Getting the Word Out: Community Design and Health

Almost 50 years ago, Jane Jacobs made the following diagnosis:

“Decaying cities, declining economies, and mounting social troubles travel together.  The combination is not coincidental.”

The diagnosis is as true today as it was then, but there are other issues in the “city ecology” (as she called it) that have come to light since the early 1960s, one of which is the health of the city’s inhabitants.  This link between city design and human health is not exactly an obvious one, but it is one that is growing in recognition as the obesity crisis worsens.  In 1950, 30% of Americans were overweight or obese.  50 years later, the CDC reported that the percentage of overweight or obese Americans had risen to 64.5%.  Click on the following link to see a fantastic graphic that shows these drastic changes by state from 1985 until 2008 ( 

According to Dr. Jeffry Weiss, this massive weight gain cannot be attributed too heavily to genetics (genes do not evolve that quickly), and it cannot be attributed to lack of nutrition knowledge, since, during the same 50 year period, the amount of nutrition information made publicly available doubled every 7 years.  Clearly, there are larger forces at work than those dealing with the body and knowledge of individuals.  Food economics are biased toward getting more food for less money.  Portion sizes at restaurants and packaged foods have ballooned between 50% and 400% in the last 40 years (National Heart, Lung, and Blood Institute).  Our work and recreation activities have become more sedentary with the continued loss of physical labor and rise of the technology economy, as well as the proliferation of televisions, computers, and video games.  And our cities have de-intensified densities and segregated land-uses, resulting in increasing dependence on the use of automobiles to get around. 

But we have a tendency to forget or ignore this final, and perhaps most important, reason for obesity, perhaps because most really just don’t see it until it is presented to them; and we do a poor job of getting the word out.  An Atlanta, GA resident, featured in a video promoting the next Congress for The New Urbanism conference, expressed just such a problem: “I never saw the connection: how community design can affect your health” (  This person was definitely not alone in his lack of awareness, but there are plenty of people – influential people – who are not so ignorant.  So why are there not more public campaigns geared toward influencing consumer housing decisions toward more compact and mixed-use urban areas?  Why do we continue to encourage suburban sprawl through lopsided mortgage subsidies, unbalanced tax structures, and new highway and road funding?  How can public health departments address this issue in a meaningful and effective way?

A new bi-county Lehigh Valley Health Department would be a terrific start to addressing the our local obesity problem.  At present, a campaign hoping to really make a difference would be difficult to achieve because it would lack significant funding due to the geographical size of its service area.  A joint department would also serve as a model for regional governance of land-use, transportation, and tax-sharing, the absence of which has been a significant reason why suburban sprawl remains unchecked and obesity has increased exponentially.

What are some other ways in which we can begin to help people make the connection between community design and health?  What partnerships could a regional health department in the Lehigh Valley enter into to ensure the greatest effectiveness of its campaigns?  I encourage you to comment with your ideas on the Crossroads blog or on my personal blog, Bethlehem By Foot.

Posted on September 12, 2009, in Health, Regions, Urbanism. Bookmark the permalink. 3 Comments.

  1. Great post! Design matters!

  2. How do you put together an effective coalition to create pressure for these kind of changes? Whenever I read anything I think makes a convincing case for the economic benefits of new urbanism ideas, I e-mail it to the Lehigh Valley Chamber of Commerce. Maybe you could try to recruit Lehigh Valley businesses who would benefit to get behind the changes you want to make and lobby city councils in the A-B-E cities. If you can bring them into the coalition by convincing them that these changes will stimulate the local economy, I think those are the sort of people who have the ear of local government. Maybe you could get supportive businesses to commit to pool money in some kind of public-private infrastructure revitalization fund. With municipal elections coming up in November, you could hold a candidates’ forum on these issues. Streetsblog NYC staff set up forums with all of our city council candidates and got them on record about community design, transportation, etc. Even if the candidates didn’t always agree, at least it raised the profile of things like zoning decisions and parking to the status of actual political issues, rather than routine bureaucratic exercises.

  1. Pingback: Meeting Notice: Board of Health at 6PM in Allentown « Crossroads

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