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Mar 5 2008, 12:10 pm Geog 361b 1
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
Mar 5 2008, 12:10 pm Geog 361b 2
Exercise
• How does the built environment effect health?• What specifically is the focus of Frank et al.?
Mar 5 2008, 12:10 pm Geog 361b 3
Frank et al.’s Framework:
Mar 5 2008, 12:10 pm Geog 361b 4
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
Mar 5 2008, 12:10 pm Geog 361b 5
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
Mar 5 2008, 12:10 pm Geog 361b 6
Causes of Death
• note the causes that disappear in later period
Mar 5 2008, 12:10 pm Geog 361b 7
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”
Mar 5 2008, 12:10 pm Geog 361b 8
Obesity Patterns• increasing over time
Causes of “Obesity”• diet• activity
Mar 5 2008, 12:10 pm Geog 361b 9
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)
Mar 5 2008, 12:10 pm Geog 361b 10
No Pain No Gain?
• 80s – early 90s 20 minutes vigorous exercise• 1996 US Surgeon General report
– 30 minutes of moderate activity on most days
Mar 5 2008, 12:10 pm Geog 361b 11
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
Mar 5 2008, 12:10 pm Geog 361b 12
Sedentary Reap New Benefits Quickest
Mar 5 2008, 12:10 pm Geog 361b 13
Modifiable Behaviours and Mortality
Mar 5 2008, 12:10 pm Geog 361b 14
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%
Mar 5 2008, 12:10 pm Geog 361b 15
Genetics or physical activity
• Maybe premature death/disability is mostly genetic?
Mar 5 2008, 12:10 pm Geog 361b 16
Genetics or physical activity
Mar 5 2008, 12:10 pm Geog 361b 17
Improvements in Physical Activity Over Time?
Mar 5 2008, 12:10 pm Geog 361b 18
Discussion
• What explains low physical activity in North America?
Mar 5 2008, 12:10 pm Geog 361b 19
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
Mar 5 2008, 12:10 pm Geog 361b 20
Physical Activity and Wealth
Mar 5 2008, 12:10 pm Geog 361b 21
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
Mar 5 2008, 12:10 pm Geog 361b 22
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
Mar 5 2008, 12:10 pm Geog 361b 23
Transportation: Modal “Choice”
Mar 5 2008, 12:10 pm Geog 361b 24
Transportation:Children and Modal Choice
Mar 5 2008, 12:10 pm Geog 361b 25
Transportation:Children and Modal Choice
Mar 5 2008, 12:10 pm Geog 361b 26
Mar 5 2008, 12:10 pm Geog 361b 27
Discussion
• How can we increase physical activity (not personally per se, but as a public health problem)?
Mar 5 2008, 12:10 pm Geog 361b 28
Design Barriers
Mar 5 2008, 12:10 pm Geog 361b 29
Design Barriers
Mar 5 2008, 12:10 pm Geog 361b 30
Designing for Pedestrians
Mar 5 2008, 12:10 pm Geog 361b 31
Exercise/Conclusion
• Do we need to sacrafice the American/Canadian dream to achieve walkable/cyclable cities?