The relationship of urban design to human health and condition

The population of the United States of America is currently experiencing increased illness from dispersed and synergistic causes. Many of the acute insults of the past have receded due to centralized health care and regulatory action. However, chronic ailments including asthma and allergies, animal-transmitted diseases, obesity, diabetes, heart disease, and depression are on the rise. These diverse illnesses join with forest fragmentation, stream degradation, wetlands destruction, and the concomitant loss of native species to suggest detrimental contributions from the built environment. This paper surveys the state of the science on the impacts of urban design on human health and well-being. Drawing primarily on recent peer-reviewed literature in a broad array of health, planning, and environmental fields, it outlines the influence of design at three spatial scales on aspects of physical and mental health, and social and cultural vibrancy. Selected ecological effects are also discussed to illustrate shared associations with urbanization. While causal chains are generally complex and not always completely understood, sufficient evidence exists to reveal urban design as a powerful tool for improving human condition. Solutions are discussed at the personal and professional level, emphasizing cross-disciplinary collaboration in urban planning and design, and the participation of residents in shaping their living environment. At the parcel scale, greenery and access to it visually and physically are the principal keys to health. These elements must be incorporated into relatively high-density neighborhood designs that include public buildings, open space, mixed land use, and pedestrian walkways to increase physical exercise and enhance civic life. Finally, neighborhoods must be embedded in existing urban infrastructure to provide larger cultural and business opportunities and reduce reliance on the automobile. Further research is recommended to strengthen the associations between design and health. Increased communication on this subject is also necessary between design and health practitioners and their clients and colleagues. (C) 2002 Elsevier Science B.V. All rights reserved.