In Governing, Alan Ehrenhalt highlights the link between urban design and public health, highlighting the arguments of public health experts that the way we design cities and buildings has a powerful impact on the health of individuals and populations.
Much of public health by design has to do with temperature re-engineering, particularly making the environment cooler at abnormally hot times and places. Reducing the amount of bituminous surfacing is one way to achieve this; too much bitumen creates a heat trap. The protection of tree cover is one more; sufficient tree cover has been shown to reduce the prevalence of asthma in large cities.
As another example, walkability affects people’s ability to exercise regularly by walking to work, school, or local amenities. Meanwhile, polluted air can counteract the positive effects of good sidewalks and crosswalks by contributing to the prevalence of lung and respiratory diseases.
Ehrenhalt provides other examples of design choices that impact public health, including stairs, ventilation, and outdoor seating. But while he does support the concept, Ehrenhalt warns that “adding health impact studies, in addition to forcing hard-to-make long-term predictions, would add significantly to the bureaucracy problem.” Nonetheless, public health lessons from the past century can inform design decisions that create healthier cities.