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Timothy Beatley
Associate Professor of Urban and Environmental Planning, University of Virginia
"Healthy Cities, Healthy Lives: The Built Environment and Public Health"
February 25 , 2004

I have a few propositions about what constitutes a healthy place or a healthy community, a few qualities, attributes, conditions that I’d like to argue for and the first one has to do with the fundamental urban form of the places in which we live and I would argue that healthy cities are almost by definition compact cities, cities that use land very sparingly, that try to move away from this consumption of land, this problem we talk about in planning and design under the heading of sprawl, sprawl a very kind of pejorative term, this pattern that we see of spreading out over the landscape, growing and developing at ever lower densities, very car-dependent, very disconnected, makes it very difficult, of course, for us to live a healthy life and makes it very difficult for us to get any exercise in the course of daily life.

It has all kinds of other issues and problems including the loss of farm land, for example. The American Farm Land Trust, a Washington-based organization, estimates that we’re losing about a million acres of farm land a year. It’s very costly from the perspective of putting in the public infrastructure that this growth pattern requires and in the process of spreading out and moving out over the landscape, consuming ever more land, we’re also leaving behind a lot of things.

We’re leaving behind buildings and infrastructure and neighborhoods. It’s not particularly good from a social or resource-efficient perspective either.

Sprawl, as I would argue, is a major public health problem for us and when you look around the U.S., this is a phenomenon that we see in almost every place. We all know about the obesity epidemic and, of course, the CDC is telling us now that something like 65% of the American population, the adult population, is considered to be overweight, 30% obese, and moving in a very alarming sort of direction. Well, obviously it’s many things, but a lot of it has to do with I believe with the sedentary lifestyles that we lead and with the kinds of communities in which we’re living and in the ways in which those communities really make it difficult for us to have the physical activity, the daily activity that we need. Just a few of the statistics that most of you are aware of already--the economic impacts of these problems, of course, substantial by some estimates. The health costs of obesity are as much as $250 billion per year and cutting short many lives--by one estimate, 300,000 lives per year and, of course, this pattern of development that makes it difficult for us to get out of our cars also connects with many of the other problems that we’re concerned about such as dependence on oil, particularly foreign sources of oil, air pollution, water pollution, many of the things that obviously connect to public health.

I do also think that there’s an important social dimension to this problem. As we spend more time in cars, as we are more disconnected from each other, I think what we see is a loss of community, a loss of connection to place, a loss of neighborliness, and as you all probably know, a number of studies in medical journals that show the important therapeutic and restorative and medical benefits to be had from strong communities and strong social ties and strong social networks, the curative and therapeutic value of friendship. Well, these things are things are very difficult to nurture and to sustain in the kind of sprawling land use pattern that we see today.

Well, what’s the remedy? What’s the alternative vision to this urban form, this sprawling urban form? Compact, mixed used, walkable, bikable reorientation towards urban and town centers. We ought to be focusing development and population growth within the existing urbanized areas and that means looking first at in-fill location, in-fill sites, looking at so-called brown fields and gray fields, brown fields being former industrial sites that often need some level of cleaning up; gray fields are places in a suburban environment that may not be contaminated, but places we’ve left behind, former retail establishment that might be converted into housing. We ought to be strengthening existing neighborhoods. We need to be thinking about connecting our street patterns and making sure that all neighborhoods have opportunities to walk and access to sidewalks and trails and notions of re-inventing village, the sort of compact village, urban villages, transit villages.

We sometimes talk about this as smart growth. This is Arlington County which is actually a very nice example of an intensifying and a filling in and a guiding of growth along the spine of the Metro system there, the orange line there. Very walkable. Very mixed use, increasingly so and I would argue, a much healthier place to live than the very very car-dependent sort of places that we typically find. Cities like Vancouver in Canada have done an excellent job of intensifying, promoting very walkable mixed use environments and very much a street-oriented kind of development pattern, a lot of emphasis on the pedestrian. This, by the way, is a beautiful trail that runs along the waterfront. Thinking about amenities like this that make living in compact communities more attractive is very important.

I’ve been looking a lot at European examples and European cities and I’ve been trying to document a number of innovative green, sustainable European projects. This a new growth district in a Dutch city, [Utetrech] which exhibits a lot of the qualities that I would advocate--very compact, connecting with the existing center of the city, promoting pedestrian and bicycle connections. There are several new transit stations with the densest development clustered along the spine of the transit. Bicycle- and pedestrian-only bridges that make it very easy to get from your home to the center of the city. Incorporating about every ecological feature that you can imagine. The homes are very low energy houses, very healthy housing designs. They utilize waste energy from an existing nearby power plant. They recycle water. All the homes have a double water system: one line for potable water and another line for recycled water and you can do all of those things and create a very walkable, healthy urban environment. You can do it in a very sort of compact way.Well, we’re doing some of these things here in this country and we do have some good examples of compact walkable neighborhoods and communities. This is a new example--it hasn’t been built yet--a project called Glenwood Park in Atlanta. Atlanta is not exactly a place that you find a lot of innovation when it comes to transit-oriented walkable sort of places, so it’s interesting to see the interest there. This is a site. It’s actually a good example of reusing a site. This is a former cement factory actually. It’s only a mile from downtown Atlanta and surrounded by neighborhoods that it will connect to. Very much walkable. Very kind of de-emphasizing of the role of the automobile. An important role of public spaces. It is a town center, a kind of a town oval here, and also Market Street where you have shops and restaurants and that sort of thing.

Another example, a good example, a project called Highlands Garden Village in Denver. Another example of mixing different housing types, including elder housing here, multi-family housing and single family housing altogether in a very compact, walkable community within an existing neighborhood within the city of Denver and obviously lots of amenities--trails and gardens and places that improve and enhance the quality of living in that neighborhood.

I do believe that part of the challenge is looking at the existing neighborhoods that we have rather than continuing to sprawl out, continuing to build at the periphery of cities. We need to strengthen the neighborhoods that we already have. The city of Chicago has embarked on a very impressive initiative to reinvigorate its bungalow neighborhoods in the city of Chicago. There’re 80,000 bungalows. These are relatively small houses that there’s a new appreciation for the quality of construction and design that goes into these houses and the city of Chicago has been doing a number of things to help keep people in these neighborhoods--very walkable neighborhoods and they often have already an impressive commercial and pedestrian sort of fabric to them.

Every city around the country has vacant parcels and we ought to be filling in those vacant parcels before we build in outlying locations. In some cities, 30, 40% of the land base is vacant and so if we’re concerned about compact, walkable places, the first strategy ought to be looking at these opportunities to build within existing cites and we ought to be much more creative about the housing types of that we design and we build. The notion of accessory housing units, this idea that in addition to a single-family primary single-family houses, there might be a granny flat or a garage unit, something that both increases the supply of affordable housing, but fills in, again, provides housing particularly suited to older folks or to younger folks where there’s a desire to have some proximity to a family member. Very interesting housing idea.
One of the themes here when you look at how hard it is to do some of this kind of housing is that the codes prevent us from doing a lot of these things, a typical residential zoning code often outlaws the accessory units housing and part of the challenge for us in planning is to see how we can reform our zoning codes, our building codes, to make a number of these things easier. A case in point is this idea of live/work units, another very interesting idea, going back to the old notion of people living above the shop. This is a new project in Maryland, by the way, and these are built as live/work units so they have an office or a retail establishment on the ground level and then the shop owner has an apartment above. Well, it turns out that this is hard to do. Builders have to adhere to both the residential building code and the commercial building code and so it’s harder to do and it’s more expensive and we’ve got to find ways to make these kind of solutions a little easier.

This notion of adaptive re-use--we have many older structures, older buildings that can be retrofitted, redesigned, can be great housing for people within cities, contribute to creating these more sort of compact, walkable communities. This is a project in Turku, Finland. It’s a former rope factory, actually, on the waterfront there. It’s been converted into a marvelous arts and cultural center. There’s a theater and los of neat things going on there.
Healthy cities are walking cities. That’s one of our big challenges I think is to get us back into a walking culture and the design of the physical environment is very important. This is Copenhagen and here they have done many things to make it easier to walk. The city adopted a policy actually that each year they will convert two to three percent of the parking in the center of the city to pedestrian space. It’s a very interesting sort of strategic gradualism, if you will. They could never have done this if they’d tried to do it all at once. This is the [troja], the most important pedestrian area in the city.
Every city will have unique opportunities to build upon. Another city I’ve been looking at--Freiburg, Germany--is one of the few cities where you have actually a network of water channels that run in the streets. It’s a beautiful element in this city and it adds to the desirability of being a pedestrian. They’ve also done a number of other things to keep people living downtown and to gradually move cars out of the center of this city. It’s becoming very much a pedestrian center, so bicycles and trams and pedestrians are given priority in this city and many of the other cities that I’ve been looking at.

We’ve got to make pedestrian areas in cities attractive, places where you would want to go and want to spend time and this is Lithuania. This is a pedestrian street that is almost three kilometers long and I actually counted the trees. There are 500 trees here on this pedestrian street. It’s just a delightful place to be, particularly during the summer and it’s the best way of getting around in this town. It goes back to those basic qualities of having a mixing of uses, having the ability to walk places, having the pedestrian infrastructure to make it possible.

There’re many things that we can do. It goes back to connected street patterns. It goes back to compactness. It goes back to investment in trails and bike lanes and bike paths and giving priority to pedestrians. Charlotte, North Carolina has done the interesting thing of outlawing cul-de-sacs, so you can’t build a cul-de-sac in that city any longer. This idea that every new development will have to have a connected street pattern so you are able, will be able, to walk from one place to another from your neighborhood to downtown Charlotte and that at least this city is not going to accept the notion of kind of enclaves growing as a series of enclaves that require one to get in one’s car.

Well, we can design in this connectedness and we can also make it fun and we can make it beautiful. This is one of my favorite examples of a pedestrian and bicycle bridge from Tucson, Arizona. It’s known as the Diamondback Bridge and it’s the design of an artist by the name of Simon Donovan and it’s this neat sort of-- It’s a pretty substantial road here that it connects across and it’s in the shape, as you can tell, of a rattlesnake and as you move through the head and through the tail, it actually rattles as you go by, so we can build in, design in, this connectedness and we can make it interesting and fun and beautiful.

Another definition of what a healthy city is one that thinks about alternatives to the private automobile. What does that mean? Well, it means many things. It means thinking about public transit. It means thinking about bicycles. The car connects with many of the public health concerns that we’ve been talking about. We are very car-dependent. The numbers show us pretty convincingly vehicles miles traveled have grown pretty dramatically in the last 20 or 30 years in particular. We’re spending more time in our cars. We seem to be more reliant on them. We’re clearly walking less. Fewer kids are walking to school or riding their bicycles to school and it has a very serious public health consequence, not the least of which is the impact of automobile accidents and we’re still losing more than 40,000 people a year as a result of crashes, six million crashes; three million deaths cumulatively when you look at when we started driving in this country. It’s an amazing sort of impact and, again, it’s a good bit of the reason for why we are living this sort of sedentary lifestyles that we are.

What are the alternatives? The alternatives I think are things like public transit and bicycles. When you look at energy consumption, air pollution, emissions, it makes a lot more sense for us to be using buses and trams and bicycles and walking. Of course, we need the urban forum, again, that lets those things happen.

Another major point--healthy cities are green cities. Probably most of you know about the literature. It’s a growing body of literature that’s pretty convincing about the restorative and therapeutic values of nature, going back to E.O. Wilson’s notion of biophilia that we have this innate need to connect to nature and lots of studies that show the more nature we have and the more we design it into our buildings and our neighborhood and our cities, we see improvements in cognitive functioning. We see stress levels go down. Lots of advantages. If we’re going to create healthy places, they have to be fundamentally green places, places full of nature and we can do it. We can do it in lots of creative ways, beginning with the green infrastructure of the place which means thinking about the open spaces, the forests, the wetlands, the flood plains, thinking comprehensively about conserving, protecting, restoring and making them accessible.
This is the German city of Hanover which has just completed an 80-kilometer green ring. It’s a pedestrian bicycle ring that connects these large blocks of green space and a very large forest in the center of the city. We’ve got to think about green everywhere, even on rooftops so this is one trend in longstanding practice, actually, in European cities. This rooftop does many things for us. It sequesters carbon. It retains stormwater. It insulates the building. It’s beautiful to look at. It’s habitat for birds and invertebrates. It reduces consumption of energy. It has many many many benefits and it enhances the quality of living.

This, by the way, is the Austrian city of Linz and they have 300 of these green rooftops, so many that you can actually see them in satellite photography imagery, a tremendous impact. And then a program for promoting and subsidizing them.

We’re doing some of this in the U.S. The City Hall in Chicago has been retrofitted. Mayor Daly’s initiative and it’s a spectacular green roof and very very well appreciated in this city. There are rumors that owners of buildings that have views of this green roof are threatening to raise their rents of the nice views.

Dealing with the issue of energy is really important. Healthy cities are renewable energy cities and when you look, for example, at one of our major health concerns--mercury in the environment--it turns out that more than a third of the mercury, the human source of mercury, comes from coal-burning power plants, so finding a way to move us away from the direction of dependence on fossil fuels and towards renewal energy is really really part of the-- Ought to be a part of the public health agenda. This is actually a study and literature from the Physicians for Social Responsibility that’s been trying to promote and tackle this issue.

Well, many things that we can be doing, should be doing. Low energy, energy efficient housing. We have several prototypes of zero-energy homes that have been built. High quality living environments, very healthy indoor spaces at the time that they have a very small energy footprint. Thinking and incorporating solar energy into all the buildings that we design, starting with this passive solar idea. This is a project in the Netherlands where three-quarters of the homes are oriented towards the south, capturing that free energy and creating enjoyable healthy kind of entire environments. This is a factory, the Eichel factory in Belgium where the interior spaces are almost entirely illuminated by natural lighting, so less energy consumed, a more enjoyable interior working space. Zero-energy developments are all over the places. This is a very interesting one called BedZED in London.

Every building that we build, every public building, ought to involve this kind of daylighting. We know how--the studies are pretty convincing that designing in daylight into our buildings very much promotes health and this is a school in North Carolina where there is full spectrum natural lighting in all of the rooms--classrooms, the gymnasium, the cafeteria, and they have been doing studies that show that kids are performing better, the test scores are going up, they’re happier. They’re actually growing faster, if you can believe it. Tooth decay is lower in these day-lit schools. It’s just something that seems so--again--not rocket science; it makes sense. We’re a species that needs the natural light, but it’s not just solar and certainly not just passive, but [photoable tax] and other forms of renewal energy that can be integrated into the built environment. That’s one of the main themes of my work that it’s not something that necessarily-- These are not investments that we make far away from where people live. We integrate them into the built environment.
This is a grocery store in London, for example, that has wind turbines out in front and this a project in Germany, a 1.8 mega watt turbine that’s only a few hundred meters from houses

My last theme is food. I’m just going to propose that a healthy city is one that thinks about healthy food and that this is not necessarily something that we think of or have traditionally thought of as a planning issue, but I think that it increasingly has to be and I would argue that we really ought to be including a food planning element in every community plan that we prepare and we’ve got to think about everything from the location, the number of locations of fast food places, the possibilities of obtaining more healthy food, the distribution of food opportunities--does every neighborhood have the possibility of getting fresh vegetables, is there a grocery within walking distance--back to the pedestrian idea.

And cities like Toronto have really been leading the way developing food security, comprehensive food security strategies, making it possible for someone to grow their own food and this idea I mentioned that every city has thousands of vacant lots. Well, these could be opportunities to grow food, healthy food, hopefully organically grown food and it could also be opportunities to strengthen neighborhoods, to strengthen community. We know actually--studies show that there is an important social dimension to community gardening.

The idea of farmers’ markets. We’ve now seen this explosion actually in the U.S. of interest in farmers’ markers and so lots of ways of doing this rethinking the kind of foods that we provide our kids in school. The Berkeley, California Edible Schoolyard Program, a little bit ahead of its time, still a model. Here the kids are actually involved in growing their own food. They learning about the food cycle. They’re growing it and they’re harvesting it and they’re sitting down and eating it with their teachers and it’s food that doesn’t have pesticides and it’s food that they have some direct ownership of and a hand in producing and it has a number of other social and other benefits to it.

I do think that we need to think about from an urban design perspective. Every new neighborhood, every new project, every new development, ought to design in the possibility of direct food growing, direct involvement in food production. This is I think my last example--a project, a new ecological district in Helsinki, Finland, called Viiki and they’ve actually designed it so that there’re little spaces, little green wedges between the blocks of housing which you see here and these are places intended to be community gardens, so this is a resident who lives in a building over here and actually lives four stories up and has a window that looks out over her garden plot and she can watch her garden growing during the summer. It’s an easy thing to do; it’s a community-building thing and injects fresh food, healthy food into this neighborhood.

This envisioning healthy urban futures--it’s a major part of what we are going to be doing in the city planning field, urban planning field in the years ahead and I increasingly realize this is a partnership and that we need to join forces and the public health and the medical communities with the planning and design communities and this is going to take a combined effort, combined strategies.

Maintained by Brittany Brown
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Copyright 2003 by the Rector and Visitors of the University of Virginia