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The Built Environment and HealthThe Built Environment and Health(Frank et al. Chapters 1 and 3)(Frank et al. Chapters 1 and 3)

Geography 361aGeography 361aEnvironment and HealthEnvironment and Health

• Discussion

• Frank et al. Model

• Physical activity and health

• Suburbanization and design

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Exercise

• How does the built environment effect health?• What specifically is the focus of Frank et al.?

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Frank et al.’s Framework:

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Elaboration of Framework

• Built environment – where we live and work• Public health – outcomes, e.g., obesity, heart

disease, stress• Activity patterns – esp. walking bicycling• Land use – e.g., proximity home, work school• Design – small scale features that influence how

people feel about an urban “environment”• Transportation systems – esp. for walking,

biking, driving, public transit

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Health Patterns

• “Premature” death (e.g. cardiovascular disease) and disability (e.g., osteoporosis) from preventable diseases

• Obesity increasing– risk factor for all sorts of illness/disease

• Many health risks decrease with increased physical activity

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Causes of Death

• note the causes that disappear in later period

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Obesity

Overweight• 1 category above normal Body Mass Index (based

on height:weight ratio)

Obese• 2 categories above

Prevalence• 1999-2000 CDC study – US 31% obese, 34%

overweight = 65% above “normal”

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Obesity Patterns• increasing over time

Causes of “Obesity”• diet• activity

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Moderate Activity Benefits

• Muscle strength• Blood pressure

– e.g., Reduction risk coronary heart disease on par with stopping smoking!

• Depression and anxiety• Obesity• Skeletal development of kids• Bone density adults• Independence (esp. elderly)

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No Pain No Gain?

• 80s – early 90s 20 minutes vigorous exercise• 1996 US Surgeon General report

– 30 minutes of moderate activity on most days

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Guideline: Active

• moderate-intensity physical activity for at least 30 minutes on 5 or more days of the week or

OR

• vigorous-intensity physical activity 3 or more days of the week for 20 or more minutes

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Sedentary Reap New Benefits Quickest

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Modifiable Behaviours and Mortality

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Improve How Much?• If half “sedentary” population became irregularly

active (not quite guideline) total # deaths from– CHD drop 3.9%– Colon cancer drop 2.5%– Diabetes 1.5%

• If same population met activity guidelines:– CHD drop 7.1%– Colon cancer drop 7.4%– Diabetes 5.2%

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Genetics or physical activity

• Maybe premature death/disability is mostly genetic?

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Genetics or physical activity

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Improvements in Physical Activity Over Time?

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Discussion

• What explains low physical activity in North America?

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Interconnected Causes of Sedentary Lifestyles

• Behavioural– “victim blaming”– choice available, e.g., transportation

• Suburbanization– landuse– design

• Time– what happened to the 35hr work week?

• Wealth– very much so

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Physical Activity and Wealth

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Is suburbanization is bad for your health?

Garden Cities• reaction to

overcrowded and dirty large cities

• access to nature (healthy)

• best aspects of rural and urban living

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Full Circle

• Olmstead – designer (Central Park), architect, writer– advocate for residential outside CBD – space, greenery

– CBD too crowed, stressful and generally unhealthy

• Levittown PA – post war American (and Canadian) dream

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Transportation: Modal “Choice”

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Transportation:Children and Modal Choice

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Transportation:Children and Modal Choice

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Discussion

• How can we increase physical activity (not personally per se, but as a public health problem)?

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Design Barriers

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Design Barriers

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Designing for Pedestrians

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Exercise/Conclusion

• Do we need to sacrafice the American/Canadian dream to achieve walkable/cyclable cities?