How to Plan with a Healthy Dose of Walkability

September 11, 2015

By Becky Steckler, AICP, Program and Policy Manager for the Oregon Chapter of the American Planning Association

Special thanks to Constance Beaumont, Transportation and Growth Management Outreach Coordinator for contributing to this article.

“Transportation officials are health officials,” says Dr. Richard J. Jackson, M.D., author of “Designing Healthy Communities” and chair of the Environmental Health Sciences Department at the University of California, Los Angeles.

What does he mean by that?

Jackson’s point is that plans carried out by transportation officials can either open up or rule out opportunities for Americans to make physical activity a natural part of their daily lives, and physical activity is critical to good health. Put another way:

• the lack of physical activity contributes to excess weight and obesity, a condition associated with such chronic health problems as diabetes, heart disease, stroke, arthritis, and cancer;[i] and
• the absence of safe places to walk or bike safely in many communities makes it harder for people to get the moderate physical activity often recommended by health officials.

Obviously genetics and diet play an important role, but physical inactivity and the weight problems linked to it are a serious health problem. Indeed, as one expert put it, “Physical inactivity is the biggest public health problem of the 21st Century.”[ii] Here in Oregon, only tobacco beats obesity as the state’s leading cause of preventable death.[iii]

But three generations of looking at transportation mainly through the motorist’s lens have yielded a transportation system that mostly encourages, well, sitting. Given competing claims on our time, this form of physical inactivity – sedentary transportation – often crowds out the recommended daily exercise.

One might add to Dr. Jackson’s observation that land use planners, too, are health officials in the sense that the plans and zoning codes they develop can promote or discourage physical activity.

Land use planning decisions literally shape our communities. In doing so, they also affect our ability to get around in ways that involve physical activity – notably by walking and bicycling. Through parking standards, large lot-size requirements, and bans on mixed land uses, for example, land use policy choices may lengthen the distance people must travel so that the only practical way to go places is by car – that is, by sitting in the car and driving.

(Related articles: “Sitting is the new Smoking” and “If Sitting Is the New Smoking, How Do We Kick the Habit?”)

Making a case for designing active cities

Studies show that more active cities – i.e., cities designed and laid out to facilitate physical activity – don’t merely alleviate one problem (poor health), they also exert a positive impact on environmental, safety, economic, and social issues as well. Active Living Research (ALR) at the University of California, San Diego, (http://activelivingresearch.org/) is at the forefront of research on the benefits of active cities.

ALR recently teamed up with Nike to conduct research and produce the “Designed to Move: Active Cities Report,”[iv] which reviewed hundreds of studies from 17 countries with over 500 findings showing that cities designed to be active enjoyed substantial economic, safety, social, health, and environmental benefits, as highlighted in Figure 1.

The research by Active Living Research found substantial evidence that park proximity; mixed land uses; trees/greenery; accessibility and street connectivity; building design; and workplace physical activity policies and programs were likely to yield multiple environmental sustainability and economic benefits.

What’s the problem with inactivity?

Today about 60 percent of Oregonian adults – and almost one-third of children in the U.S. – are overweight or obese.[v] The costs of obesity account for about 9 percent of all health care expenditures in the U.S.[vi]

“There is a large and growing body of … evidence linking transportation and land use patterns to physical activity and obesity, and physical activity and obesity to [health care] costs,” observes the American Public Health Association.[vii]

Obesity-related illnesses cost the nation $190 billion annually, according to the Institute of Medicine.[viii] In Oregon, they approached $1.6 billion in 2006. But these are just taxpayer costs and don’t include personal outlays for obesity-related health care. Obese people incur annual medical costs that exceed those of others by $1,429, according to the Oregon Health Authority.

As the health and financial costs of a sedentary life style have soared, an “active transportation” movement has emerged to advocate a transportation system that promotes walking, bicycling, and using transit, not just driving. Active transportation is defined by the Centers for Disease Control and Prevention as “any self-propelled, human-powered mode of transportation, such as walking or bicycling.” Experts include transit among the “active” travel modes because most transit trips begin and end with a walk or bicycle trip.

The good news is that designing cities so that it is easy to bike and walk not only improves local residents’ health, it also makes them wealthier and safer, improves the environment, and facilitates social interaction. The following sections draw from the literature and research reviewed in the “Designed to Move: Active Cities Report 2015” (DTM: ACR 2015) unless otherwise noted. The full report can be found at www.designedtomove.org/resources/active-cities.

The economic benefits of active cities

Walking and cycling are great for business. Multiple studies have shown that improving the pedestrian and cycling environment can increase retail rents by 20 percent (DTM: ACR 2015, p. 9). Another study showed that a higher Walk Score® ranking was associated with a higher net retail operating income of over 40 percent (DTM: ACR 2015, p. 9) and values of properties with a Walk Score of 80 are between 30 percent and 49 percent higher than those with a Walk Score of 20 (DTM: ACR 2015, p. 9).

People know walkable neighborhoods are desirable and are willing to pay for it. A study in 15 cities found homes in more walkable neighborhoods to be $4,000 to $34,000 more valuable than homes in less walkable neighborhoods (DTM: ACR 2015, p. 10).

A study in Portland found that by 2040, public investments in bike facilities ranging between $138 million to $605 million will result in corresponding health care cost savings of $388 million to $594 million, fuel savings of $143 million to $218 million, and savings in the value of statistical lives of $7 million to $12 billion (DTM: ACR 2015, p. 10).

The social benefits of active cities

People like to live in cities and communities where it is easy to walk and bike. Designing cities for active living leads people to have a greater sense of community and positive feelings about their cities.

One of the best places to see this is at a park. People who use parks feel less lonely (DTM: ACR 2015, p. 11). Reconstructing playgrounds in New York City resulted in a 25 percent increase in structured play and a 240 percent increase in unstructured play among kids, which is important given the rising obesity rates and declining physical activity rates among youth (DTM: ACR 2015, p. 11).

People who participate in cycling events that close streets to cars for a day (like Portland’s Sunday Parkways: http://www.portlandoregon.gov/transportation/46103) say that these events make them feel better about their city (DTM: ACR 2015, p. 11). On the other hand, a lack of transportation options can negatively affect people’s impressions of their city — more than half of residents without easy access to public transit are dissatisfied with the lack of availability (DTM: ACR 2015, p. 11).

The safety benefits of active cities

Designing for active living can also decrease crime, collisions, and injuries. For example, one city experienced a 74 percent decrease in crime when it was converted to car-free space on weekends (DTM: ACR 2015, p. 10). Criminals often select properties based on how easy it is to drive away from the crime scene (DTM: ACR 2015, p. 10).

Building gardens and green space can also decrease crime by over 50 percent (DTM: ACR 2015, p. 9).

Just a few of the treatments shown to reduce the risk of pedestrian-vehicle crashes are single-lane roundabouts, sidewalks, exclusive pedestrian signal phasing, pedestrian refuge islands and increased roadway lighting (DTM: ACR 2015, p. 10). Want to reduce crash rates by 30 percent to 50 percent on major highways that go through larger suburban areas and smaller urban areas? Implement traffic calming on highways in these locations (DTM: ACR 2015, p. 10). Pedestrian injuries can decline by more than 40 percent with implementation of a Safe Routes to School program (DTM: ACR 2015, p. 10).

The health benefits

It just makes sense that people who live in cities designed for physical activity tend to see better health outcomes. According to the Oregon Health Authority (and other research – e.g., DTM #47), people living in more walkable neighborhoods in Portland, Corvallis, Eugene, and Ashland have a lower body mass index (BMI) than residents in suburban or car-dependent communities, as shown below. The downtown and surrounding neighborhoods are for the most part dark green—indicating that the residents have a normal or healthy weight BMI. The light green to red dots show where residents live who are considered overweight or obese, many in suburban locations and less walkable towns.

The strongest evidence of healthy outcomes is the proximity of parks and open space to where people live. People feel healthier, less stressed, less lonely, and less anxious (DTM: ACR 2015, p. 11). Hospitals, like Eugene/Springfield’s PeaceHealth, locate hospitals in natural settings in part because greenery from trees and bushes has been found to accelerate hospital recoveries and improve mental health (DTM: ACR 2015, p. 11).

The environmental benefits

Oregon is already seeing some of the environmental benefits of building more compact, walkable cities. Unlike every other state in the country, Oregon has experienced an increase in economic productivity and population while at the same time reducing total VMT, not just VMT per capita. This is in large part because of Oregon’s planning efforts in the Portland metro area and other cities across the state.[ix] Across the country, studies show that more compact development can reduce vehicle drive times by up to 40 percent, which in turn could reduce carbon dioxide emissions up to 10 percent (DTM: ACR 2015, p. 10). Increasing walkability by just 5 percent has resulted in a 6.5 percent reduction in vehicle miles traveled (VMT) (DTM: ACR 2015, p. 10).

Public transportation plays an important role in protecting the environment. It produces 95 percent less carbon monoxide, 90 percent less volatile organic compounds, and half the carbon monoxide and nitrogen oxide per passenger mile as driving a private vehicle (DTM: ACR 2015, p. 10).

Also, not only do Safe Routes to Schools programs increase safety for kids, they also reduce emissions by up to 15 percent (DTM: ACR 2015, p. 10).

Where can I find out more?

This article lists just a few of the benefits of building more walkable and bikable communities. In addition, more and more organizations, including the American Planning Association, are focusing on health and the built environment. The Planning and Community Health Center (https://www.planning.org/nationalcenters/health/) includes a wealth of information for planners, including information on health impact assessments, benefits of street-scale features for walking and bicycling, planning tools for health, and a clearing house of information on the built environment.

Many other organizations also focus on the built environment and health, including the Centers for Disease Control’s Healthy Planning Tools (http://www.cdc.gov/healthyplaces/health_planning_tools.htm), Building Healthy Places Initiative by the Urban Land Institute (http://uli.org/research/centers-initiatives/building-healthy-places-initiative/), and background research at Active Living Research (http://activelivingresearch.org/).

AARP recognizes the importance of the built environment on the health of seniors through the use of it’s Livability Index (http://livabilityindex.aarp.org/?cmp=LVABLIDX_MAR25_015), which looks at how neighborhoods rate on housing, neighborhood amenities, transportation, environment, health, engagement, and opportunities for seniors.

If you live in the Portland Metro region and would like to find out more about planning for seniors, be sure to attend the Livability Forum from noon to 4:30 p.m. Sept. 22 at the Round in Beaverton, 12725 S.W. Millikan Way. Registration: https://aarp.cvent.com/livabilityforum92215. A second Livability Forum will be held the from 8:30 a.m. to 3:30 p.m. Sept, 23 in Medford at Inn at the Commons, 200 N. Riverside Ave. Registration: https://aarp.cvent.com/livabilityforum92315.

On the other end of the age spectrum, Safe Routes to School is one of the most successful programs to improve the environment for children to safely travel to and from school. The Oregon program focuses on events and programs like Walk & Bike Challenge Month and Walk and Bike to School Day to encourage biking and walking. It also encourages residents to create an Action Plan that helps identify infrastructure improvements and programs related to education, encouragement and enforcement. Find out more about Safe Routes to School programs in Oregon at http://oregonsaferoutes.org/.

In Oregon, the Transportation and Growth Management Program (TGM) offers planning grants and other services that help cities enable active transportation. The services include free educational workshops and public lectures on health and active transportation for interested communities. For more: www.oregon.gov/LCD/TGM/pages/index.aspx and www.oregon.gov/LCD/TGM/Pages/outreach.aspx.Many cities are working to improve the pedestrian environment. The City of Tigard made walkability the cornerstone of its Strategic Plan and is committed to making Tigard “the most walkable city in the Pacific NW where people of all ages and abilities enjoy healthy and interconnected lives.” The City has conducted multiple studies on how to make Tigard more walkable and has invested in infrastructure. It supports programs that encourage residents to walk and recently partnered with TGM in hosting public lectures by Jeff Speck, author of Walkable City. Find out more: http://www.tigard-or.gov/community/tigard_walks.php.

References:
[i]              See Oregon Overweight, Obesity, Physical Activity and Nutrition Facts, p. 4. Oregon Health Authority, 2012, and http://www.cdc.gov/healthyplaces/transportation/promote_strategy.htm;

http://www.cdc.gov/healthyplaces/transportation/hia_toolkit.htm

[ii]               Statement by Steven N. Blair, PED, University of North Carolina, in documentary, Everybody Walks, at http://www.everybodywalk.org/documentary.

[iii]             Oregon Overweight, Obesity, Physical Activity and Nutrition Facts, p. 4. Oregon Health Authority, 2012. Per the Harvard School of Public Health: “Apart from tobacco, there is perhaps no greater harm to the collective health in the U.S. than obesity.”

[iv] ©Nike, Inc. (2012), DESIGNED TO MOVE: A Physical Activity Action Agenda.™ All RIGHTS RESERVED. See https://www.designedtomove.org/resources.

[v]               Oregon Overweight, Obesity, Physical Activity and Nutrition Facts, Oregon Health Authority, 2012. “Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation,” Institute of Medicine Report Brief, May 2012

[vi]              “The Hidden Health Costs of Transportation,” p. 2. American Public Health Association (February 2010)

[vii]             “The Hidden Health Costs of Transportation,” p. 3. American Public Health Association (February 2010)

[viii]           “Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation,” Institute of Medicine Report Brief, May 2012

[ix] “Fossil Fuel Debate: Why are Oregonians Driving Less” by Jacob Anbinder, Newsweek, June 18, 2015. http://www.newsweek.com/fossil-fuel-debate-why-are-oregonians-driving-less-344522.