Clinical vital signs include heart rate, blood pressure, temperature, weight, and height. But other, nonmedical vital signs—such as employment, education, health, literacy, or safe housing—can also significantly impact health. Historically, settlements were unhealthy places. Early settlement patterns brought people and animals into close proximity with their refuse and effluent. Prehistoric settlers typically experienced higher mortality rates than nomads in the same region. The quality of human and physical environments affects health significantly. Changing places has a therapeutic side. Wanderlust and "the grass is always greener" are phenomena basic to the immigrant and American nature. Places that engage all the senses contribute to a healthy life. This is particularly important for the vision- and hearing-impaired, for whom multisensory design increases independence and integration in the community. Elements of built form like stairs can promote health. Stairs that are visible and welcoming encourage exercise and can contribute to social life.