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The Topography of Wellness

How Health and Disease Shaped the American Landscape
Sara Jensen Carr

BUY Cloth · 288 pp. · 7 × 9 · ISBN 9780813946290 · $79.50 · Oct 2021
BUY Paper · 288 pp. · 7 × 9 · ISBN 9780813946306 · $34.50 · Oct 2021
BUY Ebook · 288 pp. · ISBN 9780813946313 · $29.50 · Oct 2021

The COVID-19 pandemic has reignited discussions of how architects, landscape designers, and urban planners can shape the environment in response to disease. This challenge is both a timely topic and one with an illuminating history. In The Topography of Wellness, Sara Jensen Carr offers a chronological narrative of how six epidemics transformed the American urban landscape, reflecting changing views of the power of design, pathology of disease, and the epidemiology of the environment. From the infectious diseases of cholera and tuberculosis, to so-called social diseases of idleness and crime, to the more complicated origins of today’s chronic diseases, each illness and its associated combat strategies has left its mark on our surroundings. While each solution succeeded in eliminating the disease on some level, sweeping environmental changes often came with significant social and physical consequences. Even more unexpectedly, some adaptations inadvertently incubated future epidemics. From the Industrial Revolution to present day, this book illuminates the constant evolution of our relationship to wellness and the environment by documenting the shifting grounds of illness and the urban landscape.


A substantial contribution to the field illustrating how public health and planning policies merged and supported each other after the Industrial Revolution, parted ways in the twentieth century, and have now remerged in tackling contemporary issues of health and the built environment. Carr draws on a myriad of sources, and the work represents sound and thorough scholarship.

Clare Cooper Marcus, University of California, Berkeley · Iona Dreaming: The Healing Power of Place

I cannot imagine a more perfect post-pandemic book. Public health provides the legal foundations for the architecture, landscape architecture, and planning professions in the United States. As a result, it is essential to understand the role that public health has played in shaping our cities. In The Topography of Wellness, Sara Jensen Carr provides a tour-de-force review and analysis of the checkered history of the contributions that public health and disease have played in designing and planning the American landscape.

Frederick Steiner, University of Pennsylvania Weitzman School of Design · Making Plans: How to Engage with Landscape, Design, and the Urban Environment

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