Objectively Healthy Cities

George Weeks

27th October 2012

george.weeks@cantab.net

Urban design for the 21st century

1) The Age of Pestilence and Famine

Represents most of human history

Pre – industrial

High birth rates

High death rates

Basic medicine

Late 1700s to early 1900sIndustrialisationPopulation growthRural – to – urban migration

Expanding Urban Populations• Liverpool: 88,000 (1801) – 165,000 (1831)• Manchester: 90,000 (1801) – 187,000 (1831)• Leeds: 53,000 (1801) – 123,000 (1831)

2) The Age of Receding Pandemics

“Noxious trades”

Sewage

Waste disposal Overcrowding

Incompatible land uses DiseaseRapid urban growth

Pollution

20th Century Responses - Zoning

Unintended consequences

Epidemiological Transition

Pestilence & Famine

Pre - industrial

Receding Pandemics

Industrial

Degenerative & Man Made Diseases

Post - industrial

Then and Now

PREVENTABLE

Physiology

Humans are designed for movement and have evolved to have high levels of energy expenditure

P T Katzmarzyk, 2010; Physical Activity, Sedentary Behavior, and Health: Paradigm Paralysis or Paradigm Shift? Diabetes;59,11

“Despite all the technological advances in modern medicine, regular physical activity is as close as we’ve come to a magic bullet for good health.”

Dr JoAnne E. Manson, Professor of Medicine, Harvard Medical School & Chief, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital

Benefits of physical activity

P T Katzmarzyk, Physical Activity, Sedentary Behavior, and Health: Paradigm Paralysis or Paradigm Shift? Diabetes; Nov 2010; 59, 11

Aerobics Center Longitudinal Study

~10,000 men~3,000 women 8 years

Types of Physical Activity

Physical Activity

Recreational

Utilitarian

Direct demand

Behavioural

Indirect demand

Environmental

Recreational Activity

Utilitarian Activity

Types of Physical Activity

Physical Activity

Recreational

Utilitarian

POLICY RESPONSE

Behaviour – based

Individual scale

POLICY RESPONSE

Circumstance - based

Environment – scale

People respond to their environment

People respond to their environment

Would you walk here................................................or here?

Would you cycle here...............................................or here?

Transportation Research Board (2005)

“built environments designed to facilitate more active lifestyles and to reduce barriers to physical activity are desirable”.

Walkability

• Density

• Mix of uses

• ConnectivityProximity}-

Residents’ assessment of their neighbourhoods’ walkability

Researchers’ own prior assessment of degrees of walkability

Very strong correlation (p<0.0001)

Measuring Urban Form

Net residential density+

Street connectivity+

Land use mix

“An objectively measured walkability index was _significantly related to objectively measured

_moderate intensity physical activity in adults.”

(Lawrence et al, 2005)

Studies of studiesGlasgow Centre for Population Health (2006)

65 studies• Australia• Canada• Japan• UK• USA

Residents of walkable neighbourhoods always tend to undertake more physical activity

Walkability encourages exercise, irrespective of whether or not people have an expressed preference for it.

Hanlon P., D. Walsh and B. Whyte (2006) “Let Glasgow Flourish”; Glasgow Centre for Population Health

Van Dyk et al (2009)

Importance of utilitarianism

““There was…a difference between There was…a difference between neighbourhoods regarding walking for errands. neighbourhoods regarding walking for errands. This…is consistent with transportation research This…is consistent with transportation research that finds that finds no differences in walking for exercise but finds significant differences in walking for transport purposes between high- and low walkability neighbourhoods" neighbourhoods"

Saelens et al, 2003

Recap

Research Implications

1. Neighbourhood walkability = objective measure

2. Walkability correlates with physical activity

3. Physical activity correlates with significantly

lower levels of illness and better health

4.Walkable and bikeable mixed use environments

contribute significantly to public health

= Objective, public health based justification for walkable, mixed use urban design

george.weeks@cantab.net