I was lucky as a college student. I lived and fell in love with Paris for six months.
I remember the first day I had recovered from my jet lag walking from a friend’s apartment to the half a dozen eighth floor walk-ups that I could afford to rent. My mouth was gaped, my eyes opened wide and my steps slow and deliberate as I soaked the city in. I breathed in the patisseries, I inhaled the smell of fresh baked bread, and I began the very deliberate inventory of the best crepe stands (my preference was the green crepery at the Metro station Ste. Germain des Pres).
I lived, I worked, I studied, I fell in love in Paris, and it was a Paris in which I walked everywhere. It was not too hard for me to walk eight to ten miles in a day as I woke in the 16th Arrondisemonth, walked across the Seine for morning classes, met up with a professor to assist him in his research, grabbed a bite to eat in the late afternoon, and hurried over to meet a lover for dinner in the 4th before heading back to her place in the 7th or mine in the 16th. It was an amazing time.
I could have afforded the Metro, I could have afforded to take cabs, I could have afforded to not wander anywhere near as much as I did, but Paris is a city that screams “Walk Me”. New York, Boston, Montreal, Washington D.C. also are cities that scream “Walk Me”. I would walk to a friend’s building and we would have seven choices of good coffee within three blocks, so we would eventually try them all. I would walk down the Quays to watch the bustlers and hustlers, or hear street jazz near the Latin Quarter. I walked to breathe the city. I would take a right down Rue de Colonel Combes instead of staying on Avenue Bosquet merely because it was there, and I knew I could eventually get to the Moosehead for my Sunday night Simpsons.
Urban design made me want to walk. It helped me lose my freshman fifteen and more while my resting pulse dropped to under 50. And then I flew back to my parents’ house where the closest walkable cup of coffee was a mile away. Walking became exercise instead of the way I navigated for my daily life. I drove or bummed a ride for the rest of winter break.
Urban design influences our trip taking and our trip choices. It influences our health as well as the Atlantic clearly lays out:
They looked at the three fundamental measures of street networks—density, connectivity, and configuration—in 24 California cities, and compared them with various maladies. In the current Journal of Transport and Health, Garrick and Marshall report that cities with more compact street networks—specifically, increased intersection density—have lower levels of obesity, diabetes, high blood pressure, and heart disease. The more intersections, the healthier the humans.
“It might not be common for people to explicitly contemplate health when selecting a place to live,” Garrick and Marshall write, “but this research indicates it is worth considering.”…
They also found that wide streets with many lanes are associated with high rates of obesity and diabetes….
The obesity epidemic is becoming a national crisis, but almost nobody connects that with neighborhood design. The connections we’re making there are all about food and exercise. But if we build neighborhoods where exercise is part of people’s daily routine, you would think that could go a long way.”
This makes sense. Walking as part of daily living is far easier than walking as exercise, and a built environment that facilitates walking as a part of life instead of as a seperate activity in a segregated space and time should encourage more walking.
Health insurance is important for better health, but the best medical care is only a minority determinant of health outcomes on average. Most of the determinants are public health measures (clean water is an amazing public good), and personal fitness which is determined by daily choices. Tilting a built environment towards a sedentary lifestyle will lead to a certain choice set, while tilting the built environment to casual, barely thought about activity produces different choice sets. Our national policy for the past seventy years has been to create a built environment that enables sedentary lifestyles with attendant health problems. If we want to think about health policy, we need to think about health financing and delivery sytsems, but also our built environment, our societal stressors and numerous other things that don’t scream “medical” to address our health problems as a society.