TRB Special Report 282 DOES THE BUILT ENVIRONMENT INFLUENCE PHYSICAL ACTIVITY?

EXAMINING THE EVIDENCE

Transportation, Land Use, and Physical Activity

Safety and Security Considerations

ANASTASIA LOUKAITOU-SIDERIS

Paper prepared for the Transportation Research Board and the Institute of Medicine Committee on Physical Activity, Health, Transportation, and Land Use

Anastasia Loukaitou-Sideris is Chair and Professor, Department of Urban Planning, University of California, Los Angeles.

Contents
Summary.........................................................................................................................................1 Introduction....................................................................................................................................2 Relationships and Factors Influencing Physical Activity...........................................................3 Types of Physical Activity...................................................................................................3 Theories Explaining Physical Activity ................................................................................4 Personal-Level Perspectives ....................................................................................4 Ecological Perspectives ...........................................................................................5 Variables Affecting Physical Activity .................................................................................6 Individual Characteristics ........................................................................................6 Social Characteristics...............................................................................................6 Physical/Environmental Characteristics of Settings ................................................7 Safety, Security, and Physical Activity ........................................................................................8 Types of Safety/Security......................................................................................................8 Physical Activity and Neighborhood Safety........................................................................9 Safety and Security Concerns among Different Sub-Populations .....................................11 Women...................................................................................................................11 Low Income People ...............................................................................................11 Children..................................................................................................................12 Adolescents ............................................................................................................13 Older Adults...........................................................................................................13 Racial/Ethnic Minorities ........................................................................................14 Urban/Suburban/Rural Context .............................................................................15 Safety, Security, and the Built Environment.............................................................................16 Crime and the Built Environment ......................................................................................16 Protecting Neighborhood Settings from Crime Through Planning and Design ................18 Fixing Broken Windows ........................................................................................19 Facilitating Eyes on the Street ...............................................................................19 Lighting the Way ...................................................................................................20 Eliminating Bad Neighbors....................................................................................20 Creating Safe Territories........................................................................................20 Protecting Access Routes and Destination ............................................................20 Complementarity of Strategies ..............................................................................20 Traffic Safety and the Built Environment..........................................................................21 Protecting Neighborhood Settings from Traffic ................................................................23 Conclusion ....................................................................................................................................26 References.....................................................................................................................................27 Tables and Figures.......................................................................................................................37

SUMMARY The importance of walking and physical activity as determinants of good health has been well established in the medical and public health literature. At the same time, a significant number of Americans live sedentary lifestyles. A plethora of variables lie behind an individuals decision to walk, cycle, or exercise. This paper focuses on a particular environmental variablethe safety of neighborhood surroundingsand explores how it is influencing physical activities. It also presents a normative framework of possible design and policy interventions that could make the neighborhood setting safer. The paper is divided into three parts. The first part summarizes background information regarding the various factors and relationships that influence an individuals decision to engage in physical activity. This part includes a concise description of the different types of physical activity (recreational and utilitarian), the theories that have been developed to explain mediators and moderators of such activity (personal level and ecological), and the classes of variables that affect an individuals decision to engage in walking, cycling, and/or other forms of physical exercise (individual characteristics, social characteristics, and physical/environmental characteristics). The second section presents an extensive literature review which identifies, qualifies, and evaluates the link between safety and security considerations and physical activity. While most empirical studies identify an important connection between the perceived security of the public environment and the propensity to walk or exercise, a few studies fail to observe such connection. The mixed results can be attributed to the different ways that researchers chose to evaluate and measure safety, the different types of dangers, and the fact that different subpopulations are impacted by safety and security concerns differently. This section distinguishes and discusses concerns about neighborhood crime as well as neighborhood traffic and their impact on physical activity. It explores how concerns about crime and traffic affect distinct subpopulations (women, low-income people, children, adolescents, older adults, racial/ethnic minorities), and how variations in neighborhood settings and urban morphology may affect the decision to walk or exercise The third section places safety and security concerns within a spatial context and examines design and policy interventions that can create defensible space. Criminological theories have established a clear link between specific environmental conditions and opportunities for crime. Similarly, the field of traffic safety has shown significant relationships between certain physical/environmental and traffic characteristics of the neighborhood and pedestrian collisions. Two major categories of interventions are discussed: 1) countermeasures to neighborhood crime; and 2) measures that mitigate the effects of traffic. Specific examples of both classes of interventions are discussed. Design interventions against crime can include the general upkeep and maintenance of the public environment, the orientation of public spaces and facilities away from negative land uses and in ways that enable natural surveillance from surrounding establishments, emphasis on adequate lighting, elimination of entrapment spots in public settings, and the creation of safe places (sidewalks, bike paths) for people to walk and bike. Coordination with other security strategies, including policing, the use of technology, educational programs, and the employment of social networks, is deemed essential. Design and policy actions to counteract the effects and danger from traffic include measures to regulate traffic, decrease traffic volumes, and reduce traffic speed in the neighborhood. These environmental modifications are more effective if they are complemented by informational

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

campaigns aimed to alter reckless behavior of drivers, cyclists, and pedestrians. Creation of defensible space (against the dangers of crime and/or traffic) is also enhanced by community support in the form of strong social networks which can offer informal surveillance of public settings. Finally, interventions should be tailored to the needs of particular sub-groups, as well as the sociophysical characteristics of the neighborhood and its various settings.

INTRODUCTION Current levels of physical activity among Americans remain low, and we are losing ground in some areas. The good news is that people can benefit from even moderate levels of physical activity. The public health implications of this good news are vast: the tremendous health gains that could be realized with even partial success at improving physical activity among the American people compel us to make a commitment and take action. With innovation, dedication, partnering, and a long-term plan, we should be able to improve the health and well-being of our people. (U.S. Department of Health and Human Services 1996). The Surgeon Generals Report on Physical Activity and Health, released in 1996, summarizes the positive effects of physical activity on numerous illnesses, and recommends that adults engage in a 30-minute moderate physical activity at least 5 days per week. But the good news in the report is followed by worrisome facts. A significant portion of the population in the United States is irregularly active or sedentary (King et al. 2002a), and an estimated threequarters of Americans do not meet the reports standard. Partly as a result of inactivity, about one quarter of the population is obese and 61% is overweight (Killingsworth 2001). At the same time, a sedentary lifestyle is considered to be a primary factor in more than 200,000 deaths per year. Walking is the most common physical activity, reported by 20% of Americans (Ross 2000). Yet walking and physical activity are decreasing rapidly in the United States. According to the 2000 census, 87.9% of all commuter trips were in private automobiles; 4.7% were by bus and rail systems, 2.9% were walking trips, 0.4% were bicycle trips; and 0.8% were by other modes; and 3.3% of the population worked at home (U.S. Census Bureau 2000). The market share of commuters who are walking or cycling to work has dropped significantly in the last decade (Table 1). At the same time, walking and biking trips to school have decreased by 40% in the past 20 years (Killingsworth 2001). But why is the propensity of Americans to walk or cycle decreasing over the years? A number of interrelated factors have been found to affect an individuals tendency for physical activity, including walking and cycling. These range from individual-level capacities (sociodemographic, cultural, and behavioral characteristics, and lifestyle attitudes and preferences) to society-level characteristics (social norms, public policies, and market forces). At the same time, physical activity takes place in a spatial context. Environmental characteristics at the scale of the building site, the neighborhood, or the metropolitan area are also likely to influence an individuals opportunity to walk, bike, play, or exercise outdoors. In the last decade, a wide range of environmental characteristics have received increasing attention by scholars and public health experts. This focus stems from the fact that such characteristics may be modifiable and can be manipulated or changed to achieve environments which are presumably more friendly

Loukaitou-Sideris

and hospitable to physical activity. This paper will focus on a particular environmental variable: the safety and security of neighborhood surroundings. It will explore the relative importance of safety and security in influencing walking and other physical activity, and will present a normative framework of possible interventions that can make the neighborhood setting safer. The paper is composed of three major sections: 1. The first section gives background information regarding the plethora of factors and relationships that seem to influence an individuals decision to engage in physical activity. This part includes a concise description of the different types of physical activity, the theories that have been developed to explain mediators and moderators of such activity, and the classes of variables that affect an individuals decision to engage in walking, cycling, or other forms of physical exercise. 2. The second section presents an extensive literature review which identifies, qualifies, and evaluates the link between safety and security considerations and physical activity. Concerns about neighborhood crime as well as neighborhood traffic and their impact on physical activity are discussed. This section also explores how concerns about crime and traffic affect distinct sub-populations differently, and how variations in neighborhood settings and urban morphology may affect the decision to walk or exercise. 3. The third section places safety and security concerns within a spatial context and examines design and policy interventions that can create defensible space. Two major categories of interventions are discussed: (a) countermeasures to neighborhood crime; and (b) measures that mitigate the effects of traffic. Specific examples of both classes of interventions are discussed.

RELATIONSHIPS AND FACTORS INFLUENCING PHYSICAL ACTIVITY Types of Physical Activity Physical activity has been defined as any body of movement provided by skeletal muscles that results in a substantial increase over the resting energy expenditure (Brouchard and Shepard 1994). Physical activity can occur in various forms and contexts (Malina and Bielicki 1996) and can be categorized in different ways based on the rate of energy expenditure (objective measurement), the level of perceived effort (subjective measurement), the type of activity (e.g., walking, cycling, swimming, aerobic exercise, etc.), as well as the primary purpose of the activity (e.g., recreational, utilitarian, etc.). For the purposes of this study we will classify physical activities in two major categories (Figure 1): 1. Recreational/leisure-related physical activities can take place either within the private auspices of the home (e.g., exercise, play, etc.) or at the public environment of neighborhood streets, trails, and parks (walking, cycling, sports, etc.). 2. Utilitarian activities include walking or biking journeys to work, school, shops, and other errands, which take place in the public environment of the neighborhood and city; as well as occupation-related activities that take place at the work setting. Different factors can influence or moderate an individuals decision to participate in each different category of physical activity. For example, the availability and accessibility of

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

recreational facilities and walking paths and their perceived security and attractiveness, may influence ones propensity to engage in recreational physical activity in the neighborhood. On the other hand, utilitarian walking is likely to be affected, among other things, by the proximity of the destination, the availability and cost of other transportation modes, and the perceived safety of the route (Hawthorne 1989). At the same time, activities taking place in public settings are shaped by different factors than activities occurring within private territories. The availability of private exercise equipment may be the most significant factor affecting an individuals decision to exercise at home, while the presence or absence of sidewalks can determine his/her decision to walk in the neighborhood. In contrast to activities which take place in the private environment of the home or work, physical activities in public environments tend to be affected by the urban morphology of the site, the neighborhood, and the metropolitan area (Handy et al. 2002). Considerations regarding traffic safety or security from neighborhood crime are important for such activities. For this reason, this paper will only examine physical activities in public environments. Theories Explaining Physical Activity Different theoretical models seeking to explain mediators and moderators of physical activity have been identified in the literature. As King et al. (2002b) explain, some theories give more emphasis on the cognitive, emotional, and psychological influences surrounding the individual and his/her choices to be active (personal-level perspectives), while other theories stress the dynamic interplay among interpersonal factors, the behavior in question, and environmental influences (ecological perspectives). Personal-Level Perspectives A series of theories articulate personal-level perspectives that seek to predict and explain a physically active lifestyle. These include the following: The health-belief model which argues that a persons propensity to be active is determined by his or her perception of the consequences of a potential illness and the perceived benefits of using physical activity as a countermeasure to the risk of getting sick. (Seefeld et al. 2002). The relapse-prevention model which derives from the study of processes common to relapse in addictions, and emphasizes the significance of maintaining a desired behavior change. Even among the regularly active population, unexpected disruptions and negative factors can decrease or end engagement in physical activity. Such negative factors (e.g., limited social support or coping skills, low motivation, and interpersonal conflicts) may be diminished if the individual anticipates them and plans to counteract them by developing skills for preventing relapses to inactivity (King et al. 1992; Seefeld et al. 2002). The social-cognitive theory which emphasizes self-efficacy as a central tenet and stresses the importance of peoples ability to regulate their own behavior by setting goals, monitoring their progress towards these goals, and actively intervening to make the sociophysical environment supportive of these goals (King et al. 1992). The rational choice theory which argues that people, as rational individuals, weigh and carefully evaluate the pros and cons of their decisions and the experienced or anticipated

Loukaitou-Sideris

hurdles and benefits from physical activity (Epstein 1998). The model draws from behavioral choice theory which attempts to understand decision making under different available options. This model, which is also referred to in the literature as the expectancy-value decision theories, views behavior as a function of ones expectations of outcomes stemming from a behavior and the evaluation of these outcomes compared with outcomes of alternative actions (King et al. 1992). The transtheoretical model which proposes that individuals generally move sequentially through five major stages of change (precontemplation, contemplation, preparation, action, and maintenance) in adopting a new behavior and maintaining an active lifestyle (Seefeldt 2002). This model overlaps with some of the theoretical formulations listed previously and incorporates several other dimensions of behavior change including an estimation of the pros and cons of change and self-efficacy. Ecological Perspectives In contrast to the previous theories that privilege personal-level attributes as the all-crucial determinants affecting behavior, ecological models assume that elements of the physical and sociocultural environment interact to influence an individuals behavior and propensity to engage in an active lifestyle (Ball et al. 2001). In the last decades, ecological models that focus on the interrelationship between people and their environment have gained in popularity. The belief that environments are important determinants of health has led to interventions that consider the influence of place rather than simply focusing on altering individual behavior (Klinenberg 2002), and try to develop health-promoting environments, defined as some combination of settings, facilities, and programs that encourage physical activity (Frank and Engelke 2001:207). Ecological models focus on both the social and physical ecology of a community or neighborhood1: The social ecology of a community is the foundation for local social life, the soil of which social networks grow and develop or alternatively wither and dissolve (Klinenberg 2002). A number of studies have posited that the support of family members, friends, neighbors, co-workers, represent significant components in adapting and adhering to physical activity (Ball et al. 2001). Communities with strong social networks and cohesion can generate and encourage such support. On the contrary, the presence of neighborhood incivilities and disorder, and chronic exposure to violence and crime can have a negative influence on an individuals inclination to use the public environment for physical activity. (Taylor and Harrell 1996; Newman 1972; King et al. 2002a; Klinenberg 2002). The physical ecology of a neighborhood is defined by its urban form, i.e., its built environment, open spaces, street network, and land use mix. Physical activity takes place in a spatial context; therefore, the urban form characteristics of a setting may encourage or discourage physical activity (Sallis et al. 1997b). Public health history shows that populationlevel changes in health behaviors are unlikely to occur without the modification of underlying environmental factors (Parks et al. 2002). For example, high levels of vehicular traffic can prevent the use of sidewalks and discourage walking (Appleyard 1981). The lack of walking paths and trails, parks and open spaces prevents recreational physical activities from taking place
While the terms neighborhood and community are often used interchangeably neighborhoods are always place-based, while communities need not be.
1

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

in the neighborhood. Conversely, studies have shown that the existence of facilities such as parks near the home, encourages children, mothers, and older people to spend time outdoors, thus providing conditions conducive to physical activity (Crewe 2001; Lund 2003). An emerging literature in urban planning is exploring how different dimensions of the built environment can encourage the construction of livable communities with urban form that is sympathetic to physical activity, biking, and walking (Frank and Engelke 2001; Handy et al. 2002). Variables Affecting Physical Activity A complex interplay of promoting and constraining variables affects an individuals decision to walk, bike, or get involved in sports and exercise. Propensity towards physical activity is caused not only by individual capacities and experiences but also by social relationships and the physical characteristics of settings. There has been considerable debate among scholars about the relative importance of individual, social, and physical/environmental variables for physical activity. An interesting empirical finding comes from Gordon-Larsen et al. (2000) who found that physical activity and inactivity were affected by different determinants, with physical activity being mostly influenced by environmental factors, and inactivity being primarily determined by sociodemographic and personal factors. Individual Characteristics Individual characteristics include a persons age, gender, race/ethnicity, income, education, biomedical status, etc. A number of studies have been able to establish strong correlations between the existence of certain individual characteristics and ones propensity to engage in physical activity. Women, in general, are found to be less physically active than men in sports and vigorous exercise. However, studies that took into consideration household and other chores found women to have similar rates of physical activity to men (Eyler et al. 1998). In general, when light and moderate activities are included gender differences seem to diminish or disappear (King et al. 1992). As expected, younger age is often found to be positively associated with physical activity (Troped et al. 2001). Comparisons by race are often obscured by the impact of socioeconomic status and level of education. Nevertheless, some studies have shown that ethnic minorities, particularly African-American and Hispanic women, are less likely to adopt and maintain an active lifestyle (Seefeldt et al. 2002). University education and higher income levels are positively correlated to physical activity (Ball et al. 2001; Ross 2000). At the same time, in neighborhoods where a high percentage of people fall below the poverty line, individuals are also more likely to walk to work and to shops because of low levels of car ownership (Ross 2000; Craig et al. 2002; Giles-Corti and Donovan 2002). Other personal barriers to walking and active lifestyle include state of personal health and physical disability, lack of time, lack of motivation and energy, and lack of self-esteem. Social Characteristics Social support of family and peers and supporting social networks, as well as the availability of a companion for physical activity have been shown to influence an individuals tendency to walk

Loukaitou-Sideris

or exercise (Amesty 2003; Stahl et al. 2001). A cross-sectional survey from 1999-2000 among adults in the United States found several social factors associated with physical activity including having friends who encourage exercise, and having friends to exercise with (Brownson et al. 2001). Social variables appear to be stronger for women than men, presumably because of safety concerns which are higher among women (Ball 2001; Eyler et al. 1999). Physical/Environmental Characteristics of Settings The characteristics of settings include a multitude of variables such as the availability, accessibility, attractiveness, and safety of neighborhood spaces and facilities. In the last years, increasing attention has focused on the neighborhood as a unit of analysis and intervention, because it is understood that neighborhood settings have the potential to host a multitude of physical activities. Indeed, a recent cross-sectional study of adults in the United States found that the majority of respondents (66.1%) identified neighborhood streets as the settings where they engage in physical activity (Brownson et al. 2001). Neighborhoods present environmental constraints and opportunities. Some have walking and bike paths, wide sidewalks, parks and public pools. Others have dangerous streets, cracked pavement, and high traffic. Neighborhoods may be characterized by physical disorder (graffiti, litter, abandoned building, and disrepair) and social disorder (crime, loitering, drunkenness, drug use). Living in neighborhoods with high physical and/or social disorder generates stress and fear. The structure of a disadvantaged neighborhood may affect behavior because people who are fearful of street crime are also likely to constrain their outdoor activities (Ross 1993; Ross and Mirowski 2001; Klinenberg 2002). Conversely, quiet, safe, and clean neighborhoods invite outdoor activity. Since significant portions of walking and cycling take place in the local environment of neighborhood streets, these activities are greatly influenced by the neighborhood context. The environmental variables affecting physical activity at the neighborhood are relatively understudied. Additionally, studies examining the relationship between the perceived neighborhood environment and physical activity have yielded inconsistent findings. Two crosssectional studies did not find associations between the perceived neighborhood environment or convenience of facilities and physical activity (Sallis et al. 1997a; Sallis et al. 1989). Other studies, however, have found a positive association between the neighborhood environment and physical activity (Hovell et al. 1989; Brownson et al. 2001; Craig et al. 2002). Despite the mixed results, a rising interest in the impact of physical variables has been generated by the recognition that the physical environment can be modified. Research on physical activity and the physical environment is at the correlates stage, and it is considered quite premature to attribute causal effects. A number of recent empirical studies have tried to establish which variables are more significant determinants of physical activity under specific sociodemographic and physical conditions. Studies on the influence of the environment on physical activity have been primarily cross-sectional or case-based. The associations documented between physical activity and environmental variables have been stronger with objective environmental variables than with self-reported and perceived environmental variables (Ball et al. 2001). Variables found to be correlates include features of the local neighborhood including convenient facilities, presence of shops and parks, more aesthetically favorable and safe environments (Ball et al. 2001; Corti et al. 1997). A consistent predictor of utilitarian walking is the distance that individuals have to travel to reach their destination (King et al. 1992). On the

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

other hand, recreational physical activity seems to be influenced by spatial access, convenience, and neighborhood safety (Giles-Corti and Donovan 2002). For walking, circulation and urban design elements (traffic, lighting, sidewalks) have been suggested as important (Brownson et al. 2001; Craig et al. 2002). Khisty (1994) found seven factors responsible for increasing the use of pedestrian facilities: attractiveness, comfort and convenience, population density, mixed land uses, safety, system coherence (directness), and continuity. Many studies have reported that increased density and mixed-use development are associated with more walking and biking but there is still debate over the consistency and interpretation of such associations (Berrigan and Troiano 2002). Most of the aforementioned studies come primarily from the fields of public health and medicine and seek to establish causal relationships between certain variables and physical activity. Some recent studies from the field of urban planning have a more normative and policyoriented scope, and seek to assess how the manipulation of urban design, land use and transportation can promote more active and healthy communities. (Handy et al. 2002; Greenwald and Boarnet 2002; Frank and Engelke 2001). Handy et al. (2002) identify six dimensions of the built environment that can affect the choice of walking: 1) density and intensity; 2) land use mix; 3) street connectivitydirectness and availability of alternative routes; 4) street scale; 5) aesthetic qualities; and 6) regional structure (i.e., distribution of activities and transportation throughout the region). A study of the literature suggests that the combined and interrelated effects of a number of environmental variables can influence an individuals propensity to walk. One of the environmental variables that emerges as particularly important is the safety and security of the neighborhood setting.

SAFETY, SECURITY, AND PHYSICAL ACTIVITY Types of Safety/Security Websters abridged dictionary defines security as the state of feeling of being free from fear, care, danger, etc.; safety or a sense of safety; freedom from doubt or uncertainty; and something that gives or assures safety; protection; safeguard (Websters 1966). Most would agree with this generic meaning of security. Nevertheless, a more specific and operational classification of the different types of danger affecting pedestrians and cyclists is necessary if we want to plan for security. For individuals involved in physical activity including walking, there can be both human and non-human sources of danger2. As shown in Figure 2, human sources include criminals who may menace the streets and other public spaces, endangering and terrifying pedestrians. Heavy traffic and/or reckless drivers provide another source of danger for pedestrians and cyclists, as their presence increases the possibility of pedestrian-automobile collisions. Non-human sources of danger include unattended dogs which can attack and injure pedestrians and cyclists, and poor or absent roadway infrastructure (cracked or uneven pavement, lack of sidewalks) that can cause falls and injuries.

Lee Rainwater (1979) first used the distinction of human and non-human sources of danger in his classic study of public housing residents in St. Louis.

Loukaitou-Sideris

It should be noted that safety or lack thereof can be perceived or actual, i.e., an environment can be truly unsafe and dangerous, based on objective criteria of measurement3 or can be perceived as such, based on subjective individual perceptions. Regardless if perceptions are true or not, they have the power to affect an individuals propensity to voluntarily be in a setting perceived as unsafe. Physical Activity and Neighborhood Safety While intuitively most would agree that if an environment is perceived as unsafe most people would not want to walk, cycle, or simply be there, the literature has mixed findings about the impact of perceived safety and security on physical activity and walking. A 1994 U.S. Department of Transportation survey found that half of the respondents would walk or walk more if there were safe pathways and crime was not a consideration (U.S. Department of Transportation 1994). Bauman et al. (1996) found that perceived safety was one of the most important environmental qualities for walking. Similarly, Hawthorne (1989) observed that safety from crime was one of the most appealing features for walking, while dangerous street crossings were perceived as an unappealing factor. In a review of the literature, Pikora et al. (2003) found that the features emerging as important across multiple studies include aesthetics, safety, and convenience of nearby facilities. A Delphi survey of experts conducted by the same author showed three broad factors as the most important for walking in the neighborhood: 1) personal safety; 2) aesthetics; and 3) presence of destinations. An analysis of Behavioral Risk Factor Surveillance System data collected in five U.S. states (Maryland, Montana, Ohio, Pennsylvania, and Virginia) revealed that higher levels of perceived neighborhood safety were associated with a lower prevalence of physical inactivity (Figure 3). Differences were greatest for people over 65, women, and minorities (Centers for Disease Control 1999). Weinstein et al. (1999) established an association between neighborhood safety and activity. He also observed a higher prevalence of inactivity among those who perceived their neighborhoods as unsafe. In a multivariate analysis of the social-cognitive and perceived environmental influences associated with physical activity of older Australians, Booth et al. (2000) found that perceiving footpaths as safe for walking was significantly associated with physical activity. Investigating environmental factors associated with being overweight, Caitlin et al. (2003) surveyed 2,821 adults in Missouri and found that an individuals negative perception of his/her community regarding crime safety, traffic safety, and appearance of pleasantry were modestly associated with being overweight. Persons who reported living in the worst neighborhoods were 1.56 times more likely to be overweight than persons living in ideal neighborhoods. Studies that have examined the relationship between fear of crime and victimization and walking have found a negative association (Ross 1993; Chandola 2001). In a national sample of 2,031 adults interviewed in 1990, Ross (1993) observed that after controlling for sociodemographic characteristics, people who were afraid of being victimized walked significantly less than those who were not afraid. On the other hand, some empirical studies found no significant links between perceived neighborhood safety and physical activity. Sallis et al. (1997a) in a cross-sectional study found no significant association between a composite neighborhood score (compiled by a number of environmental factors including perceived safety) and walking behavior. Similarly, King et al.
For example, the number of pedestrian-automobile collisions at a given setting within a given timeframe, controlling for pedestrian traffic.
3

10

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

(2000), in a national sample of 2,912 women 40 years of age or older, did not find safety to be a prominent or significant activity barrier among women, as the vast majority of respondents ranked their neighborhoods as safe or very safe. Giles-Corti and Donovan (2002), in a survey of 1,803 healthy adults in Perth, Australia, found that the role of the physical environment in influencing activity was not as prominent as the role of sociodemographic characteristics of individuals. A study of women in Missouri found that lack of neighborhood safety did not appear to be an important variable among walking trail users; only 11% of the users perceived unsafe conditions (Manson et al. 1995). A study of the environmental determinants of vigorous exercise among adolescents showed that perceived neighborhood safety was unrelated to exercise frequency (Zakarian et al. 1994). Finally, a cross-sectional study of low-income children 3-5 years of age found no link between being overweight and level of neighborhood crime (Burdette and Whitaker 2003). The mixed results in the aforementioned studies regarding the relationship between neighborhood safety and physical activity can be explained by the following observations. Some studies use neighborhood safety as an independent variable while others use a composite outcome measure which combines safety attributes with other physical and aesthetic characteristics of the neighborhood. The latter practice can obscure the observation of relationships between variables. The dependent variable varies from study to study and is measured in different ways. It can represent the percentage of residents walking, or walking to work, being physically active, being involved in vigorous exercise, being inactive, or being overweight (which is assumed as a proxy of being inactive). Some studies are characterized by a lack of variation in the safety variable; i.e., they are either studying unsafe neighborhoods (Burdette and Whitaker 2003) or are performed in safe neighborhoods, where safety is not an important concern for the vast majority of respondents (Manson et al. 1995). Some studies do not distinguish between physical activity in an outdoor environment and total physical activity (which may include indoor exercise). But as Humpel et al. (2000) argue, safety concerns are primarily applicable to physical activities taking place outdoors. Some studies do not distinguish between different categories of safety, such as safety from crime, safety from injury from falling, safety from unattended dogs; or safety from pedestrian-automobile collisions. This is important because each source of danger is related to different safety concerns. The mobility of the study population may limit accurate assessments. Some studies that examine the relationship between neighborhood safety and physical activity often discount the possibility that people may be physically active also in other environments. A final observation is that some studies examine the relationship between crime and physical activity using objective measures of crime (e.g., number of reported crimes in a neighborhood per capita, or number of emergency 911 calls ), while others examine perceived crime. The subjective measurement of crime is justified by the fact that it is peoples beliefs and perceptions that ultimately affect their behavior towards walking, biking, or exercising.

Loukaitou-Sideris

11

Safety and Security Concerns Among Different Sub-Populations Perceptions of safety and security vary significantly by demographic characteristics and. impact different sub-populations in different ways. Women The literature on the correlates of physical activity in women has found that safety issues, limited finances, and lack of social support provide barriers to exercise and becoming physically active (King et al. 2000; Johnson et al. 1990). Crime and fear of crime seem to be more prominent among women than men. When income, vehicle ownership, and time constraints are controlled women are expected to walk less than men because of fear for their safety. Indeed, in 10 focus groups of minority women in California and Missouri, fear of the surroundings was mentioned by all groups in all settings (urban, suburban, and rural) as a detriment to exercising or being physically active outdoors (Eyler et al. 1998). Studies have shown that women are more likely to avoid walking after dark for reasons of personal safety (Atkins 1989; Ross 2000). Many women tend to perceive city centers and public transportation services as dangerous (Trench 1991, Loukaitou-Sideris 1999). A study of womens fears in public settings in Reading, England, found that women anticipated being at risk in several specific settings such as multi-story parking structures, public transportation stations and bus stops, open spaces, alleys, and underground passages (Valentine 1990). Safety seems to be an important concern particularly for minority women. A focus group study of urban African-American women aged 20-50 years found that many were reluctant to venture from their own porch because they feared for their safety. They expressed the opinion that African-American women were not provided the same protection to exercise freely in their communities as women of the dominant culture. For these women, the homeless and mentally ill presented the potential for verbal threats on the sidewalks and in parks. (Wilbur et al. 2002). Another focus group study of well-educated urban African-American women found that while most of them lived in safe neighborhoods, traffic and personal safety were major concerns. Most, however, could readily identify safe places to be physically active or articulate a strategy to make the environment safer (walk with others or with a dog) (Young et al. 2002). Perceived lack of safety also emerged as an important barrier for physical activity in focus group discussions with American-Indian women (Thompson et al. 2002) and Latina immigrant women (Evenson et al. 2002). Low-Income People Low-income people typically live in distressed and disadvantaged urban environments characterized by physical and social disorder. Residents of such neighborhoods report worse health than those of advantaged neighborhoods, partly because of the environmental characteristics of their surroundings (Ross and Mirowski 2001). Studies have shown that environmental barriers to walking such as safety are higher among low-income people (Craig et al. 2002), who often live in small apartments and houses with no backyards or adequate space to exercise. A national telephone survey found that twice as many low-income (31%) as moderateincome (15%) respondents identified worry about safety in their neighborhoods as an obstacle of physical activity (Moore et al. 1996; Sallis et al. 1998). These fears are justified by empirical

12

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

studies in the United States. Lower socioeconomic status has been shown to be the single most important predictor of injuries for children. A study in northern Manhattan found that children in predominantly low-income areas were more than twice as likely to receive injuries from all causes (Durkin et al. 1994). Lower socioeconomic status is also found to be associated with unsafe neighborhoods and transient domiciles (Seefeldt et al. 2002). In a survey of Illinois residents, Ross (2000) found that residents of poor neighborhoods had higher levels of fear of being victimized and injured. Nevertheless, despite their fear, they walked more than residents of affluent neighborhoods for utilitarian purposes (see Figure 2), out of necessity. Recreational walking in low-income neighborhoods is often impeded by fears for the perceived lack of personal and traffic safety. An Australian cross-sectional survey of 1,803 adults in the city of Perth found that respondents in low-income neighborhoods were less likely to use available recreational facilities in their neighborhoods because they viewed streets as unsafe because of crime and traffic (Giles-Corti and Donovan 2002). Children Safety concerns affect children walking and biking to school, but also their propensity to play outdoors. Recent censuses have shown a consistent and dramatic decline of walking, cycling, and participation in physical activity among children in the United States, Great Britain, and Australia (Kohl and Hobbs 1998). In England and Wales, between 1985-1992 the average distance walked in a year by children aged 0-14 declined by 20% from 247 miles to 197 miles, while the average distance cycled in a year fell by 26% from 38 miles to 28 miles. During the same time, the average distance that children traveled by car in a year increased by 40% from 2,259 miles to 3,158 miles. Girls showed substantially larger declines in walking and cycling than did boys (DiGiuseppi 1997). In the United States the decline of walking is even more dramatic. Only a small minority of children walk or bike to school (Figure 4), compared with a majority of children a generation ago (Killingsworth 2001). In contrast, a survey in England and Wales showed that 69% of the children walk to school and only 29% are driven to school by private car. These ratios, however, are swiftly changing in favor of car use. International surveys of childrens physical activity find that a substantial proportion (more than 50%) of children and adolescents are not sufficiently active; and considerably smaller portions of girls than boys are active; (King et al. 1998). A 2-year assessment of after-school and summer activities of children in Detroit found that only 8% of children participated in nonschool sports programs. Parents cited unsafe travel between neighborhoods as a major reason for low participation rates (Seefeldt et al. 2002). Lack of safety among children and teenagers is an escalating problem that affects physical activity. The Youth Risk Behavior Surveillance System reported that nationwide 4.4% of students missed at least 1 day of school during the preceding 30 days because they felt unsafe at school or traveling to school (Kann et al. 1995). Studies have documented that today, more than ever, parents tend to impose more restriction on their childrens use of public spaces because of fear for their safety (Valentine and McKendrick 1997; Jones 2000). The dramatic decrease in childrens independent mobility is partly blamed for the increasing obesity among children (DiGiuseppi et al. 1997). Indeed, 40% of parents asked about the barriers to children walking to school cited traffic as a major concern (Surface Transportation Policy Project 2002). For children whose parents do not feel safe letting them walk on the street, walking is not part of the choice set of transportation modes. Parental fear about stranger danger and traffic danger greatly influences the decision to drive children

Loukaitou-Sideris

13

to school (DiGiuseppi et al. 1998b; Roberts 1993), or to not allow them to walk to their neighborhood park. For this reason, perception of safety by parents emerges as an extremely important predictor of non-school related physical activities of children. Many empirical studies have substantiated this fact. Parents identified the safety of parks as the most important factor to deciding whether to use them (Sallis et al. 1998). Similarly, a survey of 300 parents found that safety was the most important of 24 factors for the selection of their childs play space (Sallis et al. 1997b). The National Safety Kids Campaign surveyed 9,000 parents and conducted walkability audits across the country. They found that nearly 60% of parents and children encountered at least one serious hazard along their routes to school, such as lack of sidewalk, complicated traffic conditions, improper parking, and speeding drivers (Surface Transportation Policy Project 2002). These parental perceptions have some substance. Children have a much higher probability than adults to become victims of pedestrian-automobile collisions. Also, as shown in Figure 5, walking and biking have injury and fatality counts among students quite higher than those expected from their exposure values (TRB 2002). Adolescents International surveys have consistently found that substantial proportions of adolescents are not sufficiently active (Stone et al. 1998). Studies have also documented a decline in walking and cycling among adolescents. Sallis (1993) estimated that there could be 1.8% to 2.7% per year decline for boys and 2.6% to 7.4% per year decline for girls 10-17 years old in reported physical activity. In England and Wales, the average annual distance walked by adolescents 15-19 years old fell by 24% between 1985-1995 from 390 miles to 295 miles, while the average distance cycled in a year fell by 31% from 135 miles to 93 miles. The average distance traveled by car increased by 35% from 2,819 miles to 3,793 miles (DiGiuseppi et al. 1998a). Increasing car use by adolescents and sedentary lifestyles have been linked with obesity and adverse health effects in later life (DiGiuseppi et al. 1998b). Data from the United States and Canada suggest that participation in physical activity declines with age during adolescence (King et al. 1998). Given that time outdoors is strongly related to physical activity, an important environmental determinant of physical activity is the safety of surroundings (Kohl and Hobbs 1998). Adolescents in poor inner city neighborhoods are often exposed to violence. Safety becomes a primary concern in this group, which often shows lower participation rates in physical activity than more affluent adolescents (Sallis et al. 1992). Some studies report that concern for safety is likely to affect adolescents decision to exercise outdoors (Amesty 2003). However, a study of environmental variables and vigorous exercise among minority high school students found no association with perceived neighborhood safety (Zakarian et al. 1994). Older Adults Older adults, for whom walking is the major physical activity, may be more influenced by safety/security concerns than other age groups. The Organization for Economic Cooperation and Development (OECD) reviewed studies from its member states on the personal mobility of the elderly and found that older adults, more than other groups, restrict their mobility for safety considerations (OECD, 1998). Similarly, a 1996 study by the Center for Decease Control (CDC) in the United States found a strong association between neighborhood safety and physical

14

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

inactivity among older adults (controlling for race and education) (CDC, 1999). Other studies have observed that concerns about personal safety may influence older people and women not to use specific bikeways (Brownson et al. 2000; Troped et al. 2001). A study by Booth et al. (2000) showed that for adults over 60, neighborhood safety and access to local facilities were important predictors of being active. A study which investigated barriers to physical activity for elderly African-American women found perceived lack of safety to be an important factor, along with inconvenient location, social embarrassment, and unpleasantness of physical surroundings (King et al. 1998). Many elderly are particularly afraid of the different dangers that await them when walking in public. Fears of victimization from crime, stress for injury from traffic-related collisions, the danger of fall, or dog bite keep many older adults at home. Along with children, the elderly represent the highest risk groups for automobile-pedestrian collisions. Traffic signals are rarely timed for the needs of older pedestrians who may require extra time to cross the street (Dorfman 1997). A long street crossing may be perceived as threatening because the traffic light could change before the crossing is complete. The poor condition of the roadway infrastructure in many neighborhoods increases the risk of falls. Uneven and cracked sidewalks are tough to negotiate for seniors with physical disabilities. The local context of the neighborhoodits safety, mix of amenities, and urban form determines if older adults are likely to venture outside or stay prisoners at their homes. This was dramatically demonstrated in a study which examined the effects on the elderly of the major heat wave that hit Chicago in July 1995. Eric Klinenberg (2002) compared two Chicago neighborhoods which had similar sociodemographic characteristics in terms of elderly population, income levels, and micro-climate but had different mortality rates from the heat wave. He found that in one neighborhood the dangerous ecology of abandoned buildings, open spaces, commercial depletion, violent crime, degraded infrastructure, low population density and family dispersion undermined the viability of public life and the strength of local support systems rendering older residents vulnerable to isolation. In the other neighborhood the busy streets, heavy commercial activity residential concentration, relatively low crime promoted social contact, collective life, public engagement and provided particular benefits to the elderly, who were more likely to leave home when they are drawn out buy the nearby amenities (p. 91). Klinenberg partly attributed the difference in the mortality rates of the two neighborhoods to the structure of their physical context. Racial/Ethnic Minorities Studies have found more barriers to walking, including neighborhoods with high-crime rates and fear for personal safety, among ethnic populations (Seefeldt et al. 2002). Despite this fact, the 2000 U.S. census showed that a higher percentage of racial and ethnic minorities are walking to work than Whites (2.9% of all American workers walked to work; 3.2% of African Americans and 4.0% of Latinos did so). This is due to the fact that Latinos and African Americans are less likely to own a car and are, therefore, more likely to walk, bike, or use public transportation for

Loukaitou-Sideris

15

their journeys to work. At the same time, ethnic and racial minorities are overrepresented in pedestrian deaths. African Americans make up more than 20% of pedestrian deaths, even though they represent just 12% of the total population (Surface Transportation Policy Project 2002). Empirical studies have shown that racial and ethnic minorities are less likely to participate in recreational physical activities. Segregation and language barriers faced by ethnic immigrant populations and perceptions of lack of safety, related to neighborhoods in which immigrants live, contribute to their isolation and physical inactivity (Amesty 2003). Feelings of insecurity are also affecting the children of ethnic minorities. A 2-year assessment of after-school summer activities of children of ethnic minorities (6-17 years of age) found that only 8% of them participated in non-school sport programs. Parents cited lack of transportation, unavailability of suitable programs, and unsafe travel as reasons for low participation rates (Seefeldt 1995). Studies have found that African-American and Hispanic women typically demonstrate lower rates of physical activity than White women (Eyler et al. 1998)4. A 1994 national Behavioral Risk Factor Surveillance System Survey found that African-American women had the highest rates of physical inactivity (46%), followed closely by Hispanic women (44%) (in Eyler et al. 1998). Safety issues, limited finances, and lack of social support are identified as major barriers for minority women to becoming more physically active (Wilbur et al. 2002). Urban/Suburban/Rural Context Urban, suburban, and rural contexts offer different incentives and barriers to walking and physical activity. The more dense and compact form of urban neighborhoods frequently offers a variety of amenities and facilities (parks, supermarkets, and other neighborhood stores) which are within walking distance from households. However, urban neighborhoods differ considerably in terms of safety, attractiveness, and level of amenities. Affluent urban neighborhoods may rank very highly on all three counts, while poor inner city neighborhoods typically suffer from high crime and a general disinvestment. Suburban and rural contexts typically feature quiet streets with less traffic than urban surroundings, but may not have shopping and other amenities easily accessible on foot. At the same time, they have fewer eyes on the street, which may discourage walkers, especially women (Jacobs 1961). Despite the methodological difficulties some studies have sought to compare activity levels in urban, suburban, and rural contexts. In a study of 27 urban and suburban neighborhoods in Canada, Craig et al. (2002) found that the percentage of population walking to work was higher in urban than suburban neighborhoods. The effects of safety, however, were difficult to be traced in this study as the authors compiled a composite environmental score based on 18 neighborhood characteristics including safety. Ross (2000) found that people who lived in the city of Chicago were more likely to walk than were residents of the suburbs, small towns, and rural areas. She hypothesized that density facilitates walking for transportation (Ross 2000), and may counteract fear because of the many eyes on the street. Similarly, the CDC analyzed national data to estimate physical activity by degree of urbanization and geographic region of respondents. They found that respondents in central metro areas had the highest levels of physical activity, while respondents in rural areas had the lowest levels of such activity (CDC 1998). In a study of 1,242 rural and 1,096 urban women over 40
However, these studies may underestimate the amount of job-related physical activity that some African-American and Hispanic women may be involved in. As a reviewer of this paper poignantly asked, Does a Black Caribbean woman immigrant with four housecleaning jobs and four children need more exercise?
4

16

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

years of age, Wilcox et al. (2000) found that rural women were more sedentary than urban women and more likely to report safety concerns because of crime as a barrier to physical activity. Focus group discussions with rural African-American women found several personal, social-environmental, physical-environmental, and policy-related barriers to physical activity. Major safety concerns related to walking were the lack of sidewalks, streetlights, and stray dogs (Sanderson et al. 2002). Focus group discussion with 33 rural White women found that walking was the activity that most of them were willing to do but personal safety concerns and lack of sidewalks and adequate lighting acted as barriers (Eyler and Vest 2002)

SAFETY, SECURITY, AND THE BUILT ENVIRONMENT Most of the literature agrees that real and perceived dangers of personal safety lead individuals to more sedentary lifestyles. But as already explained, a significant portion of walking, cycling, and physical exercise can take place in the public environment of the neighborhood. What then is the link between safety, security, and the built environment? Which policy or design interventions can instill a sense of safety in the neighborhood? Which elements of the urban form discourage criminal activity? Can we design out crime by changing the built environment? Can physical planning and urban design mitigate the danger of traffic? Crime and the Built Environment Since the 1960s there has been a growing interest in the link between the physical environment and crime. The idea of crime prevention through environmental design attracted particular attention when Jane Jacobs (1961) argued that modern city design typically undermines peoples ability to observe public streets, thus breaking down informal social control of criminal activity. She asserted that crime and the physical environment are related in a systematic, observable, and controllable manner. Jacobs viewed natural surveillance (eyes on the street) as a good deterrent of criminal activity. In a similar manner, Jeffrey (1971) argued that the crime prevention strategy with the greatest potential involved heavy reliance on design and physical changes that could help reduce criminal opportunities in the environment. The theoretical discussions of Jacobs and Jeffrey drew attention to the importance of investigating the link between the built environment and public safety. Studying commercial street crime in Oakland, California, Angel (1968) discovered that the physical environment can exert a direct influence on crime settings by delineating territories, reducing or increasing accessibility by the creation or elimination of boundaries and circulation networks, and by facilitating surveillance by the citizenry and the police (p. 15). He considered the commercial strip environment as particularly vulnerable to crime, because the linearity of its design thins out and thereby reduces the intensity of activity, which in turn reduces informal surveillance. The most influential empirical study and one of the earliest to examine the crimeenvironment connection was conducted in the early 1970s by Oscar Newman and George Rand. Focusing on public housing developments, this work highlighted a number of physical factors that were hypothesized to contribute to the high levels of crime and fear present in these developments. In a series of publications, Newman (1972, 1976, 1981) elaborated the idea of defensible spacean environment that exhibits physical characteristics, through its layout, that allow residents to assume primary authority for ensuring their safety. Newman (1972) argued

Loukaitou-Sideris

17

that defensible spaces display three characteristics. One is territoriality, defined as the capacity of the physical environment to create perceived zones of territorial influence (p. 50). According to Newman, individuals or groups with a sense of ownership or territory are more likely to protect their space against criminals. The second is natural surveillance, defined as the capacity of the physical environment to provide surveillance opportunities for residents and their agents (p. 50). The third is proper location, which involves the juxtaposition of space with safe zones (clean and well maintained spaces). During the 1980s, British academics also proposed similar theories about the relationship between crime and environment (Coleman 1985; Poyner 1983). Poyner (1983), for instance, suggested that accessibility (easy access to and escape from a site) is an important element to be considered in strategies for crime prevention. Studying neighborhoods in Atlanta, Greenberg and Rohe (1984) found that physical characteristics such as the number of housing units per structure, the commercial use of land, the street type, and the physical insulation from surrounding areas had direct effects on crime levels. All these studies were characterized by a faith in the ability of the physical environment to influence crime. While the U.S. government gave some support to Crime Prevention through Environmental Design (CPTED) programs in the 1970s, interest in environmental crime prevention languished in the United States in the 1980s (Clarke et al. 1997). In recent years, however, new theories have emphasized the importance of place (Eck and Weisburd 1995; Eck 1996). We have, thus, witnessed a resurgence of interest in the role of the built environment to exacerbate or mitigate crime (Block and Block 1995; City of Toronto 1992; Cooper Marcus and Sarkissian 1992; Taylor and Harrell 1996; Wekerle and Whitzman 1995). Researchers observed that a limited number of sites and situations constitute the loci for the vast majority of offenses. Criminologists call these high-crime spots crime generators or hot spots (Buerger et al. 1995; Nasar and Fisher 1993; Sherman 1995). Crime researchers have suggested that crime is strongly related to the aggregate elements of the physical environment such as nodes, paths, end edges (Brantingham and Brantingham 1993a). This new generation of studies in the 1990s has shifted attention from a macro scalethe ecological studies of large city areas (exemplified by the work of Shaw and McKay 1929)or a meso scalestudies that focused on city neighborhoods (e.g., Greenberg and Rohe 1984) or large public projects (Newman 1972, 1976)to a micro scale (Loukaitou-Sideris 1999). Some recent studies have used the block as a unit of analysis (Perkins et al. 1993); others have concentrated on the role of certain facilities or features of the built environment (Block and Block 1995; Roncek and Meier 1991; Spelman 1993). This stream of research is concerned with micro-level situational correlates of crime and seeks to understand the environmental factors that may create opportunities for crime. It is informed by new criminological theories such as the routine activity theory (Cohen and Felson 1979; Felson, 1994) and rational choice theory (Cornish and Clarke 1986) that argue that as opportunities for crime increase, more crimes will be committed, and conversely that crime declines as opportunities are reduced. Finally, crime pattern theory (Brantingham and Brantingham 1993b) seeks to explain the distribution of crime across places and time. This theory explores the interaction of offenders with the physical and social environments that influence their choices of targets. The concept of place is central, as characteristics of place affect the likelihood of crime (Eck and Weisburd 1995). Research on the micro-environment of crime settings has shown that both the possibility of surveillance of a site by bystanders and signs of care that give the appearance that there are natural guardians who may intervene can strongly discourage potential criminals. In their study

18

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

of crime in Chicagos rapid transit stations, Block and Davis (1996) observed that high levels of guardianship in some high-traffic stations negated the great number of potential targets. Conversely, criminologists have also argued that signs of dereliction and incivilitiesphysical conditions such as litter on or near property, graffiti, and exterior dilapidation, and social behaviors such as boisterousness, loitering, drunkenness, and panhandlingcontribute to higher incidence of crime (Perkins et al. 1993; Skogan 1990; Taylor et al. 1984). The relationship of physical incivilities to crime is central to the well-known broken window thesis first popularized by Wilson and Kelling (1982). A broken window left unrepaired sends a signal that social control is attenuated in the area. Abandoned commercial and industrial structures, boarded up doors and windows, broken benches, cracked sidewalks, uncollected trash, and litter all give the impression that an area is a no-mans land. Sensing that no one is in control, potential criminals are apt to prey on the locality. Studies have shown that certain inherent features of the micro-environment affect the likelihood of crime. For example, it is easier for criminals to commit crimes near major streets (Brantingham and Brantingham 1993a). The greater the number of escape routes (streets and alleys) in the vicinity of a site, the easier it is for a criminal to escape (Poyner 1983). The surrounding land uses can also affect crime, with certain land uses (e.g., liquor stores, taverns, pawn shops, pool halls, vacant lots, and abandoned buildings) considered to be crime generators (Byrne 1986; Block and Block 1995; Greenberg 1986). Examining bus stops in Los Angeles, Loukaitou-Sideris et al. (2001) found that certain urban form and bus stop characteristics influence transit crime. For example, crime rates were higher at bus stops in areas with alleys and mid-block passages (corroborating the idea that crime is high where there are avenues for escape) and near multifamily housing, liquor stores, check-cashing establishments, vacant buildings, and buildings marked by graffiti and litter. For violent crimes in particular, the location of check-cashing establishments near bus stops and the presence of alleys had the strongest positive correlation with crime rates. Other features of the built environment are viewed as having the potential to deter crime. Such defensible space features include lighting, good visibility, places to sit outdoors, actual and symbolic barriers, and territorial symbols such as neighborhood watch signs, alarm signs, watch dogs, and home personalization signs (Perkins et al. 1993). Protecting Neighborhood Settings from Crime Through Planning and Design The previous literature review establishes clearly that the design of urban form and the layout and appearance of public spaces influence perceived and actual safety, and provide environmental cues as to whether to engage in physical activity. As a consequence, certain planning and design interventions can help block opportunities for crime, instill feelings of safety, and, thus, facilitate physical activity. Many dimensions of the physical environment should be considered in developing appropriate planning and design interventions, such as 1) the characteristics of the population and their relevant physical activity needs as well as fears; 2) the characteristics of the setting (residential neighborhood, city center, school, workplace, etc.); and 3) the activity itself (type, intensity, frequency) (King et al.1992). While crime prevention is situational and should be tailored to the social and spatial specificities of each neighborhood or setting, certain planning and design strategies seem to hold particular promise for blocking crime and reducing fear of crime in public spaces.

Loukaitou-Sideris

19

Fixing Broken Windows Access to environments that support physical activities is hurdled by the erosion of public space and public amenities in many neighborhoods. General neglect of the building stock and public environments, graffiti and litter, empty buildings and broken windows are signs that no one really cares about or regulates a street, neighborhood or public space; that both the physical and social context suffer from disorder. Physical interventions that reduce fear-producing incivilities in streets and other public spaces; improve the appearance of buildings, fill in derelict areas, and ensure good maintenance and cleanliness of the streetscape counteract the broken-window effect and help reduce fear. Facilitating Eyes on the Street Empty streets and desolate public spaces generate fear and also provide opportunities for criminal acts to go unnoticed. The segregation of the American city into single-use cells through zoning has often denied neighborhoods the opportunity to host an overlay of activities that produces a critical mass of people in public spaces. Nevertheless, the design orientation of buildings with windows facing the street can increase natural surveillance by neighbors. In mixed-use and commercial areas, design can improve opportunities for surveillance by introducing storefronts facing the sidewalk. The placement of transit facilities away from desolate areas, and near places where they can be overseen by shop owners or neighbors, the replacement of pedestrian subways with safe, ground level crossings, the elimination of empty alleys, as well as fences and heavy landscaping blocking sightlines can reduce fear and feelings of anxiety. Design can create preconditions for informal but effective control of the public environment Since the 1990s New Urbanism has advocated the development of more compact urban forms and a reappraisal of attitudes toward zoning that favors distribution of land uses such as homes, workplaces, stores, and schools, so that they can generate a critical mass of pedestrian activity. New Urbanists expect that their neo-traditional designs will generate more pedestrian activity. But some scholars have asserted that any observed differences in the travel behavior of residents in neotraditional neighborhoods may be more a function of the values and preferences of the neighborhood than of its urban form (Krizek 2000). In other words, such neighborhoods may be simply attracting people with preponderance for walking and physical activity.5

There is a debate in the literature around the New Urbanist claim that neotraditional designs can reduce the number of vehicle trips and increase walking. Bookout (1992) asserted that New Urbanist plans can reduce vehicular traffic by 43% compared to conventional suburban subdivisions. Studies by McNally and Ryan (1993) and Crane (1996a; 1996b) seemed, however, to refute New Urbanist claims. A few empirical studies that have sought to test the assumption that New Urbanist neighborhood design generates more walking had mixed results. Surveying residents in four inner city and four suburban neighborhoods and controlling for sociodemographic factors, Lund (2003) found that neighborhoods with New Urbanist features such as parks and shops had higher levels of pedestrian travel; however, she also underscored the importance of personal attitudes toward walking. In a comparative study of Irvine, Columbia, and the Woodlands, Forsyth (2002) found that higher densities and mixed-use centers and corridors (which conformed to New Urbanist practices) were not adequate in themselves to reduce automobile trips.

20

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

Lighting the Way Dark public places often generate feelings of fear. Research has shown that good lighting of streets, parks, bus shelters, and stations can reduce assaults and perceptions of fear. (Tien 1979; Valentine 1990). A research project in the London borough of Hammersmith showed a clear reduction in womens perception of danger after lighting was enhanced in public spaces (Trench et al. 1992). Eliminating Bad Neighbors The land uses that line up a street or surround a public space are crucial for their safety. Negative land uses (such as liquor stores, seedy motels, bars, check cashing establishments, pawnshops, and adult bookstores and movie theaters) can generate crime because they can encourage antisocial behavior, concentrate lucrative targets, and attract potential criminals. Such uses often give a neighborhood a bad reputation and increase the fear of crime. These bad neighbors should be eliminated from the vicinity of parks, bus stops, and public spaces. Creating Safe Territories Parks and public spaces tend to concentrate people from different ages, and walks of life. Some groups, such as the elderly, may feel threatened by other groups (e.g., teenagers) co-existing in the same limited territory. The creation of safe hang out places, such as a senior citizen center or a group of tables and benches, within a larger public setting can help a user group feel safe by experiencing a sense of territoriality and group ownership. Design of public spaces should help ease tension and fear between different groups by promoting their peaceful co-existence (Loukaitou-Sideris 1995). Cooper Marcus and Francis (1990) talk about layering and separation, the formation of time and activity zones through design and planning in parks and public spaces that allow different groups to use the same space. Protecting Access Routes and Destination While some public spaces and facilities such as station platforms or parks may be sufficiently policed and protected, the route to these facilities may not always be perceived as safe. The planning and design of a recreational or transit facility should extend beyond the facility itself to incorporate the public environments that lead to or are closely associated with the facility (pathways, sidewalks leading to the destination, parking lots, park-and-ride lots, overheads and underpasses). Complementarity of Strategies Crime prevention through environmental design should be complemented by a variety of strategies, which may include 1) policing and surveillance by public or private security officers, and/or neighborhood watch groups; 2) educational programs, information and media campaigns (such as anti-drug messages); 3) the use of technology such as closed-circuit television on station platforms; emergency phones; surveillance cameras in public spaces, and 4) employment of social capital and social networks (where available) to oversee the security of the neighborhood

Loukaitou-Sideris

21

through informal social control. The balance and mix of these strategies should be based on the particularity of each setting, the wishes of the community, and the resources available. Traffic Safety and the Built Environment The fear of victimization from crime is not the only safety consideration for many. Barriers to taking a walk around the neighborhood may also be environmental (traffic, deteriorating sidewalks, pollution). Among these issues, traffic safety emerges as a major concern for neighborhoods. Indeed in an early survey published in Great Britain in 1980 by the Office of Population Censuses, people identified five items making the streets dangerous: traffic speed, traffic volume, parked vehicles, busy intersections, and lack of pedestrian facilities (in NCC 1987). People are not likely to walk in environments where they feel threatened by traffic. For pedestrian activity to exist a symbiotic relationship is necessary between motorists and pedestrians. Streets with wide sidewalks, bike lanes, and pedestrian crosswalks are perceived safer. Perception of safety is also influenced by the speed of automobile traffic (Handy 1996). The type of interaction between pedestrians and automobiles affects the existence and intensity of pedestrian activity. There is no room for pedestrians in environments exclusively designed for the automobile. Many postwar neighborhoods were developed according to modern traffic engineering standards that were pre-occupied with enhancing the speed and access of automobility (Ewing 1994; Southworth and Ben Joseph 1997; Hess 1997; Southworth 1997). Many suburban residential streets have typical curb-to-curb widths of 38 feet for easy vehicular traffic and to minimize auto-to-auto collisions (Jacobsen et al. 2000). Such streets are quite unsafe for pedestrians as they are difficult to cross and negotiate on foot.6 Many arterials are designed as limited access roads, separating neighborhoods, and encouraging automobile use even for short trips (Bosselmann, Macdonald, and Kronemeyer 1999). Similarly, modern city planning techniques encouraging the segregation of land uses have resulted in a sprawling urban form, and suburban environments that are not considered safe for walking. The lack of attention to pedestrians has made streets less safe. Even sidewalks, considered as the minimum of pedestrian amenities, are not mandatory in many municipal codes. Nearly 6,000 pedestrians and cyclists are killed nationwide every year, and an additional 119,000 suffer from injuries inflicted upon them by a moving vehicle (National Highway Traffic Safety Administration 2002). Some states score much worse than others in pedestrian fatalities. According to researchers the most dangerous metropolitan areas for walkers are newer, sprawling, southern and western communities where transportation systems are more focused on the automobile at the expense of other transportation options (Jackson and Kochtitzky 2001). The field of traffic safety has investigated the role of a number of factors in the causation of pedestrian-automobile collisions. In general, we can classify these factors in four categories: 1) the social and behavioral characteristics of drivers and victims; 2) road design characteristics; 3) traffic characteristics (both vehicular and pedestrian traffic); and 4) area characteristics, i.e., the social, physical, and land use characteristics of neighborhoods. A number of studies have explored the social and behavioral characteristics of drivers and pedestrians involved in collisions. In general, such studies have found that gender and age
In recent decades a number of communities have sought to modify their street standards to make streets more pedestrian friendly (Ben Joseph 1995). Calls for narrower street widths have come from both transportation planners (Homburger et al. 1989; American Society of Civil Engineers 1990) and urban designers (Calthorpe 1993; Kelbaugh 1997).
6

22

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

characteristics, driving experience, and drunkenness of drivers are significantly linked to pedestrian-automobile collisions. A study that analyzed pedestrian fatalities in New York City between 1994-1997 found that younger drivers (19-34 years of age) caused 48% of the deaths (Komanoff 1999). Studies analyzing the sociodemographic characteristics of victims have found that children and the elderly are the two age groups most vulnerable to pedestrian-automobile collisions. Nearly one fifth of all traffic fatalities under age 16 were pedestrians. Elderly pedestrians accounted for 17% of all pedestrian fatalities in 2002 (NCSA 2002). While the proportions of children and the elderly that fall victims to the car are different for different geographic regions, these two groups comprise the greatest number of all pedestrian-automobile collisions relative to their share of population. In a study of motor vehicle collisions in Honolulu, Levine et al. (1994) found that 28.8% of the victims were children under 15, while 15.4% of the victims in pedestrian-automobile collisions were seniors. In the aforementioned New York City study, older New Yorkers accounted for 35% of the victims (Komanoff 1999). Even though fewer children are now walking than in the previous decades, pedestrian injury remains the second leading cause of unintentional injury-related death among children ages 5-14 (Surface Transportation Policy Project 2002). Child pedestrian-automobile collisions tend to happen in residential areas, near a childs home (Sharples et al. 1990) and on the journey to school. Behavioral factors (e.g., overactivity) and the length of exposure in public spaces have been associated with children injuries. However, for collisions involving children victims environmental influences have been found to be more significant than behavioral factors (Corless and Ohland 1999). Even though the total annual number of fatalities of children walking or biking to school represents only 16% and 6% respectively of the total annual student fatalities of the journey to school, on a per mile basis, school-aged bicyclists have the highest injury and fatality rates, followed by school-aged pedestrians (TRB 2002). The traffic engineering field has also examined the relationship of road characteristics (e.g., type of road, lane width, pavement characteristics, intersection geometry, street lighting, existence of marked crosswalks, availability of raised medians, etc.) and pedestrian-automobile collisions. A study in Seattle found that the highest number of such collisions (54%) occurred on main arterials, followed closely by minor arterials (39%) (Walgren 1998). Studies have also explored how the presence of marked sidewalks in uncontrolled locations (with no traffic lights) affects pedestrian collision rates. A recent study found that in high traffic multilane streets marked crosswalks were associated with higher pedestrian crash rates (FHA 2002). Studies have explored the relationship between pedestrian crashes and traffic and parking characteristics. A significant relationship has been found between traffic volume and the number of collisions (Levine et al. 1994; Roberts et al. 1995; Jackson and Kochtitzky 2001). Traffic speeds have also been associated with increased risk of injury to pedestrians (Jacobsen et al. 2000). High densities of curb parking are associated with increased numbers of pedestrianautomobile collisions (Roberts et al. 1995), for the reason that parked cars can impair the visibility of incoming traffic. However, this might be a spurious correlation because it is also likely that many cars are parked in high-activity areas with many pedestrians. As expected, pedestrian exposure has been typically associated with collision risk. Finally, a set of studies has examined the relationship between pedestrian-automobile collisions and the social and physical characteristics of neighborhoods. In 2000, most pedestrian fatalities occurred in urban areas (71%), at non-intersection locations (78%), and at night (64%) (USDOT 2000). A significant number of pedestrian-automobile collisions (37%) resulting in

Loukaitou-Sideris

23

children fatalities took place in non-traffic locations, such as driveways, sidewalks, and parking lots (Safe Kids Campaign 2002). Many researchers have found a relationship between an areas social deprivation and lack of affluence and pedestrian-automobile collisions (Scottish Executive 2001). Child pedestrian injuries occur significantly more often in poor neighborhoods with restricted access to play space and dangerous streets with high traffic (Corless and Ohland 1999). This seems to hold true not only for children but also for adults. In a study that examined the relationship between an areas social characteristics and road-accident casualties in Scotland, Abdalla et al. (1997) found that the rate of casualties per 10,000 residents was above the regions average in the most deprived areas, and below the regions average in the most affluent areas. A California study that examined the relationship between race/ethnicity of California children and pedestrian-automobile collisions in 1996, found that Latino and African-American children, presumably living in some of the states most disadvantaged neighborhoods, were disproportionately represented among all pedestrian fatalities and injuries relative to their share of the population (Corless and Ohland 1999). Similarly, a study that examined pedestrian safety data between 1990 and 2000 found that during that period Black children had a pedestrian death rate more than twice that of White children (Safe Kids Campaign 2002). A recent study has speculated that the link between pedestrian deaths and ethnicity is due to the fact that Latinos and African Americans are more likely to walk, bike and/or take public transportation, resulting in greater exposure to the dangers of the street (Surface Transportation Policy Project 2002). While the relationship between pedestrian-automobile collision risk and the sociodemographic characteristics of neighborhoods is not disputed, few studies have actually examined the effects relating to the physical environment and geographic locations associated with disadvantaged areas: the number, type, and positioning of streets, the number of four-leg intersections, the adequacy of street lighting, the condition of roads, the relationship of bus stops to the streets, the marking of crossroads, the positioning of neighborhood schools and playgrounds in relation to the street network, the type of land uses, etc. Yet, the indication is that certain physical and land use factors may be augmenting the risk of collision for pedestrians. A small number of studies have revealed that much. Investigating the significance of particular land uses, Levine et al. (1994) found that the number of schools and bars in a block-group predicted the number of pedestrian crashes, along with the population and employment variables. The same researchers found that the number of miles of freeway ramps and access roads, and the number of miles of major arterials in a neighborhood were positively related to the number of crashes occurring. Walgren (1998) found that in Seattle 89% of the high collision locations were within 150 feet of a bus stop, while 90% of such locations were within 70 feet of a crosswalk. Most of the collisions occurred at intersections without traffic light. A study by the Santa Ana Unified School District in California found that more than half of the citys 72 pedestrianautomobile collisions during the first 6 months in 1998 involved children walking near schools (Los Angeles Times 1999). Protecting Neighborhood Settings from Traffic In the last three decades, efforts to address and mitigate the negative effects of vehicular traffic and accommodate pedestrian transportation and cycling have originated in Western Europe. Countries such as Denmark, the Netherlands, Germany, and Great Britain have adopted innovative physical and policy measures to encourage pedestrianism and safe travel by nonmotorized means of transport.

24

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

As shown in Table 2, both design and policy interventions can be utilized to mitigate the effects of traffic and make neighborhoods safer for pedestrians and cyclists. At a minimum, all municipalities enforce a traffic code that seeks to manage and regulate traffic through the use of traffic control devices such as traffic signals and lights, stop signs, pavement markings, and crosswalks. These devices provide a basic level of protection for pedestrians and cyclists, but to be more effective they should be customized to the specific needs of particular neighborhoods. For example, examining the effectiveness of crosswalks, Koepsel et al. (2002) found that they did little to protect older pedestrians, giving them only a false sense of security. When no traffic signal or stop signs were present, marked crosswalks were associated with three- to six-fold increase in risk. Crosswalks should be designed taking into consideration the age and other characteristics of pedestrians and should be avoided at intersections with high-traffic speeds, poor illumination, and insufficient visibility for drivers (Runge and Cole 2002). Efforts to reduce the volume of automobiles often focus on the encouragement of alternative modes of traffic, by providing the infrastructure and policy incentives for the adoption of these modes, and by making the use of private automobiles more expensive. At the neighborhood level, the provision of sidewalks, pedestrian paths, and bike lanes are necessary but not sufficient steps to promote walking and biking. An integrated and continuous pedestrian and bicycle network that connects points of origin with popular destinations should be in place before we can observe major modal changes. Very few U.S. cities can boast such a network, with the notable exception of Davis, California, which features 35 miles of continuous bike lanes, including 11 grade-separated intersections and special bicycle traffic signals. As a result, bike trips in Davis exceed 20% of all transportation trips (NHTSA 2003). At the metropolitan scale, the accommodation of carpools and buses on special lanes can offer some incentives to drivers to switch modes. Such efforts have only had modest success in reducing automobile travel. Scholars have argued that pricing mechanisms (e.g., congestion parking, gasoline taxes, high license fees, etc.) that make the use of automobile more expensive have a better chance to promote alternative transportation modes; however, such mechanisms often do not enjoy wide public support in the United States. A variety of innovative design means have been utilized by municipalities in Europe, and more recently in Canada and the United States in an effort to slow down traffic speeds in residential neighborhoods and near schools and public places. Such measures, often called traffic calming, seek to reduce the negative effects of automobiles, alter driver behavior, and improve conditions for pedestrians and cyclists (Lockwood 1997). Traffic calming devices are designed to be self-enforcing, although their effectiveness varies according to the particular measures employed. The principal measures fall into four categories: 1) vertical deflections (speed bump and humps, raised intersections); 2) horizontal deflections (chicanes, bends, and deviations); 3) road narrowing (through neckdowns, chokers, and bulbs); and 4) medians, central islands, and traffic circles (FTA 1994; Kim and Smith 1999). Case studies of the effect of traffic calming on pedestrian and bicycle travel in Northern Europe have shown that it increases biking and walking, slows vehicular traffic, and decreases pedestrian accidents (Eubank-Ahrens 1987; Tolley 1989, 1993). In the United States a number of cities, such as Palo Alto and Santa Monica in California, Portland, Seattle, and New York City have implemented different versions of traffic calming programs, reporting good results. Seattle, for example, reported a 77% reduction in traffic crashes after implementing a city-wide traffic calming program (NHTSA 2003).

Loukaitou-Sideris

25

In addition to design means, policy regulations have targeted the lowering of vehicular speeds in areas with high concentrations of pedestrians. The establishment of school safety zones (20 mph) in Europe and the United States and home zones in certain residential areas in the United Kingdom has become common practice, and has been shown to result in increased pedestrian safety. Targeting more 20 mph zones would reduce parental concerns about traffic danger. A special designation of a slow traffic zone, is that of the Woonerf in the Netherlands, where automobile-only streets in residential neighborhoods are converted to shared-use areas, where automobiles, bikes, and pedestrians can co-exist on the roadway. Through the use of design means such as planters, special pavements, speed bumps, and posted traffic signs drivers are warned to slow down and yield to pedestrians and cyclists. While the aforementioned measures are primarily targeting the behavior of drivers, another set of interventions can target the behavior of pedestrians and cyclists. At a minimum, the provision of a physical infrastructure for pedestrianism and cycling (sidewalks, bike lanes and paths, pedestrian overpasses, crosswalks, etc.) is a necessary but not sufficient precondition for walking and cycling. Upkeep and good maintenance and keeping the sidewalks clear from obstructions are also important for the avoidance of tripping and falling accidents. Pavement accidents are in fact far more frequent than collisions with motor vehicles. A survey of 2,000 adults in the United Kingdom found that about one quarter had problems trying to walk in the neighborhood. Broken pavements and a shortage of pedestrian crossings presented the two major causes of concern (National Consumer Council 1987). Neighborhoods with strong social capital have initiated a number of interventions that rely on volunteerism, neighborhood watch, and community policing to make the trip to and from school safe. Volunteers have acted as crossing aids for busy intersections on the route to school. Programs such as the Safe Routes to School, have been initiated in Western Europe and the United Kingdom, but have been increasingly applied to different school districts in the United States as well. They involve a series of educational and physical measures to create safe routes to school, including identification and mitigation of hazards along the main routes to school, encouragement of safe cycling, restrictions on vehicle speeds, and other traffic calming measures (NHTSA 2003). Pilot programs conducted in 1995 in 10 British schools resulted in an increase of cycling and walking, reductions in child road casualties by 32%, and reductions in car use by 12% to 17% (SUSTRANS 2003). Other model programs, such as the Walking School Bus, or Bike Train (Figure 6), involve adult volunteers who accompany children to school, stopping at designated locations where children can join the bus or train at prearranged times. (Wethmore 2001). The greater number of children who compose the walking bus are more visible to motorists and provide an additional safety factor. Other escort programs include monitors on the street or find neighbors to offer their homes as safe houses in urban areas where crime is a major concern. Two notable programs in Southern California that rely on social networks in the neighborhood are Safe Corridors and KidWatch. The first takes place in the city of Santa Ana and has volunteer parents patrol to and from school in areas where children have experienced problems with gangs and thefts of lunch money. If threatened, students have also the option of ducking into identified safe houses where residents have offered shelter. KidWatch is also a program designed to provide a safe trip to and from school for more than 8,200 children, in the West Adams neighborhood near the University of Southern California in Los Angeles. The program, which is a partnership between residents, the university, the police, and five neighborhood schools, mobilizes more than 700 volunteers who are committed to being alert during the time that children walk to or from

26

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

school, performing different chores (sweeping sidewalks, watering their lawns) and informing the police of any danger. A recent evaluation indicated that KidWatch makes children and their parents feel safer. Residents also reported that the program has increased a sense of community togetherness and pride (USC 2003). Finally, the implementation of education and information strategies, and age-appropriate, training programs have been pursued by various school districts, non-profit coalitions and community activists in an effort to make the streets safer for pedestrian travel and cycling. A program that has attracted national attention and admiration is the Injury Free Coalition for Kids established in 1988 by Dr. Barbara Barlow of the Harlem Hospital Injury Prevention Program. The coalition renovated 45 playgrounds in Harlem, replacing dangerous or drug-infested lots with safe play spaces. The project hired mothers from Harlem to act as administrators, sponsored anti-violence counseling and street smart workshops, and resulted in a 55% reduction in injuries requiring hospitalization and 36% reduction in motor vehicle and bicycle injuries, compared to the pre-intervention period. The Harlem model has spread to eight other citiesChicago, Kansas City, Pittsburgh, Los Angeles, Saint Louis, Atlanta, Philadelphia, and Dallas (Lucentini 2002). The Harlem Hospital Injury Prevention Program. also established the Safety City Program that teaches street safety to all 3rd grade children who practice on a model street constructed on their schools playground. The program has been expanded to the Mobile Safety City Program, which visits schools in New York City training all 3rd graders (Durkin et al. 1999). Table 2 summarizes a variety of design and policy actions targeting drivers, pedestrians, or cyclists that seek to mitigate the negative effects and danger from traffic.

CONCLUSION Fears about danger of injury from traffic, violence, or fall, whether perceived or real, affect an individuals propensity to engage in activities that take place in public environments. At an extreme, angst over personal vulnerability may result in agoraphobia, a fortress ideology, the suppression of social engagement, and the complete avoidance of activities in public spaces. At a minimum, fear can produce stress and intimidation, and a general reluctance to patronize neighborhood streets and parks. The link between safety and security concerns and propensity for physical activity is well established in the literature, even though most researchers would readily admit that feelings of safety are important but not sufficient prerequisites to induce physical activity outdoors. The link between the built environment and safety from crime and/or traffic danger is equally wellestablished. Therefore, design and policy interventions that aim to enhance neighborhood safety are the necessary first steps for the encouragement of physical activity. At the same time, complementary strategies involving intrapersonal, interpersonal, institutional, community, and public policy approaches are required that tackle individual, environmental, and social factors that are barriers to physical activity. Strategies and interventions that focus on enhancing public safety and security should be composite and synergistic. For example, environmental modifications may be complemented by informational campaigns aiming to alter reckless or unsafe individual behavior. Design of defensible space is enhanced by community support in the form of strong social networks that can offer formal or informal surveillance of public spaces. Interventions also need to be tailored to the needs of particular sub-groups, as well as the characteristics of the neighborhood and its

Loukaitou-Sideris

27

various settings (residential and commercial streets, parks and other public spaces, school, bus stops, etc.). It is also important to evaluate whether proposed interventions are reaching the populations who seem to be in greatest danger of physical inactivity and who display growing obesity problemsthe children, the elderly, women, inner city residents, and low-income people. In 1996 the U.S. Surgeon General urged researcher collaboration, dedication, partnering, and long-term planning as necessary prerequisites for the improvement of physical activity levels among Americans. The last 5 years have witnessed an unprecedented level of interest and work on the subject from researchers in different fields. While collaboration, dedication, and partnering among researchers are undoubtedly there, we also need extensive collaborations with school and park districts, municipalities, and other authorities that affect the design, planning, and programming of the built environment. Community input is also essential for choosing and implementing interventions that are well-matched to local capabilities, needs, and preferences. Increasing the levels of physical activity of the public is not a simple challenge, and cannot happen overnight. But the stakes are nothing less than the health of the American people.

REFERENCES Abdalla, I., R. Raeside, D. Barker, and McGuigan, D. 1997. An investigation into the relationships between area social characteristics and road accident casualties. In Accident Analysis and Prevention, Vol. 29, No. 5, pp. 583593. Amesty, S. C. 2003. Barriers to physical activity in the Hispanic community. In Journal of Public Health Policy, Vol. 24, No. 1, pp. 4158. Angel, S. 1968. Discouraging crime through city planning. (Working Paper #75) University of California at Berkeley, Center for Planning and Development Research. Appleyard, D. 1981. Livable Streets. University of California Press, Berkeley. Atkins, S. 1989. Critical paths: Designing for secure travel. Design Council. Ball, K., A. Bauman, E. Leslie, and N. Owen. 2001. Perceived environmental aesthetics and convenience and company are associated with walking for exercise among Australian adults. In Preventive Medicine, Vol. 33, pp. 434440. Bauman, A., F. Wallner, A. Miners, and V. Westley-Wise. 1996. No ifs no buts Illawarra physical activity project: Baseline research report. Commonwealth Department of Health and Family Services, Warrong, New South Wales. Berrigan, D., and R. P. Troiano. 2002. The association between urban form and physical activity in U.S. adults. In American Journal of Preventive Medicine, Vol. 23, No. 2 (supplement 1), pp. 7479. Block, R. L., and C. R. Block. 1995. Space, place, and crime: Hot spot areas and hot places of liquor-related crime. In Crime and Place (J. Eck and D. Weisburd, eds.). Willow Tree Press, Monsey, N.Y. Block, R., and S. Davis. 1996. The environs of rapid transit stations: A focus for street crime or just another risky place? In Preventing Mass Transit Crime (D. Clarke, ed.). Criminal Justice Press, Monsey, N.Y. Bookout, L. W. 1992. Neotraditional town planning: Cars, pedestrians, and transit. In Urban Land, pp. 1015.

28

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

Booth, M. L., N. Owen, A. Bauman, O. Clavisi, and E. Leslie. 2000. Social-cognitive and perceived environmental influences associated with physical activity in older Australians. In Preventive Medicine, Vol. 31, pp. 1522. Bosselmann, P., E. Macdonald, and T. Kronemeyer. 1999. Livable streets revisited. In Journal of the American Planning Association, Vol. 65, No. 2, pp. 168180. Brantingham, P. L., and P. J. Brantingham. 1993a. Nodes, paths, and edges: Considerations on the complexity of crime and physical environment. In Journal of Environmental Psychology, Vol. 13, pp. 328. Brantingham, P. L., and P. J. Brantingham. 1993b. Environment, routine, and situation: Toward a pattern theory of crime. In Routine Activity and Rational Choice: Advances in Criminological Theory (R. V. Clarke and M. Felson, eds.). Transaction Publications, New Brunswick, N.J., pp. 259294. Brouchard, C., and R. J. Shepard. 1994. Physical activity, fitness, and health: The model and key concepts. In Physical Activity, Fitness, and Health: International Proceedings and Consensus Statement, (C. Brouchard and R. J. Shepard, and T. Stephens, eds.). Human Kinetics, Champaign, Ill.. pp. 7788. Brownson, R. C., R. A. Houseman, D. R. Brown, J. Jackson-Thompson, A. C. King, B. R. Malone, and J. F. Sallis. 2000. Promoting physical activity in rural communities. In American Journal of Preventive Medicine, Vol. 18, No. 3, pp. 235241. Brownson, R. C., E. A. Baker, R. A. Houseman, L. K. Brennan, and S. J. Bacak. 2001. Environmental and policy determinants of physical activity in the United States. In American Journal of Public Health, Vol. 91, No. 12, pp. 19952003. Buerger, M., E. Cohn, and A Petrossino. 1995. Defining the hot spots of crime, operationalizing theoretical concepts for field research. In Crime and Place (J. Eck and D. Weisburd, eds.). Willow Tree Press, Monsey, N.Y., pp. 237258. Burdette, H. L., and R. C. Whitaker. 2003. Neighborhood playgrounds, fast food restaurants, and crime: Relationships to overweight in low-income preschool children, submitted to Preventive Medicine. Byrne, J. 1986. Cities, citizens, and crime: The ecological/nonecological debate reconsidered. In The Social Ecology of Crime (J. Byrne and R. J. Sampson, eds.). Springer Verlang, New York, pp. 77101. Caitlin, T. K., E. J. Simoes, and R. C. Brownson. 2003. Environmental and policy factors associated with overweight among adults in Missouri. In American Journal of Health Promotion, Vol. 17, No. 4, pp. 249258. Calthorpe, P. 1993. The next American metropolis: Ecology, communities, and the American dream. Princeton Architectural Press, New York. CDC. 1999. Neighborhood safety and prevalence of physical inactivity in selected states, 1996. In Morbidity and Mortality Weekly Report, Vol. 48, No. 7, pp. 143146. CDC. 1998. Self reported physical activity by degree of urbanizationUnited States, 1996. Morbidity and Mortality Weekly Report, Vol. 47, No. 50, pp. 10971100. Chandola, T. 2001. The fear of crime and area differences in health. In Health & Place, Vol. 7, pp. 105116. City of Toronto. 1992. A working guide for planning and designing safer environments. Safe City Committee and Planning Development Department, Toronto.

Loukaitou-Sideris

29

Clarke, R. V., P. L. Brantingham, P. J. Brantingham, J. Eck, and M. Felson,. 1997. Designing out crime. In Critical criminal justice issues: Task force reports for the American Society of Criminology (NIJ Report No. 158837). National Institute of Justice, Washington, D.C. Cohen, L., and M. Felson. 1979. Social change and crime rate trends: A routine activity approach. In American Sociological Review, Vol. 44, pp. 588605. Coleman, A. 1985. Utopia on trial: Vision and reality on a planned housing estate. Hilary Shipman, London. Cooper Marcus, C., and C. Francis. 1990. People places: Design guidelines for urban open space. Van Nostrand Reinhold, New York. Cooper Marcus, C., and W. Sarkissian. 1992. Housing as if people mattered. Architectural Press, London. Corless, J., and G. Ohland. 1999. Caught in the crosswalk. www.transact.org/ca/caught99/ack.htm. Cornish, D., and R. V. Clarke. 1986. The Reasoning criminal. Springer Verlag, New York. Corti, B., R. J. Donnovan, and C. D. J. Holman. 1997. Factors influencing the use of physical activity facilities: results from qualitative research. In American Journal of Health Promotion, Vol. 7, pp. 1621. Craig, C. L., R. C. Brownson, S. E. Cragg, and A. L. Dunn. 2002. Exploring the effect of the environment on physical activity: A study examining walking to work. In American Journal of Preventive Medicine, Vol. 23, No. 2 (supplement), pp. 3643. Crane, R. 1996a. On form versus function: Will the new urbanism reduce traffic, or increase it? In Journal of Planning Education and Research, Vol. 15, pp. 117126. Crane, R. 1996b. Cars and drivers in the new suburbs: Linking access to travel in neotraditional planning. In Journal of the American Planning Association, Vol. 62, pp. 5165. Crew, K. 2001. Linear parks and urban neighborhoods: A study of the crime impact of the Boston South-West corridor. In Journal of Urban Design, Vol. 6, No. 3, pp. 245264. DiGuiseppi, C., I. Roberts, and L. Li. 1997. Influence of changing travel patterns on child death rates from injury: Trend analysis. In British Medical Journal, Vol. 314, pp. 710713. DiGuiseppi, C., L. Li, and I. Roberts. 1998a. Influence of travel patterns on mortality from injury among teenagers in England and Wales, 1985-95: Trend analysis. In British Medical Journal, Vol. 316, pp. 904905. DiGuiseppi, C., I. Roberts, L. Li, and D. Allen. 1998b. Determinants of car travel on daily journeys to school: cross sectional survey of primary school children. In British Medical Journal, Vol. 316, pp. 14261428. Dorfman, R. A. 1997. Taking a Walk: No longer safe for elders in urban America and Asia. In Journal of Aging and Identity, Vol. 2, No. 2, pp. 139142. Durkin, L. M. S.,L. Davidson, L. Kuhn, P. OConnor, and B. Barlow. 1994. Low-income neighborhoods and the risk of severe pediatric injury: A small-area analysis in Northern Manhattan. In American Journal of Public Health., Vol. 84, No. 4, pp. 587592. Durkin, L. M. S., D. Laraque, I. Lubman, and B. Barlow. 1999. Epidemiology and prevention of traffic injuries to urban children and adolescents. In Pediatrics, Vol. 103, No. 6, pp. 18. Eck, J., and D. Weisburd, D. (eds.) 1995. Crime and Place. Willow Tree Press, Monsey, N.Y. Eck, J. 1996. Preventing crime at places. In Preventing Crime: What Works, What Doesnt, Whats Promising (L. Sherman, D. Gottfredson, D. Mackenzie, J. Eck, P. Reuter, and S. Bushway, eds.). Report to the U.S. Congress prepared by the National Institute of Justice, Washington, D.C.

30

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

Epstein, L. H. 1998. Integrating theoretical approaches to promote physical activity. In American Journal of Preventive Medicine, Vol. 15, No. 4, pp. 257265. Eubank-Ahrens, B. 1987. A closer look at the users of woonerven. In Public Streets for Public Use (A. Vernez Moudon, ed.). Van Nostrand Reinhold, New York. Ewing, R. 1994. Residential Street Design: Do the British and Australians Know Something Americans Dont? In Transportation Research Record 1455, TRB, National Research Council, Washington, D.C., pp. 5362. Eyler, A. A., E. Baker, L. Cromer, A. C. King, R. C. Brownson, and R. J. Donatelle. 1998. Physical activity and minority women: a qualitative study. In Health Education and Behavior, Vol. 25, No. 5, pp. 640652. Eyler, A., R. C. Brownson, R. J. Donatelle, A. C. King, D. Brown, and J. F. Sallis. 1999. Physical activity, social support, and middle- and older-aged minority women: results from a U.S. survey. In Social Science and Medicine, Vol. 49, pp. 783787. Eyler, A., and J. Vest. 2002. Environmental and policy factors related to physical activity in rural white women. In Women and Health, Vol. 36, No. 2, pp. 111121. Evenson, K. R., O. L. Sarmniento, M. L. Macon, K. W. Tawney, A. S. Ammerman. 2002. Environmental, policy, and cultural factors related to physical activity among Latina immigrants. In Women and Health, Vol. 36, No. 2, pp. 4357. Federal Highway Administration. 1994. Traffic calming, auto-restricted zones and other traffic management techniques. The National Bicycling and Walking Study: Transportation Choices for a Changing America, Final Report. U.S. Department of Transportation. Federal Highway Administration. 2002. Safety Effects of Marked vs. Unmarked Crosswalks at Uncontrolled Locations: Executive Summary and Recommended Guidelines (FHWARD-01-075), U.S. Department of Transportation, McLean, Va. Felson, M. 1994. Crime and everyday life: Insight and implications for society. Pine Forge Press, Thousand Oaks, Calif. Forsyth, A. 2002. Planning Lessons from Three U.S. New Town of the 1960s and 1970s: Irvine, Columbia, and the Woodlands. In Journal of the American Planning Association, Vol. 68, No. 4, pp. 387415. Frank, L. D., and P. O. Engelke. 2001. The built environment and human activity patterns: Exploring the impacts of urban form on public health. In Journal of Planning Literature, Vol. 16, No. 2, pp. 202218. Giles-Corti, B., and R. J. Donovan. 2002. The relative influence of individual, social and physical environmental determinants of physical activity. In Social Science and Medicine, Vol. 54, pp. 17931812. Gordon-Larsen, P., R. G. McMurray, and B. M. Popkin. 2000. Determinants of adolescent physical activity and inactivity patterns. In Pediatrics, Vol. 105, No. 6, pp. 18 [http://www.pediatrics.org/cgi/content/full/105/6/e83] Greenberg, S., and W. Rohe. 1984. Neighborhood design and crime. In Journal of the American Planning Association, Vol. 50, pp. 4861. Greenberg, S. 1986. Fear and its relationship to crime, neighborhood deterioration and informal social control. In The Social Ecology of Crime (J. Byrne, and R. J. Sampson, eds.). Springer Verlag, New York, pp. 4762. Greenwald, M., and M. G. Boarnet. 2002. The Built Environment as a Determination of Walking Behavior: Analyzing Non-Work Pedestrian Travel in Portland, Oregon. In

Loukaitou-Sideris

31

Transportation Research Record: Journal of the Transportation Research Board, No. 1780, TRB, National Research Council, pp. 3342. Handy, S. 1996. Urban Form and Pedestrian Choices: Study of Austin Neighborhoods. Transportation Research Record 1522, TRB, National Research Council, pp. 135144. Handy, S. L., M. Boarnet, R. Ewing, and R. E. Killingsworth. 2002. How the built environment affects physical activity: views from urban planning. In American Journal of Preventive Medicine, Vol. 23, No. 2 (supplement), pp. 6473. Hawthorne, W. 1989. Why Ontarians walk, why Ontarians dont walk more: A study of the walking habits of Ontarians. Energy Probe Research Foundation, Ontario. Hess, P. 1997. Measures of connectivity. In Places: A Forum of Environmental Design, Vol. 11, No. 2, pp. 5865. Hovell, M. F., J. F. Sallis, C. R. Hofstetter, V. M. Spy, P. Faucher, and C. J. Caspersen. 1989. Identifying correlates of walking for exercise: an epidemiologic prerequisite for physical activity promotion. In Preventive Medicine, Vol. 18, pp. 856866. Humpel, N., N. Owen, and E. Leslie. 2002. Environmental factors associated with adults' participation in physical activity: A review. In American Journal of Preventive Medicine, Vol. 22, No. 3, pp. 188199. Jackson, R., and C. Kochtitzky. 2001. Creating a healthy environment. Sprawl watch Clearinghouse Monograph, Washington D.C. www.sprawlwatch.org. Jacobs, J. 1961. The death and life of great American cities. Vintage Books, New York. Jacobsen, P., C. Anderson, D. Winn, J. Moffat, P. Agran, and S. Sarkar. 2000. Child pedestrian injuries on residential streets: Implications for traffic engineering. In Institute of Transportation Engineering Journal on the Web, February, pp. 7175. Jeffrey, C. R. 1971. Crime prevention through environmental design. Sage, Beverly Hills, Calif. Johnson, C. A., S. A. Corrigan, P. M. Dubbert, and S. E. Gramling. 1990. Perceived barriers to exercise and weight control practices in community women. In Women and Health, Vol. 16, No. 3-4, pp. 177191. Jones, O. 2000. Melting geography: Purity, disorder, childhood, and space. In Childrens Geographies: Playing, Living, Learning (S. Holloway and G. Vallentine, eds.). Routledge, London and New York. Kann, L., C. W. Warren, and W. J. Harris. 1995. Youth risk behavior surveillance-United States, 1993. In Morbidity and Mortality Weekly Report, Vol. 44 (SS-1), pp. 155. Kelbaugh, D. 1997. Common place: Toward neighborhood and regional design. University of Washington Press, Seattle:. Khisty, C. J. 1994. Evaluation of Pedestrian Facilities: Beyond the Level-of-Service Concept. In Transportation Research Record 1438, TRB, National Research Council, pp. 4550. Killingsworth, R. E., and J. Lamming. 2001. Development and public health: Could our development patterns be affecting our personal health? In Urban Land, Vol. 60, No. 7, pp. 12, 1417. Kim, T., and J. Smith. 1999. Towards a new street life: Planning for pedestrians in Venice. M.S. thesis. UCLA Department of Urban Planning, Los Angeles. King, A. C., N. S. Blair, E. Bild, K. Dishman, P. M. Dubbert, B. H. Marcus, N. B. Oldridge, R. R. Paffenbarger, Jr., K. E. Powell, and K. K. Yeager. 1992. Determinants of physical activity and interventions in adults. In Medicine and Science in Sports and Exercise, Vol. 24, No. 6, pp. S221236.

32

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

King, A. C., W. J. Rejeski, and D. M. Buchner. 1998. Physical activity interventions targeting older adults. A critical review and recommendations. In American Journal of Preventive Medicine, Vol. 15, No. 4, pp. 316333. King, A. C., C. Castro, S. Wilcox, A. A. Eyler, J. F. Sallis, and R. C. Brownson. 2000. Personal and environmental factors associated with physical inactivity among different racialethnic groups of U.S. middle-aged and older-aged women. In Health Psychology, Vol. 19, No. 4, pp.354364. King, A. C., A. Bauman, and D. B. Abrams. 2002a. Forging transdisciplinary bridges to meet the physical inactivity challenge in the 21st century. In American Journal of Preventive Medicine, Vol. 23, No. 2 (supplement), pp. 104106. King, A. C., D. Stokols, E. Talen, G. S. Brassington, and R. Killingsworth. 2002. Theoretical approaches to the promotion of physical activity: Forging a transdisciplinary paradigm. In American Journal of Preventive Medicine, Vol. 23, No. 2 (supplement ), pp. 1525. Klinenberg, E. 2002. Heat wave: A Social autopsy of disaster in Chicago. The University of Chicago Press. Koepsell, T., L. McCloskey, M. Wolf, A. Vernez Moudon, D. Buchner, J. Krauss, and M. Patterson. 2002. Crosswalk markings and the risk of pedestrian-motor vehicle collisions in older pedestrians. In Journal of the American Medical Association, Vol. 288, No. 17, pp. 21362148. Kohl, H. W., and K. E. Hobbs. 1998. Development of physical activity behaviors among children and adolescents. In Pediatrics, Vol. 101, No. 3 (supplement), pp. 549554. Komanoff, C. 1999. Killed by automobile: Death in the streets of New York City 1994-1997. Right of Way, New York City. Krizek, K. 2000. Pre-testPosttest Strategy for Researching Neighborhood-Scale Urban Form and Travel Behavior. In Transportation Research Record: Journal of the Transportation Research Board, No. 1722, TRB, National Research Council, Washington, D.C., pp. 48 55. Levine, N., K. Kim, and L. Nitz. 1994. Traffic safety and land use: A spatial analysis of Honolulu motor vehicle accidents. Presented at the 1994 ACSP Conference, Phoenix, Ariz. Lockwood, I. 1997. ITE Traffic calming definition. In ITE Journal, July. Los Angeles Times. 1999. Walk to school hazardous for Santa Ana kids. May 27. Loukaitou-Sideris, A. 1995. Urban form and social context: Cultural differentiation in the meaning and uses of neighborhood parks. In Journal of Planning Education and Research, Vol. 14, No. 2, pp. 101114. Loukaitou-Sideris, A. 1999. Hot spots of bus stop crime: The importance of environmental attributes. In Journal of the American Planning Association, Vol. 65, No. 4, pp. 395411. Loukaitou-Sideris, A., R. Liggett, and H. Iseki. 2001. Measuring the effects of built environment on bus stop crime. In Environment and Planning B: Planning and Design, Vol. 28, No. 2, pp. 255280. Lucentini, J. 2002. A childhood injury prevention champion. In In Vivo: News From Columbia Health Sciences, Vol. 1, No. 3, February 11. Lund, H. 2003. Testing the claims of New Urbanism: Local access, pedestrian travel, and neighboring behaviors. In Journal of the American Planning Association, Vol. 69, No. 4, pp. 414429.

Loukaitou-Sideris

33

Malina, R. M., and T. Bielicki. 1996. Retrospective longitudinal growth study of boys and girls active in sport. In Acta Paediatrica, Vol. 85, pp. 570575. Manson, J. E., F. B. Hu, and J. W. Rich-Edwards. 1995. A prospective study of walking as compared with rigorous exercise in the prevention of coronary heart decease. In New England Journal of Medicine, Vol. 341, pp. 650658. McNally, M., and S. Ryan. 1993. Comparative Assessment of Travel Characteristics for Neotraditional Design. In Transportation Research Record 1400, TRB, National Research Council, Washington, D.C., pp. 6777. Moore, B. J., N. Glick, B. Romanowski, and H. Quinley. 1996. Neighborhood safety, child care, and high costs of fruit and vegetables identified as barriers to increased activity and healthy eating and linked to overweight and income. In FASEB Journal, Vol. 10:A562 (abstract). Nasar, J. L., and B. Fisher. 1993. Hot spots of fear and crime. A multi-method investigation. In Journal of Environmental Psychology, Vol. 13, pp. 187206. National Center for Statistics and Analysis. 2002. Traffic Safety Facts 2002: Pedestrians. (DOT HS 809 614), U.S. Department of Transportation, accessed at www.nrd.nhtsa.dot.gov/pdf/nrd-30/NCSA/TSF2002/2002pedfacts.pdf. National Consumer Council. 1987. Whats wrong with walking? A consumer review of the pedestrian environment. Her Majestys Stationary Office, London. National Highway Traffic Safety Administration. 2002. Traffic Safety Facts 2002, accessed at www-nrd.nhtsa.dot.gov/pdf/nrd-30/NCSA/TSFAnn/TSF2002Final.pdf. National Highway Traffic Safety Administration. 2003. Safe routes to school: Overview, accessed at www.nhtsa.gov. Accessed September 4, 2003. National Safety Council. 2001. Fact sheet library. www.nsc.org/library/pedstrns.htm. National Safety Council. 1994. Accident Facts. National Safety Council, Ithaca, Ill. Newman, O. 1972. Defensible space: Crime prevention through urban design. MacMillan Co., New York. Newman, O. 1976. Design guidelines for creating defensible space. National Institute of Law Enforcement and Criminal Justice, Washington, D.C. Newman, O. 1981. Community of interest. Doubleday, New York. Organization for Economic Cooperation and Development. 1998. Safety of vulnerable road users (DSTI/DOT/RTR/RS7(98)1FINAL). Directorate for Science, Technology, and Industry, Scientific Expert Group on the Safety of Vulnerable Road Users, OECD, Paris. Parks, S. E., R. A. Housemann, and R. C. Brownson. 2002. Differential correlates of physical activity in urban and rural adults of various socioeconomic backgrounds in the U.S. In J. Epidemiology and Community Health, Vol. 57, pp. 2935. Perkins, D. D., A. Abraham, R. Richard, and R. B. Taylor. 1993. The physical environment of street crime. Journal of Environmental Psychology, Vol. 13, pp. 2949. Pikora, T., B. Giles-Corti, F. Bull, K. Jamrozik, and R. Donovan. 2003. Developing a framework for assessment of the environmental determinants of walking and cycling. In Social Science and Medicine, Vol. 56, pp. 16931703. Poyner, B. 1983. Design against crime. Butterworth, London. Rainwater, L. 1979. Fear and the house-as-haven in the lower class. In Housing in America: Problems and Perspectives (R. Montgomery and D. R. Mandelker, eds.), 2nd edition. The Bobbs-Merrill Co., Indianapolis, Ind. pp. 1420.

34

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

Roberts, I. 1993. Why have child pedestrian rates fallen? In British Medical Journal, Vol. 306, pp. 17371739. Roberts, I., R. Norton, R. Jackson, R.. Dunn, and I. Hassal.1995. Effect of environmental factors on risk of injury of child pedestrians by motor vehicles: A case-control study. In British Medical Journal, Vol. 310, pp. 9194. Roncek, D. W., and P. A. Meier. 1991. Bars, blocks, and crimes revisited: Linking the theory of routine activities to the empiricism of hot spots. In Criminology, Vol. 29, pp. 725755. Ross, C. E. 1993. Fear of victimization and heath. In Journal of Quantitative Criminology, Vol. 9, No. 2, pp. 159175. Ross, C. E. 2000. Walking, exercising, and smoking: does neighborhood matter? In Social Science and Medicine, Vol. 51, No. 2, pp. 265274. Ross, C. E., and J. Mirowsky. 2001. Neighborhood disadvantage, disorder, and health. In Journal of Health and Social Behavior, Vol. 42, No. 3, pp. 258276. Runge, J., and T. Cole. 2002. Crosswalk markings and motor vehicle collisions involving older pedestrians. In Journal of the American Medical Association, Vol. 288, No. 17, pp. 2172 2174. Safe Kids Campaign. 2002. Report to the nation on child pedestrian safety. Available at www.safekids.org. Sallis, J. F., M. F. Hovell, C. R. Hofstetter, P. Faucher, J. P. Elder, J. Blanchard, C. J. Caspersen, K. E. Powell, and G. M. Christenson. 1989. A multivariate study of determinants of vigorous exercise in a community sample. In Preventive Medicine, Vol. 18, pp. 2034. Sallis, J. F., B. G. Simons-Morton, E. J. Stone, C. B. Corbin, L. H. Epstein, N. L. Faucette, R. J. Iannotti, J. D. Kellen, R. C. Klesges, C. K. Petray, T. W. Rowland, and W. C. Taylor. 1992. Determinants of physical activity and interventions in youth. In Medicine and Science in Sport and Exercise, Vol. 24, No. 6 (supplement), pp. S248S257. Sallis, J. F. 1993. Epidemiology of physical activity and fitness in children and adolescents. In Critical Reviews in Food Science and Nutrition., Vol. 33, pp. 403408. Sallis, J. F., M. F. Johnson, K. J. Calfas, S. Caparosa, and J. F. Nichols. 1997a. Assessing perceived physical environmental variables that may influence physical activity. In Research Quarterly for Exercise and Sport, Vol. 68, No. 4, pp. 345351. Sallis, J. F., T. L. McKenzie, J. P. Elder, S. L. Broyles, and P. R. Nader. 1997b. Factors parents use in selecting play spaces for young children. In Archives of Pediatrics & Adolescent Medicine, Vol. 151, pp. 414417. Sallis, J. F., A. Bauman, and M. Pratt. 1998. Environmental and policy interventions to promote physical activity. In American Journal of Preventive Medicine, Vol. 15, No. 4, pp. 379 397. Sanderson, B., M. Littleton, and L. V. Pulley. 2002. Environmental, policy, and cultural factors related to physical activity among rural, African-American Women. In Women and Health, Vol. 36, No. 2, pp. 7590. Scottish Executive. 2001. Road accidents and children living in disadvantaged areas. www.scotland.gov.uk/cru/kd01/blue/r-acc04.htm. Seefeldt. V. (ed.) 1995. Recreating recreation and sports in Detroit, Hamtramck and Highland Park: Final report to the Skillman Foundation. The Skillman Foundation, Detroit, Mich. Seefeldt, V., R. M. Malina, and M. A. Clark. 2002. Factors affecting levels of physical activity in adults (review). In Sports Medicine, Vol. 32, No. 3, pp. 143168.

Loukaitou-Sideris

35

Sharples, P. M., A. Storey, A. Aynsley-Green, and J. A. Eyre. 1990. Causes of fatal childhood Accidents involving head injury in Northern region, 1979-86. In British Medical Journal, Vol. 301, pp. 11931197. Shaw, C., and H. McKay. 1929. Delinquency areas. University of Chicago Press. Sherman, L. 1995. Hot spots of crime and criminal careers of places. In Crime and Places ( J. Eck and D. W. Weisburd, eds.). Willow Tree Press, Monsey, N.Y. Skogan, W. G. 1990. Disorder and decline: Crime and the spiral decay in American neighborhoods. MacMillan, New York. Southworth, M., and E. Ben Joseph. 1997. Streets and the shaping of towns and cities. McGraw Hill, New York. Southworth, M. 1997. Walkable suburbs? An evaluation of neotraditional communities at the urban edge. In Journal of the American Planning Association, Vol. 61, No. 1, pp. 6581. Spelman, W. 1993. Abandoned buildings magnets for crime? In Journal of Criminal Justice, Vol. 21, pp. 481495. Stahl. T., A. Rutten, D. Nutbeam, A. Bauman, L. Kannas, T. Abel, G. Luschen, J. A. Rodriguez, J. Vinck, and J. van der Zee. 2001. The importance of social environment for physically active lifestyle: results from an international study. In Social Science and Medicine, Vol. 52, pp. 110. Stone, E. J., T. L. McKenzie, G. J. Welk, and M. L. Booth. 1998. Effects of physical activity interventions in youth (review and synthesis). In American Journal of Preventive Medicine, Vol. 15, No. 4, pp. 298315. Surface Transportation Policy Project. 2002. Mean Streets. www.transact.org. SUSTRANS. 2003. Information on Safe Routes to School programs. www.saferoutestoschools.org.uk/html/what_srs.htm. Accessed Sept. 4, 2003. Taylor, R. B., S. D. Gottfredson, and S. Brower. 1984. Block crime and fear: Defensible space, local social ties, and territorial functioning. In Journal of Research in Crime and Delinquency, Vol. 21, pp. 303331. Taylor, R., and A. Harrell. 1996. Physical environment and crime. National Institute of Justice Research Report, Washington D.C., May 1996. Tien, J. 1979. Street light project. Department of Justice, Washington D.C. Tolley, R. 1989. Calming traffic in residential areas. Brefi Press, Wales. Tolley, R. (ed.). 1993. The greening of urban transport: Planning for walking and cycling in western cities. Belhaven Press, London. Thompson, J. L, P. Allen, L. Cunningham-Sabo, D. Yazzie, M. Curtis, and S. M. Davis. 2002. Environmental, policy, and cultural factors related to physical activity in sedentary American Indian women. In Women and Health, Vol. 36, No. 2, pp. 5974. Transportation Research Board. 2002. Special Report 269: The Relative risks to school travel. TRB, National Research Council, Washington, D.C. Trench, S. 1991. Reclaiming the right. In Town & County Planning, Vol. 60, No. 8, pp. 235237. Trench, S., T. Oc, and S. Tiesdell. 1992. Safer cities for women: perceived risks and planning measures. In Town Planning Review, Vol. 63, no. 3, pp. 279296. Troped, P. J., R. P. Saunders, R. R. Pate, B. Reininger, J. R. Ureda, and S. J. Thompson. 2001. Associations between self-reported and objective physical environmental factors and use of a community rail-trail. In Preventive Medicine, Vol. 32, pp. 191200. University of Southern California. 2003. Neighborhood Kids Watch. Fact Sheet. www.usc.edu/ext-relations/unipark/kid_watch.html. Accessed Sept. 16, 2003.

36

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

U.S. Census Bureau. 2000. American FactFinder. DP-3. Profile of selected economic characteristics: 2000 data set: Census 2000 summary file(SF 3). U.S. Department of Health and Human Services. 1996. Surgeon Generals report on physical activity and health. Report S/N 017-023-00196-5. Washington D.C. U. S. Department of Transportation. 1994. Final report: The national bicycling and walking study: Transportation choices for a changing America. Federal Highway Administration, U.S. Department of Transportation. U. S. Department of Transportation. 2000. Traffic safety facts: Pedestrians. DOT HS 809 331. Washington, DC: Valentine. G. 1990. Womens fear and the design of public space. In Built Environment, Vol. 16, No. 4, pp. 288303. Valentine, G., and J. H. McKendrick. 1997. Children outdoor play: exploring parental concerns about childrens safety and the changing nature of childhood. In Geoforum, Vol. 28, pp. 219235. Walgren, S. 1998. Using Geographic Information System (GIS) to analyze pedestrian accidents, City of Seattle Transportation Department, Washington. www.cityofseattle.net/td/ite.asp. Websters New World Dictionary of the American Language: College edition. 1966. The World Publishing Company, Cleveland and New York. Weinstein, A., P. Felgley, P. Pullen, L. Mann, and L. Redman. 1999. Neighborhood safety and the prevalence of physical inactivityselected states. In Journal of the American Medical Association, Vol. 281, pp. 1373. Wekerle, G., and C. Whitzaman. 1995. Safe cities: Guidelines for planning, design and management. Van Nostrand Reinhold, New York. Wethmore, J. 2001. Reducing student pedestrian perils. www.pedestrian.org/articles/riskmanagement.html. Accessed Sept. 8, 2003. Wilbur, J., P. Chandler, B. Dancy, J. Choi, and D. Plonczynski. 2002. Environmental, policy, and cultural factors related to physical activity in urban, African-American Women. In Women and Health, Vol. 36, No. 2, pp. 1728. Wilcox, S., C. Castro, A. C. King, R. Housemann, and R. C. Brownson. 2000. Determinants of leisure time physical activity in rural compared with urban older and ethnically diverse women in the United States. In Journal of Epidemiology and Community Health, Vol. 54, pp. 667672. Wilson, J. Q., and G. L. Kelling. 1982. Broken windows: The police and neighborhood safety. In Atlantic Monthly, Vol. 249, No. 3, pp. 2938. Young, D. R., X. He, J. Harris, and I. Mabry. 2002. Environmental, policy, and cultural factors related to physical activity in well-educated urban African-American women. In Women and Health, Vol. 36, No. 2, pp. 2941. Zakarian, J. M., M. F. Hovell, R. Hofstetter, J. F. Sallis, and K. J. Keating. 1994. Correlates of vigorous exercise in a predominantly low SES and minority high school population. In Preventive Medicine, Vol. 23, pp. 314321.

Loukaitou-Sideris

37

TABLE 1 Changes in Walking and Biking for the Journey to Work Trip 19602000a (U.S. Census)
Commuters Walk 1960 6,416,343 9.92% N/A 1970 5,689,819 7.40% N/A 1980 5,413,248 5.60% 468,348 0.48% 1990 4,488,886 3.90% 466,856 0.41% 2000 3,758,982 2.93% 488,497 0.38%

Bicycle
a

Percentages represent the market share of commuters.

38

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

RECREATIONAL

UTILITARIAN

In and Around Home Play Exercise

In the Neighborhood Walking Cycling Playing Sports

Commuting Trips Walk/Cycle to Work School Shops Errands

OccupationRelated

PUBLIC ENVIRONMENT

FIGURE 1 Classification of physical activities.

Loukaitou-Sideris

39

HUMAN

NON-HUMAN (ENVIRONMENTAL)

Heavy traffic Reckless drivers

Criminals

Unattended Dogs

Poor roadway Infrastructure

Pedestrianautomobile crashes

Crime Violence

Injury from bites

Injury from falls Pedestrianautomobile crashes

FIGURE 2 Sources of danger for pedestrians and cyclists.

40

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

FIGURE 3 Percentage of respondents who reported physical inactivity, by sex, age group, and perceived neighborhood safety level Maryland, Montana, Ohio, Pennsylvania, and Virginia, Behavioral Risk Factor Surveillance System, 1996. (Source: CDC, 1999).

Loukaitou-Sideris

41

FIGURE 4 Percentage of trips in the U.S. during normal school travel hours, and age categories shown across travel modes. (Source: TRB, 2002, p. 88)

42

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

FIGURE 5 Comparisons of percent miles, percent injuries, and percent student fatalities in the U.S. by travel mode. (Source: TRB, 2002, p. 91)

Loukaitou-Sideris

43

TABLE 2 Design and Policy Interventions to Mitigate the Effects of Traffic

Target Drivers Objective Manage/regulate vehicular traffic Physical Planning and Design Actions Traffic control devices: Traffic signals Roadway signs Crosswalks, Pavement markings Etc. Infrastructure accommodating alternative modes: Sidewalks, paths, trails Bike lanes Busways Carpool lanes Traffic Calming Devices: - Vertical deflections - Horizontal deflections - Road narrowing - Central islands and medians Creation of cul-de-sacs Provide physical infrastructure for pedestrians and cyclists (sidewalks, bike paths, crosswalks, lighting) Upkeep sidewalks and eliminate sidewalk obstructions Policy Actions - Enforcement of traffic regulations - Fees and penalties for noncomplying drivers -Make use of private automobile more expensive through gasoline and parking prices, license fees and other taxes. -Congestion pricing Designation of slow speed areas: - Woonerfs - School safety zones - Home zones

Reduce vehicular traffic volume

Reduce traffic speed

Pedestrians Cyclists

Increase of safety for pedestrians and cyclists

-Preferential treatment of nonmotorized modes when they intersect with motorized modes. - Crossing aids for school children - Escort to school programs - Enforcement of helmets Training programs for children about safe travel, walking and biking.

Educate, inform about dangers of traffic

44

TRB Special Report 282: Does the Built Environment Influence Physical Activity? Examining the Evidence

FIGURE 6 Walking school bus and bike train.