Posted January 5th 2011 at 10:14 am by
in Health by Design, Thesis Chronicles

Healthy By Design: Part I

This post is part of the Thesis Chronicles series.

Did you hear? New York City is trying to ban salt again. First they required nutrition labels on my glorious cinnamon dulcé latte and now this? Don’t they know that those lattes are the only thing that gets me in the office on Mondays? Workers will revolt, GDP will go down and …who knows, maybe this mass deprivation will bring us together? A Brotherhood of Blandness, Sisterhood of the Salt-Free…

This recent flurry of activity that seeks to ban salt, post calories on menus, place a moratorium on fast-food franchises, and replace Little Debbies with baby carrots in school vending machines is part of a growing challenge to the existing food environment(s). These changes aim to shift the array of available food options from those that are calorie dense and unhealthy to those that are nutrient dense and healthy.

Though changes to the consumer food environment have generated a large amount of controversy and publicity, they are not the only means by which cities across the nation are attempting to create healthier communities through planned spaces and policy. Across the United States, there are pockets of activity that aim to make cities healthy by design, meaning that the built environment supports opportunities for safe and accessible physical activity as well as improved and equitable community food environments.

Through this research, I have found that there are far more questions than answers about the impact of urban form on the incidence of overweight, obesity, and obesity-related illnesses. We know that this new generation has a shorter life expectancy than their parents due to obesity and obesity-related illnesses. We know that vehicle miles traveled in many cities remain on the rise. It is also true that grocery stores have left urban centers in the last several decades, leaving an unhealthy and barren community food environment, what we now call “food deserts”.

But we also know that there have been many victories for Complete Streets legislation, bringing greater spatial equity to active transit. Yet what we do not understand about the relationships between the built environment, planned spaces, weight and disease far overshadows what we do know.

We have not quite figured out why segregation of either white or black communities produces poorer health outcomes. As professionals, public health officials and urban planners share no common language with which to create an agenda for urban health. Will mixed-use zoning really dismantle sixty years of spatial mismatch between jobs, housing, shops and amenities? And what exactly will we do with all those suburbs once we all decide to live in compact urban communities with gridded streets? Why do those who live in urban communities with sidewalks and gridded streets have higher rates of overweight, obesity, and obesity-related illnesses if, in fact, these are key to creating walkable communities?

Though there are many more questions than answers plaguing the integration of urban health and planning, it is clear that cities around the country are moving forward with built environments, planned spaces, and long-range policies that aim to halt this daunting crisis of obesity. How are we doing it, and how can we do it better?

This article is part I of a series about my graduate thesis on the role of urban planners in the promotion of non-obesigenic environments and healthier communities. The thesis aims to move beyond well-documented challenges that tend to paralyze the integration of public health and planning, looking instead at the context in which the ability of urban planners to meet improve health is constrained. I hope you will join me in my learning efforts.

Post by Laura Tolkoff.  For questions related to the thesis or this series, please e-mail me at Many thanks are due to thesis advisors Barbara Parmenter and Christine Cousineau at the Department of Urban and Environmental Policy and Planning at Tufts University.

One response to “Healthy By Design: Part I”

  1. jamesmoore80 says:

    I’m looking forward to reading more of your articles. Thank you.