr. Palacio said. The first is the Mobilizing
Action for Planning and Partnerships (MAPP) process, and the other is
the Protocol for Assessing Community Excellence in Environmental
Health (PACE EH). These tools bring together multiple sectors—
business, education, development and urban planning—in government-
private partnerships to examine changes that are needed in policies,
systems, and the environment.
Several grants awarded to the Harris County Public Health and
Environmental Services address policy systems, Dr. Palacio said. She
described a grant funded by the Centers for Disease Control and
Prevention (CDC), the Community Transformation Grant, which
supports community-level efforts to reduce chronic diseases such as
heart disease, cancer, stroke, and diabetes, in the hopes that these efforts
will improve health, reduce health disparities, and control health care
spending in these communities. Similarly, a Community Prevention
Grant is addressing tobacco use, mental health and substance abuse, and
the need for physical activity.
Dr. Palacio noted that the Sustainable Communities Regional
Planning grant received by the Houston-Galveston Area Council also
supports planning efforts that “integrate housing, land use, economic and
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HUMAN CAPITAL 25
workforce development, transportation, and infrastructure investments in
a manner that empowers jurisdictions to consider the interdependent
challenges of: (1) economic competitiveness and revitalization; (2) social
equity, inclusion, and access to opportunity; (3) energy use and climate
change; and (4) public health and environmental impact”.9 These three
grants were awarded nearly simultaneously, noted Dr. Palacio, and
require close communication and contact among the funded
organizations. The project leaders of these grants are actively identifying
opportunities for synergy and ways to minimize duplication. By aligning
planning processes, the organizations are working together to achieve
their individual missions and to optimize benefits for the community.
Dr. Palacio concluded her talk by challenging the group to think
about how to develop some clear and consistent language related to
complex problems that arise in creating more sustainable communities.
For example, she noted that in talking about resilience, there is often
confusion about what this refers to and what mitigation strategies should
be used, as well as the costs of those strategies. Similarly, when talking
about adaptability, the goals and outcomes are not often clear. Dr.
Palacio noted that the words we choose do matter because they help us
move forward together.
Natasha Prudent, health scientist with the National Center for
Environmental Health, Centers for Disease Control & Prevention (CDC),
provided a brief overview of the health impacts of climate change.
Health impacts associated with climate change generally fall into three
broad categories: (1) weather-related impacts; (2) impacts related to
environmental changes that occur in response to climate change; or (3)
impacts resulting from the consequences of climate-induced economic
dislocation, environmental decline, and conflict. Health effects
associated with weather are somewhat more easily quantifiable, because
they can be measured using indices such as deaths and injuries due to
extreme weather events, including flash floods, wildfires, and extreme
heat waves.
The second category of health impacts, those resulting from
environmental changes that occur in response to climate change are more
difficult to quantify because these changes are not limited to a specific
health effect; instead, other, more-complicated factors are involved such
9
Availabile at
http://portal.hud.gov/hudportal/HUD?src=/program_offices/sustainable_housing_commu
nities/sustainable_communities_regional_planning_grants.
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26 PATHWAYS TO URBAN SUSTAINABILITY-HOUSTON
as the built environment or population dynamics. An example of this
type of health impact would be the spread of infectious diseases due to
changes in ambient temperature, Ms. Prudent said. The last category of
health impact related to climate change includes climate-induced
economic dislocation, environmental decline, and conflict. This category
is the most difficult to quantify and is typically discussed as a qualitative
measure—for example, the rise in domestic violence among hurricane
evacuees who are relocated. Ms. Prudent noted that mechanisms such as
climate adaptation measures could help mitigate many of these health
effects.
Ms. Prudent discussed CDC’s efforts to develop vulnerability
assessments or decision support tools to help states and public health
entities identify communities most vulnerable to health problems
resulting from climate change, as well as adaptation measures and
resiliency efforts that could reduce those effects. CDC found that
vulnerability can vary significantly depending on scale; for example,
vulnerability is likely to be less at the state level than at the county or
census block levels.
Ms. Prudent stated that the CDC developed vulnerability
assessments for Travis County, Texas, which along with Austin, is
participating in the Climate-Ready Cities and States Initiative. This
initiative offers localities assistance in developing and using models to
predict climate-related health impacts, monitor health effects, and
identify those areas that are most vulnerable to these effects. So far,
health impacts have not generally been a part of the climate change
discussions. The CDC program focuses on climate policies that could
benefit human health, and identifies communities within Travis County
where policies can be developed to address the built environment and
social demographics, in addition to human health.
Two natural hazards—extreme heat and flash flooding—were
identified as critical priorities in Travis County as a result of this
assessment, Ms. Prudent said. To conduct the vulnerability assessment,
CDC evaluated various social measures in Travis County, including
population density, ethnicity, age, renters’ status, low educational
attainment, primary language spoken at home, prevalence of disability,
and measures of low income and public assistance. For the built
environment, measures of impervious surface or lack of vegetative cover,
and average surface temperature were used. To assess flood
vulnerability, data for 100-year floods and the density of low water
crossings were used.
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HUMAN CAPITAL 27
To evaluate health issues associated with extreme heat, CDC
assessed cardiovascular and hypertension mortality and diabetes. Ms.
Prudent noted that the literature supports a fairly strong relationship
between heat vulnerability and cardiovascular mortality. With extreme
events, pre-existing chronic conditions tend to be exacerbated—a
concern given the large demographic shift from a younger population to
an elderly one in the region. When heat events do occur, there tends to be
a corresponding spike in cardiovascular deaths. This is somewhat due to
public health departments classifying these deaths as cardiovascular in
nature rather than due to hyperthermia. Flood-related health effects tend
to be more difficult to understand, and there has been little research to
date on this issue; however, some data are available on displacement
associated with flooding.
CDC developed several vulnerability maps of the county to identify
communities at risk of impacts from extreme heat and flooding, Ms.
Prudent said. The purpose of the maps was to assist city planners in
thinking about land use; for example, to determine where to plant trees to
lessen the urban heat island effect. Two areas were identified as having
high vulnerability—both socially and in terms of the built environment—
due to extreme heat events and their resulting negative health outcomes.
The high vulnerability was driven by population demographics. One area
includes a poor, traditionally minority community. Another area highly
vulnerable to extreme heat included a community with a significant
elderly population. The agency also developed vulnerability maps for
flooding, and found that an indicator for a highly vulnerable community
was one that is traditionally minority and had experienced flooding in the
past.
It is important to look at vulnerability assessments not only from the
perspective of science but also from the perspective of a community’s
human and cultural dynamics, said Ms. Prudent. These dynamics offer an
appreciation for the community and understanding of the implications of
policy decisions. Also, without understanding the community, it may not
be possible to gain the buy-in needed to successfully implement policies.
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