At the Intersection of Urban Planning and Health in the New York Metro Region

Jul 12, 2016, 4:48 PM, Posted by Mandu Sen

Urban planning plays a role in addressing health challenges in America and can help give everyone the opportunity to live their healthiest lives possible. A new report shows us how.

More perhaps than any place in the world, the New York metropolitan region is known for its urban form—its physical layout and design. From the Manhattan skyline to the neon lights and tourist-packed streets of Times Square to the rolling hills and winding paths of Central Park, New York’s built and natural environment is part of what makes it such a vibrant, dynamic place to live. The distinctive form also has important health impacts. But, as discussed in a new report, State of the Region’s Health: How the New York Metropolitan Region’s Urban Systems Influence Health, these impacts are often poorly understood.

The report, written by the Regional Plan Association (RPA) with support from RWJF, provides an in-depth look at health in the New York metropolitan region, where 23 million people live in cities, suburbs, villages and rural communities stretching from New Haven, Connecticut to Ocean County, New Jersey. It finds that New York region residents live longer than U.S. residents overall, but they are not necessarily healthier.

People of the region fared less well than residents of other large metropolitan areas on broad measures of health. For example, they reported having more bad health days—both physically and mentally—than other Americans. And although average life expectancy in the New York region increased significantly between 1990 and 2010, those gains did not benefit everyone equally. Life expectancy for blacks is four to seven years shorter than for whites and Hispanics. Men in Morris County, New Jersey live six years longer than men in neighboring Essex County. Across the region, health problems tend to be concentrated in poor, non-white communities.

Additionally, the overall gains in life expectancy don’t translate into overall quality of life. The region’s performance in some measures of quality of life is average compared to other regions: in the New York area the typical adult reports feeling both physically and mentally unhealthy 3.3 days a month, compared to 2.9 days for the best performer, Washington, D.C.

Air and water quality, the location of affordable housing, access to public transportation—these and other factors are all part of the environmental mix that shapes our health. Housing affordability in particular is a challenge in the New York region where 45 percent of households spend more than 30 percent of their income on housing. That’s why regional and urban planners need to integrate planning for health with planning for community.

This isn’t an entirely new idea. Modern-day urban planning began largely in response to health crises such as infectious disease epidemics. Notable successes included the development of sanitation and water systems and municipal parks, which the great landscape architect Frederick Law Olmsted described as the “lungs of the city,” enabling urban dwellers to breathe clean air and enjoy the health benefits of nature.

Today, we face different health challenges, from chronic diseases such as heart disease, cancer and diabetes, as well as from the increasingly pervasive effects of climate change. Addressing these health concerns requires thinking explicitly about how urban planning affects a community's health. That means examining how the physical features of our community landscapes—sidewalks, roads, transit systems and buildings—serve either as health assets or health obstacles.

For example, health-oriented urban planning today would factor in not only the need for public parks, but also the need for walkability so that residents can enjoy walking as part of their everyday lives. It would also factor in the cost and ease of getting to parks and beaches and other important destinations, like grocery stores and large employers. This is particularly important for people in low-income urban neighborhoods or suburbs who rely on public transportation.

And while urban planners are increasingly integrating physical activity, food access and environmental considerations into their work, there is much more to be done. This is a shared responsibility that requires collaboration among planning departments, transportation agencies, housing departments, school districts, public health agencies and others to ensure that our homes, workplaces, schools and streets promote our well-being. It requires a system approach to planning, as well as an open and inclusive process that enlists the input of residents from low-income and underserved communities, which often are left out of such conversations.

Several regional planning partnerships are showing how this can be done. The Southern California Association of Governments is investing $500 billion in transit-oriented development after health professionals and urban planners came together to reduce air pollution and increase walkability in the region. In Pennsylvania, the Delaware Valley Regional Planning Commission has conducted a wide-ranging study exploring what it will take to create a regional food system to help ensure access to healthy food for people in low-income communities.

Urban planning is health planning, and vice versa. Everyone deserves the opportunity to live the healthiest life possible, regardless of where they live. Everyone deserves the opportunity for  the healthiest life possible, regardless of where they live. The RPA report shows that when we place health at the center of planning and policymaking, a Culture of Health is within reach.

Read the full State of the Region's Health Report to learn more on how the New York Metropolitan region's urban systems influence health.

Mandu Sen is a senior planner at Regional Plan Association, working primarily on the Fourth Regional Plan, a long-range vision for the New York Metro area's shared prosperity, health, resiliency and good governance. Read her full bio.