Active Living: A Planning Subfield Comes of Age

On a cold and rainy night in the winter of 2000, a subfield of urban planning was born. Actually, it may have been balmy night in the summer of 2001. I have no memory of the weather or even the year, but I do recall what happened that evening.

A group of urban planners, public health experts, and Robert Wood Johnson Foundation staff had gathered at the RWJF headquarters in Princeton, New Jersey. RWJF had decided to shift its emphasis from tobacco control to physical activity promotion and obesity prevention. The decision was timely. Smoking rates in the U.S. were falling, while inactivity and obesity rates were rising.

RWJF had organized the meeting to lay the foundation for a three-part initiative to create better environments for active living: Active Living Research was the research program; Active Living by Design was the action program; and Active Living Leadership worked to engage leaders in implementing the lessons from the other two programs.

RWJF had learned a lot from the smoking wars, specifically that individual exhortations and appeals were less effective than policy and environmental changes. RWJF was instrumental in getting smoking banned from public places and enacting sharp increases in taxes on cigarettes. The reduction in smoking is attributable to these types of measures far more than public information campaigns.

So RWJF applied the same logic to physical activity promotion and obesity prevention. The conceptual model they posited, at that time, went like this: The built environment of the U.S. has become increasingly carcentric, and levels of physical activity have correspondingly declined. Reduced physical activity, and constant or increasing calories, has resulted in population weight gains. Therefore, to counter these trends, it is necessary to make communities more conducive to physical activity once again, particularly walking and cycling.

Planners were invited to the table because we, as a profession, exercise (pun intended) the greatest influence on the built environment of any profession (except perhaps land developers).

Illustration by Stephen Ravencraft

Meeting of the minds

We sat around a dinner table that evening — a somewhat ironic setting, considering the topic — and discussed our respective fields. I was surprised to learn that public health experts were doing research on the built environment and physical activity that roughly paralleled what was happening in urban planning. In the early 1990s, planners had begun to study the effects of the D variables (development density, land-use diversity, street design, etc.) on walking, bicycling, and transit use. Meanwhile, physical activity researchers were studying the effects of park space, trails, playgrounds, and other recreational facilities on exercise and leisure-time activity. We were in roughly the same business and had all reached roughly the same conclusion: the built environment matters.

Jim Sallis, then of San Diego State University and now at University of California, San Diego, was a leader that evening. He would later head the Active Living Research Program. Kate Kraft was there as well. She later came to coordinate RWJF initiatives and now directs the America Walks Coalition.

In the ensuing years, RWJF pumped millions of dollars into these three programs. Then, about five years later, RWJF shifted the focus to childhood obesity with an initial $500 million commitment, incorporating the active living programs and adding healthy eating programs to the childhood obesity initiative.

Growing body of work

Fast forward to today. The work of planners has risen to the top of the agenda for U.S. public health. Indeed, the Surgeon General's recent call to action was about walking and walkability. When this effort started, no one in the health community knew what walkability was.

The amount of research on the built environment and public health that exists today is truly amazing. One of APA's three research centers is dedicated to this topic — the Planning and Community Health Center.

Our first research study on the built environment and obesity was published in 2003 (with funding from RWJF). A 2014 review of literature by J.D. Makenbach et al. Published in BMC Public Health found more than 5,000 original articles published since then, examining associations between physical environmental characteristics and adult weight status. While the research is still maturing, the weight (another pun) of evidence backs up what we said back in 2003: Urban sprawl makes you fat, sick, and dead.

The earliest studies of the built environment and public health appeared in established journals such as the Journal of the American Planning Association and the American Journal of Preventive Medicine.

Since then, due to the volume of research, other journals have sprouted up. A favorite of mine is the Journal of Transport & Health, established in 2014. Its mission is to research the many interactions between transport and health.

In one article in the latest issue (vol. 3, issue 2) by Langlois et al. (tinyurl.com/zyphpbz), the authors conducted surveys of residents living in seven transit-oriented developments in North America: Rosslyn Station, Arlington, Virginia; South Orange Station, South Orange, New Jersey; Berkeley Station, Berkeley, California; Mockingbird Station, Fort Worth, Texas; Downtown Plano Station, Dallas; Equinox Station, Toronto; and Joyce-Collingwood Station, Vancouver, British Columbia.

They found that individuals who use public transportation are more likely to achieve recommended levels of physical activity than those who do not. Pedestrian friendliness of the residential location, affordability of public transport, and good weather all had positive effects.

It has been said more than once that planning has its roots in public health ("health, safety, welfare"). Now, after decades of planning for the automobile, we have finally come full circle.

—Reid Ewing

Reid Ewing is chair of the Department of City and Metropolitan Planning at the University of Utah, an associate editor of the Journal of the American Planning Association, and an editorial board member of the Journal of Transport & Health.