By 2050, it is estimated that around 6.3 billion people will live in cities (United Nations Population Fund, 2011). Indeed, nearly 70% of humanity will live in cities, representing a unique moment in time in human history. As we hurtle towards this uncertain future, land use, transport, and infrastructure decision-making has never been more important: in the next two decades—and on our watch—the decisions made by the students and professionals taught, advised, and mentored by academics across multiple disciplines—including land use and transport academics—will profoundly impact the sustainability of cities and the health and wellbeing of their residents.
The translation of research into tangible health benefits via changes to urban planning policy and practice is a key intended outcome of academic active-living research endeavours. Conversely, policy-makers and planners identify the need for policy-specific evidence to ensure policy decisions and practices are informed and validated by rigorously established evidence. In practice, however, these two aspirations rarely meet and a research-translation gap remains. The RESIDE project is a unique longitudinal natural experiment designed to evaluate the health impacts of the 'Liveable Neighbourhoods' planning policy, which was introduced by the Western Australian Government to create more walkable suburbs. This commentary provides an overview and discussion of the policy-specific study methodologies undertaken to quantitatively assess the implementation of the policy and assess its active living and health impacts. It outlines the key research-translation successes and impact of the findings on the Liveable Neighbourhoods policy and discusses lessons learnt from the RESIDE project to inform future natural experiments of policy evaluation.
Purpose. Evaluate the implementation of a government planning policy (Liveable Neighbourhoods Guidelines) and its impacts on residents' walking behaviors. Design. Cross-sectional study of participants from the RESIDential Environments project (RESIDE). Setting. Nineteen "liveable" and 17 "conventionally designed" housing developments across Perth, Western Australia. Subjects. Five hundred ninety-four participants from RESIDE who resided in 36 housing developments. Measures. Developed in geographic information systems to assess the on-ground implementation of 43 policy requirements. Policy compliance was defined as the degree to which construction of the developments adhered to the standards outlined. Walking behaviors were measured using the Neighborhood Physical Activity Questionnaire. K-means cluster analyses identified groups of homogeneous developments with respect to policy implementation. Analysis. Logistic regression with generalized estimating equations estimated the odds ratios (ORs) and 95% confidence intervals (95% CIs) for the likelihood of undertaking any and ≥ 60 minutes of transport and recreational walking associated with (1) policy compliance and (2) different clusters of developments. Results. There were few significant differences in on-ground outcomes between the two development types. Despite incomplete implementation, the odds of walking for transport increased with overall levels of policy compliance (OR= 1.53, 95% CI 1.13–2.08) and compliance with the community design (OR = 1.3, 95% CI 1.13–1.42), movement network (OR = 2.49, 95% CI 1.38–4.50), and lot layout elements (OR = 1.26, 95% CI 1.06–1.50). Conclusion. Consistent with the aims of the policy, residents in walkable (i.e., liveable) neighborhoods may be more physically active.
Few studies have specifically investigated fear of crime as a deterrent to walking. This study tested the hypothesis that fear would inhibit residents from walking in their local neighborhoods. Homeowners ( n = 1,044) in Perth, Western Australia, reported their fear of crime, neighborhood problems and walking, and objective environmental measures were generated for each participant's neighborhood. Multivariate logistic regression models examined the association between fear and walking, with progressive adjustment for other correlates. Fear was associated with lower odds of transport walking (OR = 0.79, p = .034); however, car access was ubiquitous so fearful participants could avoid walking. A similar association between fear and recreational walking attenuated after controlling for other neighborhood factors. Findings suggest that the capacity for fear to deter recreational walkers is not fixed, and that a supportive environment can lessen its impact. Community initiatives that encourage social interaction between residents and improve neighborhood aesthetics may increase levels of recreational walking.
Housing options, such as retirement villages, that promote and encourage healthy behaviors are needed to accommodate the growing older adult population. To examine how environmental perceptions relate to walking, residents of retirement villages in Perth, Australia, were sampled, and associations between a wide range of village and neighborhood environmental attributes and walking leisurely, briskly, and for transport were examined. Perceived village features associated with walking included aesthetics (odds ratio [OR] = 1.72), personal safety (OR = 0.43), and services and facilities (OR = 0.80), whereas neighborhood attributes included fewer physical barriers (OR = 1.37) and proximate destinations (OR = 1.93). Findings suggest that locating retirement villages in neighborhoods with many local destinations may encourage more walking than providing many services and facilities within villages. Indeed, safe villages rich with amenities were shown to be related to less walking in residents. These findings have implications for the location, design, and layout of retirement villages.
Victorian local governments (LGs) are required to develop evidence-based Municipal Public Health and Wellbeing Plans (MPHWPs) that improve health and wellbeing. This study evaluated the implementation of this requirement across 79 LGs. Evidence in 116 documents was categorised by source, issue, and policy specificity. Over 11,000 evidence-occurrences from 200 sources were recorded. More evidence on social determinants was identified than on epidemiology or health behaviours. Most (96%) evidence was descriptive and only 4% supported MPHWP actions. The results suggest the community is an important source of novel interventions, and proposes three related reasons for the dearth of intervention level evidence.
There is growing concern that the built forms resulting from conventional suburban design may be adversely affecting the social well-being, sense of community, and psychological health of its residents. This study tested the premise that suburban neighborhood developments ( n = 36) designed in accordance with a New Urbanist inspired planning policy in Perth, Western Australia, improved residents' ( n = 644) sense of community and mental health. Findings revealed that with each 10% increase in policy compliance, residents odds of experiencing high sense of community increased by 21% ( OR = 1.21, 95% CI = [1.04, 1.41]) and low psychological distress increased by 14% ( OR = 1.14, 95% CI = [1.01, 1.28]). These results add empirical input to the debate surrounding the rhetoric and purported social goals and benefits of the New Urbanism, indicating that implementation of its neo-traditionalist neighborhood design principles may help create the conditions for positive neighborhood sense of community and mental health.
Both children and adults benefit from living in communities and neighborhoods that are rich in social capital. However, the research literature is relatively silent with respect to the influence that children may play as catalysts for the formation and maintenance of community or family stocks of social capital. This article investigates whether having dependent children living at home play a role in forging adult connections, community involvement, and social capital in a suburban context. The qualitative data were derived from 12 focus groups and the quantitative data from a survey of 339 residents in three Western Australian suburbs. Overall, the quantitative results found that social capital, neighborhood cohesion, and community participation were all significantly higher among respondents with dependent children living at home. The results have implications for urban design and community infrastructure, including the extent to which the built environment caters for children and fosters social connectedness among parents, families, and the broader community.
More than half the world's population now live in urban settlements. Worldwide, cities are expanding at their fringe to accommodate population growth. Low-density residential development, urban sprawl, and car dependency are common, contributing to physical inactivity and obesity. However, urban design and planning can modify urban form and enhance health by improving access to healthy food, public transport, and services. This study used a sequential mixed methods approach to investigate associations between food outlet access and body mass index (BMI) across urban-growth and established areas of Melbourne, Australia, and identify factors that influence local food environments. Population survey data for 3141 adults were analyzed to examine associations, and 27 interviews with government, non-government, and private sector stakeholders were conducted to contextualize results. Fast food density was positively associated with BMI in established areas and negatively associated in urban-growth areas. Interrelated challenges of car dependency, poor public transport, and low-density development hampered healthy food access. This study showed how patterns of suburban development influence local food environments and health outcomes in an urbanized city context and provides insights for other rapidly growing cities. More nuanced understandings of the differential effect of food environments within cities have potential to guide intra-city planning for improving health and reducing inequities.
Sponsorship is a rapidly growing tool in both commercial and social marketing areas, in Australia and overseas. Australian health promotion foundations distribute substantial funds to arts, sports, and racing organizations for the opportunity to have these organizations' events sponsored by health promoting organizations. However, in spite of substantial commercial and health expenditures, there has been little published systematic evaluation of sponsorship. Recent years have seen far more attention to this area. This article presents the results of a study designed to evaluate sponsorship effectiveness in terms of its two main communication objectives: brand awareness and brand attitude. Two health and four commercial sponsorships were evaluated at two major sporting events. Overall, the data suggest that sponsorship can influence both brand awareness and brand attitude, and that the health sponsorships had more impact than the commercial sponsors studied. These and other data confirm the potential usefulness for greater use of sponsorship in social marketing campaigns.
The neighborhood influences on walking are well recognized, yet less is known about how the environment impacts sedentary behaviors. This study used a social-ecological model to examine the correlates of sitting time, independent of walking behavior. Objective built environment measures and self-reported community participation were examined for associations with sitting time for 1,179 residents in Perth, Western Australia. Neighborhood built environment and social factors were significantly associated with women's sitting time only. In particular, the presence of community infrastructure was negatively associated with women's weekday sitting (relative reduction = 0.951; p = .037), but statistical significance weakened after accounting for community participation (relative reduction = 0.951; p = .057). Community participation was independently associated with both women's weekday and weekend sitting (both p < .001). More walkable neighborhoods may help limit women's sitting time by providing better access to community infrastructure, as local venues may afford additional opportunities for social interaction and participation.
Purpose. To examine associations between environmental and lifestyle factors and overweight or obesity. Design. A cross-sectional survey and an environmental scan of recreational facilities. Setting. Metropolitan Perth, Western Australia. Subjects. Healthy sedentary workers and homemakers aged 18 to 59 years (n = 1803) living in areas within the top and bottom quintiles of social disadvantage. Measures. Four lifestyle factors, one social environmental factor, and five physical environment factors (three objectively measured). Results. After adjustment for demographic factors and other variables in the model, overweight was associated with living on a highway (odds ratio [OR], 4.24; 95% confidence interval [CI], 1.62–11.09) or streets with no sidewalks or sidewalks on one side only (OR, 1.35; 95% CI, 1.03–1.78) and perceiving no paths within walking distance (OR, 1.42; 95% CI, 1.08–1.86). Poor access to four or more recreational facilities (OR, 1.68; 95% CI, 1.11–2.55) and sidewalks (OR, 1.62; 95% CI, .98–2.68) and perceiving no shop within walking distance (OR, 1.84; 95% CI, 1.01–3.36) were associated with obesity. Conversely, access to a motor vehicle all the time was negatively associated with obesity (OR, .56; 95% CI, .32–.99). Watching 3 or more hours of television daily (ORs, 1.92 and 1.85, respectively) and rating oneself as less active than others (ORs, 1.66 and 4.05, respectively) were associated with both overweight and obesity. After adjustment for individual demographic factors and all other variables in the model, socioeconomic status of area of residence and leisure-time physical activity were not associated with overweight or obesity. Conclusion. Factors that influence overweight and obesity appear to differ, but aspects of the physical environment may be important. Objectively measured neighborhood environment factors warrant further investigation.
