Columbia: There’s nothing controversial about physical activity: everyone agrees
it’s an essential part of health. Yet fewer than half of Americans meet
the Surgeon General’s minimum standard for exercise: 30 minutes, five
times a week. How come? It’s not laziness. Many public health
experts agree that our built environment has engineered us out of active
living: Absent adequate sidewalks and well-designed bike lanes, we’re a
lot less likely to take a walk or get on our bikes. In a recent talk,
Lawrence Brown, professor of Health Policy and Management,
looked at some of the obstacles and incentives cities encounter as they
attempt to remake their streets to support physical activity. In
2002, the Robert Wood Johnson Foundation awarded grants to 25 U.S.
cities to promote active living through changes to the built
environment. They asked Brown to evaluate progress by surveying key
players in four of the communities. He is now writing up the findings
for a book.An Uphill Climb
Improving urban thoroughfares is easier in theory than in reality, Brown says. “How hard is it to paint a line down the side of the street to make a bike lane or repair a sidewalk? Yet they can be extraordinarily hard to make happen.”Bike lane advocates, in particular, are likely to run into all manner of objections. People worry that the changes will disrupt local business, displace parking, worsen traffic, and impede emergency vehicles. Some of this pushback is fueled by what Brown terms “the sprawl community”— businesses that have benefited from decades of infrastructure investments geared to automobiles, from highways to shopping malls.
Answering these concerns takes skillful negotiation with stakeholders like community boards and block associations. And aptitude comes with experience: in recent years, New York City has become especially adept in this role after adding hundreds of miles of bike paths.
Active living proponents face another speed bump as they are faced with coordinating between various layers of local bureaucracy, and sometimes still others at the state and federal levels of government. As he began his study, Brown quickly learned that he needed to broaden it well beyond the local public health department to include representatives from the Departments of Transportation, Public Works, and the City Design and Urban Planning Authorities.
These agencies’ institutional priorities often don’t easily align with active living projects. For example, the Department of Transportation functions “to move vehicles quickly and safely,” said Brown. “For them, bikes get in the way.”
For Brown, the much-repeated dictum “health in all policies” doesn’t give public health license to supersede other priorities. “Health in all policies should mean that health comes to terms with other policies in a mutually respectful fashion. It’s not about a war on cars.”
Millennials and Other Motiving Factors
According to Brown, every city that remakes its built environment requires a champion willing to spend their political capital. In New York City, this was Mayor Michael Bloomberg, for whom improving the health of the population was a top priority. But what motivates champions to push for change varies from place to place.In Wilkes-Barre, Pennsylvania, business leaders saw walkability as crucial to a revival of their downtown. In Louisville, Kentucky, the catalyst was a well-organized biking community with allies in city hall and in key public agencies. Sacramento, California, sought to align itself with the state’s stringent anti-pollution laws. In Albuquerque, the mayor saw too many young people leaving for Austin, Portland, and Denver—cities with vital downtowns where walking and biking, much like farmers markets, hold cachet among Millennials.
No matter the motivations, remaking cities to support active living takes time—sometimes years, even more than a decade. According to Brown, this extended timeline can make active living policies less attractive to officials than interventions targeting threats to health such as smoking, where a tax or ban can be enacted with relative speed. Moreover, he says, accurately accounting for the benefits of active living improvements in the built environment is not easy to achieve.
So is all the effort worth it? Brown says it is. As cities remake themselves to encourage physical activity, they will encourage others to follow suit. “It’s about creating healthy options, and responding to a growing constituency for active living.”