health impact assessment harvard divinity school · in an emergency, some accessibility issues in...

Health Impact Assessment Harvard Divinity School FALL 2014 Harvard Graduate School of Design SES0533000 Healthy Places Prof. Ann Forsyth TA: Alex Chen Students: Shahab Al Bahar Blanca Espuig Justin Feldman Yun Fu Matthew Furman Allison Green Cara Michell Elizabeth Mitgang Kelsey O’Brien

TABLE OF CONTENTS Introduction .................................................................................................................................................. 2

Ambient Environment ................................................................................................................................. 10

Building Maintenance and Management ................................................................................................... 25

Food ............................................................................................................................................................ 37

Housing ....................................................................................................................................................... 50

Mental Health ............................................................................................................................................. 57

Physical Activity and Commute ................................................................................................................... 72

Safety .......................................................................................................................................................... 78

Social Capital ............................................................................................................................................... 88

Spirituality and Health ................................................................................................................................ 96

Appendix A: Background Information for Harvard Divinity School (HDS) ................................................ 106

Appendix B: Products in Rock Café ........................................................................................................... 107

References ................................................................................................................................................ 129

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Introduction In 2014 the Healthy Places course in the Harvard Design School collaborated to conduct a Health impact Assessment (HIA) of the Divinity School campus at Harvard University. It included facilities in Andover Hall, Rockefeller Hall, and the Center for the Study of World Religions (see figure below). The exercise aimed to give the class experience conducting an HIA. The prior year students had conducted a similar assessment of Harvard Graduate School of Design. Students in this year’s team came from public health, design, and planning programs but not the divinity school. However as is noted in the individual chapters students drew on observations, focus groups, and a survey to make their assessment. Figure: Harvard Divinity School Study Areas

http://hds.harvard.edu/files/hds/files/hds_2012map.pdf

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Process Early in the semester students brainstormed relevant topics, divided up topics and conducted research on specific issues, drafted chapters, participated in a workshop to prioritize recommendations, and then revised their chapters. In the first stage of the HIA workshop, one key statement was taken from the individual reports that the participants produced. The participants then voted on the topic that they felt was the most important to the Divinity School’s health. The results are reproduced below. The topic receiving the most votes was unhealthy food (vending, nutrition information, portion sizes, and overconsumption related to free food), followed by affordable housing, safety (bicycle/pedestrian conflicts and emergency preparedness), and ambient conditions (lighting, ventilation, noise, and temperature). Part 1: Voting on Statements

1. Of greatest [food] concern, are the unhealthy options that are present in the vending machines, lack of available nutrition information, portion sizes, and student’s overconsumption of food at events.

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2. More than 50% of the people … that answered the survey mentioned that they do not believe they have access to affordable housing near campus.

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3. The primary safety hazards on campus include the injury risk that bicycle users pose to pedestrians and a lack of knowledge regarding emergency preparedness among the HDS community.

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4. Four issues emerged from student feedback concerning the ambient environment. Complaints focused on lighting, ventilation, noise, and temperature.

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5. Community members value the warm atmosphere and opportunities for social interaction created by HDS. However, that warmth is not always extended to visitors and interactions are often limited within existing social groups.

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6. More doors to bathrooms should be free swinging to avoid germ transmission on handles/knobs upon entry/exit.

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7. HDS could implement small‐scale interventions that attempt to enhance mental well‐being on campus.

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8. HDS can enhance the spiritual health of its affiliates by strengthening connections to other parts of the Harvard community and nature.

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The second stage involved brainstorming areas that were positive or negative in terms of health, then voting on them. Some of the positive areas with the highest votes include robust community activities, the new park developed in place of the parking lot, the library’s ambient conditions (e.g. lighting), and the infrastructure for interfaith connections. Negative aspects included issues with knowing what to do in an emergency, some accessibility issues in bathrooms, vending machine food options, lack of obvious posted information on mental health, and physical spaces originally designed as Christian even if now open to all.

Statement Votes

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Part 2: Health Effects

Health Direction

Issues Votes

Positive

Robust community activities (tea, meditation, com table, mass) 2

Transformation of car park into green space 1

Good ambient condition in library 1

Social Infrastructure for interfaith connection, noon service led by different groups

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Negative

Lack of knowledge about what to do in an emergency 4

Narrow stall space 3

Vending machine food options, Food nutrition? (salty) 3

Christian‐centric physical spaces, even though its open to all 3

Lack of resources/info on mental health 3

Google shows HDS as bike route 2

Fluorescent lighting 2

Time spent sitting is quite long 2

Bathroom – don’t meet the “you don’t have to touch anything” criteria (gold standard)

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Lack of nutrition information in the cafeteria 1

Motorized mode of transport (car of bus) to get to HDS (motorized commutes) 1

Portion sizes are huge 1

The final stage of the HIA involved the most specific and actionable items derived from the highest priority items of the previous round of voting. Though there are many ways to analyze the data the highest priority items are encouraging underrepresented groups to take leadership positions at the Divinity School (for social capital), checking emergency plans (and making them more prominent), eliminating vending machines or providing healthier options in them, and including gym memberships in tuition.

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Task 3: Changes to Enhance Positives or Reduce Negatives

Recommendations Votes

Increasing Positives

Programming to encourage underrepresented groups to campus leadership 3

More seating in green space 2

Programming for winter 1

Find ways for HDS to be a wider resource for larger campus, especially leadership

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Reducing Negatives

Check emergency plans 4

Vending – eliminate or provide healthy options 3

Gym membership included in tuition 3

LED light narrow space and mirrors 2

Standing stations in the library/Treadmill desks 2

Walking meetings 2

Relocate bike paths, clear paths, create better bike path 2

Mental health info in public spaces, not just website, especially in restrooms 2

Increase outdoor lighting at night to increase sense of safety 2

Regular weekend jog club, yoga‐expand (Tai‐Chi, Buddhist meditation, self defense)

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Invite faith communities in [to the school] more, especially distance ones or help reach distant locations (money or guides)

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Full spectrum light in library, other locations, or loan 1

The students’ reports are reproduced in subsequent chapters. They make the following recommendations:

Ambient Conditions Recommendations Short Term

Supplement existing lighting with warm lighting options to complete the lighting color spectrum.

Identify resonance frequency in silent study room and install acoustic panels for that frequency. Medium Term

Make the current inoperable windows into operable windows.

Modify the air condition system to act as fan when the humidity and temperature of exterior air is suitable for direct use.

Install reflective devices like light shelves to allow light to penetrate deeper into the library space.

Separate archive and work space to maintain optimal temperature and humidity for each type of space.

Long Term

Completely segregate stacks from study areas by building an extension or annex

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Install better thermal and vapor installation in the walls of peripheral rooms when the library is next renovated.

Building Maintenance and Management Recommendations Short Term:

Post health literature consistently in all bathroom facilities—especially where there is currently only composting literature.

Reposition hand sanitizing stations away from restrooms to encourage hand washing with warm water and soap.

Redesign recycling/composting signs to include visuals of appropriate products (pictures or actual products) that go in each bin.

Find and implement alternative cleaning agents for the current cleaning products identified as relatively harmful.

Medium Term:

Address damages to the interior walls in Andover Hall and clean up cracking wall residue, which could contain lead due to age of building.

Introduce new recycling/composting education program at the beginning of each academic semester – developed and executed by the HDS Green Team—to ensure that new/incoming HDS community members understand best practices.

Install waste and recycling receptacles around the perimeter of campus to maintain already pristine campus grounds.

Install doggie bag (biodegradable) dispensers near waste receptacles to maintain amicable community relations with dog owners while concurrently promoting clean campus grounds.

Long Term:

Reconfigure bathrooms when possible into multi‐stall configuration and replace door handles with free‐swinging doors.

Replace all paper towel/soap dispensers and faucets with motion sensor technology to reduce germ transmission.

Food Recommendations Short Term:

Provide access to nutritional information: o Post the Healthy Eating Plate o Provide healthy recipes o Post information about dietitian services at Harvard

Remove candy bowl at CSWR or move it to a less prominent location.

Survey staff to better understand the use of the kitchenettes. Small improvements could result in greater use.

Medium Term:

Offer more vegetarian options.

Slowly reduce the portion sizes of the meals.

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Remove foods that scored poorly on the Environmental Working Group’s Food Scores.

Remove vending machines completely or replace them with healthy vending machines.

Incorporate more elements of choice architecture into placement of foods at Rock Café. For example, place healthier options at eye‐level, near the cash register, or at the beginning of the line.

Long Term:

Continue buy locally sourced foods and engage in sustainable practices.

Consult with a registered dietitian weekly about the Rock Café menu.

Housing Recommendations Short Term:

Install clear signs at the CSWR stating the different accesses and boundaries for the residential and the office spaces, so that visitors, as well as residents and workers, respect the privacy of the occupants of the building.

Upgrade the maintenance schedule and action plans at least one a year in all university housing buildings, to make sure that they are in accordance with the systems and the occupants needs.

Admit some personal furniture in the CSWR apartments for the commodity and the well being of the occupants. The third floor should be used as a storage room for the furniture that the tenant does not need.

Medium Term:

Upgrade the building envelope of the university housing buildings, this will lower specially the heating demand and the rent prices could be lowered.

Install energy production systems for the university housing buildings, this way, part of the energy demand of these can be balanced with the on‐site energy production and the rent prices could be lowered.

Long Term:

Acquire or construct more housing buildings to meet the demand of the students.

Upgrade the roof of the CSWR to better meet the standards of such a cold climate like Cambridge’, this upgrade should allow the evacuation of the snow by itself while keeping the architectural image of the building.

Adequate the circulation spaces of the apartments at the CSWR to the long and cold winters. The circulation space has to be flexible and dynamic, open during summers to allow natural ventilation and closed in winter to serve as a buffer space at the arrival of the tenants.

Mental Health Recommendations Short Term:

Openly acknowledge that there is a mental health problem.

Discuss mental health during student orientations, in student handbooks, and through student meeting with advisors.

Recognize marginalized or underrepresented groups and integrate them into the existing community.

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Long Term:

Address rent rate increase in the area, which are pushing students to live further and further away from campus.

Improve the perception of safety and social connectedness on campus.

Physical Activity and Commute Recommendations Short Term:

Promote participation of existing Harvard programs like Hubway bikeshare and Get Moving Harvard through a print campaign to increase participation.

Send email or SMS alerts to HDS affiliates with a quick reminder to get up and stretch or go outside and take a walk once or twice a day.

Introduce walking and standing meetings, in staff, faculty, or classroom settings. Medium Term:

Allow students to opt out of the gym membership so they can use it towards purchasing a bicycle.

Implement pedometer based walking program to encourage at least 10,000 steps a day, or to ride bikes. See the Australian study in Global Corporate Challenge® (GCC®)1, which showed that this reduced the risk for cardiovascular disease and diabetes in two months and encouraged increased vegetable and fruit intake (Freak‐Poli, Wolfe, Wong, & Peeters, 2014).

Safety Recommendations Short Term

Develop and post signage with evacuation maps, evacuation procedures, and shelter‐in‐place procedures.

Improve lighting and install parabolic mirrors for pathway leading from Divinity Hall to HDS main campus.

Medium Term

Develop trainings on emergency procedures and deliver to students (during orientation) as well as faculty and staff.

Install bicycle path to exit campus through parking lot to Francis Ave.

Station HUPD officer to instruct cyclist about policies during first week of 2015‐16 academic year

Install signage at end of bicycle path showing routes to popular destinations. Long Term

Work with community members to identify and address other campus areas with inadequate lighting.

Work with City of Cambridge to develop bike route signage around Francis Ave.

Work with HDS community to assess issues involving profiling and discrimination of students.

1 Global Corporate Challenge®: An annual pedometer‐based workplace program established internationally. Workers wear a visible pedometer for 125 days (May to September) and are encouraged to meet the goal of 10,000 steps. The challenge is competitive and requires employees to compete in teams of seven for the highest number of steps.

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Social Capital Recommendations: Short, Medium, and Long Term Short Term

Place benches on both sides of hallways to encourage conversation between people waiting for appointments with HDS administrative staff and faculty.

Medium Term

Retrofit existing lounge and atrium spaces to foster informal social interaction with circular style seating arrangements and large communal tables.

Long Term

Create one central space for each building that functions simultaneously as a meeting space for students and faculty, a waiting or entrance space for visitors and a break room for staff.

Spirituality and Health Recommendations: Short, Medium, and Long Term Medium Term

Create a Harvard‐wide Leadership Institute, much like the Harvard Graduate School Leadership Institute, which has regular retreats and programming to bring together students from across the university. An HDS Leadership Institute could focus on the moral or spiritual leadership issues.

Develop a programming plan for green spaces to create an informal use schedule that minimizes conflict (e.g. children’s day care and quiet reflection). This would include quiet relaxation areas screened from paths through shrubbery, and separated patterns of usage.

Long Term

Consider turning the Andover Parking Lot into green space, or turn roof space into urban agriculture space.

Reprogram inactive lawns, like the one between Andover and Francis Avenue, with small garden patches, a bocce court, or a Zen garden.

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Ambient Environment By Fu Yun

Overview of Findings

The study considers five ambient factors in the Andover Library: light, noise, humidity, temperature, and CO2 concentration. In general, the conditions are healthy, and conducive to long periods of sedentary work. The limited light spectrum from existing florescent sources is a potential area for improvement. Locally, workspaces on the lower floor and peripheral rooms performed poorer in the categories of temperature, humidity, and CO2 concentration.

Lighting

All workspaces require artificial lighting, at least in a supplementary capacity. Fluorescent tubes are used universally. Brightness in workspaces is adequate, with all eight locations registering light intensity between 197–338 lux. Factor of difference between direct and reflected intensity is within 3.8‐5.8, except the Fenn Reading room, which may have issues of glare at 12.1. The limited light spectrum from existing florescent lighting was a specific point of complaint in the survey. Colour temperature at the eight locations range from 2940–3679K, falling within acceptable workspace standards. All the spaces had large gaps in the light spectrum, with the Ground floor reading room registering the most severe gap between ~2000–4000K.

Noise

The eight workspaces registered noise level between 43–61 dB, within the acceptable range for a quiet workspace. The source of noise is primarily from the air conditioning, which recedes easily into the background as grey noise. Acoustic profile in all workspaces was consistently low, except in the Quiet Study Room, which has a resonance frequency at ~190hz.

Humidity

High levels of relative humidity are associated with increased incidence of respiratory infections and allergies. As a study describes (Arundel et al. 1986), the indoor size of allergic mite and fungal population is minimized when the RH is below 50%. The survival of airborne‐transmitted infectious bacteria and viruses are also minimized with RH below 70%. Relative humidity in the library mostly falls within a comfortable and healthy range of 30‐40%. Workroom G2 is the outlier, registering both the largest amplitude and the highest absolute value at 57%.

Temperature

Temperature fluctuation is relatively stable, with most of the locations fluctuating between 20‐25°C over the sample period of 2 days. As with humidity, Workroom G2 is the outlier, registering both the largest amplitude and lowest absolute value at 16°C. At all eight locations, the surface temperature closely tracks the dry bulb temperature. Windows looking to the exterior are slightly colder, remaining 2–4°C below the dry bulb temperature at each location. CO2 Concentration

While CO2 may be considered as a potential inhalation toxicant and asphyxiate, it is highly unlikely that CO2 concentration will reach critical levels exceeding 1% in the typical HDS setting (Seppanen, Fisk, and Mendell 1999). In our case, the health implication of CO2 concentration is primarily

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as an indicator of ventilation and the presence of fresh air. The eight locations registered CO2 concentration between 552–831ppm, falling comfortably below the US occupational health exposure limit at 5000ppm, and ASHRAE standard for indoor spaces at 2100ppm. The standing workstations on the second floor performed the best, and the Quiet Study Room performed the worst.

Background: Why this Topic Matters As Dannenberg’s article (2011) point out, the workplace has important health impacts for three

reasons. First, workers often spend a tremendous amount of time at the location, second only to their residence. Second, most of the occupants have limited ability to affect the environment around them. Third, with management primarily concerned with productivity, a higher‐level risk is tolerated compared to other typologies of space. All three qualities apply to workspaces in the HDS. On the other hand, the concentrated occupancy and centralized management also makes the workspace an effective point of intervention.

The survey suggests concentrated occupancy in the Andover Library. Students occupy it

frequently, and often for periods of 4 hours or longer. In general, ambient factors in the Andover Library rarely deviate enough to cause critical health hazards. However, given the prolonged periods of concentrated activities at this location, minor factors may have accumulative effects towards distraction, fatigue and stress.

As an indicator of the ambient environment’s wider implications, the lighting in the Andover Library was cited in chapter studying social integration as being harsh and a deterrent to social gathering.

Description: The Situation at HDS Four issues emerged from student feedback concerning the ambient environment. Complaints

focused on lighting, ventilation, noise, and temperature. Adequacy of lighting in workspaces was rated at 7.75/10, with standard deviation of 2.06. Specific complaints were made against fluorescent lighting in the library, where presumably the limited light spectrum was a nuance for long periods of study. The 73% of students wearing glasses or contact lens may be particularly vulnerable to the poor lighting.

Adequacy of ventilation in workspaces was rated at 6.95/10, with standard deviation of 2.33.

Most windows in the Andover Library are not operable, and the buildings rely primarily on centralized air conditioning. Students cited noise as an essential quality for an environment to be appropriate for prayer/ reflection/ meditation/ relaxation, with 18% of respondents rating it as the primary factor. Specific complaints were made against noise in 1st floor of the Andover Library. 32% of students often wear headphones when working, which may be an ad‐hoc response to the condition.

Student’s opinion on temperature was not surveyed, although specific complaints emerged,

specifically regarding the chilliness on the 2nd and basement floor of the Andover Library. Perception of coldness may be a result of low dry‐bulb temperature, or from loss of radiation through low surface temperature.

List potential positive and negative impacts and use the table below to evaluate the severity and distribution of impact.

Health Impact (issue)

Positive or negative? +++ strongly positive ++ moderately positive + mildly positive 0 neutral ‐ mildly negative ‐ moderately negative ‐ ati strongly negative U uncertain

Likelihood of impact? S = Speculative P = Probable

Differential impacts on groups (e.g. children, elderly, persons with disabilities, persons with lower incomes)

Distributionof impact? S = HDS H = Harvard M = Metro N = National

Measurable indicator?

Evidence base for knowing about the issue

Light Intensity + P ‐People wearing contact lens and spectacles. ‐People with weak vision.

S Intensity (lux)Direct/reflected light ratio

HDS Survey

Light Spectrum ‐ P People wearing contact lens and spectacles. People with colour blindness. People with weak vision.

S Light temperature (K) Light spectrum (K)

HDS Survey

Noise 0 P People wearing headphone. People with hearing impairment or wearing hearing device.

S Noise (dB) HDS Survey

Acoustic Profile 0 P People wearing headphone. People with hearing impairment or wearing hearing device.

S Reverberation Time (sec) Frequency (Hz)

HDS Survey

Humidity + S People with dry skin, allergy or with respiratory issues.

S Relative Humidity (%)

Comment from Building Services

Temperature ‐ P Elderly and children.People with existing illness.

S Dry Bulb Temperature (C)

HDS Survey

Surface Temperature

+ S Elderly and children.People with existing illness.

S Surface Temperature(C)

HDS Survey

CO2 concentration

+ P People with respiratory issues.Smokers.

S CO2 Concentration (ppm)

Comment from Building Services

Identifying Potential Changes to HDS Campus

Positive impact #1 Large Gaps in Light Spectrum

Positive impact #2 Temperature & Humidity in Peripheral Rooms

Positive impact #3 Resonance Frequency

Identify potential changes to proposal to mitigate each of the negative impacts identified above.

The predominantly florescent light system can be supplemented by wide‐spectrum light options.

Localize monitoring and air‐mixing in peripheral rooms.

Introduction of frequency specific absorption material.

Use of natural light can be promoted when conditions allow.

Improve thermal and vapor insulation in peripheral rooms.

Avoid consistent noise source at resonance frequency (e.g. air conditioning).

Negative impact #1 Light Intensity & Spectrum

Negative impact #2 Noise & Air Quality

Negative impact #3 Humidity & CO2 Concentration

Identify potential changes to proposal to enhance each of the positive impacts identified above.

Integration of natural lighting to supplement artificial lighting, providing energy saving and better colour spectrum.

Integration of natural ventilation to supplement air conditioning, providing energy savings and reduced noise.

Both measurements indicate consistent high air quality. An opportunity for occupancy‐sensitive reduction of air conditioning use.

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Ambient Conditions Recommendations: Short, Medium, and Long Term Short Term

Supplement existing lighting with warm lighting options to complete the lighting color spectrum.

Identify resonance frequency in silent study room and install acoustic panels for that frequency. Medium Term

Make the current inoperable windows into operable windows.

Modify the air condition system to act as fan when the humidity and temperature of exterior air is suitable for direct use.

Install reflective devices like light shelves to allow light to penetrate deeper into the library space.

Separate archive and work space to maintain optimal temperature and humidity for each type of space.

Long Term

Completely segregate stacks from study areas by building an extension or annex

Install better thermal and vapor installation in the walls of peripheral rooms when the library is next renovated.

Appendix Sample Location on Plan

Sample Location Photograph

Light Temperatures and Spectrum

Acoustic Profiles

Light Intensity over 3 Days

Humidity over 3 Days

Temperature over 3 Days

Direct vs. Reflected Light

Surface Temperature

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Building Maintenance and Management By Elizabeth Mitgang


Clean and accessible bathroom facilities.

Green cleaning products used by custodial staff for campus safety and sustainability.

Products with high NFPA rating should be used with caution and/or phased out of use

Excellent recycling and composting program.

Damages to the interior walls of Andover Hall (likely due to the age of the building) should be assessed and repaired.

Pristine campus grounds.

Background: Why this Topic Matters At the most fundamental level, sanitation is defined by the US Centers for Disease Control as

“having access to facilities for the safe disposal of human waste (feces and urine), as well as having the ability to maintain hygienic conditions, through services such as garbage collection, industrial/hazardous waste management, and wastewater treatment and disposal “ (CDC 2014). Adequate water, sanitation, and hygiene (WASH) infrastructure and related amenities provide a first line of defense for protecting a population against pathogens (agents that cause disease).

Mechanisms in the built environment such as sewage systems and bathrooms serve as barriers to mitigate human interaction with pathogens found in excreta, sullage, drainage, and solid waste. Constructing this infrastructure is necessary but not sufficient for disease control; maintenance of the above systems is also imperative. In order to protect a population, the implementation and maintenance of WASH infrastructure must be supported consistently in a number of key locations. In developed environments, these areas of human habitation include: residential spaces, semi‐public spaces (e.g., medical service providers, schools, stores), and public spaces (WSSCC and WHO 2005).

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Fig 1. The F‐diagram pictured here depicts fecal‐oral transmission pathways. The blue dotted lines represent barrier points for mitigating transmission. One of the central foci of this chapter is to provide an assessment of the barriers currently in place at HDS to mitigate pathogen transmission, and to propose additional strategies for health improvement

Description: The Situation at HDS At the Harvard Divinity School, two distinct sets of support staff are responsible for the

sanitation/hygiene infrastructure: the custodial staff and the maintenance staff. It is important to make this distinction between these two sets of staff due to the specific roles assumed by each employed team. The custodial staff, comprised of about ten HDS employees, executes the day‐to‐day campus cleaning as well as waste collection and management, whereas the maintenance staff is outsourced from the University and employed to address HDS campus repairs on an “as needed” basis. The majority of the observations and findings documented herein are custodial in nature.

The primary areas of focus and assessment for the building maintenance/management portion

of the HIA include: bathroom facilities, cleaning agents/equipment, and waste/refuse management. Each area enumerated directly influences the health and well‐being of the HDS community – students, staff, and faculty.

Bathrooms

The presence of and access to bathrooms is a key component of a healthy living and working environment for affiliates of the HDS community. The CDC cautions that the absence of such facilities can result in: (1) an unhealthy environment contaminated by human waste and (2) the spread of many diseases/conditions that can cause widespread illness and death (CDC 2014). For these self‐evident reasons, it is important to evaluate the quality of the bathroom infrastructure, design, and upkeep in each of the HDS buildings under review for this HIA.

The American Restroom Association outlines a number of recommendations for strong

consideration when designing and/or furnishing a restroom. The criteria enumerated below served to inform the development of the assessment tool used measuring the quality of the HDS restroom facilities.

Handicap accommodations ‐ facilities should meet the Americans with Disabilities Act Accessibility Guidelines

Door handles ‐ restrooms should allow patrons to exit the facility without touching a door handle (e.g., free‐swinging doors) in the case that previous patrons did not wash their hands prior to exiting. Touch‐free, automatic devices (e.g., soap and paper towel dispensers) are also the gold standard for germ containment.

Hot water ‐ hot water should be available in a timely manner for optimal hand washing practice

Ventilation ‐ adequate ventilation systems reduce waste odor and provide patrons with improved air quality and a sense of cleanliness. In the event that custodial staff is using harsher cleaning supplies, ventilation also reduces fume concentration (American Restroom Association, 2014).

The bathroom facilities evaluation involved a walk‐through of a sample of bathrooms in each of

the three HDS buildings. Each bathroom was evaluated based on the criteria in Table 1. Upon the completion of this evaluation, the buildings were given a “gold,” “silver,” or “bronze” ranking.

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The Center for the Study of World Religions demonstrates the gold standard in bathroom design and cleanliness. Each bathroom assessed was handicap accessible, supplied hot water in a timely manner for optimal hand washing, provided fully stocked soap, utilized hand dryer technology (reducing the number of surfaces touched in the bathroom), provided ventilation, and posted health literature addressing various topics (e.g., best practices for coughing and hand washing).

Rockefeller Hall performed at nearly the same level, but received a silver rating due to the

excessive time needed for the sinks to produce warm water, the toilet paper found on the floor, and the potential overuse of resources by providing hand dryers and paper towels. The lack of hot water in Rockefeller Hall is due, in part, to the motion sensing faucets, which turn off and on frequently during use and delay the water from becoming warm. In this case, there is a clear tradeoff between the lack warm water for optimal hand washing and the reduced number of surfaces touched my bathroom occupants.

While the bathrooms in Andover Hall and Andover‐Harvard Theological Library received the

lowest rating, the overall quality was still more than satisfactory. The bathrooms in Andover Hall and Library had the greatest amount of visible waste on the floor (mainly paper towel/toilet paper) and had the least health literature posted (only material on composting). The bathroom configuration in Andover Hall is predominately single stall, which increases the potential for pathogen transmission when entering/exiting the facility due to inevitable contact with the doorknob or handle fixture.

Fig 2 and 3. Left: Center for the Study of World Religions, right: Andover Hall

Table 1: HDS Bathroom Facilities Evaluation

Building/ bathroom location

Layout Handicap accessible?

Door knobs/ handles

Hot water

Hand drying Soap Visible waste

Ventilation Health literature

CFWR Gold Standard First floor ‐ administrative

1 stall Yes Yes 20 s Paper towels Foam soap & hand sanitizer

None Fan Proper hand washing

First floor ‐ female

2 stalls Yes Yes 17 s Dyson Airblade

Liquid soap

None 2 vents Proper hand washing; cover your cough

First floor ‐ male 2 stalls Yes Yes 5 s Dyson Airblade

Liquid soap

None 2 vents Proper hand washing; cover your cough

Rockefeller Silver Rating

First floor female

3 stalls Yes No >1 min Xlerator hand dryer & paper towels

Liquid soap

Minimal 2 vents Proper hand washing; composting

First floor male 2 urinals, 1 stall

Yes No >1 min Xlerator hand dryer & paper towels

Liquid soap

None 2 vents Proper hand washing; cover your cough; composting

Andover Hall & Library Bronze Rating

Ground floor library ‐ female

2 stalls Yes Yes 10 s Paper towels Foam Minimal 2 vents Composting

Ground floor library ‐ male

1 urinal, 1 stall

Yes Yes 8 s Paper towels Foam Minimal 2 vents Composting

Ground floor ‐ unisex

1 stall Yes Yes >1 min Hand dryer & paper towels

Liquid soap

None 1 vent Composting

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Cleaning Chemical/Equipment A routine and thorough cleaning regimen is an important component for ensuring the quality of

a school campus and the well‐being of its affiliates. To this end, custodians at HDS use a core set of cleaning agents. The Occupational Safety and Health Administration reports that in recent years, there has been a growing movement for employers to provide green cleaning products for their custodial staff to reduce employee exposure to harsh and potentially harmful chemicals (OSHA and NIOSH 2012). In full compliance with this movement, HDS has adhered to a green cleaning program for the last decade (as early as 2004)—the first Harvard school to pursue this initiative. This proactive change speaks directly to the School’s commitment to employee safety as well as overall occupant health (Harvard University Sustainability 2014).

Information regarding the cleaning agents and equipment used by HDS custodial staff was

ascertained through three main sources: anecdotal evidence from a focus group; the HDS Facilities Manager, Flory Makuwa; and general observations. The focus group took place in Rock Café and involved 5–7 custodial team members and their supervisor. This meeting provided useful information related to the roles and responsibilities of the custodial staff, the challenges they face, and the equipment they use.

Table 2 provides a list of the core cleaning agents used by the HDS custodial staff and the

National Fire Protection Association (NFPA) rating for each product located online via the Material Safety Data Sheets. Overall, the staff uses mild and environmentally conscious cleaning products. However, in speaking with the team, they did report that at times, harsher agents must be used. These products, such as All‐Purpose Carpet Spotter, register higher scores for the “health” and “flammability” components of the NFPA rating system – indicating a possible hazard. This rating suggests that the custodial staff should use these agents sparingly and with the proper protective equipment due to potential health and safety risks. However, emphasis should be placed on the large majority of mild, green cleaning agents used by the custodial team. During the focus group, the Custodial Supervisor commented that an essential part of her job is educating her staff on the importance of using these green cleaning agents. Even though, at times, the products might take longer to do the job and do not necessarily foam or give off an odor associated with cleanliness, the Supervisor commented that they ensure a healthier environment for her staff as well as those frequenting the buildings.

In addition to the cleaning agents used by the custodial team, hand sanitizing stations are

another way for all of the HDS community to reduce pathogen transmission throughout the campus. Both the Purell and Deb hand sanitizing stations (generously distributed throughout the academic buildings) dispense a hand sanitizing solution with over 60% alcohol concentration, which is the most effective solution for killing germs in the absence of soap and warm water (CDC 2013).

Best practices in cleaning should consider not just the cleaning agents, but also the equipment.

The custodial staff reports that over the last few years, HDS replaced all outdated vacuums with high‐filtration HEPA filter vacuums for improved performance and better air quality. This equipment upgrade is particularly beneficial for individuals with asthma and/or allergies, where adverse health events can be triggered by particulates in the air (e.g., dirt, dust, and pollen).

Waste Management: recycling & composting

A campus setting provides a unique opportunity for pursuing waste reduction initiatives, such as recycling and composting, which can profoundly reduce costs, energy consumption, and reliance on natural resources (EPA 2003). Additionally, providing alternative, “green” receptacles for waste disposal

30

has the potential to make individuals more cognizant of one’s consumption behavior when faced with the choice of how to dispose of one’s waste.

As a university, Harvard has demonstrated exemplary work in reducing the amount of waste

produced on campus (see Figure 1). According to data provided by the Office for Sustainability, HDS was the University’s 2010 leader in recycling with a 70% recycling rate. While the Office for Sustainability was not able to provide school‐specific, temporal data for recycling/composting achievements due to university waste collection processes, anecdotal evidence provided during the focus group revealed that the custodial staff handles more recycling than trash on fairly regular basis.

The three buildings of focus for this HIA were fully equipped with composting and recycling

receptacles (pictured below) and signs describing best practices. All used paper towels discarded in campus restrooms are composted, and related composting literature is a prominent feature in these facilities. When asked candidly about the recycling/composting program on campus, informal conversations with students and staff revealed that this green initiative was in no way a burden on the HDS campus. In fact, it was viewed with a strong sense of pride and achievement, which could contribute in a small, but meaningful way to the mental health and unity of the HDS community.

Fig 4. University‐wide waste reduction and recycling, 2004 – 2013

Fig 5, 6, and 7. Assorted waste, recycling, and composting stations generously provided throughout the HDS campus Left: Andover Hall; middle: Rock Café; right: Center for the Study of World Religions

Table 2: Cleaning Agent Inventory and NFPA Rating

National Fire Protection Association Rating

Health Flammability Reactivity

General cleaning chemicals

#4 Delta Mild 2000 0 ‐ No unusual hazard 0 ‐ Not combustible 0 ‐ Stable: Not reactive when mixed with water.

#11 Enzysan 2000 0 ‐ No unusual hazard 0 ‐ Not combustible 0 ‐ Stable: Not reactive when mixed with water.

#72 Wavelength Eco H202 0 ‐ No unusual hazard 0 ‐ Not combustible 0 ‐ Stable: Not reactive when mixed with water.

Pol Green WC Gel Cleaning and Hygiene Solution

0 ‐ No unusual hazard 0 ‐ Not combustible 0 ‐ Stable: Not reactive when mixed with water.

Biolink Stainless Steel Cleaner 1 ‐ Caution may be irritating 0 ‐ Not combustible 0 ‐ Stable: Not reactive when mixed with water.

Carpet and floor care

Single Pass Carpet Extractor Cleaner 1 ‐ Caution may be irritating 0 ‐ Not combustible 0 ‐ Stable: Not reactive when mixed with water.

Pro‐Link Defomer 1 ‐ Caution may be irritating 0 ‐ Not combustible 0 ‐ Stable: Not reactive when mixed with water.

All‐Purpose Carpet Spotter 2 ‐ Warning may be harmful if inhaled or absorbed

2 ‐ Combustible liquid flash point of 100absorbed° ‐0 ‐ Stable: Not reactive when mixed with water.

Pro‐Link Green Certified Zinc Free Floor Finish

1 ‐ Caution may be irritating 0 ‐ Not combustible 0 ‐ Stable: Not reactive when mixed with water.

Wave‐Length Gleam‐Spray Buff 1 ‐ Caution may be irritating 0 ‐ Not combustible 0 ‐ Stable: Not reactive when mixed with water.

Other

Oxivir

0 ‐ No unusual hazard 0 ‐ Not combustible 0 ‐ Stable: Not reactive when mixed with water.

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Other During a walk‐through of Andover Hall, relatively large cracks in the walls of the stairways

leading to the upper‐floors were observed (pictured below). These damages left chipped paint/wall residue on the stairs. If this paint contains lead (possible given the age of the building), this could be viewed as a health hazard. These repairs would fall under the responsibility of the University maintenance staff.

As of 2009, Rockefeller Hall achieved LEED Gold certification—making it one of 89 certified

buildings at Harvard (Harvard University Sustainability 2014). The campus grounds of HDS are in pristine condition. The landscaping is manicured and no litter

was encountered on a walk around the grounds.

Fig 8 and 9. Repairs needed in Andover Hall Left: large cracks in the interior walls on upper floors of the building Right: wall residue left on stairs beneath cracks

Health Impact (issue) Positive or negative?+++ strongly positive ++ moderately positive + mildly positive 0 neutral ‐ mildly negative ‐ moderately negative ‐ ati strongly negative U uncertain

Likelihood of impact? S = Speculative P = Probable

Differential impacts on groups (e.g. children, elderly, persons with disabilities, persons with lower incomes)

Distribution ofimpact? S = HDS H = Harvard M = Metro N = National



Many touchable surfaces in bathrooms (faucets, door handles, etc.)

‐ S N/A S Informally through observation in bath

Observation

Proximity of hand sanitizing stations to bathrooms

0 S N/A S N/A Observation

Cleaning agents with high NFPA scores: All‐Purpose Carpet Spotter

‐ ‐ P HDS custodial team

S Potential for reported adverse health incidents at work

Material Safety Data Sheets

Overall recycling/composting initiative

+++ P N/A S, H, M Weight of recycled/composted material

HUOS/informal conversations/ focus group

Signage for compostable materials lacks visual aids

‐ P HDS custodial team S, H Time needed to manage composted/recycled materials and weight

Focus group/ observation

Damages to interior walls of Andover Hall (upper floors)

‐ ‐

S Individuals frequenting upper floors of Andover Hall

S N/A Observation

List potential positive and negative impacts and use the table below to evaluate the severity and distribution of impact

Lack of waste receptacles around campus perimeter

0/‐ S N/A S, H Maintained level of pristine grounds

Observation


Positive impact #1 Hand washing

Positive impact #2 Recycling/composting

Positive impact #3 Campus perimeter waste management


Encourage hand washing with soap and water as the gold standard by increasing the proximity between hand sanitizing stations and bathrooms

Station HDS Green Team members at key recycling/composting areas (Rock Café) during the first week of each semester to educate HDS affiliates on proper recycling/composting practices.

Install waste/recycling receptacles around the perimeter of campus to maintain pristine campus grounds

Post hand washing literature consistently in all bathrooms accessible on HDS campus

Redesign recycling and composting signs displaying pictures or physical visuals of recyclable/compostable products (as seen in HSPH dining area)

Install doggie bag (biodegradable) dispensers near waste receptacles to maintain amicable community relations with dog owners while promoting clean campus grounds

Negative impact #1 Bathrooms

Negative impact #2 Harmful cleaning agents

Negative impact #3 Building damages


Reconfigure bathrooms when possible into multi‐stall facilities; replace door handles with free‐swinging doors

Find alternative cleaning agents for harsh cleaning products

Repair damages to interior walls on upper floors of Andover Hall

Replace all paper towel/soap dispensers and faucets with motion sensor technology to reduce germ transmission

Consistently post health literature in all restroom facilities

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Building Maintenance and Management Recommendations: Short, Medium, and Long Term Short Term:

Post health literature consistently in all bathroom facilities – especially where there is currently only composting literature.

Reposition hand‐sanitizing stations away from restrooms to encourage hand washing with warm water and soap.

Redesign recycling/composting signs to include visuals of appropriate products (pictures or actual products) that go in each bin.

Find and implement alternative cleaning agents for the current cleaning products identified as relatively harmful.

Medium Term:

Address damages to the interior walls in Andover Hall and clean up cracking wall residue, which could contain lead due to age of building.

Introduce new recycling/composting education program at the beginning of each academic semester—developed and executed by the HDS Green Team – to ensure that new/incoming HDS community members understand best practices.

Install waste and recycling receptacles around the perimeter of campus to maintain already pristine campus grounds.

Install doggie bag (biodegradable) dispensers near waste receptacles to maintain amicable community relations with dog owners while concurrently promoting clean campus grounds.

Long Term:

Reconfigure bathrooms when possible into multi‐stall configuration and replace door handles with free‐swinging doors.

Replace all paper towel/soap dispensers and faucets with motion sensor technology to reduce germ transmission.

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Food By Kelsey O’Brien

Overview of Findings The main sources of food at HDS are Rock Café, HDS events, and vending machines. Of greatest

concern, are the unhealthy options that are present in the vending machines, lack of available nutrition information, portion sizes, and students’ overconsumption of food at events.

HDS excels in their commitment to sustainability and sensitivity of different dietary restrictions.

HDS’s support of a student Food Fellow illustrates the school’s commitment to excellence within the food environment and the value the school places on student input. This fellow engages the HDS community and the greater Harvard community in discussions on food related issues and provides feedback to Rock Café about changes that could be implemented.

The food environment at Harvard Divinity School (HDS) was assessed in Andover Hall,

Rockefeller Hall, and CSWR. Data was collected through a focus group conducted at the community table on Tuesday, November 4, 2014 and discussions with students at the community tea. Data was also collected by survey and direct observation.

Background: Why this Topic Matters The United States has one of the highest rates of obesity (36.5% of people with BMI over 30) in

the world (OECD 2014). In an effort to prevent disease and prolong life, food systems are being closely examined to assess practices in food production, distribution, nutrition, and waste. The modern lifestyle increasingly demands that food is consumed away from the home, yet meals prepared away from the home have been found to have poorer nutritional quality (Guthrie, Biing‐Hwan, and Frazao 2002).

Assessment of the food environment can help to identify targeted interventions that could

improve nutritional standards.

Many universities are focusing on providing healthy options within their cafeterias. According to the Huffington Post (2011), below are the top 10 schools with the healthiest dining halls:

Bowdoin College

Stephen F. Austin State University

Oberlin College and Conservatory

St. Olaf College

Lewis and Clark College

Bates College

Pitzer College

UC Berkley

University of Washington

Humboldt State University

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Some reasons why these schools ranked so highly include: access to free nutritional counseling, dietitians help to plan the menus each week, use of whole‐wheat bread and pastas, contracts with local farmers, organic foods, no fried foods, and antibiotic free chicken.

Description: The Situation at HDS Rock Café

Jules Catering was founded in 1987 and serves the Greater Boston area (Jules Catering 2014). Jules Catering also operates Rock Café, which is the HDS’s cafeteria. All students and staff who were interviewed enjoy the taste and variety of the food offered at Rock Café. The catering staff members are personable and friendly which adds to the relaxed and laidback feeling of Rock Cafe. Both students and staff feel welcome to eat, socialize, or study within Rock Café. A few students noted in the survey that the cafeteria is a good space for relaxation and meditation.

Additionally, Jules Catering is accommodating and responsive to the HDS community. Due to

nutritional concerns, Jules Catering stopped serving chocolate chip muffins. One staff member was disappointed with this change and as soon as Jules Catering found out, they reintroduced chocolate chip muffins back to Rock Café.

There is a conscious effort to always have a vegetarian entrée. During the focus group, the Food

Fellow noted that strong efforts are being made to consistently have a vegetarian soup option available. All foods were clearly labeled with their ingredients so individuals with food allergies can select appropriate options.

An area of Rock Café that was particularly strong was their commitment to sustainability. There

is a conscious effort to source and produce food in a sustainable manner. Sustainability at Rock Cafe:

All electricity is powered by wind power

All dining areas are cleaned with green cleaners

Rockefeller Hall is LEED Gold rated

Fair trade coffee

Organic foods: greens, oils, vinegars, cereals, legumes, beans, peanut butter, tofu, chocolate bars

Follow the Monterey Bay Seafood Watch standards

33% of entrees are vegan or vegetarian friendly

Recyclable and compostable dishware

Reusable mug and water bottle program, with discounts for refills

25% of the food budget is spent on local goods

Purchases from approximately 250 local farms

The salad bar is prominently displayed as one of the first foods that you see when entering the cafeteria and the soda fountain is tucked back in the corner. This is particularly important when thinking of the principles of choice architecture. Choice architecture uses behavioral economics to influence choices through design and placement of food. For example, foods placed at the beginning of a line or at eye‐level will be purchased more frequently than items that are seen last or are not at eye‐level.

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Fig 1. The salad bar is one of the first options people see when entering the cafeteria

Fig 2. Placing water in the grab‐n‐go station could encourage more purchases of water over sugar‐sweetened beverages (these fruit smoothies/sweet teas contain a lot of sugar)

Students identified a few concerns at Rock Cafe. One student would like to see more Asian foods represented in the cafeteria, specifically, noodle dishes. Another student was concerned about the Rock Cafe hours: “I like the options at the Rock Cafe, but when classes are not in session, it is not open—J‐Term; summer; spring break, etc. This causes me to go to the vending machines and the options there are not always healthy. Soda and bottled water are the only drink options.” However, the overwhelming consensus by students is that they enjoy Rock Café.

While the students thought the food was a good value because you receive large portions for

less than $10, there is concern about portion sizes being too large. Public health efforts have identified

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the need for people to consumer smaller portion sizes to reduce the amount of energy consumed during a meal (Young and Nestle 2002). A reduction in the portion sizes would help to reeducate and reinforce perceptions of a proper portion size. Resetting of norms may help to change eating behaviors not only at HDS but also while consuming meals away from campus.

Fig 3. One entrée at Rock Café. While students appreciate the value, there is concern that portion sizes are too large

Additionally, there was a lack of nutrition information available within the cafeteria. Rock Café could benefit if it posted the healthy eating plate in a visible location for all diners to see. Furthermore, entrees at Rock Café should strive to resemble the healthy eating plate. As you can see from the meal above, whole wheat pasta and bread would better fit the recommendations of the healthy eating plate and the whole grains should be reduced to approximately 1/4th of the plate. Pamphlets about healthy sources of protein, healthy recipes, or information about dietitian services could also be made available to students as resources. Finally, as with many cafeterias, Rock Café could have weekly consultations with a registered dietitian to plan weekly menus to meet the nutritional standards of a well‐balanced diet.

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Fig 4. Healthy Eating Plate This report was unable to assess the nutritional quality of the prepared food at Rock Café, however, a selection of prepackaged foods and drinks were assessed by the Environmental Working Group’s Food Scores (see appendix). Scores range from 1.0 (best score) to 10.0 (worst score) and take into account nutrition concerns, ingredient concerns (pesticides, food additives, contaminants, and antibiotics), and processing concerns. Of note, San Pelegrino and Snapple Lemonade score particularly poorly (8 and 9, respectively). Nantucket nectars orange juice scores relatively well compared to other orange juices. Doritos Nacho Cheese and Doritos Cool Ranch are the worst scoring (7) chips available in the cafeteria and Classic Lay’s Potato Chips are the best (4). Eating behaviors

Many students bring their own lunch to stay within their budget. Students who eat at Rock Café say that convenience and value are the biggest reason why they choose to eat at Rock Café. Although, some students think that the prices could be a little lower.

One staff member mentioned that there is a problem with students walking off with trays of

food during events. She believes this is motivated by the tight budgets of graduate students who are eager to take advantage of free food. The same staff member, who is responsible for ordering event food, noticed that the least healthy foods tend to be consumed first. For example, all the cookies will be consumed and there will be plenty of salad leftover at the end of the event. She believes the high stress

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environment encourages the consumption of “comfort” foods that are higher in sugar, salt, and fat. She believes that students are more concerned with a free meal than what they are actually consuming. Community Tea

The community tea is a long‐standing HDS tradition that is hosted every Tuesday from 4pm to 5:30pm in the Braun Room. Students are encouraged to attend to foster community over shared food. The food varies week‐to‐week depending on the student organization hosting the event. The community tea held on Tuesday, November 4, 2014 was hosted by admissions for prospective student. There was a substantial amount of food available to eat. It would be great to see choice architecture implemented at this event. For example, the first foods people could select where the cheeses and at the very end of the table were the vegetables. If vegetable were placed first, this could help “nudge” behavior to the healthier options. Additionally, the dessert table was up front making it easy to mindlessly take a dessert on the way out the door. Locating the dessert table towards the back of the room would help to eliminate the impulsive selection of desserts. HDS could go one step further and eliminate the dessert option altogether.

Fig 5 and 6. Food served at the Community Tea on November 4, 2014 CSWR

The CSWR has a candy bowl at the front desk. The staff member who fills this bowl says that approximately one giant bag of candy from BJs is consumed every week. There were also free sodas available for people to take.

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Fig 7. Candy bowl in CSWR Fig 8. Free sodas in CSWR Vending Machines

There are vending machines for snacks and sodas in the basement of Andover Hall and near Rock Café. Students and staff report using the vending machines infrequently and most often when Rock Café is closed. All of the foods were nutritionally poor and included candy bars, chips, salami sandwiches, and instant noodles. The appendix (see the end of the report, before the references) details nutritional, processing, and ingredient concerns.

Fig 9 and 10. Vending machine options

Fig 11. Frosted Flakes Fig 12. Maruchan Instant Lunch: Chicken Flavor

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Fig 13. Pierre Jumbo Flamebroiled Bacon Cheeseburger Water

HDS provides plentiful access to water. The water coolers do not offer cups and it is a cultural norm to have your own water bottle with you. When Poland Spring tries to leave cups, they are told to take them back to reduce waste.

Fig 14. Water fountains Places to eat near HDS When not eating food on campus, students and staff mentioned the following locations to purchase food:

Divinity Avenue Food Truck

Science Plaza Food Truck

P & K Delicatessen

Zoe’s Gourmet Chinese Cuisine

Pho and Rice

Cambridge Common

Changsho

The Kebab Factory

The Biscuit

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R.F. O’Sullivans

Fig 15. All of these locations are within 0.2 to 0.6 miles of Harvard Divinity School and there are a wide variety of food options within a 10‐minute walk from the school Kitchenettes

There are several kitchenettes located on every floor of Rockefeller, and in Andover Hall near the library. They are equipped with refrigerators, microwaves, sinks, toasters, coffee machines and a seating area for staff. This offers a nice option for faculty and staff members who bring their own lunch.

Fig 16. Divinity School Kitchenette

List potential positive and negative impacts and use the table below to evaluate the severity and distribution of impact Health impact (issue)

Positive or negative?+++ strongly positive ++ moderately positive + mildly positive 0 neutral ‐ mildly negative ‐ ‐ moderately negative ‐ ‐ ‐ strongly negative U uncertain

Likelihood of impact? S = speculative P = probable

Differential impacts on groups (e.g. children, elderly, persons with disabilities, persons with lower incomes)?

Distribution of impact? S = HDS H = Harvard M = Metro N = National



Vending Machine ‐ ‐ ‐ P N/A S Yes Byrd‐Bredbenner et al. 2012

Rock Café Food Sustainability

+++ P N/A S, M Yes Flyer posted at HDS

Rock Cafse Dining Area

++ S N/A S Yes HDS affiliate statements

Rock Café Food Portion Size

‐ ‐ P N/A S Yes Young and Netstle 2002

Kitchenettes + S N/A S Yes Direct observation

Water Availability +++ P People who forget reusable container

S Yes Direct observation

Caters to Special Dietary Needs

++ P People with food allergies/dietary restrictions

S Yes Direct observation/ HDS affiliate statements

Lack of Nutrition Information

‐‐ P N/A S Yes Direct observation

Overconsumption of Food at HDS Events

‐‐‐ P Individuals with tight food budgets

S Yes HDS affiliate statements

Community Tea Fosters Social Engagement

++ S N/A S Yes Direct observation/ HDS affiliate statements

Candy Bowl at CSWR

‐ P N/A S Yes Direct observation/ HDS affiliate statements

Food Fellow ++ S N/A S, H Yes Direct observation

Rock Café Staff ++ S N/A S Yes Direct observation/ HDS affiliate statements

Salad Bar Placement

+ P N/A S Yes Direct observation


Positive Impact #1 Kitchenettes

Positive Impact #2 Community Tea

Positive Impact #3 Food Sustainability


Promote the use of kitchenettes and survey staff to see if they are interested in any changes

Identify ways to encourage healthier food purchases for the community tea

Identify a kitchenette that students feel comfortable using

Use principles of choice architecture to place the healthier food items first

Negative Impact #1 Vending Machines

Negative Impact #2 Lack of Nutrition Information

Negative Impact #3 Overconsumption of Food at Events


Remove vending machines Post the healthy eating plate in Rock Cafe Have someone serve the food to attendees rather than allowing them to take the food themselves

Change vending machines to healthy vending machines which include yogurt, nuts, hummus, etc.

Make healthy recipes available and post information about nutrition services at Harvard

Do not leave trays of free food unattended

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Food Recommendations: Short, Medium, and Long Term Short Term:

Provide access to nutritional information: o Post the Healthy Eating Plate o Provide healthy recipes o Post information about dietitian services at Harvard

Remove candy bowl at CSWR or move it to a less prominent location.

Survey staff to better understand the use of the kitchenettes. Small improvements could result in greater use.

Medium Term:

Offer more vegetarian options.

Slowly reduce the portion sizes of the meals.

Remove foods that scored poorly on the Environmental Working Group’s Food Scores.

Remove vending machines completely or replace them with healthy vending machines.

Incorporate more elements of choice architecture into placement of foods at Rock Café. For example, place healthier options at eye‐level, near the cash register, or at the beginning of the line.

Long Term:

Continue buy locally sourced foods and engage in sustainable practices.

Consult with a registered dietitian weekly about the Rock Café menu.

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Housing By Blanca Dasi Espuig

Overview of Findings The data collected raises a concern about the affordability of housing around the Harvard campus as more than 50% of the people affiliated to the Harvard Divinity School that answered the survey mentioned that they do not believe they have access to affordable housing near campus. For this reason, again, more than 50% of them stated that they live within a radius bigger than 2 miles away from campus; this could affect their level of stress and affect their mental health. More specifically, the Center for the Study of World Religions at the Harvard Divinity School, offers a few privileged apartments for Harvard’s affiliates. The center provides office spaces and housing at the same time, open common areas as well as indoor common areas, it seems to be a calm and peaceful environments at a lower price than other Harvard housing apartments. The quality of the apartments also seems high after a personal interview with the facility manager. Being close to campus, with a high quality environment and housing in good condition it seems like the perfect place to live. However, there are some questions that should be answered to further discuss the quality and the price of these apartments. For example, the condition of the facilities that are 55 years old, comfort of the furniture offered, or the quality of the materials, paints, and appliances used to upgrade the apartments almost 10 years ago.

Background: Why this Topic Matters Cambridge is home to two of the world’s most notable universities, and it is the fifth most

populated city in the state of Massachusetts. Every year new people arrive in Cambridge, especially new students and professors, hoping to find an ideal place to live. Because of this, there is a great demand for rental housing in the city, especially in the surrounding areas of these two universities, Harvard University and the Massachusetts Institute of Technology, and therefore, the pricing for residential housing here is higher than in neighbor cities. Finding a good quality place within the range of one’s budget may be very challenging in the city of Cambridge, for this, the universities offer university housing, but it is important to make sure that the quantity and quality offered is adequate.

Description: The Situation at the Harvard Divinity School To measure the impact of the housing market in Cambridge, including the university housing

market, and how it affects the people at HDS, a survey was sent. 64 different people affiliated to the Harvard Divinity School answered the survey; the responses were recorded and compiled. The following graphs provide a summary of the findings.

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Fig 1. What type of housing do you live in?

Fig 2. How far from the HDS do you live?

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Fig 3. Do you think you have access to affordable housing near HDS?

Harvard University offers a wide range of housing services to the University’s affiliates (graduate students, faculty, and employees). All of the properties are near the campuses areas, Cambridge, Allston, and Longwood, where public and Harvard transportation systems are easily accessible. Economically it is a great opportunity, since the university does not require a security deposit, application fee, or finder’s fee, and all utilities are included in the rent, making it a better deal than many of the other properties in the area. As one may assume, these properties are managed by Harvard University, offering after‐hours emergency services and sustainable living programs, integrating sustainable practices into all of their operations. As a plus, all of the properties are non smoking, some of them are pet friendly, fully furnished, and family friendly with on‐site play areas.

The Harvard Divinity School presents an interesting case for studying the housing situation of its students and professors, since this school owns the Center for the Study of World Religions, a small building with both, office spaces and apartments. The center was constructed in 1960, and the last renovation took place in the summer of 2006. There are thirteen apartments located within the building, which include two studio apartments, six one‐bedroom units, four two‐bedroom units, and one three‐broom apartment. Moreover, one of the units was retrofitted to meet the Americans with Disabilities Act (ADA) requirements for accessibility. All of the apartments are furnished and uniformly painted with warm neutral‐toned colors, as well as equipped with an electronic kitchen, with stove and oven, a microwave oven, a refrigerator, dishes, and cooking utensils. All of the apartments are available for rent by graduate students and affiliates of Harvard University. The big difference between this specific Harvard Housing and the rest, is that one has to apply directly to the Center, not to the University, and residents are selected based on their particular interests in world religions in combination with their potential for contributing and benefiting, at the same time, from their stay at the Center.

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Fig 4. General plan of the first floor Fig 5. Courtyard view of the Residences

Fig 6. View of the kitchen of one of the studios








Housing Market

Residence far from the school

‐ ‐ P People with disabilities

H Yes Survey

Low offer of school housing

‐ ‐ P H Yes Survey

High rents ‐ ‐ P People with low income

M Yes Survey

CSWR

Office vs. Housing + S H No Interview

Open circulation areas

‐ P Children, elderly, disabilities

H No Plans

No elevator ‐ P Children, elderly, disabilities

H No Observation

Flat roof ‐ ‐ ‐ P S No Interview

Furniture ‐ ‐ S Disabilities H No Interview

Price + + P People with low income

H Yes Interview

Maintenance + + + P H Yes Interview

3rd floor 0 S H No Interview


Positive Impact #1 CSWR Housing vs. Office

Positive Impact #2 CSWR Price

Positive Impact #3 CSWR Maintenance


Keep public/private area limits clear Upgrade the building envelope (windows, doors, insulation, thermal bridges)

Keep following maintenance plans

Residents and workers must be related Introduce energy production systems

Negative Impact #1 CSWR Open Circulation Areas

Negative Impact #2 CSWR Flat Roof

Negative Impact #3 CSWR Furniture


Unexposed circulation areas to winter environment

Update the roof Admit outside the furniture

Let it be flexible to be open in summer Install necessary features for snow safety Have a storage space for extra furniture

Use warmer finish materials (wood) Keep architectural image Rearrangement furniture service

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Housing Recommendations: Short, Medium, and Long Term Short Term:

Install clear signs at the CSWR stating the different accesses and boundaries for the residential and the office spaces, so that visitors, as well as residents and workers, respect the privacy of the occupants of the building.

Upgrade the maintenance schedule and action plans at least one a year in all university housing buildings, to make sure that they are in accordance with the systems and the occupants needs.

Admit some personal furniture in the CSWR apartments for the commodity and the well being of the occupants. The third floor should be used as a storage room for the furniture that the tenant does not need.

Medium Term:

Upgrade the building envelope of the university housing buildings, this will lower specially the heating demand and the rent prices could be lowered.

Install energy production systems for the university housing buildings, this way, part of the energy demand of these can be balanced with the on site energy production and the rent prices could be lowered.

Long Term:

Acquire or construct more housing buildings to meet the demand of the students.

Upgrade the roof of the CSWR to better meet the standards of such a cold climate like Cambridge’, this upgrade should allow the evacuation of the snow by itself while keeping the architectural image of the building.

Adequate the circulation spaces of the apartments at the CSWR to the long and cold winters. The circulation space has to be flexible and dynamic, open during summers to allow natural ventilation and closed in winter to serve as a buffer space at the arrival of the tenants.

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Mental Health By Shahab Albahar

Overview of Findings Although HIAs make an effort to integrate mental health into the data collection and analysis, it is nonetheless a challenging task. This is because interpersonal and individual factors besides the physical environment are major influencers of mental well‐being. “Accurate measurement and improvement of population mental health requires the recording of indicators that capture the full spectrum of disease severity (Tannenbau 2009).” Health indicators for mental health surveillance are lacking. Mental health indicators currently in use include suicide rates, hospitalization, utilization rates of health, and self‐reported use of mental health services or disorders. Unfortunately, these mental health indicators do not capture the broad spectrum of severity that characterizes this field. However, an overview study of mental health at Harvard Divinity School (HDS) suggests:

Overall and when compared to other Harvard campuses, the HDS has a relatively good standing in mental well‐being among its students, faculty and staff.

“HDS is a happy (though exclusive) bubble within Harvard, which is a happy (though exclusive) bubble within the world” (GSD 2014).

The HDS acknowledges and emphasizes the importance of mental health. The school’s website communicates the importance of maintaining a well state of mind and provides its students and faculty accessibility to mental health counseling and referrals through the HUHS.

“Being a graduate student is both rewarding and challenging. While there are enormous opportunities at Harvard, the sheer number of talented people all in one place can be intimidating. Graduate school can sometimes be isolating: long hours in the library, high‐stakes relationships with faculty, competing priorities of a demanding program, and concerns about the next step after graduation. Although it is natural to feel a little down or overwhelmed on occasion, sometimes all the stress may seem too much. In an atmosphere that often places high value on success, acknowledging the need for assistance in getting through the rough spots is not always easy, but ignoring or putting off problems can make them more serious and disruptive” (HDS 2014).

The HDS could implement small‐scale interventions that attempt to enhance mental well‐being on campus. Such interventions could vary from community planning involving social functions to physical interventions such as lighting fixtures, landscaping, interior ambiance and furnishings. Other potential interventions are associated with local policy reforms such as the dissemination of information, raising public awareness on mental well‐being and training academic advisors on mental health issues.

Sustainability is already a core theme among the community of the HDS. Therefore, the HDS

must acknowledge and embrace the importance of mental health as an integral part of its plan for a sustainable future.

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Background: Why this Topic Matters “Good mental health enables people to realize their potential, cope with the normal stresses of life, work productively, and contribute to their communities. Mental health matters, but the world has a long way to go to achieve it. Many unfortunate trends must be reversed‐neglect of mental health services and care, and abuses of human rights and discrimination against people with mental disorders and psychosocial disabilities.” ‐ Dr. Margaret Chan, Director General of World Health Organization (WHO 2014).

It is estimated that only about 17% of U.S adults are considered to be in a state of optimal mental health (HHS, 1999). Yet what is optimal mental health? And how can we measure it? According to the World Health Organization (2001) the definition of mental health is as follows: “Mental health is defined as a state of well‐being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”

There are many different risk factors that can affect the mental well‐being of an individual. Such factors range from biological, physiological and emotional to socio‐economic, environmental and incidental factors. However, the three most significant determinants of mental health are:

Social inclusion

Freedom from discrimination and violence

Access to economic resources

Fig 1. Factors Affecting Mental Health

Whereas it may be difficult to control or monitor some of the risk factors to mental health, it is important to acknowledge them as indicators in order to propose policies and tactics to mitigate their negative impacts on mental well‐being. Prior to expanding on the data findings from the HDS survey that correlate to mental health, it is important to understand and differentiate between mental health and mental illness. Whereas mental health is defined as the well‐being of an individual and optimal productivity levels, the CDC (1999) defines mental illness as:

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“Collectively all diagnosable mental disorders” or “health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning.”

The National Alliance on Mental illness estimates one in four American adults to experience mental illness in a given year (NIMH 2013). Anxiety and depression disorders are the most common mental illness in the US affecting more than 26% of adults (Murray and Lopez 1996). It has been estimated that by the year 2020, depression will be the second leading cause of disability throughout the world, trailing only ischemic heart disease (Murray and Lopez 1996). Figure 2 illustrates some of the most prevalent mental illnesses.

Fig 2. Common Mental Disorders Among College Students

It is worthwhile noting that optimal mental health does not necessarily mean the absence of

mental illness and vice versa where the existence of a diagnosed mental illness leads to poor mental health. Figure 3, shown below, is adapted from Mental Health for Canadians: Striking a Balance. It illustrates how mental health and mental illness are found on two separate continuums. Optimal mental health, often referred to as mental well‐being or mental wellness, is at one end of the continuum, while poor mental health, also referred to as languishing is at the other end. On the horizontal axis, having a serious mental illness is at one end of the continuum, while having no symptoms of a mental illness is at the other end. Ultimately, this means that someone can be mentally healthy with a mental illness and that someone can have poor mental health without a mental illness (The Health Communications Unit 2014).

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Fig 3. The Mental Health/Illness Continuum2

The WHO has only recently emphasized the importance of good mental health. Much global attention is given to infectious and pandemic diseases and less on non‐communicable diseases that tend to have longer‐term effects. The 66th World Health Assembly, consisting of Ministers of Health of 194 Member States, adopted the WHO’s Comprehensive Mental Health Action Plan 2013‐2020 in May 2013. The action plan recognizes the essential role of mental health in achieving health for all people. It is based on a life‐course approach, aims to achieve equity through universal health coverage and stresses the importance of prevention (WHO 2013).

Description: The Situation at HDS “HDS is a happy (though exclusive) bubble within Harvard, which is a happy (though exclusive) bubble within the world.” “I feel like we at HDS enjoy a Zen retreat here on our campus. It is so much more relaxed and less busy than the rest of Harvard campus (es).” “There is a culture of pervading spirituality at HDS that helps me to feel calm even when stressed and under serious pressure in my job. The fact that people are disposed to be kind rather than demanding makes this a special place to work.” “The campus is beautiful and that helps me cope with stress. I really appreciate the tremendous improvements over the past 9 years.”

2 Workplace Mental Health Association. http://wmhp.cmhaontario.ca/workplace‐mental‐health‐core‐concepts‐issues/what‐is‐mental‐health‐and‐mental‐illness#_ftn4

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The above statements were extracted from the HIA survey distributed at the Divinity school. Surely, they seem to portray a very positive attitude towards the HDS campus—one that is relaxing to be at and stress free. However, the data results from the survey provide a more holistic understanding of the mental health status at the HDS.

By looking at the chart below (Figure 4), immediately we begin to realize that the major mental

health concern at the HDS is stress. 37% of the HIA survey respondents said that they often or quite often feel stressed. This compared to a previous HIA conducted in 2013 at another Harvard campus (the GSD) where 90% of survey respondents; scored relatively well, but nonetheless stress is of major concern when the goal is to sustain optimal mental health. Undergraduate and graduate students alike often suffer from anxiety, depression, and other mental health issues. Many students move to new cities or countries to start their degree and thus lack social connections and support, commonly feel overwhelmed by teaching and research loads, and often have persistent fears of failure and inadequacy. These and other causes can lead to anxiety and depression that drain students’ creativity and motivation. In one study of over 3,000 international graduate students, 44% said they had mental health issues that “significantly affected their well‐being or academic performance” (Hyun, Quinn, Madon, and Lustig 2007). In addition, these can lead to graver health concerns, most dramatically suicide, which, among college students across 10 universities, was found to be highest among graduate students (Silverman, Meyer, Sloane 1997). As the previously stated in this chapter many factors affect stress levels which in turn may lead to anxiety and depression. Getting enough sleep is very important. Sleep loss may result in irritability, impatience, inability to concentrate, and moodiness and serious sleep disorders have been linked to hypertension, increased stress hormone levels, and irregular heartbeat. An HIA conducted at the GSD around the same time last year shows that there is a culture of sleep deprivation at the Design school with 96% of students unable to get 8 hours of sleep per night. This data compared with similar data collected at the HDS on average sleeping hours where 25% of students get 8 hours of sleep a night and the median result was 7 hours (Figure 4), renders HDS a campus free of devoid of sleeping concerns. Yet lack of sleep is only one potential factor in increased stress levels.

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Fig 4. HDS Health Impact Assessment Survey 2014‐ Mental Health

Fig 5. HDS Health Impact Assessment 2014 & GSD Health Impact Assessment 2013‐ Sleep and Stress

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Fig 6. HDS Andover Hall and Adjacent Green Space (Looking at architectural spatial qualities)

While some stress inducing factors are more difficult to regulate such as socio‐economic status

and cultural pressures, planners, architects, landscape architects and urban designers can certainly alter others factors linked to the physical environment to sustain optimal mental health or enhance its current status. At HDS, many students have voiced their preference to be at the Rockefeller building over Andover Hall. It only takes a single visit to the campus to understand perhaps why that is. On the exterior Andover Hall sets itself apart from its surroundings as an architectural marvel. Completed in 1911, it is the only building at Harvard built in the Collegiate Gothic style of architecture. Although somewhat subjective, the interiors of Andover Hall (Figure 6) are rather depressing for a student atmosphere. Long narrow hallways lined with relatively low ceilings and dark wood furnishings give the space an overall rather depressing ambiance. This is further perpetuated by the furnishings and lighting. Many hardwood church benched line up the narrow hallways facing doors upon doors of faculty and administrative offices. While the purpose of these benches is to provide seating space for students while waiting to meet with a faculty or administrative member, being in a confined space facing bland walls raises the likelihood of anxiety and discomfort levels.

Another observation at Andover Hall is the excessive use of fluorescent lighting. Over‐

illumination has been linked to various negative health effects. The intensity of fluorescent lighting can induce such chronic illnesses as headaches, fatigue, stress and anxiety. Despite the absence of scientific evidence to show the effects color has on mood and stress levels; exposure to natural daylight induces serotonin levels in the body which is proven to have positive impacts on mood, lowering stress, and improving sleep. The orientation of Andover Hall fails to optimize on natural daylight. The hallways are pushed to the western façade of the building and the classrooms to the east. In temperate climates where there is a seasonal change and a risk of SAD (Seasonal Affective Disorder) due to reduced daylight hours, it is important to capitalize on afternoon light and have large west facing windows. In the case of Andover Hall, the hallways benefit from the setting sun and the classroom spaces almost never receive direct sunlight during the cold winter months.

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Fig 7. HDS aerial 2004 (Left) and HDS aerial 2014 (Right) showing the conversion of the parking lot into the present green space

“Love the new additions to the green space. Getting rid of the old, ugly parking lot is a great improvement! I get annoyed when people smoke on HDS' lawn though‐‐ and they do. It'd be great if the Rock had a healthy vegetarian soup every week‐‐ they do sometimes, but not always it seems. I think HDS' campus is wonderful in general!”

Researchers have discovered that when some people who are injured or ill are exposed to open, undeveloped land, also known as green space, they recover faster than others who were not exposed. The conversion of the parking lot into a green space at the HDS campus (Figure 6) is a huge success and speaks to its green sustainability campaign. However, it is important to note that marginalized groups such as people with disability might experience difficulty accessing the green space from Andover Hall due to the absence of a ramp. Furthermore, upon exiting Andover Hall, being elevated in the landscape is reassuring when the eye is able to see far. However, Figure 8 shows the eyesight level and how most of the “green” falls below that line.

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Fig 8. HDS green space as seen from the West entrance to Andover Hall. Exposure to natural elements and greenery

“People are more introverted than at other schools, friendly in one‐to‐one meetings but not a lot of participation or initiative for group activity compared to other schools.”

HDS has a comprehensive website, with pages dedicated to health, wellness and safety as well as sexual and gender based harassment. Contact information and hotline numbers for counseling support and what to do in case of assault are all included in their homepage. Currently, for any mental health related issues, HDS students would have to go to HUHS mental health services located in Harvard Square which falls outside a 5 minute walking radius from any HDS building. Distance, coupled with the introverted nature of HDS students could discourage people from the HDS to take advantage of university resources. Also, overall there is a lack of public awareness on mental health. With the exception of one poster that advertises “stereotype threats” (Figure 9) there is nothing around the HDS campus that raises alertness on the importance of mental well‐being.

Fig 9. Mental Health related poster on the wall by the Rock Cafe








Lighting (use of fluorescent lighting)

‐ S HDS affiliates would be most affected.

S N/A Primary research and observations

Conversion of Andover parking lot into Green Space

+++ P N/A S, H N/A HDS affiliate statements

Overall stress levels at the HDS (Socio‐economic and other factors)

‐ ‐ P HDS affiliates would be most affected but others they come into interaction with may be affected too due to behavioral changes inflicted by stress.

S and potentially H, M

# of affiliates who answered sometimes and quite often stressed in survey

Primary researchHDS survey data analysis

Access to counseling services and presence of support system at HDS

+ S, P Mostly HDS students S, H # of visitors to the HUHS student mental health services from HDS

Primary researchHDS affiliate statements

Mental health Awareness

‐ S HDS affiliates S, H # of posters and signage that communicates mental health concerns

Primary researchObservation

Furniture arrangement (Social space)

‐ S HDS students S N/A Primary observation

Crowding ‐ ‐ S HDS affiliates S Number of students per classroom

HDS survey statements

Perceived statements class

+ + S HDS affiliates but mostly the female population who feels more targeted after sundown and relatively unsafe

S, H N/A HDS survey data analysis and statements


Positive Impact #1 Conversion of Andover parking lot into Green Space

Positive Impact #2 Access to counseling services

Positive Impact #3 Community support system and social functions

Positive Impact #4 Perceived “safety” on campus


Introduce more landscape elements into the existing green spaces such as benches and tables that foster social interaction and the implementation of speed bumps on pathways to slow down cyclists cutting through.

Considering the introverted nature of many HDS students and the distance of the HUHS from the campus, having a weekly counseling session on campus might encourage more students to speak about their mental well‐being and share their support with others.

Incorporate more social events and functions into the HDS’s calendar. For example the GSD hosts a beer and dogs almost every Friday to alleviate the overall stress where the students can blow off some steam while engaging in social interaction with students outside of their concentrations too. The HDS could benefit greatly from something very similar to this

Introduce more lighting around the campus to enhance vision in outdoor spaces after sundown. Manipulate topography effectively in green spaces augment field of vision.

Introduce ambient lighting and illuminate pathways in the outdoor green spaces to induce a greater feeling of safety during dark hours.

Capitalizing on the privacy of bathrooms as spaces where females (and males) can share their concerns anonymously and even talk about any accounts of sexual harassment or abuse and seek support and advice.

Introduce more safety measures to the external spaces at HDS such as surveillance cameras, card only access to HDS buildings after 8pm and perhaps even have a member of HUPD or security officer be present on campus.

Negative Impact #1 Excessive use of fluorescent lighting and relatively low ceiling levels

Negative Impact #2 Stress levels at the HDS

Negative Impact #3 Organization of furniture and crowding


Replacing fluorescent lighting with alternatives such as Full Spectrum Light Bulbs that simulate natural lighting to improve the light quality and the body’s response to that light. Many practitioners accept the theory that light therapy using full‐spectrum lighting can dramatically affect biological functioning and mood by regulating hormones and body chemistry.

Introducing routine meditative activities such as yoga can help mitigate stress levels overall and foster stronger community bonding.

Recruit more full time faculty members to reduce student to faculty ratio and therefore reduce crowding in classes, which could instigate higher stress levels and anxiety.

The introduction of color to the interiors of classrooms. While there is no concrete evidence that color affects mood, emotions, or psychological well‐being in any systemic manner, vibrant colors such as yellow when introduced to a classroom setting might be a valid experiment to test for levels of increased productivity and focus.

Organize weekly weekend runs among HDS members to increase physical activity geared towards reducing stress levels. This also fosters community bonding.

At the current state, countless wooden benches line up the endless hallways facing faculty and administrative offices intended for use while waiting to meet with a member of the faculty or staff. A rethinking of this to introduce more comfortable furnishings and seating arrangements that have facing counterparts could harness more social interaction.

Negative Impact #1 Excessive use of fluorescent lighting and relatively low ceiling levels

Negative Impact #2 Stress levels at the HDS

Negative Impact #3 Organization of furniture and crowding


For windows that do not receive much direct light, introducing architectural elements such as reflective panels/louvers etc. could indirectly increase natural light in spaces otherwise lacking.

Introduce ambient relaxing music in the hallways and circulation paths that could help reduce stress levels.

The HDS could collaborate with other nearby campuses such as the science center and engineering school for a cross‐utilization of facilities to distribute the students across a larger campus area and alleviate the crowding issue at the HDS while simultaneously catalyzing greater cross‐disciplinary involvement.

Occupy the green space even during the winter months. One way is to set up a temporary climatically controlled structure that can host different functions, lectures, social events etc. Another is to invite public from the surrounding neighborhood to occupy the space. An opportunity for the green space to be activated during the snowy season would be the introduction of an ice skating rink for instance.

Distribute a student guidebook on healthy living to incoming students in their acceptance package (The GSD is successful in doing this). This will allow students to familiarize themselves with the school, the neighborhood, university and city as a whole before arriving. It will also provide them with much needed useful information on housing options, where to get groceries, local emergency and medical centers, gyms etc.

Academic advisors should receive training on preventing, recognizing, and addressing mental health issues in their students (and themselves too!).

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Mental Health Recommendations: Short, Medium, and Long Term Short Term:

Openly acknowledge that there is a mental health problem.

Discuss mental health during student orientations, in student handbooks, and through student meeting with advisors.

Recognize marginalized or underrepresented groups and conduct greater efforts to integrate them into the existing community and eliminate disparities.

Long Term:

Address rent rate increase in the area, which are pushing students to live further and further away from campus.

Improve the perception of safety and social connectedness on campus.

Look to recommendations in other related areas: food, ambient environment, and social connectedness.

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Physical Activity and Commute By Allison Green


A survey and focus group conducted with students, faculty and staff affiliated with the Harvard Divinity School revealed details about commuting and physical activity patterns. Survey results indicate that half of the HDS affiliates surveyed live more than 2 miles outside of campus and the chief mode of transport used among survey respondents is walking, followed by public transportation. Only 17% of respondents use a bike to get to campus, which in combination with the 38% who walk, means that the majority of those surveyed use active transport to get to and from the HDS campus. Once on campus students and staff report sitting for many hours at a time as they work and study and although HDS subsidizes a percentage of fees required for gym membership, many respondents choose not to have a gym membership on campus.

Many students walk to campus, meaning that they live within distances that allow for active modes of transport.

Most faculty and staff live outside of a two‐mile radius of Harvard Divinity School campus and some who drive or rely on public transportation have identified inconvenience of the bus schedule and traffic congestion as a problem.

Emphasizing the availability of on‐campus recreation facilities or even building physical activity into the programming of HDS activities is an opportunity to increase overall health and well being for those that work and learn in the HDS community.

Students, faculty and staff spend long hours sitting while working at the HDS campus, some complain of related bodily discomfort. This highlights opportunities to incorporate physical activity into the working and learning environment through programming and policy adjustments on a variety of scales.

Background: Why this Topic Matters Through publications such as the Sustainability Plan and the annual Parking and Transportation

Demand Management Plan, Harvard University has expressed a devoted to creating a campus culture based on sustainable practices and attitudes. Paying attention to patterns of commuting and physical activity allows for the development of strategies to promote sustainability, active lifestyles, productivity, and wellbeing in and beyond the workplace. Emphasis on using sustainable transport has led to a focus on how people commute and the effects of such trends on environmental pollution. Harvard’s university‐wide sustainability initiative puts great emphasis on lowering the environmental impacts of transportation by trying to promote rideshares, shuttles, biking and walking as an alternative to driving alone to the Harvard/Allston campuses (Harvard University Office of Sustainability 2015). Harvard’s sustainability initiative also encourages increased use of active transport such as walking or biking as not only a greener form of transport but also a method of being more physically active during the day. The correlation between levels of physical activity and short term, as well as cumulative health is widely documented in the medical community. According to a report by the United States Department of Health:

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“Strong evidence demonstrates that, compared to less active persons, more active men and women have lower rates of all‐cause mortality, coronary heart disease, high blood pressure, stroke, type II diabetes, metabolic syndrome, colon cancer, breast cancer, and depression” (U.S. Department of Health and Human Services 2008). The link between physical activity and spiritual wellbeing is only recently gaining acceptance in scientific research circles but has long been held across a wide group of religious and spiritual faiths. Walking, running, Tai Chi and yoga are some mainstream physical activities that are associated with enhancing spiritual practice (Gotz 2001).

Description: The Situation at HDS Modest to Low Use of Campus Recreational Services

While the Harvard Divinity School offers a partial subsidy to students and an insurance credit to faculty and staff for use at gyms outside the Harvard system (Harvard Divinity School 2014), 61% of HDS community members participating in this study reported not having a gym membership. Additionally, 29% of respondents expressed that access to Hemenway Gym, the nearest gym to HDS was too far from the campus and 40% reported having no previous knowledge of Hemenway Gym. In a focus group conducted at Community Tea with students and administrative staff, only one staff member had a gym membership and specified that it was a gym unaffiliated with Harvard. Focus group attendees sited overcrowding during peak hours, long waitlists and busy work and study schedules as reasons for not having a gym membership on campus. HDS community members report long periods of sedentary behavior

HDS students and staff reported spending significant amounts of their time sitting down when on the HDS campus. Of particular concern were health issues cited by faculty members that have a link to the HDS culture of work and study. Staff members reported sitting between six and eight hours per workday while students reported sitting down closer to 10 hours per workday. A report by the CDC on interventions to reduce occupational sitting cited existing research demonstrating “associations of prolonged sitting time with premature mortality; chronic diseases such as cardiovascular disease, diabetes, and cancer; metabolic syndrome; and obesity” (Pronk NP 2011). High use of active transport to commute to HDS campus

Many survey respondents affiliated with HDS walk or ride a bike to campus. This trend has positive implications for sustainability as well as physical health. A majority of 82% of students who reported walking to school live within 2 miles of campus while those walking to campus from distances of 2 miles or more only made up 18%. The latter indicates that there may be some opportunity to encourage more students living outside of the 2‐mile radius to bike to campus instead of relying solely on public transportation. A High Percentage of HDS affiliates living more than two miles outside of the HDS campus cite traffic and inconvenience as an issue when commuting to the campus

In response to the survey, half of HDS staff respondents reported to living more than two miles outside of campus and not having access to affordable housing. During this study, one HDS staff member participating in a focus group reported spending at least an hour in traffic when commuting to HDS by car. In the same focus group, only one faculty member reported living more than 2 miles outside of HDS and not having access to affordable housing but because of a small sample size of faculty

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participants, it is difficult to determine whether survey results indicate general satisfaction with distance from campus and availability of affordable housing near campus among HDS faculty. Among students surveyed for this study, 33% live more than 2 miles outside of HDS.

List potential positive and negative impacts and use the table below to evaluate the severity and distribution of impact. Health impact (issue) Positive or negative?

+++ strongly positive ++ moderately positive + mildly positive 0 neutral ‐ mildly negative ‐ ‐ moderately negative ‐ ‐ ‐ strongly negative U uncertain






Long periods of time spent sitting

‐ ‐ ‐ P n/a N Hours spent sitting

Focus Group

Moderate to low Utilization of Campus Recreation Facilities

‐ P Students with lower incomes

Focus Group

Conflict between pedestrians and bikers on campus pedestrian paths

‐ ‐ ‐ P Bikers vs. Pedestrians Survey and Focus Group

Walkable campus with attractive paths

+ + + P Pedestrians Survey

Stairs generally preferred to elevator

+ + S n/a Survey and focus Group

Longer commute for at least half of students faculty and staff

S Survey and Focus Group

Half of the HDS community lives 2+ miles outside of campus

S Students outside of 2 mile radius

Survey and Focus Group

HDS offers an Ergonomics Evaluation for staff members

P HDS Faculty and Staff


Positive Impact #1 High Use of Active Transport by Students

Positive Impact #2 Subsidized Gym Membership for HDS Affiliates

Positive Impact #3 Available Ergonomics Evaluations


Improve bike infrastructure to accommodate to accommodate HDS affiliates who commute by bike

Create greater awareness of available gym/recreational services

Promote the availability of Ergonomic services available through Harvard

Create awareness around the positive health effects of walking

Require students to opt out of gym membership vs. opting in

Arranging Ergonomics workshops or info sessions for faculty, staff and students

Posting basic tips about improving ergonomics in libraries offices and study areas

Negative Impact #1 HDS community members report long periods of sedentary behavior

Negative Impact #2 A High Percentage of HDS affiliates living more than two miles outside of the HDS campus cite traffic and inconvenience as an issue when commuting to the campus

Negative Impact #3 Modest to Low Use of Campus Recreational Services


Incorporate a Pedometer Based Walking Program for Faculty and staff

Pilot a rideshare program that helps HDS faculty commute to work together

Program more outdoor outings and retreats using campus recreational services

Create a system that uses email or SMS to remind HDS affiliates to take regular breaks from sitting

Consider extending shuttle service to areas outside of current service routes

Introduce a pilot program that encourages standing or walking meetings for faculty and staff

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Physical Activity and Commute Recommendations: Short, Medium, and Long Term Short Term:

Emphasize and enhance existing transportation and physical activity solutions that HDS affiliates may be unaware of through a print campaign:

o Ergonomics counseling o Promote participation of existing Harvard programs like Hubway bikeshare o Get Moving Harvard (program encourages active lifestyle by encouraging group walking

and jogging events)

Send email or SMS alerts to HDS affiliates with a quick reminder to get up and stretch or go outside and take a walk once or twice a day.

Introduce walking and standing meetings, in staff, faculty, or classroom settings.

Medium Term:

Allow students to opt out of the gym membership at the beginning of the year, or to use gym subsidy toward purchasing a bicycle. This is one way to spread awareness about the availability of gym services and cater to HDS affiliates who aren’t comfortable exercising within a gym environment.

Implement pedometer based walking program to encourage at least 10,000 steps a day, or to ride bikes. See the Australian study in Global Corporate Challenge® (GCC®)3, which showed that this reduced the risk for cardiovascular disease and diabetes in two months and encouraged increased vegetable and fruit intake (Freak‐Poli, Wolfe, Wong, & Peeters 2014).

3 Global Corporate Challenge®: An annual pedometer‐based workplace program established internationally. Workers wear a visible pedometer for 125 days (May to September) and are encouraged to meet the goal of 10,000 steps. The challenge is competitive and requires employees to compete in teams of seven for the highest number of steps.

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Safety By Justin Feldman

Overview of Findings Overall, safety hazards at Harvard Divinity School pose a low risk to faculty, students, and staff. Additionally, the community generally perceives of the campus as a safe place to work and study. Responding to the statement “I feel safe on campus in general,” all 63 HDS community members who took the survey indicated that they either agreed (32%) or strongly agreed (68%).

Fig 1. Response to “I feel safe on campus in general” While this report will address other topics as well, the primary safety hazards on campus include the injury risk that bicycle users pose to pedestrians and a lack of knowledge regarding emergency preparedness among the HDS community.

Background: Why this Topic Matters This section of the health impact assessment reviews safety‐related risks at the Harvard Divinity

School. Broadly defined, safety involves preparing students, staff, and faculty for emergencies; preventing injuries and violent incidents; and improving perceptions about the campus as a place that is free of threats to health and well‐being. Apart from the direct health consequences of physical hazards and violence, perceiving the campus as an unsafe place can increase levels of stress, decrease satisfaction with the campus, and negatively impact social life among the HDS community.

To collect data for this section of the assessment, I conducted a walkthrough of the HDS campus

where I took photographs of potential safety hazards. Additionally, I reviewed the previous month of incidents (October 6 to November 6, 2014) reported by the Harvard University Police Department,

Disagree0%

Agree32%

StronglyAgree68%

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noting events that took place in the vicinity of HDS campus. Finally, I surveyed HDS students, staff, and faculty about their perceptions of campus safety and spoke with staff from the Office of Operations.

Description: The Situation at the GSD Violence

HDS is located in the residential Aggasiz neighborhood of Cambridge, which experiences lower levels of violence compared to other parts of Harvard University, Cambridge, and urban Massachusetts:

Cambridge had a lower violent crime rate – 412 incidents per 100,000 residents – than the state average for comparably sized cities, which was 595 per 100,000 residents (Cambridge Police Department 2012, 5).

HDS is located in Cambridge’s Aggasiz neighborhood, which had “lower‐than‐average rate for almost every measured crime” compared to the city of Cambridge as a whole (Cambridge Police Department 2012, 79).

One street robbery was the only incident of violent crime reported in the neighborhood during the period 2011–2012.

A review of the Harvard University Police Department’s police logs (Harvard University Police Department 2014) for the dates October 6, 2014 to November 6, 2014 revealed more than 100 reported incidents over the one‐month period for the entire university. None of the incidents, however, took place on the HDS campus or in its immediate vicinity.

According to Office of Operations staff, several faculty members have received threats in the

past due to the sometimes‐controversial nature of their scholarly work. These threats have not resulted in actual violence and all of the faculty members that participated in the survey indicated that they feel safe on campus. The sample included only four faculty members respondents, however, so it is unclear if other professors share these sentiments.

Additionally, there are a number of features that HDS currently uses to maintain a campus free

of violent incidents:

Buildings with windows adjacent to the quad provide informal surveillance (Mair and Mair, 2003).

Outdoor lighting is abundant on the quad.

There is an emergency call box located outside of Rockefeller Hall.

All faculty members have buzzers in their offices to signal for help if needed.

Campus buildings are locked on the weekends.

The author of this section considered a number of additional safety measures including installing security cameras increasing police presence on campus, and controlling access to buildings by requiring identification cards. These safety measures may change the feel of the campus environment in a way that undermines the Divinity School’s humanistic spirit and is inimical to its mission of building a community in which members “peacefully live and work together across religious and cultural divides” (HDS 2013). Considering the school’s values and the low assessed risk of violence, these measures are therefore not recommended.

One of the safety hazards that HDS should address in collaboration with the University involves the walking pathways that lead from the Department of Molecular and Cellular Biology (pictured below).

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Fig 2 and 3. Walking pathways that lead from the Department of Molecular and Cellular Biology

These pathways, which are the most convenient route to HDS for those entering from southwestern parts of the university campus, allow for the anticipation of pedestrians’ movements while restricting their line of sight. An attacker could hide behind the corner of one of these buildings and wait for someone to walk through. As one survey respondent noted, “The area around Div Hall (especially the passageway from Divinity Avenue back to the sand‐volleyball court area) always feels dark and sketchy to me.” Lighting should be improved on this part of campus and parabolic mirrors should be placed on the sides of the buildings to allow for surveillance around the corners of these buildings (Mair and Mair 2003).

Additionally, HDS staff should conduct a more throughout assessment of lighting around

campus, particularly in front of Andover Hall, around the Center for the Study of World Religions, and around Divinity Hall. Among survey respondents, 20% of women (but no men) reported feeling unsafe on campus at night. Several comments noted poor lighting in the pathways between HDS campus buildings and between Francis Avenue and the HDS campus.

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Fig 4. Women Reporting Feeling Unsafe on Campus at Night Bicycles

Injury hazards posed by collisions between cyclists and pedestrians represent the most visible safety hazard on HDS campus. Among survey respondents, 35% believed that bicycles made it unsafe to walk on campus.

Fig 5. Responses to “Bicycles make it unsafe to walk on campus”

2%

18%

69%

11%

StronglyAgree

Agree

Disagree

StronglyDisagree

18%

16%

41%

25%StronglyAgree

Agree

Disagree

StronglyDisagree

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Additionally, 8 out of 18 safety‐related survey comments referred specifically to bicycle hazards. Office of Operations staff members have also mentioned bicycles as the most pressing safety concern. During the campus walkthrough, the author of this section witnessed several cyclists riding on HDS pedestrian paths despite a posted sign indicating that cyclists must walk their bicycles.

Fig 6, 7, 8, and 9. Top left: A stop sign appears along the pathway at the HDS entrance; Top right: A commonly used bike rack at the center of campus; Bottom left: a cyclist breaks the rules and rides on HDS paths; Bottom right: A sign indicates that cyclists must walk their bicycles

Both the design and location of the HDS campus contribute to the bicycle problem. First, HDS is located at the end of a wide asphalt path starting near Massachusetts Avenue. For a cyclist who wants to exit the campus and travel east, cutting through HDS is the most convenient option. In fact, Google Maps (which many cyclists use to plan their routes) suggests that cyclists ride through the HDS campus to reach points northeast of Harvard. Another issue is that a commonly used bike rack is located in the middle of HDS campus. Cyclists who use this rack will inevitably ride across campus to park their bikes.

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Finally, the signage requiring cyclists to dismount is inadequate. There seems to be only one small sign and it is not located at the HDS entrance.

Due to the location of HDS and the Google Maps issue, it seems very unlikely that cyclists will stop cutting through the campus to reach destinations to the east of Harvard. HDS should therefore make changes to its bicycle infrastructure to maximize safety:

Cyclists should be diverted to a single, marked pathway through campus that pedestrians know to avoid.

Replace the stop sign with a different sign indicating that all bicycle traffic must travel on the pathway on the right side of the fork.

Paint a designated bike lane on this pathway starting at the sign and ending at the parking lot

The bike lane can continue through the parking lot and exit the campus onto Francis Avenue.

Because the street configuration is confusing and many streets are one‐ways, HDS staff would also ideally work with the City of Cambridge to install bike path markers that direct cyclists to Kirkland Street to the south and Beacon Street to the north.

Fig 10. Above: Proposed route for bike lane, which would take up half of the walkway until the parking lot, then continue through the parking lot. Signage posted at the Francis Avenue exit could direct cyclists to their destinations

Additionally, the bike rack located at the center of campus should be relocated to the edge of campus to discourage cyclists from riding on restricted areas. One possible location would be over the pavers in front of the current stop sign. Finally, an HUPD officer could be stationed near the walkways during the first week of the school year and inform cyclists of the HDS bicycle policies. HUPD ran a similar campaign in front of the Science Center at the beginning of the 2014–15 academic year. Emergency Preparedness

A majority of students (55%) along with 22% of staff and 25% of faculty responded that they did not know what to do in case of an on‐campus emergency. Additionally, there were no evacuation maps or other emergency‐related instruction signs visible in HDS buildings (with the exception of emergency exit signs).

HDS staff should develop and post signage with evacuation maps, evacuation procedures, and

shelter‐in‐place procedures. They should also integrate information on emergency procedures into the student orientation process in addition to providing training for faculty and staff.

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Discrimination

The issue of discrimination on the basis of race or other characteristics overlaps with safety in various ways. Member of the HDS community who perceive discrimination directed against them may also feel physically or psychologically threatened on campus. Responding to the statement “I am concerned about being profiled on HDS campus because of the way I look,” 3 out of 38 students (8%) agreed or strongly agreed. Since the survey did not collect demographic data on respondents besides gender, these results cannot be broken down by race/ethnicity or other characteristics. Eight percent of students reporting profiling may seem like a small proportion, but only 31 percent of HDS students are people of color. Thus, if the survey were a representative sample of students, as many as 25% of students of color may be reporting concerns about profiling. The extent of concerns regarding discrimination on HDS campus – and the degree to which they can be ameliorated by changes to the build environment – warrants further investigation.






Measurable indicator? Evidence base for knowing about the issue

Lack of emergency preparedness knowledge

‐ ‐ ‐ P S Pre/post‐test of emergency preparedness knowledge

Survey

Bicycle hazards ‐ ‐ ‐ P H Number of cyclists riding on prohibited areas each day

Survey, communication with staff, direct observation

Inadequate lighting

‐ S Women report more concern

H Survey HDS community perceptions

Survey

Dangerous pathway from Dept. of Molecular Bio

‐ ‐ S Women report more concern

H Survey HDS community perceptions

Survey, direct observation


Positive Impact #1 Emergency preparedness signage and trainings

Positive Impact #2 Changes to bicycle infrastructure

Positive Impact #3 Improvements to lighting


Increased knowledge about evacuation and shelter‐in‐place procedures

Fewer collisions between cyclists and pedestrians

Decreased risk for adverse events in emergency situations

Increased perceptions of safety among pedestrians

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Safety Recommendations: Short, Medium, and Long Term Short Term

Develop and post signage with evacuation maps, evacuation procedures, and shelter‐in‐place procedures.

Improve lighting and install parabolic mirrors for pathway leading from Divinity Hall to HDS main campus.

Medium Term

Develop trainings on emergency procedures and deliver to students (during orientation) as well as faculty and staff.

Install bicycle path to exit campus through parking lot to Francis Ave.

Station HUPD officer to instruct cyclist about policies during first week of 2015‐16 academic year

Install signage at end of bicycle path showing routes to popular destinations. Long Term

Work with community members to identify and address other campus areas with inadequate lighting.

Work with City of Cambridge to develop bike route signage around Francis Ave.

Work with HDS community to assess issues involving profiling and discrimination of students.

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Social Capital By Cara Michell


Survey and focus group findings for the Harvard Divinity School HIA show that community members value the warm atmosphere and opportunities for social interaction created by HDS. However, that warmth is not always extended to visitors and interactions are often limited within existing social groups. Creating more spaces to promote informal interaction between students, faculty and staff, and retrofitting ritual spaces to reflect the school’s increasing spiritual and cultural diversity will make the already welcoming HDS environment an even healthier place for people from diverse backgrounds.

Background: Why this Topic Matters The Centers for Disease Control and Prevention define social capital as “the individual and

communal time and energy that is available for such things as community improvement, social networking, civic engagement, personal recreation, and other activities that create social bonds between individuals and groups.” (CDC) This concept is an important one in a community like the Harvard Divinity School because the perceived life and vibrancy of the school is almost exclusively dependent on community members’ participation in the school beyond fulfilling their minimum duties as students, teachers and staff. Beyond creating an engaging and vibrant atmosphere, the University of Minnesota and Design for Health’s publication “Key Questions: Social Capital” identifies the direct and indirect impacts of social capital, claiming that it can be responsible for one’s mental health and for the network that a person relies on when they are sick or overwhelmed (Design for Health).

According to the World Bank, “ Increasing evidence shows that social cohesion is critical for

societies to prosper economically and for development to be sustainable.” This can be translated on a smaller scale to the HDS community. (The World Bank WEB) In graduate school environments, students and faculty members in particular invest a significant amount of their time and energy at that school. In order for the HDS community to continue to feel safe with that investment, they must also be reassured that their investment will produce a network of people on whom they can rely.

Description: The Situation at the GSD Most survey responses describe the HDS as a warm, welcoming place, especially due to the

friendliness of the cafe staff, as well as events and cleaning staff members. However, some survey responses reflect social fragmentation at the HDS along racial, ethnic and religious lines. One respondent writes, “It feels ‘click‐y’ here, cool kids there, the UU kids there, white girls’ click there, etc.” Similarly, another respondent laments that “being Jewish excluded [her] from interaction with the Christian faculty while [she] is not Jewish ‘enough’ for the few other Jewish faculty.” Beyond ethnic and religious identity, the survey also shows that 3 out of 63 participants are concerned with being profiled on the HDS campus because of the way they look.

Furthermore, while levels of comfort with various members of the HDS community are all quite high (between 80–97%), there is a great disparity between HDS members’ relative discomfort with visitors (20% are not comfortable interacting with visitors) and with students (just 3% are uncomfortable

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interacting with HDS students). The rates of comfort in interacting with staff and faculty, on the other hand, are both quite high and relatively similar with rates at 92 and 90% respectively. In addition, a significant number of survey responses reveal room for improvement in the existing communal spaces and opportunities for social interaction provided by HDS. Many respondents feel there are inadequate forums for social interaction and participation in group activities. However, the school is lauded for providing opportunities for students, faculty and staff to interact during the events that exist already. A lack of unscheduled opportunities for social interaction might be explained by how often the campus’ communal spaces are closed for use. If more campus buildings were open throughout the week that might provide a greater number of people who would pass through use the Divinity’s best communal spaces like the Rock Cafe and lounge. While Andover Library and the HDS grounds in general are used by some Divinity school members during the weekend, the Rock Cafe [figure 4], which has the most potential for social connection of the four survey options, is not in operation during the weekend. Simply providing more shared workspaces (like another library or communal offices) might be an inadequate solution because those spaces would likely group people who already belong to the same social, vocational or academic group. Furthermore, 8 out of 63 respondents are only sometimes comfortable in shared workspaces, and 3 out of 63 are rarely comfortable. The rates of discomfort are higher in shared workspaces than in the Rock Cafe or outside of the HDS. In addition to the survey responses, brief interviews on November 7 with an HDS student and faculty members revealed that the Rock Cafe is considered the only space that students, faculty and staff often use simultaneously. One student noted that HDS staff often use other lounge space in the morning, but this is not always when faculty and students are using those spaces as well. Another observation from the same student addressed the fluorescent lighting in most study and lounge spaces (like the Rock Cafe and Andover library), which is undesirable for some students who prefer not to hang out or study on the Divinity School campus when it is not necessary. One factor that might contribute to this culture of leaving the HDS campus as soon as class ends might be the fact that the Rock Cafe is closed during breaks and weekends, and many campus doors are locked during weekends. If the cafe were open more often, that might create a draw for students, faculty, staff and visitors to use HDS communal spaces during leisure time and create more opportunities for cross‐group interaction. As can be expected from observations of the HDS community spaces, a focus group on November 12 with three students revealed that the Rock Cafe is thought to be the best model for HDS communal spaces, while the existing ritual space is considered very Protestant, and possibly alienating to some HDS members. When discussing the Rock Cafe, students interviewed during the focus group cited the ease of interaction with faculty, Jules’ (of Jules catering) involvement in campus life and the first name basis employed by cafe staff and students as factors that make the Rock Cafe a great place for social interaction. The chapel, on the other hand, highlighted a more pervasive problem that the school’s physical and ritual spaces do not adequately reflect its increasing diversity for the focus group participants. Among the Divinity School students, disparities in social capital between students of various religious backgrounds seem to be a growing issue as well. While HDS has made great strides to increase diversity of people with different racial, ethnic, gender, sexual and religious identities, equitable representation of these groups has not yet risen to the ranks of student leadership. For example, this year marks the first when a Muslim woman has been elected student president. However, as the focus

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group participants reflected on her election, they remembered that the current president was originally doubtful about running in a historically Protestant school because of her Muslim identity. The presence of programs like weekly service (which invites leaders from various religious and cultural groups to lead a service for all HDS members) and regular meetings between spiritual group leaders, however, suggests that HDS has a lot of positive momentum propelling it towards a more meaningfully diverse and equitable environment. The social capital of the student body within greater administrative and institutional decisions seems to be an issue as well. The experiences of one participant when she and other students attempted to bring back an ethics course that was instructed with prison inmates taught her that the faculty and administration heavily supported the student’s efforts and desires, but the existing bureaucracy still left them somewhat powerless. This participant referenced a lack of institutional memory among students as a factor that inhibited their ability to navigate the institutional bureaucracy. In light of these observations, creating stronger connections between HDS student and alumni networks could help pass down important knowledge institutional memory that would put more power into the hands of students. One other concern revealed by the focus group that may promote huge positive changes is addressing diversity within the faculty. Ensuring that all faculty are equipped to reflect and address issues of privilege, vulnerability and race will help to make HDS more welcoming and healthier for students from all backgrounds. The focus group participants were deliberate in ending our discussion with the message that in most aspects, the Divinity School is an overwhelmingly positive and supportive environment. Community members really care about each other. For example, after a town meeting last year about creating a more supportive environment for trans students, the community created a trans‐friendly bathroom by changing the door labels. In this investigation of social capital at the HDS, it has become clear that the Divinity School possesses all of the components of a welcoming, caring and invested community. But as this community grows and becomes more diverse, HDS may feel pressure to make more minor spatial and institutional changes that reflect this diverse community.

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HDS Communal Spaces:

Fig 1, 2, 3, and 4. All outdoor spaces with seating are enclosed within the HDS campus buildings, instead of facing the main road, making them uninviting to visitors or new community members

Fig 5, 6, and 7. The hallways in Andover hall attempt to provide seating in front of administrative and faculty offices, which gives the semblance of a communal space. However, the benches on only one side of the wall do not create good opportunities for impromptu conversation

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Fig 8. This seating area provides space for students or faculty who would like to do research with the ability to converse with other people. It also provides a space where all library users can interact freely. Unfortunately these library users do not usually include HDS staff according to Director of Operations, Ralph DeFlorio

Fig 9 and 10. The lounge outside of the Rock Cafe provides circular seating patterns to encourage interaction between classmates, faculty members, staff and strangers. The television set encourages people to use HDS space outside of normal hours








Lack of opportunities for interaction between existing social groups

‐ ‐ ‐ P Y S Y Interviews/ survey

Closed off nature of outdoor communal spaces

‐ S Y H Y Observation

Lack of indoor communal spaces that support diverse needs and activities

‐ ‐ ‐ S Y S Y Observation/ survey

Lack of social capital for students engaging in administrative issues


Positive Impact #1 Interaction between faculty, staff and students

Positive Impact #2 Warm, friendly and open atmosphere

Positive Impact #3 Scheduled opportunities for interaction between spiritual and cultural groups


Create spaces that provide for diverse needs and activities to encourage interaction between interest groups.

Provide communal seating areas on front lawn of Andover Hall in addition to inner‐campus courtyard.

Create an additional weekly event or study‐break series that can be hosted by various cultural and spiritual groups in the Rock Cafe lounge.

Negative Impact #1 Inadequate opportunities for group interaction

Negative Impact #2 Fragmentation along racial, ethnic and religious lines

Negative Impact #3 Dismissive response to HDS members’ concerns from high‐ranking faculty/staff

Negative Impact #4 Lack of social capital for students engaging in administrative issues


Add more circular style seating arrangements to lounges and waiting areas.

Organize more events that aim to draw connections between various cultures and spiritual traditions.

Create online or physical (poster‐board) forum for students to express their needs and opinions.

Strengthen connections between HDS student and alumni networks to bolster institutional memory and empower students.

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Social Capital Recommendations: Short, Medium, and Long Term Short Term

Place benches on both sides of hallways to encourage conversation between people waiting for appointments with HDS administrative staff and faculty.

Medium Term

Retrofit existing lounge and atrium spaces to foster informal social interaction with circular style seating arrangements and large communal tables.

Long Term

Create one central space for each building that function simultaneously as a meeting space for students and faculty, a waiting or entrance space for visitors and a break room for staff.

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Spirituality and Health By Matthew Furman


Although academics acknowledge that it plays a role in health, spirituality is not typically included in health impact assessments (HIA). However, a study of spiritual health at Harvard Divinity School (HDS) suggests:

Analyses of spiritual health should recognize that this element of health is defined differently by each individual.

HDS has uniquely robust spiritual infrastructure.

HDS can enhance the spiritual health of its affiliates by strengthening connections to other parts of the Harvard community and nature.

Background: Why this Topic Matters Spirituality has a long history of being considered within health goals. In the early 1980s, the

World Health Organization debated whether or not there is a spiritual element to well‐being. Agenda 21, a non‐binding action plan for sustainable development crafted by the United Nations in the early 1990s, argued that individuals deserve “healthy physical, mental, and spiritual development.” In 1995, a group of European governments signed the Copenhagen Declaration on Social Development, which includes a commitment to meeting the spiritual needs of individuals, families, and communities. More recently, the Bangkok Charter for Health Promotion highlighted the spiritual dimension of health (Vader 2006).

Despite these goals, spirituality has been largely excluded from HIAs. According to Vader (2006),

Chuengsatiansup (2002), and Chatters (2000) this can be attributed to several factors:

The definition of “spirituality” is complex and debatable.

Spirituality and biomedicine belong to different scientific paradigms; Newtonian and Cartesian thought rationalizes spirituality out of consideration.

Even if one is able to define spiritual health, then it is difficult to quantitatively measure the factors that impact it.

The causal pathways that link spirituality to health are the subjects of great debate. Race, class, ethnicity, and other variables might intervene between spirituality and health.

Spirituality remains, in spite of these complications, an important topic to consider. Spirituality might impact health in numerous ways, including (Chatters 2000):

Spirituality can help one to find meaning in life. This, in turn, allows one to live actively and with fulfillment. This can be particularly important for individuals who have compromised health;

Spirituality might produce psychological and physical impacts. Research, for instance, has linked religious involvement to positive mental health outcomes.

Spirituality might impact one’s sense of safety and peace.

Religious participation can allow one to access resource reserves and social networks;

Religious views can determine health care seeking behavior.

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Description: The Situation at HDS Before delving into analysis of HDS, it is important to clarify the definition of “spiritual health.”

Many groups, including charities and ecological conservation movements, define spirituality as an effort to determine and fulfill a vision of “the good life.” Spirituality can be seen as being one with the god or truth, but it can also be conceived of as finding self‐purpose, meaning, and actualization. Thus, religion is merely one gateway to spiritual life (Chuengsatiansup 2002). Vader (2006) suggests a number of possible indicators of spiritual health including, “generosity, charity, solidarity, self‐abnegation, concern for others, self‐sacrifice, self‐discipline, and self‐restraint. At the societal level, indicators might be manifestations of solidarity, equity, justice, sexual equality, unity in diversity, participative decision‐making, and power sharing.”

A series of informal interviews conducted with HDS affiliates suggest that they define spiritual health in a number of different ways. As shown in Figure #1, these definitions can be placed on two intersecting spectra. The first spectrum relates to whether or not an individual believes that his or her spiritual health is enhanced by community involvement. Some individuals stress that their spiritual health depends on relationships with others. One HDS affiliate, for instance, indicated that she is enlivened by the sense of “common purpose” at the school. Other benefits of community are the ability to discuss issues of spirituality and the inner calm provided by a sense of belonging. Alternately, some HDS affiliates stated that they work towards spiritual health as individuals. These respondents highlighted self‐care and accountability to personal goals as key indicators of spiritual health.

Fig 1. Defining spiritual health at Harvard Divinity School (HDS). HDS students offer numerous definitions of spiritual health, which fall into two spectra and suggest different types of preferred activities

The second spectrum relates to whether or not an individual believes that spiritual health is promoted by consistency. Many respondents indicated that they believe that rituals and participation in ceremonies enhance their health. These rituals do not need to be religious. For instance, one interview subject stated that regular exercise is important to his sense of spiritual health. On the other hand, some respondents clearly find spiritual fulfillment in unplanned moments, such as having time for trips to

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nature. An interview subject characterized being in positive spiritual health as meeting a person for the first time and having them offer a smile that conveys openness.

Bearing in mind these dimensions of spiritual health, this HIA uses a framework developed by Chuengsatiansup (2002) to analyze HDS. Chuengsatiansup argues that an HIA should evaluate whether or not a site has:

Infrastructure for spiritual health.

An environment that supports spiritual health.

Positive contextual changes.

Researchers gathered data by conducting an online survey of students, staff, and faculty, conducting semi‐structured interviews with students in convenience settings, and reviewing primary and secondary source documents. The interviews were conducted at Community Tea and a focus group. Infrastructure for Spiritual Health

Spiritual infrastructure is made up of the cultural elements that support spirituality. This includes: knowledge (books, metaphors, symbols), institutions (temples, mosques, churches, religious functionaries, spiritual leaders), and spatial‐temporal organization. Spatial‐temporal organization relates to the idea that certain rituals and ceremonies, as well as meditation and spiritual pursuits, are tied to particular places and times. Policies, such as allowing dog walking on a green during a time when that space is used for meditation, can impact whether the spiritual pursuit is successful for the adherent.

In both the online survey and interviews, HDS affiliates were asked what places on campus support prayer, meditation, reflection, and relaxation. 63 individuals took the survey. As shown in Figure #2, 57 survey participants (90%) identified at least one site. The most commonly noted sites are Andover Chapel (32 people), the HDS lawns (29 people), and the labyrinth (25 people). Interview respondents highlighted the same places as suitable for prayer, reflection, mediation, and relaxation, but also spoke about some spaces that they perceive to be problematic. These spaces include the library basement, the third floor of the Center for the Study of World Religion (CSWR), and certain classrooms.

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Fig 2. Spaces identified as sites for prayer, meditation, reflection, and relaxation Comments offered by HDS affiliates provide some insights into what features of the spaces drive these perceptions. There are three major conceptions of what makes a space suitable for prayer, reflection, meditation, and relaxation:

Access to nature, with natural light, openness, and quiet.

Functionality for rituals. The chapels are perceived to be excellent by many respondents, but non‐Christian interview subjects indicate that their practices cannot be fully realized within the spaces.

A sense of energy and community. Beyond these broad assessments of space, respondents offered several specific critiques of HDS

infrastructure as it relates to spiritual health:

Compliance of 3rd floor of CSWR with fire codes.

Insufficient classroom technology.

Dark furniture and lack of light in classrooms. The spiritual infrastructure at HDS encompasses more than just places. The collective knowledge

of students, professors, and the institutions’ library is a remarkable asset. The university also provides access to denominational councilors, who have office hours and support related student groups. Individuals who had visited with these councilors characterized them as useful. However, a significant number of respondents indicated that they have no interest in this resource. Many of these same individuals stated that deep engagement with their spiritual community involves reaching out beyond HDS. By all accounts, HDS staff does a satisfactory job of connecting students to religious communities

0

5

10

15

20

25

30

35#ofRespondents

Student Staff Faculty

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outside of the university. Nonetheless, it is important that HDS consider the geographic relationship between their campus and other religious communities.

As shown in Map #1, a significant number of the spiritual communities that HDS’ staff

recommends to affiliates are located greater than two miles from the campus. For affiliates who are new to the area, have language or mobility barriers, or have difficulty traveling due to customs this distance could pose a problem. Hindu, Muslim, Presbyterian, and Sikh communities are located particularly far from the campus. Environment that Supports Spiritual Health

Chuengsatiansup (2002) contends that the best environment for spiritual health is one in which: psychological needs are met, there are multiple generations present, gender is balanced, the community is cohesive, there is time for calmness, and there is shared cultural heritage. The online survey, interviews, and HDS documents allow assessment of several of these factors.

Multiple generations are present at HDS. For the class admitted in 2014, students range from 20

years‐of‐age to 50 years‐of‐age (HDS 2014). Gender is also balanced at HDS. For the class admitted in 2014, 51% of students are female. According to the higher‐education counseling company Peterson’s (2014), 51% of the university’s faculty is female.

Fig 3. Faith communities located greater than 2 miles from center of Harvard Divinity School

Community cohesion stands out, in some ways, as both a pro and a con for HDS. Many interview

respondents highlighted the strong community at the university as one of its strengths. The common sense of purpose among HDS affiliates was, for instance, extolled by several people. At the same time, some respondents suggested that the university is too isolated from other elements of Harvard. Interview subjects suggested that cross‐registration and dual degree students are important to further promote. Connection to other universities is key because HDS affiliates are well‐suited to help peers

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make meaning out of major events, such as the recent racial unrest in Ferguson, Missouri. Members of the HDS community can both serve as Harvard‐wide leaders and help to train the leaders who are at Harvard. Positive Contextual Changes Changes in context in a community that might negatively impact spiritual health include (Chuengsatiansup 2002):

Detachment from nature.

Masculinization of thought.

Decrease in cultural diversity.

Increase in materialism. To the extent that changes in these contextual factors are identifiable at HDS, the university performs well. One of the most significant physical changes to occur at the university in recent years is the replacement of a parking lot with a green space. VSBA, the architecture firm responsible for this renovation project, indicates that one of HDS’ explicit goals was to “reconfigure […] Rockefeller Hall’s landscape to strengthen connections between inside and outside, and between it and the rest of the HDS campus [and] provide […] a sustainable, healthy environment that allows careful stewardship of School and University resources, initially and over the long term.” (Mayer and Stinson 2010). Images #1 and #2 demonstrate the transformation of this space.

Fig 4. Rockefeller Hall prior to renovations (Salano 2014)

Fig 5. Rockefeller Hall after renovations (Mayer and Stinson 2010)

The promotion of diversity is a consistent theme at HDS. Since the mid‐2000s, the university has run a three‐day Diversity and Explorations Program for college undergraduates, which aims to increase participation among groups that are underrepresented in the study of religion. Students of color make up 31% of HDS’ 2014 incoming class. Students in this class identify with over 20 religious denominations (HDS 2014). HDS faculty and students have contributed to the Pluralism Project, a major research

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initiative at Harvard devoted to studying the increase in religious diversity that has occurred in the United States during the past half century (Pluralism Project 2014).








Religious communities of some HDS affiliates geographically removed from campus

‐ S Greater impact on individuals who have difficulty traveling due to disability, language barrier, or custom (ex: Muslim women)

S, H, M Distance between HDS and religious facility

HDS affiliate statements

Renovation of campus open spaces

+++ P N/A S, H N/A HDS affiliate statements

Lack of light and technology, as well as, overcrowding in classrooms

‐‐ S HDS students would be most affected

S # of students per square foot in classroom


Multi‐disciplinary Pluralism Project

+ S N/A S, H N/A Primary research

Amount of work leaves limited time for spiritual pursuits

‐ S Students would be more impacted than staff

S, H Average hours of work per week


Many community groups provide spiritual outlets

+ P Students would be more impacted than staff or faculty

S # of group meetings; # of participants

HDS affiliate statements; HDS web resources


Positive Impact #1

Positive Impact #2 Renovation of campus open spaces

Positive Impact #3 Ample community group meetings


Forge new partnerships with other Harvard graduate schools

Create operating plan for campus space that fits different uses (quiet, active play) both physically (landscaping) and temporally

Seek to position HDS denominational groups as resources for other segments of Harvard

Create programming to position HDS as a place that nurtures leadership from across all branches of Harvard

Develop capital plan in conjunction with neighboring units of Harvard to convert additional impervious surfaces to green space

Encourage groups to develop opportunities for both group interactions and self‐development

Utilize building lawns, such as that which lies between Andover Hall and Francis Avenue, in functional ways

Negative Impact #1 Religious communities of some HDS affiliates geographically removed from campus

Negative Impact #2 Perceived lack of light and technology in classrooms

Negative Impact #3 Amount of assigned work may leave inadequate time for spiritual pursuits


Develop reciprocal relationships with Boston‐area religious groups by proactively inviting them to campus events

Develop capital plan for replacement of classroom resources

Organize retreats

Develop mentoring, guide, and/or travel subsidy programs that enhance the ability of HDS affiliates to travel to outside religious communities

Explore the use of alternative spaces, such as the green, for teaching

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Spirituality and Health Recommendations: Short, Medium, and Long Term Medium Term

Create a Harvard‐wide Leadership Institute, much like the Harvard Graduate School Leadership Institute, which has regular retreats and programming to bring together students from across the university. An HDS Leadership Institute could focus on the moral or spiritual leadership issues.

Develop a programming plan for green spaces to create an informal use schedule that minimizes conflict (e.g. children’s day care and quiet reflection). This would include quiet relaxation areas screened from paths through shrubbery, and separated patterns of usage.

Long Term

Develop plan for creation of additional green space.

Consider turning the Andover Parking Lot into green space, or turn roof space into urban agriculture space.

Reprogram inactive lawns, like the one between Andover and Francis Avenue, with small garden patches, a bocce court, or a Zen garden.

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Appendix A: Background Information for Harvard Divinity School (HDS)

Appendix B: Products in Rock Café Products Environmental

Working Group Rating

Concerns Positives Ingredients

Chobani Yogurt: Strawberry

5

Not certified organic, contains food additives, antibiotics were likely used in the production of the dairy ingredients, hormones may have been used, 4 teaspoons of added sugar, contains the non‐specific ingredient "flavor", classified as having moderate processing concerns

Good source of naturally occurring calcium, high in protein

NONFAT YOGURT (CULTURED PASTEURIZED NONFAT MILK, LIVE AND ACTIVE CULTURES, S. THERMOPHILUS, L. ACIDOPHILUS, BIFIDUS AND L. CASEI), STRAWBERRIES, EVAPORATED CANE JUICE, PECTIN, NATURAL FLAVOR, LOCUST BEAN GUM. FRUIT AND VEGETABLE JUICE CONCENTRATE (FOR COLOR).

Chobani Yogurt: Blueberry

5 Not certified organic, contains food additives, antibiotics were likely used in the production of the dairy ingredients, hormones may have been used, 4 teaspoons of added sugar, contains the non‐specific ingredient "flavor", classified as having moderate processing concerns


NONFAT YOGURT (CULTURED PASTEURIZED NONFAT MILK, LIVE AND ACTIVE CULTURES, S. THERMOPHILUS, L. ACIDOPHILUS, BIFIDUS AND L. CASEI), BLUEBERRIES, EVAPORATED CANE JUICE, PECTIN, LOCUST BEAN GUM, NATURAL FLAVOR.

Products Environmental Working Group Rating


Chobani Yogurt: Peach 5 Not certified organic, contains food additives, antibiotics were likely used in the production of the dairy ingredients, hormones may have been used, 4 teaspoons of added sugar, contains the non‐specific ingredient "flavor", classified as having moderate processing concerns


LOW FAT YOGURT (CULTURED PASTEURIZED NONFAT MILK, CREAM, LIVE AND ACTIVE CULTURES. S. THERMOPHILUS, L. BULGARICUS, L. ACIDOPHILUS, BIFIDUS AND CASEI), PEACHES, EVAPORATED CANE JUICE, PECTIN, LOCUST BEAN GUM, NATURAL FLAVORS.

Stonyfield Yogurt: Strawberry

4 Contains food additives, 5 teaspoons of added sugar, contains the non‐specific ingredient "flavor"

Certified organic, antibiotics not allowed in organic dairy production, hormones not used, excellent source of naturally occurring calcium, high in protein

CULTURED PASTEURIZED ORGANIC NONFAT MILK, ORGANIC STRAWBERRIES, NATURALLY MILLED ORGANIC SUGAR, PECTIN, ORGANIC BEET JUICE CONCENTRATE (FOR COLOR), NATURAL FLAVOR, VITAMIN D3, SIX LIVE ACTIVE CULTURES. S. THERMPHILUS L. ACIDOPHILUS L. CASEI L. BULGARICUS BIFIDUS L. RHAMNOSUS

Stonyfield Yogurt: Blueberry

4 Contains food additives, 5 teaspoons of added sugar, contains the non‐specific ingredient "flavor"

Certified organic, antibiotics not allowed in organic dairy production, hormones not used, excellent source of naturally occurring calcium, high in protein

CULTURED PASTEURIZED ORGANIC NONFAT MILK, NATURALLY MILLED ORGANIC SUGAR, ORGANIC BLUEBERRIES, PECTIN, NATURAL FLAVOR, ORGANIC ELDERBERRY JUICE CONCENTRATE (FOR COLOR), VITAMIN D3, SIX LIVE ACTIVE CULTURES



San Pelegrino Sparkling Lemon

8 Product is not certified organic, contains food additives, 8 teaspoons of added sugar, contains the non‐specific ingredient "flavor", moderate processing concerns, sugars may be genetically engineered

NA WATER, LEMON JUICE FROM CONCENTRATE, SUGAR, CARBON DIOXIDE, NATURAL FLAVOURS

San Pelegrino Sparkling Orange


NA WATER, ORANGE JUICE FROM CONCENTRATE, SUGAR, CARBON DIOXIDE, CITRIC ACID, NATURAL FLAVORS

San Pelegrino Sparkling Blood Orange


NA WATER, SUGAR, ORANGE JUICE FROM CONCENTRATE, BLOOD ORANGE JUICE FROM CONCENTRATE, CARBON DIOXIDE, NATURAL FLAVORS, BLACK CARROT AND PAPRIKA (FOR COLOR), CITRIC ACID

Nantucket Nectars: Apple

4.5 Product is not certified organic, 7 teaspoons of added sugar

Does not contain artificial or industrial ingredients, low processing concerns

PRESSED APPLE JUICE NOT FROM CONCENTRATE

Nantucket Nectars: Orange

4.5 Product is not certified organic, 7 teaspoons of added sugar

Does not contain artificial or industrial ingredients, low processing concerns, good source of naturally occurring vitamin A

ORANGE JUICE NOT FROM CONCENTRATE



Sweet Leaf: Citrus Green Tea

4.5 Contains food additives, 5 teaspoons of added sugar, contains the non‐specific ingredient "flavor", moderate processing concerns

Certified organic product FILTERED WATER, ORGANIC CANE SUGAR, ORGANIC GREEN TEA NATURAL FLAVOR, CITRIC AID, AND ASCORBIC ACID (VITAMIN C)

Sweet Leaf: Mint and Honey Green Tea

4.5 Contains food additives, 4 teaspoons of added sugar, contains the non‐specific ingredient "flavor", moderate processing concerns

Certified organic product FILTERED WATER, ORGANIC CANE SUGAR, ORGANIC GREEN TEA, ORGANIC HONEY, NATURAL FLAVORS, CITRIC ACID, ASCORBIC ACID (VITAMIN C)

Arnold Palmer 5 Product is not certified organic, contains food additives, 3 teaspoons of added sugar, contains the non‐specific ingredient "flavor", contains sucralose and acesulphame potassium, moderate processing concerns, corn syrup may be genetically engineered

NA PREMIUM BREWED BLEND OF BLACK TEAS USING FILTERED WATER, L HIGH FRUCTOSE, CORN SYRUP, (GLUCOSE FRUCTOSE SYRUP) LEMON JUICE FROM CONCENTRATE, PEAR JUICE, FROM CONCENTRATE CITRIC ACID, VITAMIN C, NATURAL FLAVORS, SUCRALOSE ( SPENDA BRAND) ACESULFAME POTASSIUM GUM ACACIA

Naked Green Machine 5 Not certified organic, contains food additives, 7 teaspoons of added sugar, contains non‐specific ingredient "flavor"

Excellent source of naturally occurring vitamin A, low processing concerns

APPLE JUICE, MANGO PUREE, PINEAPPLE JUICE, BANANA PUREE, KIWI PUREE, SPIRULINA, NATURAL FLAVORS, CHLORELLA, BROCCOLI, SPINACH, BARLEY GRASS, WHEAT GRASS, PARSLEY, GINGER ROOT, BLUE GREEN ALGAE, ODORLESS GARLIC



Naked Acai Flavored Juice Blend

5 Not certified organic, contains food additives, 6 teaspoons of added sugar, contains non‐specific ingredient "flavor", moderate processing concerns

Excellent source of naturally occurring vitamin A

APPLE JUICE, BANANA PUREE, PLUM PUREE, ACAI PUREE (WATER, ACAI PULP), CONCORD GRAPE JUICE FROM CONCENTRATE (WATER, CONCORD GRAPE JUICE CONCENTRATE), NATURAL FLAVORS, ELDERBERRY EXTRACT, BEET POWDER, VITAMIN E (AS ACETATE), BLACK CURRANT POWDER, ASCORBIC ACID (VITAMIN C), BETA CAROTENE (VITAMIN A), GRAPE SEED EXTRACT, SOY LECITHIN, CHLOINE BITARTARATE, D‐CALCIUM PANTOTHENATE (VITAMIN B5)

Diet Snapple Lemon Tea

5 Not certified organic, contains food additives, contains non‐specific ingredient “flavor”, contains aspartame, moderate processing concerns

NA

FILTERED WATER, CITRIC ACID, TEA,

ASPARTAME, POTASSIUM CITRATE,

NATURAL FLAVORS

Snapple Lemonade 9 Contains food additives, contains 12 teaspoons of added sugar, contains the non‐specific ingredient “flavor”, moderate processing concerns, sugars and lecithin (soy) may be genetically engineered

NA

FILTERED WATER, SUGAR, CITRIC

ACID, LEMON JUICE CONCENTRATE,

ACACIA GUM, SALT, ASCORBIC ACID

(VITAMIN C), NATURAL FLAVORS,

SOY LECITHIN, BETA CAROTENE

(COLOR)



Snapple Lemon Tea 7 Not certified organic, contains food additives, 7 teaspoons of added sugar, contains non‐specific ingredient “flavor”, moderate processing concerns, sugars my be genetically engineered

NA FILTERED WATER, SUGAR, CITRIC ACID, TEA, NATURAL FLAVORS

Lay’s Classic Potato Chips

5 Not certified organic, moderate processing concerns, canola oil and corn oil may be genetically engineered

Does not contain artificial or industrial ingredients

POTATOES, VEGETABLE OIL (SUNFLOWER, CORN AND/OR CANOLA OIL) AND SALT

Lay’s Baked Potato Chips

4 Not certified organic, moderate processing concerns, corn starch, sugars, lecithin (soy) and corn oil may be genetically engineered, contains sugar and dextrose


DRIED POTATOES, CORN STARCH, SUGAR, CORN OIL, SALT, SOY LECITHIN, AND DEXTROSE



Lay’s Sour Cream and Onion

5 Not certified organic, moderate processing concerns, ingredients derived from animals that were possibly treated with growth hormones and antibiotics (sour cream, skim milk, cultured cream, buttermilk)


POTATOES, VEGETABLE OIL(SUNFLOWER, CORN AND/OR CANOLA OIL), SOUR CREAM & ONION SEASONING(SKIM MILK, SALT, MAITODEXTRIN [ MADE FROM CORN] , ONION POWDER, WHEY, SOUR CREAM [ CULTURED CREAM, SKIM MILK] , CANOLA OIL, PARSLEY, NATURAL FLOUR, LACTOSE, SUNFLOWER OIL, CITRIC ACID, WHEY PROTEIN CONCENTRATE, AND BUTTERMILK)

Lay’s Barbecue 6 Not certified organic, contains food additives, contains the non‐specific ingredient ING(SKIM MILK, SALT, MAITODEXTRIN [ MADE FROM CORN] , ONION POWDER, WHEY, SOUR CREAM [ CULTURED CREAM,cally engineered

NA POTATOES, VEGETABLE OIL (SUNFLOWER, CORN, AND/OR CANOLA OIL), BBQ SEASONING (SUGAR, SALT, DEXTROSE, MALTED BARLEY FLOUR, ONION POWDER, YEAST, MOLASSES, SPICES, GARLIC POWDER, NATURAL FLAVORS, PAPRIKA, TOMATO POWDER, CORN STARCH, YEAST EXTRACT, AND PAPRIKA EXTRACTS)



Cape Cod Potato Chips 4.5 Not certified organic Does not contain artificial or industrial ingredients, low processing concerns

POTATOES, CANOLA OIL, SALT

Doritos Nacho Cheese 7 Not certified organic, contains food additives, contains synthetic dyes, contains the non‐specific ingredient “flavor”, contains 24% of the Institute of Medicine’s daily sodium recommendations, contains dextrose and sugars, high processing concerns, ingredients derived from animals that were possibly treated with growth hormones and antibiotics (cheddar cheese, milk, cheese cultures, buttermilk, Romano cheese, part skim cow’s milk), corn, vegetable oil, canola, corn oil, corn flour and sugars may be genetically engineered

NA CORN, VEGETABLE OIL(SUNFLOWER, CANOLA, AND/OR CORN OIL), MALTODEXTRIN(MADE FROM CORN), SALT, CHEDDAR CHEESE(MILK, CHEESE CULTURES, SALT, ENZYMES), WHEY, MONOSODIUM GLUTAMATE, BUTTERMILK, ROMANO CHEESE(PART‐SKIM COW'S MILK, CHEESE CULTURES, SALT, ENZYMES), WHEY PROTEIN CONCENTRATE, ONION POWDER, CORN FLOUR, NATURAL AND ARTIFICIAL FLAVOR, DEXTROSE, TOMATO POWDER, LACTOSE, SPICES, ARTIFICIAL COLOR(INCLUDING YELLOW 6, YELLOW 5 AND RED 40), LACTIC ACID, CITRIC ACID, SUGAR, GARLIC POWDER, SKIM MILK, RED AND GREEN BELL PEPPER POWDER, DISODIUM INSONATE, AND DISODIUM GUANYLATE



Doritos Cool Ranch 7 Not certified organic, contains food additives, contains synthetic dyes, contains the non‐specific ingredient “flavor”, contains corn syrup solids, sugars and dextrose, high processing concerns, ingredients derived from animals that were possibly treated with growth hormones and antibiotics (skim milk, milk, cheddar cheese, cheese cultures, buttermilk), corn, corn oil, maltodextrin, cornstarch, corn syrup solids, sugars and canola oil may be genetically engineered

NA CORN, VEGETABLE OIL (CORN,

CANOLA, AND/OR SUNFLOWER

OIL), MALTODEXTRIN (MADE FROM

CORN), SALT, TOMATEO POWER,

CORN STARCH, LACTOSE, WHEY,

SKIM MILK, CORN SYRUP SOLIDS,

ONION POWDER, SUGAR, GARLIC

POWDER, MONOSODIUM

GLUTAMATE, CHEDDAR CHEESE

(MILK, CHEESE CULTURES, SALT

ENZYMES), DEXTROSE, MALIC ACID,

BUTTERMILK, NATURAL AND

ARTIFICIAL FLAVORS, SODIUM

ACETATE, ARTIFICIAL COLOR

(INCLUDING RED 40, BLUE 1,

YELLOW 5), SODIUM CASEINATE,

SPICE, CITRIC ACID, DISODIUM

INOSINATE, AND DISODIUM

GUANYLATE

Products in the Vending Machine Products Environmental Working Group

Rating Concerns Positives Ingredients

Doritos Nacho Cheese

7 Not certified organic, contains food additives, contains synthetic dyes, contains the non‐specific ingredient CORavor”, contains 24% of the Institute of Medicine’s daily sodium recommendations, contains dextrose and sugars, high processing concerns, ingredients derived from animals that were possibly treated with growth hormones and antibiotics (cheddar cheese, milk, cheese cultures, buttermilk, Romano cheese, part skim cow’s milk), corn, vegetable oil, canola, corn oil, corn flour and sugars may be genetically engineered

NA CORN, VEGETABLE OIL (SUNFLOWER, CANOLA, AND/OR CORN OIL), MALTODEXTRIN (MADE FROM CORN), SALT, CHEDDAR CHEESE (MILK, CHEESE CULTURES, SALT, ENZYMES), WHEY, MONOSODIUM GLUTAMATE, BUTTERMILK, ROMANO CHEESE (PART‐SKIM COW'S MILK, CHEESE CULTURES, SALT, ENZYMES), WHEY PROTEIN CONCENTRATE, ONION POWDER, CORN FLOUR, NATURAL AND ARTIFICIAL FLAVOR, DEXTROSE, TOMATO POWDER, LACTOSE, SPICES, ARTIFICIAL COLOR (INCLUDING YELLOW 6, YELLOW 5 AND RED 40), LACTIC ACID, CITRIC ACID, SUGAR, GARLIC POWDER, SKIM MILK, RED AND GREEN BELL PEPPER POWDER, DISODIUM INSONATE, AND DISODIUM GUANYLATE



Lay’s Classic Potato Chips

5 Not certified organic, moderate processing concerns, canola oil and corn oil may be genetically engineered


POTATOES, VEGETABLE OIL (SUNFLOWER, CORN

AND/OR CANOLA OIL) AND SALT

Stacey Pita Chips: Cinnamon Sugar

5 Not certified organic, 21% sugar by weight, 2 teaspoons added sugar, moderate processing concerns

High in protein

ENRICHED WHEAT FLOUR (WHEAT FLOUR, NIACINAMIDE, REDUCED IRON, THIAMIN MONONITRATE, RIBOFLAVIN, FOLIC ACID), SUNFLOWER OIL (ROSEMARY EXTRACT, ASCORBIC ACID) AND/OR CANOLA OIL, SUGAR, AND LESS THAN 2% OF THE FOLLOWING: WHOLE WHEAT FLOUR, ORGANIC CANE SUGAR, BROWN SUGAR, CINNAMON, SEA SALT, YEAST, OAT FIBER, AND MALTED BARLEY FLOUR

Ruffles Cheddar and Sour Cream Flavored Potato Chips

6 Not certified organic, contains food additives, contains the non‐specific ingredient “flavor”, moderate processing concerns, ingredients derived from animals that were possibly treated with antibiotics and hormones (sour cream, cream, cheddar cheese, milk, cheese cultures, buttermilk, skim mils, butter, blue cheese)

NA POTATOES, VEGETABLE OIL (SUNFLOWER, CORN, AND/OR CANOLA OIL), CHEDDAR & SOUR CREAM SEASONING (SALT, WHEY PROTEIN CONCENTRATE, CHEDDAR CHEESE [MILK, CHEESE CULTURES, SALT, ENZYMES], MALTODEXTRIN [MADE FROM CORN], WHEY, ONION POWDER, CORN OIL, NATURAL FLAVOR, CANOLA OIL, BUTTERMILK, SOUR CREAM[CULTURED CREAM, SKIM MILK], LACTOSE, BUTTER [CREAM SALT], YEAST EXTRACT, CITRIC ACID, LACTIC ACID, BLUE CHEESE [MILK, CHEESE CULTURES, SALT, ENZYMES], SKIM MILK, PAPRIKA EXTRACTS, GARLIC POWDER, SUNFLOWER OIL, MILK PROTEIN CONCENTRATE, AND ANNATTO EXTRACTS)



Fritos Original Corn Chips

5 Not certified organic Does not contain artificial or industrial ingredients, low processing concerns

CORN, CORN OIL AND SALT

Cheez‐It Baked Snack Crackers

5 Not certified organic, moderate processing concerns, ingredients derived from animals that were possibly treated with antibiotics and growth hormones (white cheddar cheese and cheese cultures)

High in protein

ENRICHED FLOUR REDUCED IRON VITAMIN B2 FOLIC ACIDS RIBOFLAVIN WHITE CHEDDAR CHEESE SALT CHEESE CULTURES PAPRIKA TURMERIC EXTRACT SOY LECITHIN

Welch’s Fruit Snacks: Mixed Fruit

6 Not certified organic, contains food additives, 43% sugar by weight, 2 teaspoons of added sugar, synthetic food dyes, contains the non‐specific ingredient “flavor”, moderate processing concerns

NA JUICE FROM CONCENTRATES (GRAPE, PEAR, PEACH AND PINEAPPLE), CORN SYRUP, SUGAR, MODIFIED CORN STARCH, FRUIT PUREES (STRAWBERRY, RASPBERRY, ORANGE AND GRAPE), GELATIN, CITRIC ACID, LACTIC ACID, NATURAL AND ARTIFICIAL FLAVORS, ASCORBIC ACID (VITAMIN C), ALPHA TOCOPHEROL ACETATE (VITAMIN E), VITAMIN A PALMITATE, SODIUM CITRATE, COCONUT OIL, CARNAUBA WAX, RED #40, YELLOW #5 AND BLUE #1, GLUTEN FREE



Wheat Thins

5 Not certified organic, food additives, moderate processing concerns

Whole grain is #1 ingredient in product, high in naturally occurring fiber

WHOLE GRAIN WHEAT FLOUR, UNBLEACHED ENRICHED FLOUR (WHEAT FLOUR, NIACIN, REDUCED IRON, THIAMINE MONONITRATE [VITAMIN B1], RIBOFLAVIN [VITAMIN B2], FOLIC ACID), SOYBEAN OIL, SUGAR, CORNSTARCH, MALT SYRUP (FROM BARLEY AND CORN), SALT, INVERT SUGAR, MONOGLYCERIDES, LEAVENING (CALCIUM PHOSPHATE AND/OR BAKING SODA), VEGETABLE COLOR (ANNATTO EXTRACT, TURMERIC OLEORESIN)

Snickers 8 Not certified organic, contains food additives, ingredients known to be a source of unhealthy manmade trans fats (partially hydrogenated soy oil), 50% sugar by weight, 4 teaspoons of added sugar, contains the non‐specific ingredient “flavor”, high levels of saturated fat, moderate processing concerns, ingredients derived from animals that were possibly treated with antibiotics and growth hormones (skim milk and egg whites)

NA MILK CHOCOLATE (SUGAR, COCOA BUTTER, CHOCOLATE, SKIM MILK, LACTOSE, MILKFAT, SOY LECITHIN, ARTIFICIAL FLAVOR), PEANUTS, CORN SYRUP, SUGAR, MILKFAT, SKIM MILK, PARTIALLY HYDROGENATED SOYBEAN OIL, LACTOSE, SALT, EGG WHITES, CHOCOLATE, ARTIFICIAL FLAVOR



Oreo Cookies

8 Not certified organic, contains food additives, 45% sugar by weight, 3 teaspoons of added sugar, added sugar is the #1 ingredient, contains the non‐specific ingredient “flavor”, moderate processing concerns

NA SUGAR, UNBLEACHED ENRICHED FLOUR, WHEAT FLOUR, NIACIN, REDUCED IRON, THIAMINE MONONITRATE (VITAMIN B1), RIBOFLAVIN [VITAMIN B2], FOLIC ACID, CANOLA OIL, PALM, CANOLA OIL, COCOA (PROCESSED WITH ALKALI), HIGH FRUCTOSE CORN SYRUP, CORNSTARCH, LEAVENING (BAKING SODA), LEAVENING (CALCIUM PHOSPHATE), SALT, SOY LECITHIN, VANILLIN ‐ AN ARTIFICIAL FLAVOR, CHOCOLATE

Skittles 9 Not certified organic, food additives, 71% sugar by weight, 7 teaspoons of added sugar, added sugar is the #1 ingredient, contains synthetic dyes, contains the non‐specific ingredient “flavor”, high processing concerns

MADE OF SUGAR, CORN SYRUP, HUDROGENATED PALM KERNEL OIL, LESS THAN 25 OF APPLE JUICE FROM CONCENTRATE, CITRIC ACID, TAPIOCA DEXTRIN MODIFIED CORN STARCH, NATURAL AND ARTIFICIAL FLAVORS, ASCORBIC ACID ( VITAMIN C) , COLORS ( RED 40 LAKE, TITANIUM DIOXIDE, RED 40, YELLOW 5 LAKE, YELLOW 5, YELLOW LAKE YELLOW 6, BLUE 2 LAKE , BLUE 1 , BLUE 1 LAKE) . SODIUM CITRATE CARNAUBA WAX

M&Ms 8 Not certified organic, contains food additives, contains synthetic dyes, contains the non‐specific ingredient “flavor, 49% sugar by weight, 5 teaspoons of added sugar, high levels of saturated fat, high processing concerns, ingredients derived from animals that were possibly treated with antibiotics and growth hormones (skim milk)

NA MILK CHOCOLATE (SUGAR, CHOCOLATE, COCOA BUTTER, SKIM MILK, LACTOSE, MILKFAT, PEANUTS, SOY LECITHIN, SALT, ARTIFICIAL FLAVORS), SUGAR, LESS THAN 1%‐CORN SYRUP, GUM ACACIA, COLORING (INCLUDES BLUE1 LAKE, YELLOW 6, RED 40), DEXTRIN



Peanut M&Ms

7 Not certified organic, contains food additives, contains synthetic dyes, contains the non‐specific ingredient “flavor, high processing concerns, ingredients derived from animals that were possibly treated with antibiotics and growth hormones (skim milk)

NA MILK CHOCOLATE (SUGAR, CHOCOLATE, COCOA BUTTER, SKIM MILK, LACTOSE, MILKFAT, PEANUTS, SOY LECITHIN, SALT, ARTIFICIAL FLAVORS), SUGAR, PEANUTS, CORNSTARCH, LESS THAN 1% ‐ CORN SYRUP, GUM ARACIA, COLORING (INCLUDES BLUE 1 LAKE, YELLOW 6, RED 40 LAKE, YELLOW 5, RED 40, BLUE 1, BLUE 2 LAKE, YELLOW 6 LAKE, YELLOW 5 LAKE, BLUE 2), DEXTRIN

Twizzlers Licorice

7 Not certified organic, contains food additives, 42% sugar by weight, 5 teaspoons added sugar, added sugar is the #1 ingredient, contains synthetic food dyes, contains the non‐specific ingredient “flavor”, high processing concerns

NA CORN SYRUP; ENRICHED WHEAT FLOUR (FLOUR, NIACIN, FERROUS SULFATE, THIAMIN MONONITRATE, RIBOFLAVIN, AND FOLIC ACID); SUGAR; CORNSTARCH; CONTAINS 2% OR LESS OF: PALM OIL; SALT; ARTIFICIAL FLAVOR ; MONO AND DIGLYCERIDES; CITRIC ACID; POTASSIUM SORBATE (PRESERVATIVE); ARTIFICIAL COLOR ( RED 40) ; MINERAL OIL; SOY LECITHIN; GLYCERIN



Starburst 9 Not certified organic, contains food additives, contains ingredients known to be a source of unhealthy manmade trans fats (hydrogenated palm kernel oil), 55% sugar by weight, 6 teaspoons added sugar, added sugar #1 ingredient, contains synthetic food dyes, contains the non‐specific ingredient “flavor”, contains high levels of saturated fat, moderate processing concerns

NA CORN SYRUP, SUGAR, HYDROGENATED PALM KERNEL OIL, FRUIT JUICE FROM CONCENTRATE (APPLE, LEMON, STRAWBERRY, ORANGE, CHERRY), LESS THAN 2%: CITRIC ACID, DEXTRIN, GELATIN, FOOD STARCH‐MODIFIED, NATURAL AND ARTIFICIAL FLAVORS, ASCORBIC ACID (VITAMIN C), COLORING (RED 40, YELLOW 5, YELLOW 6, BLUE 1)

Fig Newtons Fat‐Free Cookies

7 Not certified organic, contains food additives, contains ingredients known to be a source of unhealthy manmade trans fats (partially hydrogenated cottonseed oil), 39% sugar by weight, 3 teaspoons of added sugar, contains the non‐specific ingredient “flavor”, high processing concerns

NA UNBLEACHED ENRICHED FLOUR (WHEAT FLOUR, NIACIN, REDUCED IRON, THIAMIN MONONITRATE {VITAMIN B1}, RIBOFLAVIN {VITAMIN B2}, FOLIC ACID), FIGS, HIGH FRUCTOSE CORN SYRUP, CORN SYRUP, SUGAR, SOYBEAN OIL, WHOLE GRAIN WHEAT FLOUR, PARTIALLY HYDROGENATED COTTONSEED OIL, SALT, BAKING SODA, CULTURED DEXTROSE, CALCIUM LACTATE, MALIC ACID, SOY LECITHIN, MALTED BARLEY FLOUR, NATURAL AND ARTIFICIAL FLAVOR, SULFUR DIOXIDE (SULFITES) ADDED TO PRESERVE FRESHNESS, WHEY (FROM MILK)



Nature Valley Crunchy Granola Bars: Oats ‘N Honey

6 Not certified organic, contains food additives, 28% sugar by weight, 3 teaspoons of added sugar, contains the non‐specific ingredient “flavor”, moderate processing concerns, sugars, canola oil, corn flower, sugar syrup and lecithin (soy) may be genetically engineered

Whole grain is the #1 ingredient, high in protein

WHOLE GRAIN OATS, SUGAR, CANOLA OIL, YELLOW CORN FLOUR, HONEY, SOY FLOUR, BROWN SUGAR SYRUP, SALT, SOY LECITHIN, BAKING SODA, NATURAL FLAVOR

PayDay 6 Not certified organic, contains food additives, 42% sugar by weight, 5 teaspoons of added sugar, moderate processing concerns, ingredients what were possibly treated with antibiotics and hormones (nonfat milk and egg whites)

Does not contain artificial or industrial ingredients, high in protein

PEANUTS; SUGAR; CORN SYRUP; NONFAT MILK; PALM OIL; CONTAINS 2% OR LESS OF: SALT; CARRAGEENAN; MONO‐ AND DIGLYCERIDES; EGG WHITES; SOY PROTEIN



Reese’s Pieces

9 Not certified organic, contains food additives, contains unhealthy manmade trans fats (partially hydrogenates vegetable oil), 53% sugar by weight, 5 teaspoons of added sugar, sugar is the #1 ingredient, contains synthetic food dyes, contains the non‐specific ingredient “flavor”, high levels of saturated fat, ingredients derived from animals that were possibly treated with antibiotics or hormones (milk)

No processing concerns

SUGAR, PARTIALLY DEFATTED PEANUTS, PARTIALLY HYDROGENATED VEGETABLE OIL(PALM KERNEL AND SOYBEAN OIL), REDUCED MINERALS WHEY(MILK); DEXTROSE CONTAIN 2% OR LESS OF: CORN SYRUP, ARTIFICIAL COLOR (YELLOW 5 LAKE, RED 40 LAKE, YELLOW 6 LAKE, BLUE 1 LAKE); SALT, RESINOUS GLAZE; SOY LECITHIN; MODIFIED CORNSTARCH; CARNAUBA WAX, VANILLIAN, ARTIFICIAL FLAVOR, MILK



Pop‐Tarts: Strawberry

8 Not certified organic, contains food additives, 31% sugar by weight, 4 teaspoons of added sugar, contains synthetic food dyes, high processing concerns

NA ENRICHED FLOUR (WHEAT FLOUR, NIACIN, REDCED IRON, THIAMIN MONONITRATE [VITAMIN B1], RIBOFLAVIN [ VITAMIN B2], FOLICACID), CORN SYRUP HIGH FRUCOSE CORN SYRUP, DEXTROSE, SOYBEAN AND PALM OIL ( WITH TBHQ FOR FRESHNESS), SUGAR, CONTAINS TWO PERCENT OR LESS OF CRACKER MEAL, WHEAT STARCH, SALT, DRIED STRAWBERRIES, DRIED PEARS, DRIED APPLES, CORNSTAR, LEAVENING ( BAKING SODA, SODIU ACID PYROPHOSPHATE, MONOCALCUIUM PHOSPHATE), CITRIC ACID, CORN COLOR, MODIFIED CORN STARCH, SOY LECTHIN, XANTHAN GUM, MODIFIED WHEAT STARH, TRICALCIUM PHOSPHATE, COLOR ADDED, TURMERIC COLOR, VITAMIN A PALMITATE, RED#40, NIAINAMIDE, REDUCED IRON, PYRIDOXINE HYDROCHLORIDE (VITAMIN B6), FOLIC ACID, BLUE #1

Pop‐Tarts: Blueberry

9 Not certified organic, contains food additives, 31% sugar by weight, 4 teaspoons of added sugar, contains synthetic food dyes, high processing concerns

ENRICHED FLOUR (WHEAT FLOUR, NIACIN, REDUCED IRON. VITAMIN B1 [ THIAMIN MONONITRATE], VITAMIN B2 [ RIBOFLAVIN], FOLIC ACID), CORN SYRUP. HIGH FRUCTOSE CORN SYRUP, DEXTROSE, SOYBEAN AND PALM OIL (WITH TBHQ FOR FRESHNESS), SUGAR, CRACKER MEAL, CONTAINS TWO PERCENT OR LESS OF WHEAT STARCH, SALT. DRIED BLUEBERRIES, DRIED GRAPES, DRIED APPLES, LEAVENING (BAKING SODA, SODIUM ACID PYROPHOSPHATE, MONOCALCIUM PHOSPHATE), CITRIC ACID. MILLED CORN, GELATIN, SOYBEAN OIL, MODIFIED CORN STARCH. MODIFIED WHEAT STARCH, SOY LECITHIN, XANTHAN GUM, CARAMEL COLOR, RED 40, VITAMIN A PALMITATE, NIACINAMIDE, REDUCED IRON, NATURAL AND ARTIFICIAL FLAVOR. BLUE 2, BLUE 1, VITAMIN B6 (PYRIDOXINE HYDROCHLORIDE), COLOR ADDED, TURMERIC EXTRACT, VITAMIN B2 (RIBOFLAVIN), VITAMIN B, (THIAMIN HYDROCHLORIDE)



Grandma’s Mini Sandwich Cremes Vanilla Cookies

10 Not certified organic, contains food additives, contains unhealthy manmade trans fats (vegetable shortening), 31% sugar by weight, 4 teaspoons of added sugar, contains the non‐specific ingredient “flavor”, contains high level of saturated fat, high processing concern, includes ingredients derived from animals that were possibly treated with antibiotics and hormones (skim milk and eggs)

NA ENRICHED FLOUR (UNBLEACHED AND BLEACHED WHEAT FLOUR, NIACIN, REDUCED IRON, THIAMIN MONONITRATE, RIBOFLAVIN, FOLIC ACID), POWDERED SUGAR, VEGETABLE SHORTENING (PALM OIL, CANOLA OIL, TBHQ AND CITRIC ACID [TO PRESERVE FRESHNESS]), SKIM MILK, AND LESS THAN 2% OF THE FOLLOWING: HIGH FRUCTOSE CORN SYRUP, CORN STARCH, EGGS, SOY FLOUR, CORN SYRUP, SALT, SOY LECITHIN, WHEY, LEAVENING (BAKING SODA), NATURAL AND ARTIFICIAL FLAVORS (INCLUDING NATURAL AND ARTIFICIAL VANILLA FLAVOR), CITRIC ACID (PRESERVATIVE), MODIFIED CORN STARCH, AND CARAMEL COLOR

Famous Amos Chocolate Chip Cookies

9 Not certified organic, contains food additives, 32% sugar by weight, 5 teaspoons of added sugar, contains the non‐specific ingredient “flavor”, high levels of saturated fat, moderate processing concerns, ingredients derived from animals that were possibly treated with antibiotics and hormones (eggs)

NA ENRICHED FLOUR (WHEAT FLOUR, NIACIN, REDUCED IRON, THIAMIN MONONITRATE [VITAMIN B1], RIBOFLAVIN [VITAMIN B2], FOLIC ACID), SEMISWEET CHOCOLATE (SUGAR, CHOCOLATE, COCOA BUTTER, SOY LECITHIN, NBATURAL FLAVOR, SUGAR, VEGETABLE OIL (SOYBEAN, PALM, AND PALM KERNEL OIL WITH TBHQ FOR FRESHNESS), CONTAINS TWO PERCENT OR LESS OF MOLASSES, SALT, EGGS, BAKING SODA, NATURAL AND ARTIFICIAL FLAVOR, WHEY, WHEY PROTEIN CONCENTRATE

Beverages Beverages Environmental Working Group

Rating Concerns Positives Ingredients

Coca Cola 6 Contains food additives, 7 teaspoons of added sugar, contains the non‐specific ingredient “flavor”, moderate processing concerns

CARBONATED WATER, HIGH FRUCTOSE CORN SYRUP, CARAMEL COLOR, PHOSPHORIC ACID, NATURAL FLAVORS, CAFFEINE

Diet Coke 6 Contains food additives, contains the non‐specific ingredient “flavor”, contains aspartame, moderate processing concerns

CARBONATED WATER, CARAMEL COLOR, ASPARTAME, PHOSPHORIC ACID, POTASSIUM BENZOATE (TO PROTECT TASTE), NATURAL FLAVORS, CITRIC ACID, CAFFEINE

Sprite Lemon Lime

5 Contains food additives, contains the non‐specific ingredient “flavor”, contains aspartame and acesulphame potassium, moderate processing concern

CARBONATED WATER, CITRIC ACID, POTASSIUM CITRATE, NATURAL FLAVORS, POTASSIUM BENZOATE (TO PROTECT TASTE), ASPARTAME, ACESULFAME POTASSIUM

Canada Dry 6 Contains food additives, 6 teaspoons of added sugar, contains the non‐specific ingredient “flavor”, moderate processing concerns

NA CARBONATED WATER, HIGH FRUCTOSE CORN SYRUP, CITRIC ACID, SODIUM BENZOATE (PRESERVATIVES), NATURAL FLAVORS, CARAMEL COLOR

Nestea Lemon Iced Tea

6 Not certified organic, contains food additives, 6 teaspoons of added sugar, contains the non‐specific ingredient “flavor”, moderate processing concerns

NA WATER, HIGH FRUCTOSE CORN SYRUP, NATURAL FLAVORS, PHOSPHORIC ACID, CITRIC ACID, TEA POWDER, POTASSIUM SORBATE (PRESERVE FRESHNESS), SODIUM BENZOATE (PRESERVE FRESHNESS), CALCIUM EDTA

128



Sprite Zero 6 Contains food additives, contains the non‐specific ingredient “flavor”, contains aspartame and acesulphame potassium, moderate processing concerns

NA WATER, CITRIC ACID, POTASSIUM CITRATE, NATURAL FLAVORS, POTASSIUM BENZOATE (TO PROTECT TASTE), ASPARTAME, ACESULFAME POTASSIUM

Barq’s Root Beer

9 Contains food additives, 11 teaspoons of added sugar, contains the non‐specific ingredient “flavor”, moderate processing concerns

NA CARBONATED WATER, HIGH FRUCTOSE CORN SYRUP, CARAMEL COLOR, SODIUM BENZOATE (TO PROTECT TASTE), CITRIC ACID, CAFFEINE, ARTIFICIAL AND NATURAL FLAVORS, ACACIA

Fuze Iced Tea Lemon

8 Not certified organic, contains food additives, 5 teaspoons of added sugar, contains the non‐specific ingredient “flavor”, contains sucralose, moderate processing concerns

NA WATER, HIGH FRUCTOSE CORN SYRUP, CITRIC ACID, TEA POWDER, NATURAL FLAVORS, PHOSPHORIC ACID, POTASSIUM CITRATE, POTASSIUM SORBATE AND SODIUM BENZOATE (PRESERVATIVES), SUCRALOSE, CALCIUM DISODIUM EDTA (PRESERVATIVE), VITAMIN B6, VITAMIN B6, CYANOCOBALAMIN (VITAMIN B12)

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