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The Built Environment and Health (Frank et al. Chapters 1 and 3)

Geography 3432 Environment and Health. The Built Environment and Health (Frank et al. Chapters 1 and 3). Discussion Frank et al. Model Physical activity and health Suburbanization and design. Discussion. How does the built environment effect health?

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The Built Environment and Health (Frank et al. Chapters 1 and 3)

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  1. Geography 3432Environment and Health The Built Environment and Health(Frank et al. Chapters 1 and 3) • Discussion • Frank et al. Model • Physical activity and health • Suburbanization and design Geog 3432

  2. Discussion • How does the built environment effect health? • What specifically is the focus of Frank et al.? Geog 3432

  3. Frank et al.’s Framework: Geog 3432

  4. Elaboration of Framework • Built environment – where we live and work • Public health – outcomes, e.g., obesity, heart disease, stress • Activity patterns – esp. walking bicycling • Land use – e.g., proximity home, work school • Design – small scale features that influence how people feel about an urban “environment” • Transportation systems – esp. for walking, biking, driving, public transit Geog 3432

  5. Health Patterns • “Premature” death (e.g. cardiovascular disease) and disability (e.g., osteoporosis) from preventable diseases • Obesity increasing • risk factor for all sorts of illness/disease • Many health risks decrease with increased physical activity Geog 3432

  6. Causes of Death • note the causes that disappear in later period Geog 3432

  7. Obesity Overweight • 1 category above normal Body Mass Index (based on height:weight ratio) Obese • 2 categories above Prevalence • 1999-2000 CDC study – US 31% obese, 34% overweight = 65% above “normal” Geog 3432

  8. Obesity Patterns • increasing over time Causes of “Obesity” • diet • activity Geog 3432

  9. 20 Minute Workout? • 80s – early 90s 20 minutes vigorous exercise • 1996 US Surgeon General report • 30 minutes of moderate activity on most days 1980s aerobics tv show “The 20 Minute Workout” Geog 3432

  10. Moderate Activity Benefits • Muscle strength • Blood pressure • e.g., Reduction risk coronary heart disease on par with stopping smoking! • Depression and anxiety • Obesity • Skeletal development of kids • Bone density adults • Independence (esp. elderly) Geog 3432

  11. Guideline: Active • moderate-intensity physical activity for at least 30 minutes on 5 or more days of the week or OR • vigorous-intensity physical activity 3 or more days of the week for 20 or more minutes Geog 3432

  12. Sedentary Reap New Benefits Quickest Geog 3432

  13. Modifiable Behaviours and Mortality Geog 3432

  14. Improve How Much? • If half “sedentary” population became irregularly active (not quite guideline) total # deaths drop by: • CHD 3.9% • Colon cancer 2.5% • Diabetes 1.5% • If same population met activity guidelines: • CHD drop 7.1% • Colon cancer drop 7.4% • Diabetes 5.2% Geog 3432

  15. Genetics or physical activity • Maybe premature death/disability is mostly genetic? Geog 3432

  16. Genetics or physical activity Geog 3432

  17. Improvements in Physical Activity Over Time? Geog 3432

  18. Discussion • What explains low physical activity in North America? Geog 3432

  19. Interconnected Causes of Sedentary Lifestyles • Behavioural • “victim blaming” • choice available, e.g., transportation • Suburbanization • landuse • design • Time • what happened to the 35hr work week? • Wealth • very much so Geog 3432

  20. Physical Activity and Wealth Geog 3432

  21. Is suburbanization bad for your health? Garden Cities • started late 1800s • reaction to overcrowded and dirty large cities • access to nature (healthy) • best aspects of rural and urban living Geog 3432

  22. Garden Cities vs Industrial Cities Philadelphia first half 20th C (Source) Hagerstown, MD 2010 (Source) Other Examples of Cities/Suburbs Inspired by the Garden City Movement • Shaker Heights, Ohio • Kapuskasing, Ontario Geog 3432

  23. Full Circle • Olmstead – designer (Central Park), architect, writer • advocate for residential outside CBD – space, greenery • CBD too crowed, stressful and generally unhealthy • Levittown NY and PA – post war American (and Canadian) dream • first “suburbs” – entire communities • traffic calming Geog 3432

  24. Transportation: Modal “Choice” Geog 3432

  25. Transportation:Children and Modal Choice Geog 3432

  26. Transportation:Children and Modal Choice Geog 3432

  27. What’s the Epidemiologic Evidence? • Many studies show significant but weak relationships between measures like “sprawl”, “walkability” etc. and “activity”, “overweight/obese”, “depression”, “alcohol abuse” (Renalds et al. 2010 A systematic review of built environment and health, Family and Community Health, 33(1): 68-78) • most use ecologic or case-control study design (what does this imply?) Geog 3432

  28. Discussion • How can we increase physical activity (not personally per se, but as a public health problem)? Geog 3432

  29. Design Barriers Geog 3432

  30. Design Barriers Geog 3432

  31. Designing for Pedestrians Geog 3432

  32. Exercise/Conclusion • Do we need to sacrafice the American/Canadian dream to achieve walkable/cyclable cities? Geog 3432

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