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The Topography of Wellness: How Health and Disease Shaped the American Landscape

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TThe 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.

288 pages, Kindle Edition

Published October 5, 2021

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Sara Jensen Carr

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Displaying 1 - 2 of 2 reviews
Profile Image for sabine.
154 reviews
February 25, 2026
nothin special. liked the discussions of leisure in mid 19th and early 20th, pairing natural resort towns with playgrounds was smart. also validated my instinctive dislike for the new urbanists lolll
Profile Image for Mark NP.
139 reviews4 followers
December 26, 2023
Jensen Carr's weighty tome on the relationship between health and the built landscape is a well researched and interesting textbook that should be required reading in coursework for undergrad and graduate architects, policy designers, and city planners. This book took me a LONG time to read (like, most of 2023), but ultimately I think it was informative and useful and I'm glad I became invested in finishing it. I came to the book on a recommendation because I was looking for information on the history of travel and tourism for health purposes (e.g. how Atlantic City was developed as a health resort, or how mineral springs were marketed to tourists as medicinal spas), but this was not the right book for that purpose. Anyway, I found the section on cemeteries as precursors to modern urban parks more useful and will be using a reference from her book.

Carr begins the book by explaining how health, environment and morality have become inextricably linked in the American imagination. She follows the progression of how cities and illness changed together, and how purposeful urban planning eradicated many transmissible diseases in the 19th century. She goes on to demonstrate how the causes and cures for chronic illness have become more complex and intertwined with the built environment. She raises critical questions about race and class throughout the book and her thoughtful approach shows how there is room for improvement as the cities of the future will be developed with health improvements in mind today. She uses very dense paragraphs with enough to chew on for a day or two every couple of pages.
Displaying 1 - 2 of 2 reviews