Health & Community Design

Most researchers agree that moderate physical activity could dramatically improve America's public health. This is easier said than done, however, because our cities and neighborhoods come with a number of built-in disincentives to getting out and about. At PPS, we believe that great public spaces - destinations that encourage physical activity and draw people together socially - can play a significant role in turning around the decline in public health.

As the average American's lifestyle grows less active and more isolated, the results of a public-health check-up are not encouraging. The biggest indicator of an overall slowdown in physical activity is the obesity rate. It is surging nationwide, most alarmingly among children, 30% of whom are overweight. Obesity, along with heart disease and diabetes, is exacerbated by a sedentary lifestyle. All of these diseases dramatically affect older people, among whom over 60% are inactive; this age group also suffers overwhelmingly from depression and mental illness, which can be heightened or prolonged by social isolation.

Most researchers agree that even a moderate amount of regular physical activity and social interaction could have a dramatic effect on these statistics. However, there are a number of disincentives to Americans getting out and about more often - and recent studies from both the planning and public-health professions locate many of them in the places where we live and work. The way these places look (boring) and the ways in which they function (they don't) do not create the need, the desire, or the opportunity for people to walk - let alone get more active types of exercise.

Instead, Americans now devote a majority of their time to relatively isolated, private activities. For instance, studies show that larger numbers of hours spent watching television, playing video games and surfing the Internet have eaten into what was formerly social and active time for both children and adults, and these activities could therefore be tied to depression and other diseases related to inactivity and isolation.

Blank walls and bleak landscapes are best viewed from a speeding car rather than on foot.

What happens when people do venture outside? A lack of sidewalks and safe places to cross streets discourages walking or bicycling; where sidewalks exist, the surrounding environment is usually so uninteresting that no one wants to use them anyway. Blank walls and bleak landscapes are best viewed from a speeding car rather than on foot. Equally dull parks lie fallow much of the time. In short, in most of our communities "there's no 'there' there," as Gertrude Stein said.

No wonder people drive instead, especially in the typical suburb, where sprawling developments and the lack of accessible public spaces and parks require adults to do errands via car and chauffeur children to activities. And so we've ended up with vehicle-dominated metropolitan areas and a crisis in traffic congestion. These conditions not only strain one's patience, but also create very real health threats: poor air quality (which can be related to increased cases of asthma and other respiratory diseases); and higher rates of pedestrian and bicycle-related deaths and injuries.

How do we make our neighborhoods safer and our lifestyles more active and engaged? Studies abound on the "public health/community design connection," as it is becoming known. Until recently, the focus of such research has been on establishing the connection. Proactive solutions coming out of this research are limited to suggestions such as constructing sidewalks, transit facilities, recreation facilities and greenways closer to people's homes; in this way, people can more easily incorporate exercise into their daily routines, and children can safely walk or bike to school.

At PPS, we believe that these solutions, to be successful, need to go farther and incorporate two critical factors. For one thing, the design of communities should focus on creating social, public places - destinations that are accessible in a multitude of ways. In addition, communities should be involved from the outset in planning and design, making changes, and generating a vision for a place.

Places to Go: Healthy Places, Healthy People

Creating places can provide the rationale for a range of solutions to foster health and livability. Making towns and neighborhood centers more navigable for walkers and bikers may promote physical and social activity - but it will not be a fruitful activity unless this accessibility is linked to great places. Who wants to use streets, sidewalks and bike trails that don't go anywhere?

Psychologically, thriving public spaces . . . promote the kinds of familiarity and social bonds that make neighborhoods safer and healthier.

"Healthy" places are valued by and accessible to everyone in a community: parks for recreation, play, and relaxation; streets and sidewalks where neighbors meet and people can shop, jog and stroll; farmers markets with fresh produce and other goods. They are also the "front porches" of public institutions: city halls, libraries, schools, and post offices. These places must be situated so that people can conveniently reach them on foot or by transit. Psychologically, thriving public spaces give residents a strong sense of community, and promote the kinds of familiarity and social bonds that make neighborhoods safer and healthier. They are critical to livable cities and healthy communities - and unfortunately, they are all too rare.

Community-based Planning and Health

One reason that cities and towns routinely fail at creating active social environments is that the community is not involved in establishing a vision for the place from the outset. Instead, officials, designers and planners use a project-based approach, whereby they deem what is wrong with a street, park or other public space, and make the necessary "improvements" without truly consulting the community in what they might want to see or do there. On the other hand, a community-based approach involves a broad cross-section of residents and other local leaders in defining the project from the start. This not only provides a prime opportunity to gather local knowledge and ideas for creating a successful place, but it also fosters the natural stewardship, in-kind donations and partnerships that contribute to that success.

What Makes A Healthy Place?

PPS's Place Diagram provides a useful context for looking at how places can support healthier communities.

Access and Linkages
According to the Department of Transportation, 25 percent of all trips are less than a mile, but 75 percent of those trips are made by car. That 75 percent could be reduced if the design of neighborhoods facilitated other forms of transportation. Instead, communities are built on streets too wide to cross comfortably, traffic that moves too quickly, and an absence or lack of sidewalks, crosswalks, and bike lanes. Access means a truly public space: one that is available and easy to reach for people of all incomes and backgrounds - who do not have to pay to use it. It is a critical factor, since public spaces are one of our most democratic institutions.

Uses and Activities
A beautifully designed space is not worth anything if people don't use it. A community-based planning process lets all the stakeholders - including residents, city agencies, local leaders and merchants - define what goes on in a place. When ideas come from the ground up, not the top down, the events, programs, recreation, and play areas in a public space are truly connected to the communities that use them. In addition, partnerships among local organizations, merchants associations, and government agencies act as new sources of ideas for activities and help a public space become a true "community place." Planning for uses and activities in this way promotes sustainability and use, and therefore activity.

Comfort and image
Places that are designed to be appealing, enjoyable, and convenient provide an incentive to getting people out and about - they become attractions, like a shady shopping street with benches and good sidewalks, or a park that supports a range of active and passive uses. Shade trees, comfortable places to sit, water fountains, waste receptacles, good views, adequate (but not overbearing) lighting: All of these amenities make people feel good about being in a public space. Unfortunately, in unattractive neighborhoods where vehicles dominate, there is a stigma to simply walking down the street. Creating places that attract people will remove this stigma.

Sociability
Like physical activity, research has shown that sociability can play a role in alleviating depression, which is strongly linked to isolation and disconnectedness. It can draw people out of the house and into community life - and it is the critical identifier of every great public space. Sociability is measured by public displays of affection, diversity, volunteerism, even people taking pictures and pointing out neighborhood monuments and special features.

 

Links:

Enrique Penalosa: Why Parks are Important to Cities

Neal Pierce, Obesity and Sprawl, the Connection Tightens April 21, 2001

Creating A Healthy Environment: The Impact of the Built Environment on Public Health

How Land Use and Transportation Systems Impact Public Health:
A Literature Review of the Relationship Between Physical Activity and Built Form
Lawrence D. Frank. PhD and Mr. Peter Engelke

Sprawl Harms Our Health
The Sierra Club

Kids Walk to School

HEY KID, TRY WALKING!
COMMUNITIES WIN WHEN SCHOOLS ARE CLOSE TO HOME

U.S. Obesity Trends 1985 to 2000

Diabetes Trends Among Adults in the U.S

The Center for Weight and Health at UC Berkeley

Neil Pierce on health

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