One great paradox of America’s public health crisis is that in many urban communities, where food deserts limit access to affordable healthy food options, obesity rates are rising.
Why is that? Inner cities and urban neighborhoods offer parks, playgrounds and public transportation; they feature smaller blocks with streets that supposedly encourage walking. And yet, obesity and physical inactivity– and their association with diabetes and cardiovascular disease–are becoming more prevalent among the urban poor.
Some of this discrepancy can be explained by other urban health risks such as the stress of poverty and violence. Crime can result in an urban neighborhood environment where outdoor exercise and recreation are risky and thus avoided. But that doesn’t explain this paradox entirely.
At a recent gathering of the American Institute of Architects’ Research Consortium on Design and Health, Nikki Nollen, a psychologist at the University of Kansas School of Medicine; Department of Preventive Medicine and Public Health, observed that minority and immigrant communities are bombarded “with cues to smoke, and therefore in many cities have lower-than-expected ‘quit rates.’” She also noted that in poorer neighborhoods it is common to see many more fast-food restaurants per square mile and fewer full service grocery stores. “Residents can walk out their door and be at a fast–food restaurant within 5 minutes while fresh fruits and vegetables are a 30-minute bus ride away,” she said.
The plague of obesity among the urban poor is correctly perceived as a political issue addressed by local governments’ ability – or lack thereof – to do things like attract brand name supermarkets. Still, architects can bring two unique attributes to any endeavor – imagination and vision – and they are both on display in these innovative efforts aimed at providing quality food sources where they are urgently needed:
- Kansas University’s School of Architecture, Design and Planning combined with KU’s School of Public Health to prove that designers and their health partners can use something as simple as changing bus stops to end a “food desert.” In the course of mapping parts of the 15-county Kansas City Metropolitan Area, the KU research team found sharp inequalities defined by a seemingly arbitrary political boundary – the Kansas counties of Wyandotte and one of the richest in the country – Johnson County. While side-by-side geographically, Johnson County outperforms nearly every Kansas county in healthy behaviors, quality of life, social and environment factors, and physical activity. Only 3% of its population—compared to 14% of Wyandotte County’s —is disadvantaged by limited access to healthy food options. Such access is defined by the USDA in geographic terms: the nearest supermarket or grocery store must be within one mile from urban residents or 10 miles in rural areas. Wyandotte County’s local government couldn’t build grocery stores and doesn’t have the resources to address other factors that create food deserts, including people’s individual behavior and cultural dietary preferences. Instead, it worked with the Kansas University research team to site bus stops within a half-mile of existing food outlets and green spaces. The project, “Connecting the Dottes,” illustrates how seemingly minor design-based approaches to health can accelerate improvements in American communities of any size.
- In the South Bronx, an orchard, gardens and grove of evergreens form the centerpiece of Via Verde/The Green Way, by Dattner Architects and Grimshaw Architects an award-winning development that was built on a former garbage-strewn lot. Each spring, the development turns its attention to planting organic spinach, collards, kale, berries, tomatoes and other vegetables and herbs to keep all of the residents’ tables filled with free, fresh produce. “The fact that a project like Via Verde can be created as affordable housing means that we can and should do this for everyone,” says Dr. Karen Lee, MD MHSc, principal of Karen Lee Health + Built Environment Consulting, and co-author of a report based on Robert Wood Johnson Foundation-funded research titled Active Design: Affordable Designs for Affordable Housing. Her Active Design Guidelines helped shape the project, and those in more than 40 other cities worldwide. Lee is also an AIA Consortium member.
- In the struggling West Philadelphia Mantua neighborhood, a team of faculty from Drexel University’s School of Public Health and Westphal College of Media Arts & Design is looking at whether proximity to a tree-lined street or park can impact physical and mental health. (link). The Drexel University researchers’ assumption is that aspects of nature can be woven into existing urban systems to create healthier populations through design. The project includes a clean, sustainable and safe playground at a local elementary school, three community gardening initiatives and a walking program at the Mantua Presbyterian Apartments, a low-income senior housing complex, where Drexel students have already designed and built an urban garden. The team hopes to generate data that is useful to city residents and policy makers in understanding and addressing the causes of urban health problems and health inequalities.
They are but the first steps – small templates – in a movement rapidly gaining momentum in our profession: architects and designers making intentional choices about design to promote the ongoing wellness of communities. Working with architects who are able to incorporate healthy design thinking into community planning will surely turn such initial steps into longer-lasting, bigger and positive results.
John Schneidawind, Director, Public Affairs & Media Relations, AIA