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Edited by L Frank, P Engelke, T Schmid. Washington, DC: 2003, $30.00, pp 253. ISBN 1-55963-917-2
Sedentary behaviour is a major cause of poor health worldwide both through the direct effects of inactivity on health and indirectly via its contribution to obesity. Health and Community Design describes the role of the built environment as a potential contributor to physical inactivity and suggests ways in which communities could be structured to encourage or require physical activity, particularly walking and bicycling.
The “built environment” is defined broadly as “…the form and character of communities” encompassing land use patterns, urban design characteristics, and transportations systems. Frank et al emphasise the influence of the built environment on physical activity and they effectively describe its potential role as a determinant of obesity. However, obesity is likely to be influenced by factors in addition to physical activity, particularly diet. This book highlights the need for a comprehensive assessment of how the built environment influences diverse determinants of energy balance, including diet, and other health behaviours. Occasionally, the authors neglect potential trade offs associated with choices concerning community design. For example, cul de sacs may decrease walking by adults but increase outdoor play of children. Understanding such trade offs is critical to improve planning and prioritisation among design choices.
All in all, we strongly recommend this book as an introduction to connections between urban planning and sedentary behaviour. The authors have done an outstanding job presenting arguments that can be made linking the built environment and physical activity and these arguments should be of great interest to public health, transportation and urban design researchers and planning professionals. The text is also accessible enough for community activists interested in understanding potential consequences of planning decisions and its maps and illustrations are particularly novel and effective for a public health audience.