Prepared by Kim Perrotta, CHASE, May 2024
When working to influence policies and investments in local communities, it is useful to recognize the intersection that exists between population health, health equity, and sustainability. Communication surveys indicate that people are more likely to support climate-related policies when they understand that those policies can produce immediate health benefits. In addition, when investments are being made in local communities to transition away from fossil fuels that are driving climate change, it is essential that consideration be given to how those investments can improve population health and reduce social inequities. Policies that foster walkable neighbourhoods have the potential to improve health and health equity, while also reducing greenhouse gases that cause climate change. These policies can increase levels of physical activity, support efficient public transit, and increase affordable access to essential services, jobs, and recreational opportunities, all of which contribute to health.
Walkable Neighbourhoods and Transit-Supportive Communities Fight Climate Change
Different terms have been used to describe neighbourhoods and communities that encourage active modes of transportation and transit use, such as “walkable neighbourhoods”, “walkable and transit-supportive communities”,[1] and “15-minute neighbourhoods”.[2]
The impact of urban form on human-induced climate change is crucial because most of the GHGs emitted within urban centres are related to the fossil fuels used for transportation and for the heating and cooling of buildings. The volume of fuel used in both sectors is related, to some extent, on factors such as population density, job density, land use mixtures, and the overall design of communities and transportation systems.[3]
A systematic review of the relationship between urban form and climate change demonstrates that urban sprawl is associated with “indisputable environmental costs, including climate change”. While “urban sprawl” is defined in many different ways in peer reviewed studies, the common characteristics are low-intensity land development patterns, low population density, the segregation of different types of land uses, and dependence upon automobiles as the primary mode of transportation. Walkable and transit-supportive communities, are generally characterized by higher population densities and a diversity of land uses in close proximity to one another organized in a way that supports walking and the use of public transit.[4]
An Urban Land Institute study found that more compact development patterns can reduce the distance travelled by vehicles by 20-40% and that people in the most walkable neighbourhoods drive 26% less often than those who live in more sprawling neighbourhoods.[5]
Walkable Neighbourhoods Increase Physical Activity and Reduce Chronic Diseases
Studies conducted over the last two decades indicate that people who live in walkable neighbourhoods are more likely to be physically active. However, it has not been clear if these associations were sufficient to have a meaningful impact on health. A large population study was designed to address this question. It examined the levels of physical activity in people from 6 to 79 years of age drawn from urban areas across Canada. The respondents were divided into five categories based on the walkability of their neighbourhoods using the Street Smart Walk Score® values. In all but the youngest group, people who lived in the most walkable areas engaged in significantly more physical activity than those in the less walkable areas. On average, among the adults 30 to 44 years of age, those living in the most walkable neighbourhoods were physically active for almost 15 minutes/day more than people living in less walkable neighbourhoods. These 15 minutes/day account for over two-thirds of the 150 minutes/week of moderate to vigorous physical activity that are recommended as a minimum for adults to maintain good health. The authors concluded that highly walkable areas can have a meaningful impact on the risk of chronic disease.[6]
Walkable neighbourhoods may also have an important impact on the commuting behaviour of school-aged children. A study that examined the school commuting habits of 11,006 children, 11 to 20 years of age, in Ontario, found that students who attend schools in more walkable neighbourhoods are more likely to walk or cycle to school. These are important findings when one considers that only one in five children in Canada currently walk or cycle to school.[7]
Walkable Neighbourhoods Improve Metabolic Health
Many studies have examined the impact that walkable neighbourhoods have on obesity, hypertension, and Type 2 diabetes, all of which are risk factors for cardiovascular disease (CVD). In their review, Nicholas Howell and Gillian Booth found that walkable neighbourhoods:
- Increase levels of physical activity, in a clinically important way, among residents; and
- Decrease Body Mass Index, obesity, prediabetes, diabetes, and hypertension, among residents; and
- May have greater health benefits for lower income neighbourhoods.[8]
Walkable Neighbourhoods Reduce Premature Deaths and Health Inequities
Several studies suggest that neighbourhood walkability may also be associated with a reduced risk of premature deaths, and that these benefits may be greater for socially and economically disadvantaged populations. A long-term study that examined 1.8 million adults who live in Canadian urban areas over 15 years has added weight to this view. It found that adults who live in walkable neighbourhoods have lower rates of premature deaths from CVD and all other non-accidental causes, with the greatest benefits occurring among those in the lowest socioeconomic groups. Specifically, it found that, relative to people living in the least walkable neighbourhoods, people who live in the most walkable neighbourhoods were:
- 9% less likely to die prematurely from CVD;
- 13% less likely to die prematurely from a stroke; and
- 3% less likely to die prematurely from all non-accidental causes.
These differences were greater for socially and economically disadvantaged populations. People living in the most walkable neighbourhoods who had little education, low household income, or lived in highly deprived neighbourhoods were 9%, 15% and 25% less likely respectively to die prematurely from CVD than similar populations living in the least walkable neighbourhoods.[9]
Neighbourhood Characteristics that Foster Active Travel
The relationship between urban design and transportation networks on active modes of travel, including public transit, have been documented in a robust body of literature. The neighbourhood features that foster active modes of travel are often referred to as the “5Ds”:
- Density of population and jobs – Sufficient densities to support local businesses and efficient transit service;
- Diversity of land uses – Stores, restaurants, and community services located in close proximity to homes;
- Design of transportation networks – Supportive street designs (e.g., grid pattern) and infrastructure (e.g., sidewalks, crosswalks, good street lighting, and street furniture) that make walking safe, pleasant and convenient;
- Distance to transit – Transit stops within a short distance (e.g., less than 10-minute walk) of homes and workplaces); and
- Destination accessibility – A transit network that can deliver people to popular or common destinations, particularly if the service can rival driving for comfort and convenience.[10]/[11]
Walkable Neighbourhoods and Health Equity
In a typical community, 20-40% of people do not drive because of income, age, or ability.[12] This means that many people within our communities are dependent on other people, active modes of transportation, or public transit to access jobs, essential services, and recreational opportunities.[13] Research suggests that people living on low incomes are more likely to live in areas where there is poorer access to schools, stores, and other essential services.[14] When low-income neighbourhoods are more walkable and bikeable in their design, and serviced with efficient transit services, social and health inequities can be reduced because those who cannot drive or afford a car have more affordable and better access to jobs, health services, grocery stores, and recreational facilities.[15]
Policies to Promote
- Land use planning policies that foster walkable or 15-minute neighbourhoods
- Revitalizing low-income neighbourhoods with essential amenities, parks, and transit stops that support walking and transit as modes of transportation
To learn more, see the report and blogs produced by CHASE with the CPHA and OPHA:
- Report: Climate Change, Population Health and Health Equity: Public Health Strategies and Five Local Climate Solutions that Produce Health and Health Equity Benefits
- Blog: Public Health and Planning Co-Creating 15-Minute Neighbourhoods in Ottawa
[1] Daniel K & Perrotta K. 2009. Creating Walkable and Transit-Supportive Communities in Halton Region. Prepared for Halton Region in Ontario.
[2] City of Ottawa. 2021. Official Plan. November 2021. https://engage.ottawa.ca/the-new-official-plan
[3] Feng Q Gauthier P. 2021. Untangling Urban Sprawl and Climate Change: A Review of the Literature on Physical Planning and Transportation Drivers. Atmosphere. 12, 547.
[4] Feng Q Gauthier P. 2021. Untangling Urban Sprawl and Climate Change: A Review of the Literature on Physical Planning and Transportation Drivers. Atmosphere. 12, 547.
[5] Flatlow D. undated as cited by Macfarlane R Perrotta K. 2019. Module 5: Climate Change Solutions with Immediate Health Benefits. Climate Change Toolkit for Health Professionals. Edited by K Perrotta. Canadian Association of Physicians for the Environment.
[6] Thielman J et al. 2016. Residents of highly walkable neighbourhoods in Canadian urban areas do substantially more physical activity: a cross-sectional analysis. CMAJ Open.
[7] Cottagiri SA et al. 2021. Are school-based measures of walkability and greenness associated with modes of commuting to school? Findings from a student survey in Ontario, Canada. Can J Public Health. Vol 112.
[8] Howell N Booth G. 2022. The Weight of Place: Built Environment Correlates of Obesity and Diabetes. Endocrine Reviews, February.
[9] Lang J et al. 2022. Neighbourhood walkability and mortality: Findings from a 15-year follow-up of a nationally representative cohort of Canadian adults in urban areas. Environmental International. Vol 161.
[10] Ewing R Cervero R. 2010. Travel and the Built Environment, Journal of the American Planning Association, 76:3
[11] Daniel K. and Perrotta K. 2017. Prescribing Active Travel for Healthy People and a Healthy Planet: A Toolkit for Health Professionals. Prepared for the Canadian Association of Physicians for the Environment.
[12] Litman T 2017 as cited by Daniel K Perrotta K. 2017. Prescribing Active Travel for Healthy People and a Healthy Planet. Canadian Association of Physicians for the Environment.
[13] Frank LD, Engelke P, & Schmid T. 2003 Health and community design: the impact of the built environment on physical activity. Island Press.
[14] Lucas K et al. 2016. Transport poverty and its adverse social consequences. Transport – Proceedings of the Institution of Civil Engineers.Volume 169 Issue 6, December
[15] World Health Organization (WHO). 2011. Health co-benefits of climate change mitigation – Transport Sector.