Speaker
Description
Background Information and Relevance to the Track:
Urban planning and design processes have always incorporated the principles of healthy living and enhancing quality of life. In recent years, particularly during the COVID-19 pandemic, the connection between public health and urban planning has gained significant attention, complying with the Sustainable Development Goals. This has led to a growing focus on built environment (BE) epidemiology, supported by accumulated experience and evidence, calling for innovative and transformative actions to address emerging challenges.
BE epidemiologists seek to identify the pathways through which BE characteristics are associated with the prevalence of chronic diseases (Sarkar and Webster, 2017).
One pathway points to the physical features influencing individuals' geospatial behavior and environmental perception, affecting healthy habits assessed by PA levels and walkability. Physical inactivity is the fourth most significant risk factor for non-communicable diseases (NCDs) worldwide, contributing to approximately 3.2 million deaths; it can also influence the rates of diabetes and obesity [Ewing et al., 2014]. A city with a high level of walkability, cycling, and green spaces can reduce these rates.
Purpose:
Based on TÜBİTAK-funded research (2019-2023), our study aims to specify urban living environments' direct and indirect effects on individual health indicators, such as people’s physical and mental health perception, PA levels and selected chronic disease prevalences.
Method:
Our cross-sectional geospatial study involved 4015 residents of Ankara (aged 18-92). Data covered information on the residents' locations, demographic and socioeconomic statuses, health status, healthy lifestyle behaviors, and evaluations of urban living environments. BE variables included distance to urban amenities (parks, fast-food outlets, eateries, schools, local health centers, shopping centers) and street morphology (street connectivity and betweenness). We fitted linear models to assess relationships between these factors and health outcomes.
Findings:
We found a significant relationship between BE characteristics and health status, the prevalence of chronic diseases, and individuals' socio-economic statuses, PA levels, and obesity prevalence, assessed by Body Mass Index (BMI). For example, selected findings show that people with chronic diseases tend to use green areas for walking more than people without chronic diseases (59,8%, non-chronic disease %49,6; p>0,05) and also show that people with high BMI use parks more often, in particular during summer months. On the other hand, people with low BMI tend to walk to urban facilities, such as markets and food chain stores (94,4% and 89,9%; p<0,001). Availability and accessibility of green spaces significantly affect PA levels; people with high PA levels stated that they live close to a park (21,4% and 9,3%; p<0,001). Housing conditions also affected the results. People living in high-rises are less likely to use these parks than people living in low-rises (60,0% and 50,0%; p<0,001).
Interpretation:
Based on experience, our research merges public health with urban planning and design guidance to reflect on a new urban agenda. We conclude that compact urban forms with high walkability, street connectivity, centrality, and land use diversity support perceived health and PA levels and diminish chronic disease prevalence.
In particular, if an urban living environment has diverse urban facilities and higher connectivity, people are more likely to walk and be physically active. The evidence points to the value of mixed-land use and proximity to urban facilities. In our study, we explore the role of urban planning and design as a transformative tool to foster active living, equal access to urban facilities, and support high-quality, walkable, and equitable urban living environments.
References
Sarkar, Chinmoy, and Webster, Chris (2017) Healthy Cities of Tomorrow: the Case for Large Scale Built Environment-Health Studies. Journal of urban health: bulletin of the New York Academy of Medicine, 94(1), pp. 4–19.
Ewing, Reid, Meakins, Gail, Hamidi, Shima, Nelson, Arthur C. (2014) Relationship between urban sprawl and physical activity, obesity, and morbidity – Update and refinement Health & Place, 26, pp. 118-126.
| Keywords | urban health; built environment epidemiology; geospatial analysis; land use diversity |
|---|---|
| Best Congress Paper Award | Yes |
