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Fostering public health

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[This is the fourth in a series of blog posts by David Dixon FAIA, principal-in-charge Planning and Urban Design at Goody ClancyDixon's posts are part of a series of expert blogs on TOD highlighting work and research that experts are doing in the field.]

The connection between compact development and improved public health is well established. At the same time, rising housing values in walkable central cities are pushing lower-income households to car-dependent outer suburbs where housing is cheaper, as Chris Leinberger noted in the March 2008 Atlantic Monthly. As a result, these Americans could face higher rates of obesity, diabetes, and other conditions kept in check by physical activity. As noted in a previous blog post, increased density is central to providing the kinds of housing options that maintain income diversity in urban neighborhoods. Without a conscious effort to preserve and create significant affordable housing in core cities, unguided market forces will relocate America’s poorest residents to its least healthy environments—auto-dependent outer suburbs.

There are also strong correlations among public health, disposable income, and density. Displacing lower-income households from transit-served urban neighborhoods to auto-dependent exurban settings also means that they will spend a far greater share of disposable income on transportation costs—Chris Leinberger has estimated roughly two and a half times as much. A recent retail market study by Annapolis-based W-ZHA of underserved Washington neighborhood demonstrated that new housing — higher-density mixed-income and market-rate development — had raised disposable income to levels that would support stores that sell fresh produce, health clinics, and other essential ingredients of enhanced public health.

For neighborhoods of any income, the real public health payoff comes from density sufficient to encourage walking. The densities that support Main Streets, active parks, and similar inviting destinations — for instance, a mix of narrow-lot single-family houses, row houses, and low-rise lofts — are the densities that invite walking. And having an attractive destination to walk to matters. The Centers for Disease Control renovated stairwells at its Atlanta headquarters but saw little change in use patterns. After coincidentally installing vending machines on stair landings, stair use shot up — the stairs became destinations that encouraged not just walking but climbing stairs.

Next: Enhancing sustainability

Part 1: Density deficits
Part 2: Restoring personal choices
Part 3: Building community in the midst of diversity
Part 4: Fostering public health
Part 5: Enhancing sustainability
Part 6: Creating places that people love

David Dixon is co-author of Urban Design for an Urban Century: Placemaking for People