Lucy Gunn

Quality of Public Open Spaces and Recreational Walking.

OBJECTIVES We examined associations between specific public open space (POS) attributes and recreational walking to local POS. METHODS Between October 2004 and December 2006, 1465 adults of the RESIDential Environments Project, conducted in Perth, Australia, reported whether they walk to a POS for recreation. For each participant, we identified all open spaces larger than 0.8 hectares within 1.6 kilometers from home. On the basis of field audit data, we created 3 scores (presence, count, size-weighted presence) for 19 specific open space attributes. RESULTS With logistic regression analyses, we found that walking to a POS was associated with the presence of gardens, grassed areas, walking paths, water features, wildlife, amenities, dog-related facilities, and off-leash areas for dogs. It was also associated with the highest number of these attributes in a single open space, but not with the total number of attributes in all POSs within 1.6 kilometers of home. CONCLUSIONS Building 1 high-quality local park may be more effective in promoting recreational walking than is providing many average-quality parks.

Cost-effectiveness of investing in sidewalks as a means of increasing physical activity: a RESIDE modelling study

Background Studies consistently find that supportive neighbourhood built environments increase physical activity by encouraging walking and cycling. However, evidence on the cost-effectiveness of investing in built environment interventions as a means of promoting physical activity is lacking. In this study, we assess the cost-effectiveness of increasing sidewalk availability as one means of encouraging walking. Methods Using data from the RESIDE study in Perth, Australia, we modelled the cost impact and change in health-adjusted life years (HALYs) of installing additional sidewalks in established neighbourhoods. Estimates of the relationship between sidewalk availability and walking were taken from a previous study. Multistate life table models were used to estimate HALYs associated with changes in walking frequency and duration. Sensitivity analyses were used to explore the impact of variations in population density, discount rates, sidewalk costs and the inclusion of unrelated healthcare costs in added life years. Results Installing and maintaining an additional 10 km of sidewalk in an average neighbourhood with 19 000 adult residents was estimated to cost A

A method for the inclusion of physical activity-related health benefits in cost-benefit analysis of built environment initiatives

4.2 million over 30 years and gain 24 HALYs over the lifetime of an average neighbourhood adult resident population. The incremental cost-effectiveness ratio was A

Using spatial measures to test a conceptual model of social infrastructure that supports health and wellbeing

176 000/HALY. However, sensitivity results indicated that increasing population densities improves cost-effectiveness. Conclusions In low-density cities such as in Australia, installing sidewalks in established neighbourhoods as a single intervention is unlikely to cost-effectively improve health. Sidewalks must be considered alongside other complementary elements of walkability, such as density, land use mix and street connectivity. Population density is particularly important because at higher densities, more residents are exposed and this improves the cost-effectiveness. Health gain is one of many benefits of enhancing neighbourhood walkability and future studies might consider a more comprehensive assessment of its social value (eg, social cohesion, safety and air quality).

Environmental Justice in Australia: Measuring the Relationship Between Industrial Odour Exposure and Community Disadvantage

The built environment has a significant influence on population levels of physical activity (PA) and therefore health. However, PA-related health benefits are seldom considered in transport and urban planning (i.e. built environment interventions) cost-benefit analysis. Cost-benefit analysis implies that the benefits of any initiative are valued in monetary terms to make them commensurable with costs. This leads to the need for monetised values of the health benefits of PA. The aim of this study was to explore a method for the incorporation of monetised PA-related health benefits in cost-benefit analysis of built environment interventions. Firstly, we estimated the change in population level of PA attributable to a change in the built environment due to the intervention. Then, changes in population levels of PA were translated into monetary values. For the first step we used estimates from the literature for the association of built environment features with physical activity outcomes. For the second step we used the multi-cohort proportional multi-state life table model to predict changes in health-adjusted life years and health care costs as a function of changes in PA. Finally, we monetised health-adjusted life years using the value of a statistical life year. Future research could adapt these methods to assess the health and economic impacts of specific urban development scenarios by working in collaboration with urban planners.

Designing healthy communities: Creating evidence on metrics for built environment features associated with walkable neighbourhood activity centres

Abstract Social infrastructure requires a consistent and measurable definition and more evidence is needed to demonstrate why it is important to health, wellbeing and the liveability of a community. In this paper, social infrastructure is defined as life-long social service needs related to health, education, early childhood, community support, community development, culture, sport and recreation, parks and emergency services. These services are needed to promote health and wellbeing and underinvestment and poor planning of social infrastructure has been linked to area-based health inequities. Current methods used to plan infrastructure delivery in communities were analysed and a new conceptual framework of social infrastructure developed and empirically tested using geocoded health survey data linked to spatial social infrastructure measures. Both accessibility and mix of social infrastructure were associated with higher Subjective Wellbeing. Residents were most likely to have close access to childcare services, dentists, doctors and sport facilities and least likely to have access to services of culture and leisure including cinemas, theatres, libraries, museums and art galleries. Results provide evidence of direct associations between social infrastructure planning and public health, the need for alternative social infrastructure urban planning methods and policies, and areas for future research.

Built Environment and Physical Activity

Community impact and environmental justice issues are examined across metropolitan Melbourne, Australia, using 2008–2011 self-reported odour complaint data as a direct measure of odour pollution exposure. Differences in pollution exposure and indicators of socio-economic disadvantage were compared across areas using spatial clustering and statistical analyses. Results found that odour affected areas have greater socio-economic disadvantage supporting the existence of environmental justice issues in metropolitan Melbourne. Commonly used buffers of 1 km surrounding polluting facilities under-represent odour affected areas. Findings have implications for urban planning and policy in establishing separation distances between residential and industrial zones in new and existing developments where guidelines are lacking.

The Role of the Built Environment on Health Across the Life Course: A Call for CollaborACTION:

BackgroundEvidence-based metrics are needed to inform urban policy to create healthy walkable communities. Most active living research has developed metrics of the environment around residential addresses, ignoring other important walking locations. Therefore, this study examined: metrics for built environment features surrounding local shopping centres, (known in Melbourne, Australia as neighbourhood activity centres (NACs) which are typically anchored by a supermarket); the association between NACs and transport walking; and, policy compliance for supermarket provision.MethodsIn this observational study, cluster analysis was used to categorize 534 NACs in Melbourne, Australia by their built environment features. The NACS were linked to eligible Victorian Integrated Survey of Travel Activity 2009-2010 (VISTA) survey participants (n=19,984). Adjusted multilevel logistic regressions estimated associations between each cluster typology and two outcomes of daily walking: any transport walking; and, any ‘neighbourhood’ transport walking. Distance between residential dwellings and closest NAC was assessed to evaluate compliance with local planning policy on supermarket locations.ResultsMetrics for 19 built environment features were estimated and three NAC clusters associated with walkability were identified. NACs with significantly higher street connectivity (mean:161, SD:20), destination diversity (mean:16, SD:0.4); and net residential density (mean:77, SD:65) were interpreted as being ‘highly walkable’ when compared with ‘low walkable’ NACs, which had lower street connectivity (mean:57, SD:15); destination diversity (mean:11, SD:3); and net residential density (mean:10, SD:3). The odds of any daily transport walking was 5.85 times higher (95% CI: 4.22, 8.11), and for any ‘neighborhood’ transport walking 8.66 (95% CI: 5.89, 12.72) times higher, for residents whose closest NAC was highly walkable compared with those living near low walkable NACs. Only highly walkable NACs met the policy requirement that residents live within 1km of a local supermarket.ConclusionsBuilt environment features surrounding NACs must reach certain levels to encourage walking and deliver walkable communities. Research and metrics about the type and quantity of built environment features around both walking trip origins and destinations is needed to inform urban planning policies and urban design guidelines.

Diversifying Experiences of Community and the Implications for Addressing Place-based Poverty

The urban design of places where people live, work and play can make a significant difference to health and wellbeing. The influence of city planning on transport mode choice, access to open space, walkability and other characteristics of the built environment on chronic diseases and their risk factors—particularly physical activity through walking—and on environmental sustainability, is now the subject of a large body of research. However, gaps and methodological shortcomings in this literature remain, and urban research finding are still rarely used by decision-makers to plan cities. This article reviews research in this field over the last decade and proposes areas and methods for future inquiry including research methods that are relevant to policy and practice.

Identifying, creating, and testing urban planning measures for transport walking: Findings from the Australian national liveability study

Introduction Creating supportive environments is a bedrock of health promotion. We know and understand the dynamic interplay that exists between people and places, and the importance of context when it comes to efforts that promote the health and well-being of individuals. The built environment refers to physical environment surroundings and conditions that are constructed by human activity (eg, buildings, streets, and parks). The distinction of environmental aspects that are manmade is important because it focuses attention toward what is modifiable. For example, aspects of the built environment can be shaped to support health and well-being, social interactions, and environmental sustainability. Built environments vary in scale; they can range from the design and layout of rooms and classrooms, which makeup the buildings in which we live and learn and work, which are located and connected to each other through sidewalks and roads in neighborhoods that collectively form our urban cities. We all engage with some aspect of the built environment every day. This means when it comes to the practice of health promotion, everyone can do something to move closer toward creating supportive and healthy built environments for all. Over 30 years of built environment and health research underpinned by socioecological models of health behavior provides a strong, evidencebased foundation from which to act. Although much of the research focuses on physical activity as the outcome, the findings are applicable to health and well-being more broadly given that as a behavior, physical activity is a ‘‘best-buy’’ when it comes to public health. This article summarizes the important influence of the built environment on health across the lifecourse (youth, adults, and older adults) and across different behavioral settings (home, neighborhood, and community; workplace; and schools). Based on decades of evidence, we call for collaboration and action (collaborACTION) from policy makers, health practitioners, nongovernment organizations (NGOs), employers, communities, and other health as well as nonhealth stakeholders to advance health for all.