Urban planners are promoting active lifestyles. Here’s how

The intentional design of our living places and environment shapes health outcomes on a large scale. To grasp the importance of this, it's essential to recognize the nature of chronic health issues first. Non-communicable diseases (NCDs) like cardiovascular disease, cancer, chronic respiratory disease and diabetes are the leading causes of death globally.

In 2021, a staggering 43 million people worldwide lost their lives due to NCDs, equivalent to 75% of non-pandemic-related deaths, while 18 million people died before the age of 70. Evidence suggests that 82% of premature deaths occurred in low- and middle-income countries. Beyond the loss of life, these diseases lead to prolonged periods of poor health and quality of life.

If current trends persist, the economic burden of NCDs could reach $47 trillion by 2030, hindering economic development and perpetuating poverty through higher medical expenses and productivity losses.

Addressing the challenge of rising NCDs partly hinges on rethinking how we shape our environments and implement interventions to foster healthier outcomes. Since NCDs are linked to behavioral and environmental risk factors — such as physical inactivity, poor diet and air pollution — preventive measures integrated into urban spaces by design can promote healthier living to be the default.

Creating and retrofitting places that promote movement and physical activity on a large scale is essential. Urban areas with extensive cycling and walking infrastructure encourage people to seamlessly integrate movement into their daily routines.

Cycling infrastructure has been linked to lower obesity levels and hypertension, and walkable neighbourhoods with interconnected streets, parks and accessible public transport can help residents achieve up to 60% of the recommended physical activity guidelines.

In Copenhagen, 49% of all work or school commutes are made by bike, with residents collectively cycling an estimated 1.44 million kilometers daily. The bike-friendly urban design incorporates calm streets, painted bike lanes, green routes, and separated cycle tracks in busier areas. By limiting vehicle speeds and connecting off-street paths to create numerous recreational routes, the city makes biking and physical activity practical and functional.

In Italy, the Romagna Region is home to about 1.1 million people and has been leading the Wellness Valley projects. The multi-stakeholder initiative addresses chronic health risks through a social innovation model, including designing preventive interventions for increasing movement. In one example, the Rimini area of the valley has transformed its coastline for walkability and cycling by creating car-free areas. Adults in this valley are 10% more active than the rest of Italy. Moreover, 23% of people in the valley walk or cycle daily compared to the national average of 10%.

While more data is needed to know the exact impact of these initiatives on NCDs and well-being, and to identify successful variables and metrics for scalability, a growing body of evidence points in the right direction.

One study across 14 cities in 10 countries found that people living in activity-friendly neighbourhoods engaged 68-89 minutes more in physical activity per week. Another study found that people living in areas designed for walkability were, on average, less obese: 43% in highly walkable neighborhoods compared to 53% in less walkable areas.

Designing urban spaces with nature in mind is also essential. Urban green spaces can offer multiple health benefits: promoting physical activity, reducing stress and enabling social interaction. While the impact of green spaces in urban settings can vary, they can also contribute to improving air quality by filtering pollutants and producing oxygen, reducing respiratory-related NCDs.

Access to nature alleviates mental health disorders, enhances cognitive function and buffers life stresses. Early exposure to green spaces in children aged four to six improves visual recognition and memory, and reduces hyperactivity levels. Furthermore, individuals who move from less green areas to greener ones experience better mental health.

Some cities and urban planners are embracing nature by design. Singapore, with its integrated parks and green roofs, exemplifies how urban planning can support outdoor activities. Similarly, the High Line in New York City was saved from demolition and built on a historic freight rail line and now provides green spaces for walking, socializing and experiencing biodiversity. It was redesigned to include gardens with the reintroduction of local wild plants.

A comparative study of the high line and the footpath below found a significant difference (37%) in air and noise pollution factors that contribute to poor health. People using the high line area have less exposure to harmful particles like PM2.5 and noise pollution.

In the Wellness Valley, Italy, the main municipalities are making almost all urban green spaces, such as urban parks, botanical gardens, equipped green areas and outdoor sports areas, accessible to residents. For example, 92% of green spaces in the city of Cesena are usable and play an important role in people’s daily lives beyond aesthetics.

Measuring health impact data is not yet a standardized practice in urban planning. The collection of factual data on the direct and indirect impact on health and well-being is key for understanding the effect of urban planning on public health.

By systematically gathering and analyzing impact data, urban planning projects can identify correlations between the design of places for movement and nature on well-being. This evidence-based approach will support informed decision-making, help prioritize strategies and projects, and enable urban areas to be designed to maximize health benefits, which also have social and economic implications. Such data can help direct investments and resources towards solutions needed to scale positive impact.

The intentional design of the physical environment holds immense potential to shape health outcomes. By addressing the behavioural and environmental risk factors of NCDs through urban planning and preventive measures at scale, cities can pave the way for a healthier future.

This necessitates reimaging and leveraging urban planning to be health-centric. Urban places can be transformed to enable walkability, cycling and exposure to nature to be the default.

It is imperative to prioritize urban designs, foster collaborations and invest in interventions that promote better health outcomes. By doing so, we can improve population health and mitigate the economic and social burdens of chronic diseases globally.