Smart growth and public health: making the connection

Urban planning and public health were both conceived around the turn of the last century by the need to provide clean drinking water, adequately lit and ventilated housing, access to parks and clean air, and public spaces for social interaction. Over time, the two fields grew apart as the basic infrastructure to assure healthy environments and adequate living standards were provided, at least in most cities of the developed world. Perhaps for this reason, the principles of smart growth were silent on the need to build environments that foster public health. In the last two decades, however, critical issues of public health - physical activity and obesity, traffic accidents, air quality, and mental health - again became recognized as systemically linked to the built environment. In this chapter we review the relationship between these newer concerns about public health and urban development patterns at multiple scales. We find that there is ample evidence that urban form and public health are indeed closely related, but often in complex and indirect ways. We conclude with suggestions for how public health could be more directly included in the pursuit of smart growth in the coming decades.