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Free Resources | Land Use | Articles |
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Point of View: Development and Public Health: Could our development patterns be affecting our personal health?By Richard E. Killingsworth and Jean Lamming Urban Land, July 2001
Accounts like this often preface passionate discussions among planners, architects, and developers of what constitutes appropriate practice. But these debates, which of-ten center on the environment, usually bypass another con-sequence of growth: how it has wrought havoc on lifestyles and personal health. Advocates of the new urbanism have been enumerating the effects of land use and transportation on communities for more than a decade. Today, an old partner of planning– public health–has resurfaced and is proving to be an important asset for advancing issues of smart growth, better community design, and equitable transportation systems. In 1996, the U.S. surgeon general released a landmark report, "Physical Activity and Health," and concluded that a sedentary lifestyle is a primary factor in more than 200,000 deaths each year–equivalent to about 25 percent of all deaths from chronic disease and 10 percent of all deaths in the United States. Cardiovascular disease, diabetes, hyper-tension, obesity, osteoporosis, and some cancers are linked to a sedentary lifestyle, making physical inactivity second only to smoking as a lifestyle risk factor for disease and pre-mature death. For public health practitioners, the issue centers on ac-cess to settings or environments that support physical ac-tivity, especially for the 75 percent of U.S. adults that do not engage in 30 minutes of moderate physical activity at least five days a week, as recommended by the Centers for Dis-ease Control and Prevention (CDC). Combine this with the reality that nearly one in four Americans is obese and 61 percent are overweight, and the result is an enormous national public health burden. In addition, there is the eco-nomic cost to society: CDC researchers say that direct and indirect costs associated with physical inactivity may total more than $150 billion annually.
A prevalent thought in the public health field is that individuals can govern their own behavior up to a point, but decisions on more complicated issues that affect lifestyle behavior, such as those involving development practices, are best addressed through communitywide efforts. This suggests that planning and development work should involve public health agencies so that the concepts of a healthier and more livable community can be more easily marketed to the people who need them. Two broad strategies may provide an opportunity to enhance such collaboration. First, change land use practices and policies to support the design of active community environments (ACEs). ACEs are places that are close to home or work, are safely and easily accessible, and that allow people to be physically active. An example would be a mixed-used neighborhood with sidewalks, trails, parks, and other facilities that encourage physical activity. The importance of these types of communities is that as they become more prevalent, they pro-vide an opportunity for people to reintroduce physical activity into their daily lives. Second, create transportation alternatives and policies to shift automobile trips to walking and bicycling, particularly trips to locations that are close to home such as schools, parks, and stores. Integrating walking and bicycling is appropriate because 25 percent of all trips are less than one mile, but 75 percent of those trips are made by car. With Americans using cars for 89 percent of all their trips, it is not surprising that the number of trips the average American adult takes on foot each year dropped 42 percent between 1975 and 1995. For children, trips to school by walking and bicycling dropped 40 percent in the past 20 years. Today, only 10 percent of children walk or bicycle to school, compared with a majority of children a generation ago, and these children now must be chauffeured to places that traditionally could be reached by foot or bicycle. This problem is compounded by the trend of schools to minimize requirements for physical education and recess periods.
The safety aspect of ACEs also is important. Each year, about 6,000 pedestrians are killed by automobiles, representing about one in every seven vehicle-related deaths. A nation-wide study by the Surface Transportation Policy Project showed that the deaths are more likely to occur in newer, sprawling, Sunbelt communities where transportation systems are most biased toward the car, including cities such as Fort Lauderdale, Miami, Atlanta, and Dallas. Safest are older cities that provide greater pedestrian amenities, such as Pittsburgh, Milwaukee, Boston, and New York. As a result of these problems, dozens of bicycle and pedestrian advocacy groups have been organized. In San Jose, California, their activism led the mayor and city council to al-locate $5 million to make the city more pedestrian friendly. In Boston, advocates persuaded officials to build pedestrian-friendly roads above the depressed central artery and to try slowing traffic on Congress Street. In Nashville, bike supporters are working on a network of on-street bicycle lanes through the downtown corridor and Music Row. The importance of these projects increases with recognition of the diminishing mobility of the elderly and how their access to grocery stores, medical care, or social outlets will be severely restricted unless the country’s land use and transportation policies are reexamined. |
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A
nostalgic view of American cities suggests they were once designed
for and accommodated people. In that bygone era, public places,
local stores, and transit stops were readily accessible by foot
or bike. But then automobiles, high-ways, suburbia, and strip malls
moved into the scene, bringing a new, but not necessarily better,
way of life.
These
statistics should convince planners, architects, developers, and
engineers to explore how community design and transportation systems
affect behavior and, ultimately, personal health. How can this national
crisis be best ad-dressed, especially when most Americans have become
anesthetized to national health problems, particularly when they
are the result of their own carelessness?
At
first glance, it may not appear that walking to school, to a transit
stop, or to a restaurant can provide meaningful health benefits,
but the fact is that these simple, routine activities provide a
tremendous opportunity to ac-cumulate physical activity throughout
the day to achieve the recommended 30 minutes of exercise. This
strategy is also a better approach than advocating sports, aerobics,
or weightlifting because structured activities only resonate with
a small percentage of the population. ACEs, on the other hand, could
enable millions of sedentary Americans to integrate physical activity
into their lives seamlessly.