Modern society has designed human movement out of daily life.
We’re overweight because we eat too much, no doubt about it. And we eat too much of the wrong things.
But we’re also bigger as a result of long-term, pervasive, systemic pressures that make daily living a largely sedentary experience for the average Coloradan.
We take elevators for one-story rides to work cubicles that tie us to a video screen for eight hours straight. The kids ride in our cars to school. Exercise means moving our smartphone thumbs more rapidly on Candy Crush. We can’t even be bothered to walk through the drugstore to pick up diabetes medication or Lipitor – prescription drive-thru windows are everywhere.
Reversing the momentum toward collective stasis is going to take a lot of hard work. One startling measure is simply the steps we walk in a given day. The Swiss walk 9,650 steps daily. Japanese citizens, even in the narrow confines of urban spaces like Tokyo, fit in 7,168 steps.
Americans? Just over 5,000 steps a day. The difference amounts to 30 to 40 fewer minutes of plain walking, every single day. The results – 35 percent obesity in American adults – are as well-known and shame-inducing as the Broncos’ Super Bowl score. Coloradans can’t duck the dangerous trend, even in stretchy yoga pants. Our adult obesity rate of 22 percent is the best in the nation, but it has doubled in 20 years.
We are Mississippi in the 1990s.
Doug Linkhart, Denver’s executive director of Environmental Health, finds numbers that trouble him even more about the near future: 31 percent of Denver Public Schools children are overweight or obese.
“We’re trending in a bad direction,” said Christopher Smith, an architect and senior program officer, Healthy Living, with the Colorado Health Foundation, and a former housing and economic development official with the City of Denver. “Seventy percent of health is dependent on behavior and environment. We’re at the beginning of recognizing this need for bringing choice back into people’s lives, in how they move about the environment.”
There is a movement of thought that promises to lead to more physical movement for us all: the “healthy places” efforts by nonprofits, health leaders and government – also referred to as “built-environment” policies – are off and running in the right direction.
In this edition of Health Elevations, we’ll explain the principles of the healthy places and built-environment movement – even some of the architects and city planners rolling up their sleeves to work on these ideas aren’t aware there is a common language and a detailed battle plan.
And because detail is always more illuminating than an abstract discussion among policy wonks, we will highlight projects that employ the principles. We will also highlight efforts that tried to employ some of the high concepts, but ran into real-world problems – problems that healthy places advocates need to consider.
In late 2013 the Urban Land Institute convened thought leaders and codified the healthy places principles. We’ll go through all 10 principles and see how they play out on the ground in Colorado and other states eager to get people moving again.
1. Put people first
In other words, stop thinking of a car’s needs first when designing a street, a sidewalk, a building front, a neighborhood plan or a new housing development.
Bill Swalling is a Colorado developer trying to put people first in two residential projects he is proposing for empty nesters: one in Fort Collins, another in the red rock formations of the Jefferson County exurbs. He has seen that his buyers don’t want big backyards or three-car garages – they would rather see smaller dwellings pushed to one side of a landscape, with trails linking their front door to the open space, a walking-distance community center for yoga classes and continuing education, and a homeowners association or municipal district to clear snow from their sidewalks and mow lawns.
What developers will need from policymakers, Swalling said, is increased density in some reluctant suburban areas. Many neighbors resist density for fear of increased vehicle traffic and parking problems, he noted.
“But empty nesters travel about half as much as those living in traditional single-family homes, so the idea of density bringing too much traffic doesn’t really happen,” he said.
2. Recognize the economic value
Designing a healthier building or streetscape shouldn’t always be seen as creating a wishful landscape with expensive doodads. Millennials are gravitating to cities where they can give up cars and walk to their favorite restaurant district,pushing up apartment rents and making development attractive. Light rail stations integrated into a healthy transit network are some of the biggest economic development draws in the nation.
Governments that spend taxpayer money on healthy, attractive open spaces are also likely to see the investment pay off economically as well as medically. Sale prices of homes within 1,500 feet of a park in Portland, Ore., were $845 to $2,262 higher than other homes (in 2000 dollars). The larger the nearby park, the greater the increase in property values, according to a report by the Robert Wood Johnson Foundation.
In Colorado, the same report noted that a greenbelt in Boulder raised the value of neighboring homes by $5.4 million, which in turn generated as much as $500,000 in new city property taxes.
Public amenities are so attractive to some Colorado developers, said Linkhart, that the city should consider asking them to contribute to improving or expanding those amenities. Apartment builders are flocking to the South Platte River and Cherry Creek confluence, he noted, in large part because of a well-designed Commons Park. “Can we capture some of those benefits?” Linkhart asked.
3. Empower champions for health
Engage the community in all phases of a project or redesign. What are the chances of creating something the community wants if residents aren’t asked what they want? How much will the new streetscape get used if it never accounted for local character and desires?
Planners in communities like Arvada have learned some of these lessons the hard way. ( See What’s Working) Not surprisingly, announcing at a community meeting that “You’re fat, and we’re here to help” is not a promising opening line.
Even residents who welcome the idea of healthier amenities can worry about the long-term results, including gentrification that will push out the very modest-income residents who could benefit most from a healthier built environment. Arvada real estate agent Mimi Tugaoen said some residents fear Olde Town improvements will further divide the suburb along its northwest/southeast contrasts.
“The southeastern part of Arvada that was previously inexpensive will now become more desirable, and cost of living might skyrocket,” Tugaoen said. “Where affordable housing will be, I don’t know.
4. Energize shared spaces
A city’s residents may seem tightly packed into commonly used spaces, but bad planning can lead to neighborhoods cut off from transit, parks and other services or amenities. Towering public housing projects of the 1960s and ‘70swere great examples of how not to build a healthy space.
Chicago researcher Frances Kuo and colleagues found that residents who lived without views of or access to green space, in notorious projects like the since-demolished Robert Taylor Homes, had higher incidents of aggressive or violent conflicts with neighbors. A “barren” landscape was linked to children outdoors without supervision, higher rates of illegal activity, property crime, graffiti and other problems, noted Kuo, a professor of natural resources, environmental science and psychology at the University of Illinois.
Denver planners promoting healthy living design ideals point to a before-and-after study of City of Axum Park in northeast Park Hill. After extensive renovations, including new play equipment and flowing walking paths, a 2011 assessment found a fivefold increase in park use compared to the 2009 baseline.
5. Make healthy choices easy
If you want more people to bike to work, you need many miles of safe bike lanes on popular streets or dedicated paths through parks. If you want children to walk to school, you need to finish sidewalks through the neighborhood, keep them clear of snow and provide safe crossings at scary intersections.
Denver architect Yong Cho and many other local designers have employed many of these principles at the redevelopment of the former Lincoln public housing project in central Denver, just southwest of downtown. Designs include appealing public corridors that seniors can use for exercise-walking in winter and a “beautiful, inviting stairway” with wide treads for sitting and talking. The stairway also acts as an observation point for a courtyard where children can gather and play, bringing the generations out at the same time, and has art integrated into the climb to draw people up and down.
“Basic, dull utility areas of a building are becoming destinations,” Cho said.
6. Ensure equitable access
Obviously it’s a matter of fairness – extend the benefits of a healthier lifestyle to as many people as possible, regardless of their race, creed, religion or “birth ZIP code” status. But it’s also a practical matter: Many unhealthy developments in American life, including obesity rates, affect minorities and low-income communities disproportionately. That includes high rates of obesity among Colorado Hispanic communities as well as intense rates of poverty and obesity in whites and blacks in the Bible Belt states.
Kaiser Permanente’s community benefit spending asks grant applicants to prioritize schools with high reduced- and free-lunch needs, and also to seek out underserved populations for “Walk & Wheel” alternative-transit funding.
The Urban Land Institute’s study of Denver’s Westwood neighborhood mapped stark inequities that block healthier communities, including the map on page 12, showing how much more green space the neighborhood would have if it rose even to the Denver average.
Addressing those gaps can mean very practical, basic steps, said Lois Brink, a professor of landscape architecture at University of Colorado Denver and a founder of the Learning Landscapes program of healthier designs at Denver Public Schools.
“Sometimes you actually have to teach kids and parents how to ride a bike. Seriously,” she said.
7. Mix it up
When a big space opens for development, design offices and retail near residences in livable ways. Make sure residents are within a half-mile of attractive open space. And “mix up” everything – housing and exercise for young and old alike,dads with strollers and grandparents with canes. Provide affordable housing near middle- and high-income housing, as Stapleton and Lowry and parts of LoDo have tried to do.
Susan Powers and other developers of the Aria project in northwest Denver put all these ideas in a blender and mixed it up at high speed. On 17 acres purchased from an order of nuns, Aria is building low-income housing near $450,000 homes, large community gardens, a production-size restaurant garden, an on-site medical and wellness clinic, walkways connecting Regis University to Zuni Park, and intergenerational cohousing.
Aria is also “mixing up” the development process itself: While Aria’s investors are a for-profit venture, they must work with nonprofits and foundations to build trails and other health amenities, and with city and state agencies on streetscape and other infrastructure.
Along the way, Powers said, Aria hopes to be a pioneer in a part of the city where the healthy places movement hasn’t yet taken hold in a big way.
“North of I-70 has been forgotten, and we’re a small part of what can happen there,” she said.
8. Embrace unique character
Don’t design away the interesting bumps and quirks of a neighborhood that give it character. Integrate existing natural systems in more useful ways, whether a city drainage ditch or a pocket park with old trees. If neighbors sun themselves on an impromptu creek side beach, connect the beach to walking and biking paths.
In an ethnically influenced neighborhood like Westwood where brightly colored buildings reflect an international tradition, encouraging more brightly colored buildings will promote walking and calm drive-by traffic.
Westwood has the kind of good news/bad news example that can be a challenge for city planners, said UCD’s Lois Brink. Weir Gulch winds through the neighborhood, beckoning redevelopment as a more attractive green space as has happened in other neighborhoods cut by the gulch. But according to Brink, some residents tell developers, “We don’t like gulches! They’re deep and scary.” Neighbors need to be involved in the redesign and see examples of how urban trails have worked elsewhere.
9. Promote access to healthy food
Attacking two problems at once can leverage the results: Create more outlets for healthier food to fight obesity, and speed up the battle by encouraging healthier paths to that store.
Colorado’s burgeoning Fresh Food Financing Fund is one of the first well-financed, cooperative programs to take on food deserts in a practical way. Launched with $7.1 million in seed money from the Colorado Health Foundation, CO4F has since gained more investors for its goal of removing “financial barriers from the construction, expansion and renovation of grocery stores in underserved areas.”
Since the launch, CO4F has added $1 million for loans from Kaiser Permanente, $1 million from The Piton Foundation and another $300,000 from The Colorado Trust.
10. Make it active
Put multiple activities in the same place to attract the most diverse participants possible. Plan housing, work and retail so that each trip can begin with a walk. Work on that “last mile” of a commute, making it easy to put a bike on alight rail train or rent transportation for the final mile to home.
The City Loop playground rebuild in City Park had grand ambitions to better activate one of the crown jewels of the open space system in Colorado. City Park looks crowded to families who only try to use it on the free zoo day, who run the Boo at the Zoo in October, or try to find parking for a peak-hour IMAX film at the Museum of Nature & Science. But in between the big events, City Park is largely empty, said Gordon Robertson, director of planning at Denver Parks and Recreation. The quiet green space is a respite to a few regulars, but not an effective or healthy use of precious land for 25,000 surrounding residents.
City Loop meant to bring innovative climbing and movement equipment for children right next to a knee-friendly walking path for seniors. A kiosk to check out sports equipment would sit near a plaza for demonstrations, including cooking hours employing goods from an on-site community garden. It was to be the city’s first “outdoor recreation center,” Robertson said.
And it was all too new, too fast, at least for that pocket of Colorado. (See Observations for an extensive Q&A deconstructing the fate of City Loop.)
Reversing 150 years of design trends in a sprawling built environment is not always smooth or swift, as you will see throughout this summer’s edition of Health Elevations. Advocates of healthy places ideas often have to take a deep breath and look at the long view, Powers said.
“These are generational projects,” the Aria developer said. “They seem like they can take forever.”
Michael Booth is the Editor in Chief of Health Elevations.
HEALTH ELEVATIONS seeks to further the goals of the Colorado Health Foundation by highlighting problems that can be solved, illuminating the people who are making progress in solving them and provoking a new way of looking at complex health issues. HEALTH ELEVATIONS reports on a variety of sources to provide information that can further the work of policymakers, grantees, providers and the engaged public in advancing better health care, health coverage and healthier living.