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Intro -- Title Page -- Copyright Page -- Table of Contents -- Preface -- Acknowledgments -- Ch. 1: What is Sprawl? What Does It Have to Do with Health? -- Defining and Measuring Sprawl -- Core Concepts: Land Use and Transportation -- Varieties of Sprawl -- The Subjective Experience of Sprawl -- Overview of This Book -- Ch. 2: The Origins of Sprawl -- Transportation -- The Pull of the Suburbs -- Expanding Cities: From Growth to No Growth -- The Automobile Age -- Zoning -- Federal Housing Policy and Suburban Growth -- Urban Sprawl in the Postwar Years -- Conclusion -- Ch. 3: The Evolution of Urban Health -- Urban Pestilence and Filth -- Industrial Pollution in Cities -- The Social Pathology of City Life -- The Future of Urban Health -- Ch. 4: Air Quality -- Land Use, Transportation, Air Quality, and Health: A Model -- Travel Behavior, Emissions, and Air Quality -- Air Quality and Public Health -- Conclusion -- Ch. 5: Physical Activity, Sprawl, and Health -- The Varieties of Physical Activity -- The Health Benefits of Physical Activity -- Physical Activity and the Built Environment -- Limits to What We Know -- Conclusion -- Ch. 6: Injuries and Deaths from Traffic -- Motor Vehicle Crashes -- Pedestrian Injuries and Fatalities -- The Risk of Leaving Home -- Ch. 7: Water Quantity and Quality -- Water and Health: An Overview -- The Hydrology of Sprawl -- Sprawl and Water Quality -- Conclusion -- Ch. 8: Mental Health -- The Mental Health Benefits of Sprawl -- The Mental Health Costs of Sprawl -- Driving and Mental Health -- Sprawl and Mental Health: The Big Picture -- Ch. 9: Social Capital, Sprawl, and Health -- What is Social Capital? -- The Decline of Social Capital -- Does Social Capital Affect Health -- Does Sprawl Undermine Social Capital? -- The Role of Income Inequality -- Conclusion -- Ch. 10: Health Concerns of Special Populations -- Women.

Objectives:This study investigated the resilience of single-family housing values in walkable versus unwalkable neighborhoods during the economic downturn from 2008 to 2012 in Dallas, Texas.Methods:Using propensity score matching and difference in differences methods, this study established a natural experimental design to compare before-and-after value changes of single-family (SF) homes in walkable neighborhoods with unwalkable neighborhoods during the Great Recession. Two thousand seven hundred ninety-nine SF homes within 18 Tax Increment Financing (TIF) districts were categorized into walkable (Walk Score ≥50) and unwalkable (<50) groups. Six hundred twenty-four dwellings in walkable neighborhoods were matched with the most identical ones in the unwalkable neighborhoods by controlling for the selected structural and residential location variables. Relative average treatment effects were examined for SF values in walkable and unwalkable neighborhoods.Results:On average, the SF homes in walkable neighborhoods held $4566 (2.08%) more value than their how walkable counterparts.Conclusions:This study aims to help planners and decision-makers by documenting the unmet demand for walkable communities and their sustained economic benefit. Increased awareness of the sustained value of walkable communities can be used by lenders who finance and by policy makers who regulate placemaking. Results from this study can be integrated with research that demonstrates health-care cost savings of walkable environments to create an even more comprehensive set of evidence-based interventions to increase their supply.

Public health impacts of transportation policies and infrastructure investment are becoming better understood, particularly for those associated with physical activity. Yet health impacts are not routinely evaluated within the context of the development of a Regional Transportation Plan (RTP) and subsequent programming and investment processes. This is particularly concerning because the spatial distribution of planned transportation infrastructure potentially has significant health equity implications for vulnerable populations at greater risk of chronic disease. This study discusses the application of the National Public Health Assessment Model (NPHAM) – a new approach that expands several scenario planning tools to include health – for the San Joaquin Council of Governments 2018 RTP. It demonstrates how quantifying health impacts at a finer spatial scale (census block groups) helps assess the extent to which RTP strategies are likely to benefit or harm health. It further enables a spatial form of health equity analysis that can help planners understand where infrastructure is most needed to meet social equity goals. To the knowledge of the authors, this is the first example of a quantified, health equity analysis of transport physical activity and a health outcome – body mass index - associated with an RTP; it demonstrates significant advancement in transportation planning practice and policy.

Purpose. To examine associations of neighborhood walkability and recreation environment variables with physical activity in adolescents. Methods. The cross-sectional study was conducted with 98 white or Mexican-American adolescents (mean age = 16.2 years). Physical activity was measured with 7 days of accelerometer monitoring. Height and weight were measured to compute body mass index (BMI). Environmental measures were created using geographic information systems. A neighborhood walkability index was based on land use mix, retail density, street connectivity, and residential density. Proximity to public and private recreation facilities was assessed. Results. In a linear regression, the walkability index within 0.5 mile of homes was related to minutes of moderate to vigorous physical activity, explaining approximately 4% of variance. Recreation variables were not related to physical activity, and BMI was not explained by environmental variables. Conclusion. Neighborhood walkability was related to adolescents' physical activity, similar to findings for adults.

OBJECTIFS: Créer et appliquer un outil empirique d'évaluation de l'impact sur la santé et sur les gaz à effet de serre (GES) qui relie des indicateurs détaillés du potentiel piétonnier et de l'accessibilité régionale aux déplacements, à l'activité physique, aux indicateurs de santé et aux émissions de GES. MÉTHODE: Les caractéristiques d'aménagement des parcelles et du système de transport ont été calculées dans une zone tampon d'un kilomètre autour de chaque code postal à Toronto. Des indicateurs du milieu bâti ont été reliés aux caractéristiques sanitaires et démographiques tirées de l'Enquête sur la santé dans les collectivités canadiennes et aux comportements de déplacement fournis par le sondage Transport Tomorrow. Les résultats ont été intégrés dans un outil logiciel existant et ont servi à prédire les indicateurs sanitaires et les émissions de GES associés à la remise en valeur des terrains de l'Ouest de la rivière Don à Toronto. RÉSULTATS: Le potentiel piétonnier, l'accessibilité régionale, les trottoirs, les installations pour cyclistes et l'accès aux installations de loisirs ont été associés positivement avec l'activité physique et négativement avec le poids, l'hypertension artérielle et les impacts des transports. Appliqué aux terrains de l'Ouest de la rivière Don, l'outil logiciel a prédit un recul important de l'usage de l'automobile au profit de la marche, du cyclisme et des transports en commun. Selon l'outil, les trajets à pied et à vélo pourraient plus que doubler, et les trajets en transports en commun pourraient augmenter du tiers. Les trajets en automobile par habitant pourraient diminuer de moitié, les kilomètres parcourus en automobile, de 15 %, et les émissions de GES, de 29 %. CONCLUSION: Les résultats présentés ici sont nouveaux et comptent parmi les premiers à relier des effets sanitaires et des caractéristiques précises du milieu bâti au Canada. L'outil qui en résulte est le premier du genre au Canada. Il peut aider les responsables des politiques, les urbanistes, les planificateurs ...

Purpose. Examine associations between worksite physical activity promotion strategies and employees' physical activity and sedentary behaviors. Design. Cross-sectional. Setting. Seattle–King County, Washington and Baltimore, Maryland–Washington, D.C. regions. Subjects. Adults working outside the home (n = 1313). Mean age was 45 ± 10 years, 75.8% of participants were non-Hispanic white, 56% were male, and 51% had income ≥$70,000/year. Measures. Participants reported demographic characteristics and presence/absence of nine physical activity promotion environment and policy strategies in their work environment (e.g., showers, lockers, physical activity programs). A worksite physical activity promotion index was a tally of strategies. Total sedentary and moderate-to-vigorous physical activity (MVPA) min/d were objectively assessed via 7-day accelerometry. Total job-related physical activity minutes and recreational physical activity minutes were self-reported with the International Physical Activity Questionnaire. Analysis. Mixed-effects models and generalized estimating equations evaluated the association of the worksite promotion index with physical activity and sedentary behavior, adjusting for demographics. Results. A higher worksite promotion index was significantly associated with higher total sedentary behavior (β = 3.97), MVPA (β = 1.04), recreational physical activity (β = 1.1 and odds ratio = 1.39; away from work and at work, respectively) and negatively with job-related physical activity (β = .90). Conclusions. Multiple worksite physical activity promotion strategies based on environmental supports and policies may increase recreational physical activity and should be evaluated in controlled trials. These findings are particularly important given the increasingly sedentary nature of employment. (Am J Health Promot 2011;25[4]:264–271.)

There is growing evidence that communities can be designed to support physical activity, but it is important to understand whether neighborhood features related to health are also considered satisfactory by residents. The study aimed to determine if there is an association between perceived and objective neighborhood environment variables and neighborhood satisfaction. Adults ( N = 1,726) were recruited from neighborhoods in two regions of the United States selected to vary on walkability and income. Perceived neighborhood environment was assessed using a validated scale, objective measures were constructed using geographic information system (GIS), and satisfaction was assessed using a 17-item survey. Participants reported greater satisfaction when they perceived their neighborhood as having greater pedestrian/traffic safety, crime safety, attractive aesthetics, access to destinations, diversity of destinations, park access, and lower residential density. Objective measures were not significant. The discrepant findings between perceived and objective environmental measures indicate that neighborhood satisfaction is a complex construct.

Purpose: To investigate relations of perceived worksite neighborhood environments to total physical activity and active transportation, over and above home neighborhood built environments. Design: Observational epidemiologic study. Setting: Baltimore, Maryland-Washington, DC, and Seattle-King County, Washington metropolitan areas. Participants: One thousand eighty-five adults (mean age = 45.0 [10.2]; 46% women) recruited from 32 neighborhoods stratified by high/low neighborhood income and walkability. Measures: The Neighborhood Environment Walkability Survey assessed perceptions of worksite and home neighborhood environments. Accelerometers assessed total moderate-to-vigorous physical activity (MVPA). The International Physical Activity Questionnaire assessed total active transportation and active transportation to and around work. Analysis: Mixed-effects regression tested relations of home and worksite neighborhood environments to each physical activity outcome, adjusted for demographics. Results: Home and worksite mixed land use and street connectivity had the most consistent positive associations with physical activity outcomes. Worksite traffic and pedestrian safety were also associated with multiple physical activity outcomes. The worksite neighborhood explained additional variance in physical activity outcomes than explained by the home neighborhood. Worksite and home neighborhood environments interacted in explaining active transportation to work, with the greatest impacts occurring when both neighborhoods were activity supportive. Conclusion: Both worksite and home neighborhood environments were independently related to total MVPA and active transportation. Community design policies should target improving the physical activity supportiveness of worksite neighborhood environments and integrating commercial and residential development.

Evidence connecting health care expenditures with physical activity and built environment is rare. We examined how detailed urban form relates to mode specific moderate-to-vigorous physical activity (MVPA) and health care costs—controlling for transit access, residential choices/preferences, sociodemographic factors. We harness high resolution data for 476 participants in the Rails and Health study on health care costs, mode specific MVPA, parcel-level built environment, and neighborhood perception surveys. To account for dependencies among outcomes, structural equation modeling framework is used. A 1% increase in bike, walk, and transit-related MVPA was associated with lower health care costs by −0.28%, −0.09%, and −0.27% respectively. A one-unit increase in neighborhood walkability index correlates with a 6.48% reduction in health care costs. Indirect associations between residential choices, attitudes, and health outcomes through MVPA were also observed. The results suggest the potential to alter behaviors and lower health care costs through retrofitting neighborhoods.

Frontmatter -- Contents -- Foreword -- Preface -- Acknowledgments -- PART I Introduction: Independent/Successful Longevity -- Introduction -- 1. New Visions for Aging in Place -- 2. A Hopeful Future -- PART II Demographics and Challenges -- Introduction -- 3. Changing Demographic Realities -- 4. Future Social and Economic Changes -- PART III Housing and Services -- Introduction -- 5. From Home to Hospice: The Range of Housing Alternatives -- 6. Community Services -- PART IV Homes -- Introduction -- 7. The Home Environment and Aging -- 8. Technology Solutions -- 9. A Contractor's Perspective -- 10. A Case Study: Interior Design for Aging in Place -- 11. Multifamily Housing -- 12. A Case Study: Th e Freedom Home -- PART V Neighborhoods -- Introduction -- 13. Healthy Communities -- 14. Local Community Action -- 15. Retrofitting Suburbs -- 16. Longevity and Urbanism -- 17. Neighborhood Development -- PART VI Strategies for Change -- Introduction -- 18. Vulnerable Populations -- 19. Housing Finance -- 20. A Political Strategy -- Conclusion: Aging in Place -- Resources -- Glossary -- Index