How Urban Planning Can Improve Public Health

This story by Jonathan Lerner tells us about smart growth as a public health tool.  Scientific studies are quantifying how our built environment affects our health.  Depression, for example has been traced to a lack of open space, suburban isolation, and a lack of transportation options.  Cars pollute the air and trap people alone for long periods of time, as well as causing accidental injuries and deaths.  They have also contributed to our sedentary lifestyle, which can lead to obesity, diabetes and other conditions.  Car-dependent development patterns destroy farmland, contributing to a lack of local food, aiding industrial farming, and forcing those who live in the suburbs to have multiple cars.  Planning was originally implemented as a public health endeavor, to get people away from polluting factories, but the two have become divorced in our time.  They need to come back together.

One example of this reunion is the joint effort of CNU and the CDC to put on CNU’s most recent conference, “New Urbanism: Rx for Healthy Places.”  A number of past efforts by CNU leaders, such as the Ahwahnee Principles, have also related to public health, while the CDC’s new Healthy Community Design initiative shows a new interest in planning issues.  Recent studies have also shown that mixed-use, walkable communities have higher levels of physical activity and lower levels of obesity, as do areas with good transit and access to parks.  Exposure to nature also may have a positive effect on ADHD.  Hopefully these new numbers can help turn theory into policy.  Other important studies show that compact communities have lower overall emissions and that people who live near major roads and highways are more prone to emissions.

More studies are needed to investigate the effect of communities and buildings on mental health and social capital.  Walkability needs more study, since a five-minute walk for a young athlete is different than a five-minute walk for an elderly person.  Parks need more research to determine whether it is better to have one large park, many small parks, or a mixture of the two.  Urban and suburban farming could address local food issues as well as take better care of vacant land.  Planning is also beginning to address issues of aging in place, or planning for all age groups, who may have different mobility and land use needs.  These improvements to public health, however, need to be accepted by a broader range of professionals and decision makers, as well as be accepted by a public that is often averse to change.  Planning needs to be recognized in a more holistic manner, addressing health, social, political and environmental issues, as well as many others.  Some municipalities are implementing health impact statements, similar to the environmental impact statements that have been required for major development since the 70’s.  But to really change the way cities and health interact, we need to make drastic changes to our transportation infrastructure and our land use patterns.

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