The Patina of Place offers a multidisciplinary analysis of workers' housing as an index to social change and cultural identity in New Bedford, Massachusetts. Kingston Heath discusses both the city's company-owned mill housing and the subsequent transition to a speculative building market that established the three-decker rental flat as the city's most common housing form for industrial workers.

In the late nineteenth and early twentieth centuries, the booming textile industry turned many New England towns and villages into industrialized urban centers. This rapid urbanization transformed not only the economic base but the regional identity of communities such as New Bedford as new housing forms emerged to accommodate the largely immigrant workforce of the mills. In particular, the woodframe "three-decker" became the region's multifamily housing design of choice, resulting in a unique architectural form that is characteristic of New England. In The Patina of Place, Heath offers the first book-length analysis of the three-decker and its cultural significance, revealing New Bedford's evolving regional identity within New England.

Using his concept of "cultural weathering" to explore the cultural imprints left by inhabitants on their built environment, Heath considers whether the three-decker is a generic type that could be transferred, unaltered, elsewhere. He concludes that the ethnic, economic, and geographic conditions of a locale serve as subregional filters that reshape the meaning, utility, and character of a building form, thereby making that form an integral and distinctive part of its community. Specifically, Heath shows how the three-decker was designed, built, and lived in,and then illustrates its transformation by later generations of residents following the collapse of the textile industry in the mid-1920s up to the present day.

By the very nature of the discussion throughout the book, the author raises the question: What factors contribute to architectural relevance? Through his intensive study of the unique building form of the three-decker, Heath shows that architecture is not merely the product of individual creative expression or initial use; instead, he argues that architecture also has relevance when viewed as a collective social act. This view allows for a redefinition of a building type's identity, meaning, and importance as it evolves over time. Thus, while The Patina of Place focuses on the three-decker in New Bedford, its overarching theme concerns the cultural, economic, and social complexities of place-making and the role that common people play in the creation of a region's identity.