By Ann Forsyth
Theme Editor Anne Lusk
Americans are getting fatter and exercising less. As Thomas Halton outlines in this issue, this has human costs; overweight and lack of exercise contribute to a variety of chronic diseases. Given the multi-billion dollar cost of health care, there are major economic costs as well. While a number of genetic and biological factors affect weight, for most individuals overweight is a result of taking in too many calories and expending too few. This is hardly news, and much money and effort has been expended to encourage, exhort, cajole and educate people to eat less and exercise more. That people don’t seem to be getting the message has encouraged those in the public health arena to look to the physical environment for ways to eliminate barriers to exercise and provide more supportive environments for physical activity. Increasing physical activity even a small amount, enough to lower obesity only a few percentage points, would save billions of dollars annually and also reduce the long-term suffering caused by chronic diseases. This could have a great impact on low-income people and people of color, since a disproportionate number of individuals in these populations are victims of such health problems.
Obesity awareness has brought new attention to the built environment. For the first time in years there is significant funding available to evaluate the human dimensions of urban environments across the US. (In the interest of full disclosure, I am the recipient of some of that funding from the Robert Wood Johnson Foundation, in collaboration with public health colleagues Katherine Schmitz and Michael Oakes.) Politicians, civic groups and the general public are getting interested in their neighborhoods, town centers, parks and trails. The buzz seems to validate the interests of planners, who have long advocated for design of healthier cities: more vibrant public spaces; better parks and trails; improved transit systems; and more supportive environments for children, youth, people of color and low-income populations. The emphasis on the infrastructure required for physical activity has the potential to link advocates for open space, public health and community redevelopment into a powerful coalition promoting investment in the civic infrastructure of US cities and the revitalization of public space. Planners are at the center of attention, and activists look to them for partnership and even leadership.
This issue on the Active City, guest edited by Anne Lusk, examines the potential of this renewed interest in the physical city to create positive changes in the built environment. It also examines some of the limits of the current debate.
In recent media coverage of this issue, and in the pronouncements of some designers and planners, there has been a tendency to get caught up in the oversimplification that sprawl makes people fat. From a public health perspective, there is certainly enormous excitement about the possibility that the environment has some small, but significant, effect on physical activity when education has seemingly stopped making a difference. Yet perhaps it is too easy to slip into a mode of thinking that enthusiastically embracesenvironmental determinism, which sees the environment as the key dimension. As Kevin Krizek points out in his article: “We intuitively know that people have a harder time walking or cycling where opportunities for these options do not exist. …But while improved conditions may be necessary, they are not sufficient for households to adopt healthy lifestyles.” Krizek, as well as Paul Schimek, both present this more complex picture, explaining how research to date has shown that other factors–including affluence, gas prices, the difficulties of driving, culture and personal preferences–are critical to whether people will walk or cycle.
Articles by Kristin Day, Anne Lusk, Paul Schimek and Larry Frank also relate systematic differences in the relationship of low-income people and people of color to the physical environment as compared to other populations. While such populations walk more for transportation, they are less likely to do many forms of physically active exercise. Overall, they may not get the recommended amount of daily physical activity and their health problems are on the rise. Creating favorable densities and street patterns, however, is not likely to be crucial for these populations, which often already live in neighborhoods with relatively high densities and good transit infrastructure. Instead, as Day explains, “insufficient parks, high crime and fear for safety, pollution, lack of jobs to walk to, dirty streets and sidewalks and residential overcrowding that limits opportunities for exercise at home,” as well as other social and economic factors, are vitally important. The media focus on suburban development patterns and middle-class concerns has obscured this point. Some planners have been happy to play along to avoid having to grapple with the situation of the entire population, and some activists have been suspicious of those who argue that the nature of the problem is very complex, since this dilutes the message activists need to promote.
As a further complication, implicit in the debate is an assumption that it is possible to change the built environment on a massive scale. Certainly the built environment is constantly being renewed, but ownership patterns and street layouts are fairly stable. While trails can be challenging to site in neighborhoods, Schimek points to the parallel and perhaps even more difficult task of increasing density in many parts of the US, particularly if higher density development comes with less off-street parking than is the norm for new development. As Karla Henderson argues, even the usually non-controversial public parks, which provide the infrastructure for physical activity, face significant challenges in sustaining their funding for maintenance and recreation programs. More hopeful may be the social marketing of the kind described by Lavinia Gordon, which seems to be able to encourage people to get out of their cars–though perhaps not onto their feet–and change their relationship to the environment without actually changing the environment at all.
Certainly, as Mark Fenton outlines, there are many tried and tested planning and design strategies to increase physical activity in streets and neighborhoods, humanizing these places at the same time. Three articles on trails–by Lusk, Phil Ganezer and Smita Mittal and Stephen Luoni–show how such activity-oriented design is being promoted. Important new strategies include: phytoremediation, to deal with contamination of rail corridors; designs to accommodate multiple modes in the same right-of-way, though not necessarily on the same pavement; and attempts to link trails to destinations relevant to low-income communities and communities of color. This interest in physical activity is providing funding for research, a public forum for publicizing and discussing results, programs such as Safe Routes to School, and some funding to test innovative designs. BladeNight, as described by Lusk, demonstrates how car-dominated streets can be humanized and used by 20,000 skaters once each week, in the process helping to improve the health of the population and modeling a way to better share existing resources.
Overall, the relationship between the physical environment and physical activity is a complex one, obscured by some of the recent hype. Obviously the environment doesmatter to the health of the public, and it is important to advocate for better public infrastructure for walking, cycling, roller blading, Tai Chi and so many other potential physical activities. And planners can capitalize on the public interest raised by the obesity debates to focus attention on creating healthier cities and regions and more vital public places. But how the environment matters is a complex issue. It is not a simple case of if you build it, they will exercise.
Research studies are demonstrating in the situation in cities today and what doesn’t work. In addition to this research, planners can work with public health professionals, transportation officials, parks and recreation professionals and the public to fund and test new models as pilot projects. Many environmental and health activists are now looking to planners as potential allies in creating this physical activity infrastructure. Progressive planners can contribute an important voice–advocating for better public infrastructure for all people, raising awareness of the limits of environmental interventions in social issues and advocating for the specific needs of low-income populations and people of color.
Ann Forsyth directs the Design Center for American Urban Landscape and is a co-editor of Progressive Planning.