A study of the link between city walkability and blood pressure, the largest ever conducted, has been held up as evidence of the "intangible value of urban design" in improving long-term health outcomes, said researchers.
The study of about 430,000 people aged between 38 and 73 and living in 22 British cities found significant links between a neighbourhood's increased walkability, lower blood pressure and reduced hypertension risk among its residents.
The outcomes were consistent even after adjustments for socio-demographic, lifestyle and physical environment variables, though the protective effects were particularly pronounced among participants aged between 50 and 60, women, and those residing in higher density and deprived neighbourhoods.
The paper was published in the International Journal of Hygiene and Environmental Health last week.
With hypertension a major risk factor for chronic and particularly cardiovascular diseases, researchers at the University of Hong Kong and Oxford University said the findings demonstrated the need for public health interventions to factor in urban design.
"With the increasing pace of urbanisation and demographic shifts towards an ageing population, we become more vulnerable to chronic diseases," said Dr Chinmoy Sarkar, an assistant professor at the Healthy High Density Cities Lab of the University of Hong Kong and lead author of the study.
"Public health interventions must consider the intangible value of urban planning and design.
"We are spending billions of pounds in preventing and curing cardiovascular diseases - if we are able to invest in creating healthy cities through small retrofits in the design of our neighbourhoods to make them more activity-friendly and walkable, then probably, we will have significant savings in future healthcare expenditures."
To measure a neighbourhood's activity-promoting potential, researchers developed an index of walkability comprising relevant urban metrics, including residential and retail density, public transport, street-level movement, and proximity to attractive destinations.
Poorly designed spaces generally inhibited walking and physical activity, promoting sedentary lifestyles; and were detrimental to social interactions, and as such associated with poorer mental health and well-being.
Because walkability was based on the underlying design of a city, such places could be modified or designed to encourage it.
"Such investments in healthy design are likely to bring in long-term gains as they are enduring and all-pervasive," said Dr Sarkar.
The world's urban population is growing, with more than half (54.5 per cent) of the total population living in cities. That figure is expected to rise to 60 per cent by 2030, with one in three living in cities with at least half-a-million inhabitants.
Designing and retrofitting cities to promote active lifestyles could therefore have significant repercussions for the health of urban populations and governments' expenditure worldwide, said Dr Sarkar.
"Well-designed cities of today will be healthy cities of tomorrow."
THE GUARDIAN
