Reduce blood pressure and hypertension with walkable cities

cherry blossoms
CC BY 2.0 Lloyd Alter/ Walking in cherry blossoms

Let's just stop talking about the "last mile problem". It's a feature, not a bug.

The evidence keeps piling up: we have an obesity and health crisis, and urban design is part of the cure. Elle Hunt of the Guardian covers a new study finding that walkable cities reduce blood pressure and hypertension risk.

The largest-ever study of the link between city walkability and blood pressure has been held up as evidence of the “intangible value of urban design” in improving long-term health outcomes, say researchers.

According to the abstract, the study looked at the association between walkability and blood pressure for 429,334 people aged 38 to 73, modeling the walkability of where they lived which was "objectively modeled from detailed building footprint-level data within multi-scale functional neighborhoods".

Neighbourhood walkability within one-kilometer street catchment was beneficially associated with all the three blood pressure outcomes, independent of all other factors....The results remained consistent across spatial and temporal scales and were sensitive to sub-groups, with pronounced protective effects among female participants, those aged between 50 and 60 years, in employment, residing in deprived, high density and greener areas.

The lead author of the study, Dr Chinmoy Sarkar, tells the Guardian:

Public health interventions must consider the intangible value of urban planning and design. We are spending billions of pounds in preventing and curing cardiovascular diseases – if we are able to invest in creating healthy cities through small retrofits in the design of our neighbourhoods to make them more activity-friendly and walkable, then probably, we will have significant savings in future healthcare expenditures.

Recently, Nick Cohen of the Observer looked at another study and concluded that cities had to be changed to give pedestrians and cyclists priority on the roads, even if the cars were forced out. In fact, none of this is news to urbanists around the world; just have a look at the related stories listed below. As the lead author notes:

Because walkability was “based on the underlying design of the city,” said Sarkar, cities could be modified or designed to encourage it. “Such investments in healthy design are likely to bring in long-term gains as they are enduring and all-pervasive.”

This is going to be where I do my usual rant about how everyone is spending all their time, money and attention on highways and autonomous vehicles, instead of investing massive dollars in pedestrian, bike and transit infrastructure. The AV people talk about solving the "last mile problem" when there is no last mile problem -- that walk home from the transit stop is a feature, not a bug. It's not just bikes and walking, either; we covered a study earlier that found that "commuting by public or active transport modes was significantly and independently predictive of lower BMI for both men and women." Men who take transit are about seven pounds lighter; women, about 5.5 pounds lighter."

driving vs walking

Health care is eating up trillions of dollars in the nations with the least fit people; we know what the disease is and we know the cure. It's stunning that we keep willfully ignoring it.

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