Environmental and Policy Approaches to Increase Physical
  Activity: Community-Scale Urban Design Land Use Policies


Center for Disease Control, February 19, 2013

Community-scale urban design land use policies and practices involve the efforts of urban planners, architects, engineers, developers, and public health professionals to change the physical environment of urban areas of several square miles or more in ways that support physical activity. They include the following.

  • Design elements that address:
    • Proximity of residential areas to stores, jobs, schools, and recreation areas
    • Continuity and connectivity of sidewalks and streets
    • Aesthetic and safety aspects of the physical environment

  • Policy instruments such as zoning regulations, building codes, other governmental policies, and builders’ practices

Summary of Task Force Recommendations & Findings
The Community Preventive Services Task Force recommends design and land use policies and practices that support physical activity in urban areas of several square miles or more based on sufficient evidence of effectiveness in facilitating an increase in physical activity.

Results from the Systematic Reviews
Twelve studies qualified for the review and evaluated a variety of effect measures.

  • Most of the studies compared the behavior of residents in automobile-oriented (or suburban) communities with those in traditional (or urban) communities.

  • Overall, the median improvement in some aspect of physical activity (e.g., number of walkers or bicyclists) was 161%.

  • Additional benefits that may have been brought about by these interventions included:
    • Improvements in green space
    • Increased sense of community and decreased isolation
    • Increased consumer choice for places to live
    • Reduced crime and stress

  • Increased walking and bicycling on urban streets, although beneficial, also pose the risk of increased injury to pedestrian or cyclist, because of increased exposure to motor vehicles.

These results were based on a systematic review of all available studies, conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice and policy related to physical activity.

The Community Preventive Services Task Force
The Task Force is an independent, nonfederal, uncompensated body of public health and prevention experts, whose members are appointed by the Director of CDC. Task Force members:

  • Oversee the prioritization process for which systematic reviews to conduct

  • Participate in development and refinement of review methods

  • Serve as members of individual review teams

  • Consider the findings of all reviews and issue recommendations and findings to help inform decision making about policy, practice, research, and research funding in a wide range of U.S. settings

Task Force Members

  • Jonathan E. Fielding, MD, MPH, MBA (Chair)
    Director of Public Health and Health Officer, County of Los Angeles Department of Health

  • Barbara K. Rimer, DrPH, MPH (Vice-Chair)
    Dean, Gillings School of Global Public Health, University of North Carolina at Chapel Hill

  • Ned Calonge, MD, MPH
    President and CEO, The Colorado Trust

  • John M. Clymer
    Executive Director, National Forum for Heart Disease & Stroke Prevention; Adjunct Assistant Professor, Loma Linda University School of Public Health

  • Karen Glanz, PhD, MPH
    George A. Weiss University Professor, Schools of Medicine and Nursing, University of Pennsylvania

  • Ron Z. Goetzel, PhD, MA
    Research Professor and Director, Institute for Health and Productivity Studies, Rollins School of Public Health, Emory University, Vice President, Consulting and Applied Research, Analytic Consulting and Research Services, Truven Health Analytics

  • Lawrence W. Green, DrPH DSc(Hon.)
    Professor, Dept of Epidemiology and Biostatistics, School of Medicine, University of California at San Francisco

  • Robert L. Johnson, MD
    Dean, Professor of Pediatrics, Professor of Psychiatry, and Director of the Division of Adolescent and Young Adult Medicine UMDNJ-New Jersey Medical School

  • C. Tracy Orleans, PhD
    Senior Scientist and Distinguished Fellow Robert Wood Johnson Foundation

  • Nicolaas P. Pronk, PhD, FACSM, FAWHP
    Vice President, Health Management, and Health Science Officer, HealthPartners; Senior Research Investigator, HealthPartners Research Foundation; Adjunct Professor of Society, Human Development and Health, Harvard School of Public Health

  • Gilbert Ramirez, DrPH
    Senior Associate Dean of Academic Affairs and Educational Effectiveness, School of Public Health, West Virginia University

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