This article from the Lancet discusses the link between cities, city planning, and population health.  Nothing is really new here, with a focus on density, public transportation and active transportation.  This reflects thinking from UBC’s School of Population and Public Health, plus City of Vancouver’s active transportation policies.  But it’s a powerful voice from another part of the world.
The Lancet’s authors are re-thinking disease prevention, and in the first of a three-part series, conclude this:

A key part of the solution is city planning that reduces non-communicable diseases and road trauma while also managing rapid urbanisation.
This Series of papers considers the health impacts of city planning through transport mode choices. In this, the first paper, we identify eight integrated regional and local interventions that, when combined, encourage walking, cycling, and public transport use, while reducing private motor vehicle use. These interventions are

  • Destination accessibility
  • Equitable distribution of employment across cities
  • Managing demand by reducing the availability and increasing the cost of parking
  • Designing pedestrian-friendly and cycling-friendly movement networks
  • Achieving optimum levels of residential density
  • Reducing distance to public transport
  • Enhancing the desirability of active travel modes (eg, creating safe attractive neighbourhoods and safe, affordable, and convenient public transport).

New Point Grey

. . . .  Designing pedestrian-friendly and cycling-friendly cities will help to reduce inequities and produce co-benefits across multiple sectors, including health, traffic management, environment (mobility, air quality, energy, water, and climate change), and the economy. Better planned and designed cities will help to build communities by decreasing commute and mandatory travel times away from one’s neighbourhood.
City planning is therefore an essential element of a multilevel, multisector response to face the major global health challenges of the 21st century. Appropriate legal, administrative, and technical urban planning and design frameworks are urgently needed to create more compact cities that facilitate active travel modes to promote health and lower greenhouse gas emissions.
Active transportation has been identified as a key personal choice that helps reduce the incidence of several common chronic conditions, such as coronary heart disease, type 2 diabetes, colon cancer, and breast cancer, as well as reducing life expectancy.

In the light of recent discussions, I am pleased to see that “road trauma” (people maimed and killed by cars, then blamed, followed by laughable penalties for death-dealing motor-vehicle operators) is also in the sights of the Lancet’s authors. Perhaps this paper helps start the wider conversation about Canada’s car culture, and how it seems so at odds with life, health and safety.  But I’m not expecting much to change.
To quote the Lancet article:

The health burden of motor vehicle-related injuries continues to disproportionately affect active transport users (as discussed in this Series) and those without access to a vehicle, including poor, young, and older people. Concerns about traffic and road safety are a major deterrent to parents permitting children to use active travel modes. In high-income countries, such as the USA and Australia, many city streets have become child-free zones, with rapid declines in the number of children using active transport modes to travel to and from school and around their neighbourhoods.
In several countries (eg, Germany, France, The Netherlands, and Sweden), injury and fatality rates for active transport users have been reduced by more than 70% (from 1975 to 2001).  These countries have implemented new laws of strict liability, where vulnerable road users (not drivers) are assumed to be innocent. These countries have also lowered speed limits in towns and cities to 30 km/h; introduced high-quality transport systems; introduced demand management strategies, including reduced car parking; devised protective road designs that reduce conflicts between pedestrians, cyclists, and drivers; and improved traffic signals. These practices could be trialed elsewhere to reduce the global burden of road injury while also increasing the demand for active travel and reducing NCD risks.


  1. I sincerely believe that if healthcare was used as an instrument of planning our transit system would have been fully funded two generations ago and terms like “car culture” would be meaningless.

    1. Ditto for cycling. Heath benefits from cycling are so impressive that it is like the proverbial money tree. If the provincial government invested $1 to $2 billion in cycling, then with matching funds provided by municipal and the federal government, we could have complete cycling networks in all municipalities in BC. Imagine the health benefits that this would achieve.

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