Audrey de Nazelle, MS, Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, CB# 7431, Chapel Hill, NC 27599, 919 843 3298, anazelle@email.unc.edu

Health organizations and foundations are increasingly calling for new approaches that involve changes in the built environment to address complex health problems. Health experts are forming partnerships with architects, planners and developers to work on designs that promote healthier lifestyles and sustainable living conditions. In particular, community designs that encourage integrating walking and cycling into daily routines as a way of life are seen as potential solutions to the obesity epidemic the U.S. faces today. Yet, the net health effect that results from changes in the built environment aimed at improving the walkablity and bikeability of communities is not known today. For instance, none of the empirical work to date has examined the extent to which increases in physical activity can result in higher exposures to hazards such as air pollution or traffic injuries. This paper lays the framework for conducting a risk assessment in a pedestrian-oriented environment. Theoretical and empirical findings that link community design to behavioral and health endpoints are reviewed. In particular, health behavior, transportation, and design studies are synthesized to uncover key behavior determinants and develop quantitative measures of active transportation and physical activity behavior resulting from features of the microscale environment. Epidemiological and environmental sciences literature provide the basis for describing qualitatively and quantitatively relationships between microscale design features, exposure profiles, and health outcomes resulting from lifestyle choices and hazardous exposures. A comprehensive conceptual model is developed as a framework to study the health and quality of life impacts of creating more walkable environments.

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