Dr. Howard Frumkin, dean, School of Public Health, University of Washington, asked the audience at the National Building Museum’s Intelligent Cities forum to imagine they were zookeepers and just received a shipment of hundreds of frogs. Immediately, the zookeepers would need to create a habitat with the correct temperature, humidity, water and plants to ensure the frogs are healthy and live long lives. Cities are really just habitats for humans and our zookeepers are our elected officials, urban planners, and designers. However, Frumkin wondered if the ideal habitat is now being created for people – one that offers a healthy environment for all?
For Christine Green, National Complete Streets Coalition, a healthy human environment offers streets “where it’s safe and convenient to be physically active.” Patrick Kinney, professor of Environmental Health and director of the Climate and Health Program at Columbia University, it’s about offering “healthy amenities in healthy ways.” William Lucy, professor of Urban and Environmental Planning, University of Virginia, believes that “a safe environment for walking really is the key.” He also explained his research into how suburban cul-de-sacs are actually far more dangerous than dense downtown streets for children, largely because in these seemingly safe suburban environments, children aren’t “well educated or exposed to the dangers” of cars.
A City Dashboard
If a city were to have a “dashboard” tracking all the important indicators of a healthy human environment, “what would it feature?”, asked Frumkin. For Lucy, the dashboard would track traffic fatalities and the percentage of people driving alone to work. Lucy said traffic fatalities are actually higher in the sparser outer areas of cities. Kinney said air pollution and water quality are key data to track. Green made the case for “new intersections, miles of sidewalks and bike lanes, and percentages of people walking to work each day.”
Frumkin believes morbidity statistics are also crucial. “Asthma, heart disease, depression, obesity, diabetes. How does a city alleviate or promote these conditions?” Others like Kinney agreed that there are epidemics of obesity and diabetes in the developed world, particularly the U.S., and they are driven by “decreasing amounts of physical activity and a changing diet.”
Lucy sees a coming population shift that will also have major health implications. Currently, “poorer people have captured the better locations in the center of cities. They live in the convenient locations.” However, this trend is changing. With the revival of cities, “white flight has turned into white return.” As a result, the poor are moving to the suburbs. Just as in Paris, where the suburbs are the site of poorer immigrant communities, U.S. cities may soon face the same issues.
Cities will be soon be dominated by “upper middle class people.” What’s worse for the poorer citizens moving to the suburbs is that they will now also have “accessibility problems,” which will create additional health problems.
Integrating Health into Urban Policymaking
All panelists seems to agree that health needs to be a “lens” for all urban policymaking and shouldn’t be “siloed” in a health department. Kinney believes health specialists need to better partner with built environment policymakers and designer. For example, local health specialists (or the rare local health department) can partner with local parks departments to ensure parks and other public spaces are designed to provide extra walking and biking features. Also important is training young health specialists to “work across disciplines” and get used to the idea of partnering with other fields.
Green sees the need to change user behavior, and sees health as critical to this effort. “We can change the built environment but then need to change behavior so the new environments are used.” With more transportation options, there may be more room for behavioral change. Within the built environment, “health can be a driver of action.”
However, Lucy sees a deeper challenge: ensuring policymakers and designers take a whole systems approach. For example, in many suburban communities, fire departments want very wide intersections so fire trucks can make turns at corners. The effect, however, is to create intersections that are not easy to cross on foot. In this sense, land use is a key determinant of health, and all those complex inter-relationships need to be closely examined.
Image credit: Central Park / Life-in-NI. Flickr