Urban Planning: How a City Gets Health

Carolyn Abate | Published on November 7, 2016

A year ago Kelly Dearman was fed up with her commute.

Every day the married mother of two would make the nearly three-mile drive from her home in San Francisco’s Cole Valley neighborhood to her office in the city’s South of Market district.

Dearman, executive director of the In-Home Supportive Services Public Authority, said the drive was only 30 minutes long. But it felt like a lifetime fraught with frustration.

“It was only two and a half miles, but I’d have to go downtown and every street was crowded,” she told Healthline. “It was such a nightmare and I’d be mad.”

Dearman still makes that commute today. But now, thanks to the encouragement from a friend who’s an avid bike rider, she does it while on the seat of her bicycle, not in the seat of her car.

“It’s very freeing,” she said. “I’m outside, breathing the air, and I’m not in my car, fighting with other cars.”

Dearman is not alone.

In the past 10 years, San Franciscans have embraced the bike as a viable means of transportation. Today, roughly 82,000 daily bike trips occur in the city, according to the San Francisco Metropolitan Transportation Authority (SFMTA).

Anyone who wants to hop on two wheels has access to a bike network that consists of 434 lane miles. Since 2006, bike ridership has increased in San Francisco by 184 percent.

“People aren’t driving in San Francisco as much,” Ben Jose, public relations officer with the SFMTA, told Healthline.

Read more: What you need to know about air pollution »

Healthy cities

The construction of bike lanes is part of larger transit-first planning policy embraced by San Francisco.

The significant infrastructure investment has altered the look and feel of the West Coast city. Everything from parks and pedestrian friendly walkways and plazas, to dedicated bus routes, and of course bike lanes, are in abundance for residents and visitors to use and enjoy.

So it should come as no surprise that San Francisco was recently named one of the top cities in the United States to provide and promote an “active living” environment for its residents.

urban planning and health

The report is part of the Gallup-Healthways, State of American Well-Being series. The data is culled from surveys taken by 150,000 people — from 50 medium- to large-size metro communities across the United States — on a number of health and wellness factors.

The active living report examined four key components within “a community’s built environment — walkability, bikeability, parks, and public transit.” Using that data, researchers then calculated an “active living score for each community.”

Boston topped out at number one and Chicago at number three. Rounding out the bottom was Indianapolis, Oklahoma City, and Fort Wayne, Indiana.

How urban planning helps

In the simplest terms, urban planning is the physical and social development of a city through design, plus the provision of services and facilities.

But in 2016, urban planning has taken on an ever greater meaning: public health and community well-being is now part of the planning package, according to Anna Ricklin, of the American Planning Association (APA).

“Planning is a holistic approach to how we solve problems — looking at land use, roads that are commonly used, the parks, trees, municipal utilities, where we might want to build and redevelop,” she told Healthline. “So looking at community and well-being is a natural feature.”

Ricklin manages the APA’s Planning and Community Health Center, and their Plan4Health grant. The grant program is a three-year project supported by the U.S. Centers for Disease Control and Prevention (CDC), designed to strengthen the connection between the planning and public health professions.

According to the CDC, adult obesity rates in the United States range from 20 to 35 percent. The highest rates hover predominantly in Southern and Midwestern states. Lower rates of obesity tend to cluster in coast cities and regions.

Along with obesity rates comes a greater risk for diabetes, high blood pressure, heart disease, and some cancers. In 2008, the estimated annual medical cost of obesity in the United States was $147 billion. The medical costs for a person who is obese are approximately $1,400 higher than those of normal weight, according to the CDC.

The CDC recommends that adults who engage in just 30 minutes of physical activity five days a week can stave off some of these complications.

urban planning and health

How a city is designed has a direct influence on how, when, and why we engage in physical activity.

That doesn’t mean if a city slaps down bike lanes all of its residents will automatically become fit. Obesity is a complex health issue with many factors in play.

But along with genetics and behavior, the CDC includes community environment as one of the top three determinants of obesity.

100 years of planning

History shows that the marriage of public health and urban planning was first embraced around the turn of the 20th century.

Back in the late 1800s and early 1900s, city planners championed the construction of large parks in urban environments. Central Park in New York is a prime example.

The idea was to create an oasis of green among the concrete, according to the CDC. The construction of sewer systems, albeit a little less glamorous than city parks, also greatly influenced public health.

By the 1950s, that mindset around urban planning fell out of favor. That’s when the car reigned and life in the suburbs with a house and garage became the American Dream.

During the 1970s and 1980s numerous cities started to refocus on urban renewal. That eventually evolved into smart growth. It wasn’t until around 2000, Ricklin said, that community health and wellness started to come into focus again.

urban planning and health

In a way, the current definition of urban planning has come full circle, according to Danielle Spurlock, assistant professor at the University of North Carolina, Chapel Hill, Department of City and Regional Planning.

“In some places public health and planning are getting back to their roots from the early parts of the century,” she told Healthline.

Coast to coast

One of the most obvious takeaways from the active living report is the location of top ranked cities.

Nearly half of the top 25 reside near the country’s two coasts. Spurlock said that’s not a coincidence.

“That’s where we settled cities first, on the coast,” she said. “Cars didn’t exist. People had to walk. People had to take a horse and buggy.”

On the other hand, about eight Sun Belt or Rust Belt cities are ranked in the bottom half of the report. That also makes sense, Spurlock said, because many of those cities saw their greatest expansion during a time that was “reflective of the automobile.”

But even in some of country’s more car-centric cities, a renewed focus on urban planning with an eye toward health and wellness, is taking root. Spurlock noted that Pittsburgh and Youngstown, Ohio, are excellent examples.

Ricklin added that a few of the cities ranked at the bottom of the report are also implementing more forward thinking health and wellness programs, as well.

Tulsa, Oklahoma, is a grantee in Plan4Health and is working on a plan for community farms and food forests, she noted. Oklahoma City is also at the forefront.

“They had a citywide competition to lose one million pounds,” she said. “They are making a real effort.”

More than bike paths

Both Spurlock and Ricklin said it’s important to remember that there is much more to urban planning and community health than just new bike lanes and parks.

It’s also about achieving health and wellness through social justice.

“Planning has been a factor in segregation,” Ricklin said. “If we want to support longer-term longevity, equity is crucial, because the way our environments are shaped, dictates the choices we have.”

Spurlock agreed.

“We want people to not just have access for parks,” she said. “We need to make sure we create healthy spaces for all, as we get rid of certain disamenities.”

This can translate into planners working to remove factories in neighborhoods where asthma levels are high.

Healthy urban planning
  • parks
  • bicycle paths
  • moving factories
  • no food deserts

It can mean installing new traffic calming mechanisms along high capacity roads so kids can safely walk to school.

Or, it can come in the form of incentives for grocery stores to move into urban food deserts.

Spurlock said that today’s urban planners are attempting to tackle the fundamental health challenge that plagues our nation — obesity.

“How do we change this trend of obesity in the United States? How do you counter that with policy and environmental change?,” she asked. “Social cohesion, better food, better mental outcomes, it’s all tied.”

Dearman said if someone told her 20 years ago that in her 50s she’d be riding her bike to work, she wouldn’t have believed them.

“I would have laughed in their face,” she said.

She doesn’t see herself going back to a car commute anytime soon. Bike riding has helped her to maintain her weight. It’s also had a huge influence on her mental health and well-being.

That’s because the sheer act of riding her bike forces Dearman to not think about all the things that mothers tend to worry about.

So, for a mere 30 minutes, twice a day, the ride to and from work has evolved into a daily, meditative journey.

“I have to focus,” Dearman said, “and that calms me down.”

http://www.healthline.com/health-news/howaa-city-gets-healthy#8

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