This is the continuation of a post I wrote yesterday (see: Photo Friday: The Social Determinants of Milo | Ted Eytan, MD).
Despite what web sites like walkable.com say, Washington, DC is the most walkable city in the United States, using a more rigorous methodology, from this 2007 report:
Washington, DC, Could be the National Model of Walkable Urban Growth—The Washington, DC, metropolitan area has the most regional-serving walkable urban places per capita in the country, having one for every 264,000 people, and one of each of the five types of walkable urban places.
The same researcher, Leinberger, produced this report in May, 2012 which looks at deeper attributes of walkability, including the use of a 162-item audit tool, to assess “objective data on built environment characteristics hypothesized to be related to physical activity.” They stratified walkability into 5 levels (5 = highest) and then looked at economic characteristics of these areas. The results confirm what we all saw in the “Weight of the Nation” series which is that lack of money is not the only problem that poor people have when it comes to their health.
- Walkable neighborhoods are more expensive to live in, which makes it harder for people with less money to move into them.
- Walkable neighborhoods have much better access to jobs, recreational opportunities, and lower transportation costs (from 15 – 21 % more jobs within 90 minutes, 340 – 360 % more parks
- Walkable neighborhoods perform better economically, have higher housing values, have higher retail sales
- Walkable neighborhoods are not as capital intensive to improve as non-walkable ones
The study authors didn’t look at health outcomes, but I can tell pretty quickly from the attached map that the non-walkable areas of Washington, DC, are the ones with an obesity rate of 42%, higher than the highest State in the United States (Mississippi), and the walkable areas shown have among the lowest obesity rate, in the 13% range. See: Do national numbers inaccurately represent Washington, DC’s obesity condition? what electronic and personal health records can do to help | Ted Eytan, MD
It appears that we’ve arrived to a place where not having the ability the walk has far reaching associations with economic and physical health. The authors make a good case for the consideration of “walkable platemaking” in the creation of policy and urban planning. The scoring methodology provides a basis for understanding gaps that can be measured, and closed for people who are disproportionately affected by an environment that conspires to reduce their individual effectiveness in being healthy and productive. The health system is very much affected too – we can imagine that the hard work of doctors, nurses, and health care organizations becomes less effective because of unsupportive community conditions.
Data like this should hopefully stimulate all community stakeholders to understand the problem and work to reduce its unequal impact across the population. For my part, I need to go see this up close. Who wants to invite me to shadow a medical practice in Ward 7 or 8? Please post in the comments.