What is a walkable place? The walkability debate in urban design

Background There is increasing interest in the potential role of the natural environment in human health and well-being. However, the evidence-base for specific and direct health or well-being benefits of activity within natural compared to more synthetic environments has not been systematically assessed. Methods We conducted a systematic review to collate and synthesise the findings of studies that compare measurements of health or well-being in natural and synthetic environments. Effect sizes of the differences between environments were calculated and meta-analysis used to synthesise data from studies measuring similar outcomes. Results Twenty-five studies met the review inclusion criteria. Most of these studies were crossover or controlled trials that investigated the effects of short-term exposure to each environment during a walk or run. This included 'natural' environments, such as public parks and green university campuses, and synthetic environments, such as indoor and outdoor built environments. The most common outcome measures were scores of different self-reported emotions. Based on these data, a meta-analysis provided some evidence of a positive benefit of a walk or run in a natural environment in comparison to a synthetic environment. There was also some support for greater attention after exposure to a natural environment but not after adjusting effect sizes for pretest differences. Meta-analysis of data on blood pressure and cortisol concentrations found less evidence of a consistent difference between environments across studies. Conclusions Overall, the studies are suggestive that natural environments may have direct and positive impacts on well-being, but support the need for investment in further research on this question to understand the general significance for public health.

Research examining the association between environmental attributes and physical activity among youth is growing. An updated review of literature is needed to summarize the current evidence base, and to inform policies and environmental interventions to promote active lifestyles among young people. A literature search was conducted using the Active Living Research (ALR) literature database, an online database that codes study characteristics and results of published papers on built/social environment and physical activity/obesity/sedentary behavior. Papers in the ALR database were identified through PubMed, Web of Science, and SPORTDiscus using systematically developed and expert-validated search protocols. For the current review, additional inclusion criteria were used to select observational, quantitative studies among youth aged 3-18 years. Papers were categorized by design features, sample characteristics, and measurement mode. Relevant results were summarized, stratified by age (children or adolescents) and mode of measurement (objective or perceived) for environmental attributes and physical activity. Percentage of significant results was calculated. Mode of measurement greatly influenced the consistency of associations between environmental attributes and youth physical activity. For both children and adolescents, the most consistent associations involved objectively measured environmental attributes and reported physical activity. The most supported correlates for children were walkability, traffic speed/volume, access/proximity to recreation facilities, land-use mix, and residential density. The most supported correlates for adolescents were land-use mix and residential density. These findings support several recommendations for policy and environmental change from such groups as the IOM and National Physical Activity Plan. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Well-designed public open space (POS) that encourages physical activity is a community asset that could potentially contribute to the health of local residents. In 1995-1996, two studies were conducted-an environmental audit of POS over 2 acres (n =516) within a 408-km2 area of metropolitan Perth, Western Australia; and personal interviews with 1803 adults (aged 18 to 59 years) (52.9% response rate). The association between access to POS and physical activity was examined using three accessibility models that progressively adjusted for distance to POS, and its attractiveness and size. In 2002, an observational study examined the influence of attractiveness on the use of POS by observing users of three pairs of high- and low-quality (based on attractiveness) POS matched for size and location. Overall, 28.8% of respondents reported using POS for physical activity. The likelihood of using POS increased with increasing levels of access, but the effect was greater in the model that adjusted for distance, attractiveness, and size. After adjustment, those with very good access to large, attractive POS were 50% more likely to achieve high levels of walking (odds ratio, 1.50; 95% confidence level, 1.06-2.13). The observational study showed that after matching POS for size and location, 70% of POS users observed visited attractive POS. Access to attractive, large POS is associated with higher levels of walking. To increase walking, thoughtful design (and redesign) of POS is required that creates large, attractive POS with facilities that encourage active use by multiple users (e.g., walkers, sports participants, picnickers).