JAMA just published an editorial co-written by Cluster faculty member, Andrew Rundle, entitled “Can Walkable Urban Design Play a Role in Reducing the Incidence of Obesity-Related Conditions?”. The editorial provides a perspective on a study published in JAMA by Creatore et al., that assessed the prevalence of obesity and incidence of diabetes from 2001 to 2012, by level neighborhood walkability across 15 municipalities in Canada.
As in many earlier studies, neighborhood walkability was described from an urban form perspective and their neighborhood measures did not consider social environment issues such as pedestrian safety, crime, displeasing aesthetic conditions, and physical disorder as contributing to neighborhood environments that support pedestrian activity. These social characteristics may interact with, or perhaps trump, urban design features that support pedestrian activity. For instance, comparisons of high- and low-poverty neighborhoods in New York City that scored equally well for urban design characteristics that support walking found that high poverty neighborhoods had higher rates of crime and pedestrian injuries, streets with higher levels of noise, more events of hostile behavior, more signs of building and sidewalk disrepair, and more garbage on the sidewalk, characteristics expected to deter pedestrian activity. Earlier studies have reported that neighborhood poverty appears to nullify the effects of supportive built environments on physical activity and body size; associations between neighborhood walkability and body mass index and physical activity are often only observed among individuals living in higher-income neighborhoods. Thus, the built environment objectives in Healthy People 2020 and the interventions described in active design guidelines may be less effective in low income communities, the very communities typically at the highest risk for obesity and diabetes.