Healthy urbanism advocates for a holistic view of urban design that considers health, the environment, social relations, political processes and the economy as part of the development process. It posits that neighborhood design elements including land use, design character, transportation systems, sustainability, and density impact a neighborhood’s health, environment and quality of life.
The connection between health and urbanism goes back almost as long as cities themselves. It was health concerns in many industrial-era cities that drove people out of polluted and unsanitary urban cores and into the first suburbs. Now the tables have turned. Evidence is mounting that the suburban lifestyle is causing health problems.
Many chronic diseases—including obesity and diabetes—as well as premature mortality, cardiovascular disease and poor mental health are associated with the sedentary and isolated populations exacerbated by our sprawling, auto dominated urban form. One of the leaders of the healthy urbanism movement is Dr. Howard Frumkin, dean of the University of Washington School of Public Health and co-author of Urban Sprawl and Public Health: Designing, Planning, and Building for Healthy Communities. Dr. Frumkin notes that:
“Well-designed communities can be interventions for public health. How we build and maintain our communities’ transportation systems, infrastructure, and public spaces can either exacerbate or reduce obesity, chronic diseases, injury rates, poor mental health, and the adverse effects of climate change.”
An increasing body of evidence backs up this statement. The doubling of driving nationally between 1983 and 2007 on auto-centric streets designed for speed has coincided with skyrocketing injury and mortality rates, exacerbated mental health problems for isolated non-drivers, and decreased air and water quality.
Additionally, suburban neighborhoods—dominated by low density, poorly connected street networks, and limited access to shops and services—have lower levels of walking.This, in turn, is connected to increased obesity. On the other hand, well-designed urban neighborhoods generate fewer vehicle miles and result in more walking and lower obesity rates than their suburban counterparts.
“Community design and building design have impacts both on mental health and on social capital. Social capital in turn is a very important determinant of overall health.”
Another impact of urban form on health relates to social capital and mental health. The WHO estimates that by 2020, mental ill-health will be the third leading cause of disability life-adjusted years globally. Some research indicates that there are higher levels of social capital in more walkable neighborhoods suggesting that urban form is important. High levels of social capital decrease the risk of social isolation, a social determinant of health linked to increased risk of premature mortality, cardiovascular disease and poor mental health.
It is clear that the quality of our cities impacts the quality of our healthy and life in general. Hopefully, this renewed interest in healthy urbanism will continue with doctors researchers working with planners and architects to design places that are healthy on both a personal and community level.