There is growing evidence showing that place impacts people’s health on multiple scales. From obesity and chronic disease to depression, social isolation, and increased exposure to environmental toxins and pollutants, the world faces very different health challenges today than it has in the past, and many of these challenges are directly related to how our public spaces are designed and operated.
In 1948, the World Health Organization (WHO) described health as more than just the absence of disease or injury, but “a state of complete physical, mental, and social well-being.” In fact, research by the University of Wisconsin Population Health Institute (2016) has found that over 40 percent of the factors that contribute to the length and quality of a person’s life are social and economic, while another 30 percent are health-related behaviors directly shaped by socioeconomic factors.
These findings are especially significant, given that discussions around the issue of health rarely address its economic components. As Leigh Ann Von Hagen, Senior Research Specialist at Rutgers University, explains: “Placemaking and health outcomes are often seen as issues wealthier communities can prioritize. Even though it’s often difficult to pin down a price, finding ways to identify and connect the economic benefits of health and placemaking is important to making the case.”
Indeed, those living in disadvantaged neighborhoods—those that struggle disproportionately with systemic issues such as unemployment and poverty—face significantly greater health challenges than those in wealthier areas. Research shows, for example, that low-income groups and racial and ethnic minorities have more limited access to well-maintained parks or and other spaces for physical activity, and they are more likely to have poor sidewalk and street infrastructure to support walking. These communities are also disproportionately affected by limited access to healthy, fresh food.
In 2015, to underscore the profound connection between the built environment, land use, and health, the Urban Land Institute (ULI) released the “Building Healthy Places Toolkit,” which details a number of ways in which placemaking strategies can improve health outcomes.
Authored in part by The Center for Active Design, who helped translate the latest health evidence into practical design applications, the report’s 21 recommendations fall under three categories: 1) the availability of opportunities to be physically active; 2) access to healthy food and drinking water, and 3) exposure to a healthy environment with a high degree of social interaction. Since each of these issues converge around public space, placemaking projects offer a way to apply multiple recommendations at once.
Strategies to increase access to healthy food in underserved neighborhoods—by establishing (or relocating) a farmers market or neighborhood grocery store, for example—can have numerous effects beyond improved nutrition. They may also create jobs, revitalize downtowns or commercial areas, and provide opportunities for social interaction. Similarly, while a community garden may provide much needed green space (and fresh food) in an urban environment, it can simultaneously improve physical and mental health, reduce neighborhood crime rates, increase walkability, and provide space for social interaction and educational opportunities.
Making streets and other public spaces more amenable to walking and physical activity also brings cascading health benefits. As former Deputy U.S. Secretary of Housing and Urban Development, Ron Sims, explained during the 2015 National Walking Summit: “If you have parks, playgrounds, community gardens, and wide sidewalks, you have good health outcomes. If you have walkable communities kids will do better in school…seniors will be healthier.”
The summit took place shortly after U.S. Surgeon General Vivek Murthy released a landmark “Call to Action” on walking—a national campaign to encourage Americans to walk more and make all communities safer and easier for walking. “An average of 22 minutes a day of physical activity – such as brisk walking – can significantly reduce the risk of heart disease and diabetes,” declared Muthy. “The key is to get started because even a small first effort can make a big difference in improving the personal health of an individual and the public health of the nation.”
"The Surgeon General’s Call to Action was key to getting walkability on the radar of multi-sectors as a core component of any Placemaking. The fact that walkability is on the Surgeon General’s agenda - and seen as a core component of health by the CDC - is huge. It is extremely important that we capitalize on it now. Walkability needs to be front and center in discussions on placemaking and heath.” –Kate Kraft, Executive Director, America Walks
It has become clear, both in the U.S. and globally, that large inequalities in health outcomes are persistent and growing. Research continues to show that poverty, income disparities, racism and poor quality of life are the “major risk factors for ill health and health inequalities.” Further, conditions like sprawl, pollution, inadequate housing, streets that are unsafe for walking and bicycling, poor transportation choices and lack of educational and employment opportunities are major culprits contributing to inequitable health outcomes. As the CDC explains in a 2008 report on Advancing Health Equity:
These systematic, avoidable disadvantages are interconnected, cumulative, intergenerational, and associated with lower capacity for full participation in society. (...) Great social costs arise from these inequities, including threats to economic development, democracy, and the social health of the nation.
Placemaking creates quality public spaces that contribute to people’s health, happiness and well-being by building on a community’s knowledge and assets. The process brings people together with a shared purpose, which in itself is a key driver of health and well-being.