Path to Better Population Health Includes Walkable Urban Street Design

City planners can play a crucial role in improving public health by encouraging physical activity through street design that allows walking and biking, according to a viewpoint published in JAMA Internal Medicine.

The authors are employees of Bloomberg Associates, a consulting group for cities seeking to improve their residents’ quality of life. The recommendation in the viewpoint is simple: making streets safer and more inviting for pedestrians and cyclists can help break the pattern of sedentary behavior that has contributed to the obesity epidemic in America. In fact, the authors write, “designing healthier streets is the most powerful weapon that urban planners have at their disposal to counteract these trends.”

Aside from the frequency of vehicular traffic crashes on America’s roads, current street design presents a more insidious danger by making routine physical activity virtually impossible in some cities and towns, they argue. Cars are the method of transportation for 86% of Americans traveling to work, and even when public transit is available, commuters may encounter unsafe routes to the bus stops or rail stations. For suburban residents, automobiles are a near necessity due to the spread-out nature of homes and businesses.

To remove these barriers to activity, the authors write that urban planners should look to successful examples of cities that have redesigned their infrastructure to encourage walking and biking. In Copenhagen, for instance, where half of all trips are taken on bicycles, coronary heart disease is less prevalent among cyclists. Closer to home, Portland, Oregon, has created a bikeable city that “reallocates road space to transportation modes other than cars,” and it now has the highest proportion nationwide of commuters who bike to work, at 5%.

Another model for street redesign is New York City, where one of the authors spearheaded a 6-year initiative to create 400 miles of bike lanes during her tenure as transportation commissioner. The ease of cycling in the Big Apple also got a boost from the Citi Bike program, which will expand to 12,000 bicycles this year. Since the program’s 2013 launch, riders have borrowed the bikes to pedal a cumulative distance equal to a trip to Mars and back, the authors report. Other ideas have helped to encourage walking, like the redesign of Times Square that transformed the busy roadway into a pedestrian plaza that 480,000 people stroll through every day.

In September 2015, Surgeon General Vivek Murthy, MD, issued a call to action urging Americans to walk more, in conjunction with a report containing a number of recommendations, including the need for measures that quell the dangers of traffic to pedestrians.

“We know that an active lifestyle is critical to achieving good overall health. And walking is a simple, effective and affordable way to build physical activity into our lives,” said Murthy in the report. ”That is why we need to step it up as a country ensuring that everyone can choose to walk in their own communities.”

In light of the abundance of evidence supporting physical activity as a method of improving public health by warding off obesity, cardiovascular disease, and a number of other health risks, the authors of the viewpoint argue that urban planners have a civic responsibility to do their part in facilitating active lifestyles.

“We aren’t going to drive ourselves to a healthier future,” the authors concluded. “We’re going to get there only under our own power, and cities need to make substantial investments to help make that possible.”