Neighborhood walkability, behavior and health and possible implications toward improving the urban environment

The physical environment built for human use such as neighborhood, city and suburb designs has been found to have an impact on human health. Qualities such as four way intersections, placing in close proximity places we live (residential), work (e.g., office) and play (e.g., retail, parks), moderate residential density, and pedestrian infrastructure (sidewalks, cover from weather), impact our likelihood of walking or driving. Walking is the most common type of physical activity in which Americans engage. Walking is predicted by what has come to be known as “walkable built environments” found in small traditional towns and mixed use urban cores. On the other hand, less walkable environments such as suburbs are associated with increased car use. Walking contributes to lower Body Mass Index, lower body weight and less chronic diseases. In contrast, non-walkable built environments are associated with less likelihood for walking and greater driving, particularly in communities with poor public transportation systems. The number of minutes we drive per day is directly related to our weight. Hence, the nation's and perhaps the world's most pervasive epidemic, overweight and obesity, is linked in the U.S. to whether we walk or drive, which in turn is linked to whether we live in walkable or non-walkable built environments. In addition, non-walkable environments that require driving to nearby and far destinations, confront the individual with much greater stress due to congested roads and long commutes. Greater stress is both a risk factor for overweight and obesity as well as for mental health challenges. Our program of research has documented the beneficial effects of mixed use at the block level with children's conduct problems at school, of the ability of elders to make eye contact between pedestrians and residents with better physical functioning, of the impact of walkability of the built environment in contributing to the Hispanic Paradox (Hispanics become less healthy as they spend more time in the US), in our case, as a result of living in less-walkable built environments. More recently our research has demonstrated that walkability of the built environment predicts a range of obesity related disorders such as diabetes among Medicare recipients, suggesting that increasing walkability of the neighborhoods in which Medicare recipients live can lower burden of illness of Medicare recipients and possibly health care costs for this population. What if we could lower rapidly growing Medicare costs – which threaten the economic well-being of our nation -- by improving the walkability of our neighborhoods? The findings in the impact of walkable environments on psychosocial and physical health may comprise yet one more argument for creating pedestrian vs. car dominated environments. Arguments about reducing our carbon footprint -- by reducing car use – because of its impact on upper respiratory diseases and climate change can be supplemented by the more immediate and urgent need to target the nation's and the world's obesity epidemic. In the United States one third of the population is overweight and another one third is obese. While the proportion of overweight has not changed dramatically in over half a century, the proportion of obese individuals has nearly tripled in this period of time. What is most remarkable about the interventions required to improve walkability, walking and health is that they do not require an outlay of governmental funds, but rather political will. Zoning, or re-zoning of communities can transform them over time from non-walkable to more walkable. In Miami, for example, a place that historically has been considered as “must have a car”, now fully one third of residents of the Brickell downtown community do not own cars, in large part because of the easy access to rapid public transit and local amenities. Miami 21 is an initiative that rezoned the city of Miami as a walkable community, supported in part by our research and led by one of our co-investigators. Public health scientists and bioclimatologists have a common cause! Not only are the objectives of this research important in lessening trace gases and other factors that can contribute to climate change and diminished air quality, a good working knowledge of neighborhood walkability can help bioclimatologists control more efficiently for certain social-behavioral factors that might reduce or exacerbate extreme weather/human health outcomes.