Our friends at Sightline Institute (formerly known as Northwest Environment Watch) have just released their 2006 Cascadia Scorecard Report. Sightline is one of the leading sustainability thinktanks focused on the issues facing Cascadia - the northwestern region comprised of British Columbia, Idaho, Oregon and Washington.

Their annual Scorecard reports on key trends in sustainability-related performance. This year's publication focuses on the connections between urban design and human health, including concerns such as obesity, car accidents, suburban growth, pollution and threats to wildlife.

By permission, we're sharing an excerpt from the report on Worldchanging today. The following is the concluding chapter, which reads as something of a prescription for factoring health into the creation of sustainable places.

A Healthy Place

In the late summer of 1854, physician John Snow, confronted by a rampant cholera epidemic in a London neighborhood, hit upon a remedy that was as remarkable for its simplicity as for its effectiveness: he asked local officials to remove the handle of a public water pump located at the epicenter of the outbreak. In an era when contagion was still poorly understood, Snow was convinced that the water from that pump contained a cholera pathogen. Removing the pump handle, he reasoned,
would be the easiest and fastest way to halt the disease’s spread. The officials agreed to act on Snow’s recommendations, and perhaps half an hour of labor sufficed to save dozens or even hundreds of lives.

This episode has become legendary in the fields of public health and epidemiology, for it embodies two critical insights: first, that preventing disease can be far easier than curing it; and second, that complex problems sometimes have simple—though not necessarily obvious—solutions.

Creating a healthier place—where people are more satisfied with their lives, less encumbered by illness, and surrounded by thriving nature—is undoubtedly more complicated than stopping a neighborhood
cholera outbreak. It involves a gradual realignment of many policies and institutions, both public and private, as well as reformation of deeply ingrained habits and outlooks. But perhaps the most effective
way to approach the task is to identify the simple, often unheralded steps that, like Snow’s pump handle, employ modest means to achieve far-reaching ends.

The connection between urban design and health is perhaps the best such example...Sprawling, poorly planned development contributes to the Northwest’s vast appetite for gasoline and diesel fuel. It strains the economy to pay for fuel imports and to build and maintain cars and roads. It entails the gradual paving of both farmland and natural lowland habitats, which frays both terrestrial and aquatic ecosystems. And as the previous chapter shows, sprawl increases driving-related health risks from car crashes, obesity, and vehicle emissions. Finding simple policy changes that promote and nourish complete, compact communities—the opposite of poorly planned sprawl—could yield compounding benefits both for Cascadia’s human inhabitants and for the natural systems that support them.

There is no one single solution to sprawl, but there are a number of modest steps that, taken together, could draw development away from the urban fringe and toward the established and growing city and town centers across the major metropolises of the Northwest. These steps require no new technologies or expensive investments, relying instead on modest alterations to the rules and systems that govern land use and transportation decisions throughout the region.

• When building roads, budget for health. As a transportation agency prepares to build a new road, it budgets assiduously for construction costs such as labor, land, and materials. But the increased car crashes and other health costs that result from road building do not appear in the agency’s ledgers. These costs are passed along to taxpayers and society at large, whether as higher medical bills, higher taxes to pay for government services, or— for those directly harmed—lower quality of life. Since these costs are not accounted for at the time that transportation projects are planned, they are invisible to the people most responsible for transportation decisions.

If transportation planners were required to incorporate—or simply to investigate—comprehensive health costs when making budgeting decisions, they might well discover that some projects simply do not merit the expense. Road projects, particularly those at the edges of metropolitan areas, might seem cost-effective on their face, but factoring in the extra traffic accidents and obesity-inducing sprawl that follows in the wake of many new roads can make them seem like expensive boondoggles. Also, a comprehensive assessment of the health benefits of pedestrian infrastructure, traffic safety, or transit investments might well find that these are surprisingly cost-effective because of their attendant benefits on health. Simply revealing what is hidden—the true costs and benefits of transportation projects—can ensure that the region makes wiser and more health-promoting transportation decisions.

• Zone for life. After World War II—when vehicle ownership was becoming widespread—public-health officials raved about the health benefits of leafy suburbs. And rightly so. Soot and industrial fumes
clouded the air in many cities and town centers, and even though traffic congestion was less prevalent then than it is now, automobile exhaust was more hazardous. Escaping to the greener spaces on the urban fringe seemed a healthy choice. Partly as a consequence, zoning rules and related policies encouraged—and in some cases even required—low-density suburbs, with homes surrounded by
large yards and segregated from stores and workplaces.

Today, however, the tables have turned. Places that are compact enough to foster walking and biking—the modern (and cleaner) city and town centers once shunned by enlightened planners—now tend to be healthier places to live than sprawling, low-density suburbs. But our policies have not changed to reflect this reality. Many locales still mandate low-density housing while restricting
infill development and accessory dwelling units (sometimes called “granny flats”) which can help more people live in the most pedestrian-friendly neighborhoods. Likewise, local land-use rules often require developers to provide overabundant parking, which makes commercial development more expensive while spreading destinations farther apart. And traffic codes—along with the engineering profession itself—still favor branching street networks that impede short trips to nearby destinations.

Changing zoning and transportation policies is, admittedly, slow work. But as Vancouver, British Columbia’s smart-growth record shows, government policies that promote higher-density development can, over the long term, be surpassingly effective at channeling growth. Thousands of Cascadians are already working to change how their communities grow—to lift onerous parking requirements, allow infill development in already developed areas, encourage a mix of stores and services in residential zones, and create development boundaries that help keep growth from spiraling outward into farms and forests. Seattle’s “center city” strategy is one example of a policy change that is helping to foster new residences within walking distance of downtown. As more voices speak out about the health benefits of curbing sprawl, this trend is likely to accelerate.

• End subsidies that accelerate sprawl. In ways that are both obvious and subtle, tax codes and government spending priorities tilt in favor of low-density development at the urban fringe and against
redevelopment in already established neighborhoods.

For example, developers rarely pay the full cost for the public infrastructure—roads, sewer and water lines, schools, police and fire stations, and the like—that services the most sprawling, low-density
development. Even the “impact fees” that many jurisdictions levy on new housing rarely make up for the expenses of development. Taxpayers and utility rate payers, regardless of where they live, pay the remaining costs. Simply requiring new development to pay its own way, rather than being subsidized by taxpayers, would foster compact neighborhoods and infill development, where infrastructure costs are lower.

In the same vein, vehicle-related fees—fuel taxes, license and registration fees, and the like—cover only part of the costs of roads, bridges, public parking spaces, and other public expenses of driving. Taxpayers, even those who drive little, pick up the rest of the tab. If drivers had to pay the full costs for owning and operating their automobiles, they would pay more to drive—and, as a consequence, they would be less inclined to choose places to live where destinations are far apart and where driving is a necessity for every trip.

These three steps are just a starting point; other examples of public policies that could reduce automobile dependence and promote healthier land-use patterns can be found in previous volumes from Sightline Institute.

Unlike Snow’s pump-handle solution, the steps we take now to curb sprawl will not take effect overnight. It may take years or even decades for the full benefits of these innovations to materialize. But just as Cascadians radically transformed their urban landscapes in the decades following World War II, they will rebuild much of what now exists over the coming half century. The question is what they will build. If they choose well, they will create cities with vital economies, safe and secure neighborhoods, flourishing communities, and low and diminishing environmental impacts. They will create cities where—with almost no one noticing at first—threats from car crashes will abate and opportunities to walk safely will abound. If northwesterners choose well, they will end up with a human habitat worthy of its creators. And they will set an example for the world.

If you would like to read the full report, you can download or order hard copies here.

urban fantasies yet again.

I have a couple of problems with your future fanciful vision.

walkable urban centers. Works great if you are 20 years old and don't mind walking in the rain, snow, sleet, wind etc. The given our aging population, weather is as big a factor for isolation as is the socially hostile environment.

ending subsidies for transportation. subsidies should be eliminated for all forms of transportation, mass and individual so they can compete on equal footing.

High-density housing as desirable living space. Look to history. High-density housing intermixed with retail establishments usually means a crime filled environment, significantly more expensive goods and services, and generally a lower quality of life. I refer you to urban low income housing of 50s through 90s. I also suggest you look at the urban environments of the times of great immigration. Again, major problems with power structures independent of government, expensive goods and services, low-quality living environment.

If you are limited by transportation to what kind of groceries or other products you can carry home, you are limited to a small number of stores and a small amount of product. in terms of cost, this will be significantly more expensive than the current grocery store system. in terms of practicality of shopping, in a two-person family with one wage earner, it's possible to have someone go to the market every day to pick up food for that day and maybe next but given that an increasing number of households are single person households or both people are employed it is important to be able to get a weeks worth of groceries in only an hour or so. again, don't think of the 20 something with a huge backpack. Think of your mother in law in her 70s struggling in the rain.

if you look at the gentrification of urban spaces, typically what has happened is the rich have pushed out the poor and encourage stratification based on income. It's entirely feasible that we will have streets patrolled by private police forces stopping people and vehicles that are not "listed as authorized".

I guess this is no way of saying that rich people will have a pretty urban environment, poor people will get the scrap leftovers. Again, this is nothing new, it has existed since the first city.

The problem I have with urban fantasies like this is that there is nothing in the pretty words and nicely formatted documents that says how they will force any change and keep things different from past experience. The power structures will remain the same and the urban experience will remain the same.

look back at the words of urban renewal in the 60s and 70s. see how they sound the same and how little changed except to make things better for the rich.

One of the ways to corral the urban fantasy is to start thinking of these things is if you were a senior citizen, not a TAB (temporarily able-bodied).

Posted by: country mouse on July 26, 2006 4:42 PM

Sorry, CM, I think several of your points are flawed.

First off, mobility for seniors is a problem they face *everywhere.* So it doesn't make sense to isolate dense urban environments as being worse for seniors that rural or suburban life. Also, although I can't cite studies, I think it's likely that pedestrian-friendly, dense, urban environments are better for the health of seniors.

The hospitals are closer, the grocery stores are closer, everthing is closer. And we know for a fact that walking is healthy for those seniors who can walk. It's certainly better for their joints than calcifying in front of a television in an isolated subdivision with no one around to hear you scream if you have broken your hip.

Secondly weather is a problem in every living environment, not just dense cities. That's not a sufficient argument to make against the reform of urban planning that WC is advocating.

CM wrote, "High-density housing intermixed with retail establishments usually means a crime filled environment, significantly more expensive goods and services, and generally a lower quality of life."

Can you cite proof of that? I could argue that abandoned, residential subdivisions during work hours also invites crime but, you and I need data to prove these assertions.

CM wrote, "if you look at the gentrification of urban spaces, typically what has happened is the rich have pushed out the poor and encourage stratification based on income. It's entirely feasible that we will have streets patrolled by private police forces stopping people and vehicles that are not "listed as authorized"."

How is this different from gated communities in the suburbs? I agree gentrification has negative side-effects. What do we do fix the problem because it exists everywhere, not just cities.

CM wrote, "Look back at the words of urban renewal in the 60s and 70s. see how they sound the same and how little changed except to make things better for the rich."

That's a pretty pessimistic assessment. "Nothing will ever change so why bother?" This seems to say that we never learn from previous mistakes.

Previous efforts at urban reform had some negative consequences but I think if you look at the history you'll find that those same efforts had expected and unexpected positive results too. That's why we have to keep trying to make cities better.

CM wrote, "Subsidies should be eliminated for all forms of transportation, mass and individual so they can compete on equal footing."

I certainly agree that many of the subsidies should be removed for private transportion and automobiles. (Except those that promote greater energy efficiency and safety.)

I agree that emergent, market driven solutions can sometimes be very fruitful.

But sometimes the market makes mistakes. Sometimes there needs to be planning and guidance from above to fix harmful feedback loops that arise in emergent systems like markets. You need both emergence *and* planning to drive innovation and change.

So no, I disagree that subsidies should be removed from all forms of mass transit. Economic shortsightedness is bad for long term environmental health.

About the only point you've made that holds water is that it's more expensive to buy land in dense cities than rural areas. That's it.

Still, I see a lot of working class people somehow managing to live in dense urban environments. How do they do that? How to we make it better for them?

Posted by: Pace Arko on July 26, 2006 6:16 PM

I disagree with your statement that high-density house means crime filled environment. It really depends on how you accomplish that density. If you look at examples of urban renewal in Cincinnati it actually reversed crime rates because of the usage of mixed used planning. Another place one can look at is Europe. Where there has traditionally been the opposite where city centers are areas of highest property value while the outlying areas are left to those who are poorer.

But in reality the idea of all this suburban sprawl is a thing of the past. With the idea of Peak Oil, many experts including the USGS have already stated that peak production of petroleum will hit (within the next 30 yrs) or has hit. So that means we can never pull out of the ground more oil that we did in the past. Therefore that means higher prices for gas and transportation. So a decentralized suburban environement will quickly price people out of that living condition.

Posted by: Rithy on July 26, 2006 9:02 PM

"I disagree with your statement that high-density house means crime filled environment. It really depends on how you accomplish that density. "

in a censored post, I searched and found gis based analysis of crime statistics. There were many more crime events per square mile than those found in suburbia.

"If you look at examples of urban renewal in Cincinnati it actually reversed crime rates because of the usage of mixed used planning. "

this is probably because of gentrification. Another exclusionary technique used to separate groups of people by economic strata.

"Another place one can look at is Europe. Where there has traditionally been the opposite where city centers are areas of highest property value while the outlying areas are left to those who are poorer."

in england (oxford, london), and sweden (various cities in the south), urban housing was cramped, expensive and poorly maintained. suburban housing was nicer and had larger living space. at least that is what I was exposed to.

"But in reality the idea of all this suburban sprawl is a thing of the past. With the idea of ...
So a decentralized suburban environement will quickly price people out of that living condition. "

may be true but prove how the future will not be slums like rio as billions dollare of failed suburban real estate inventments sink banks and individuals alike.

Posted by: country mouse on July 27, 2006 1:41 PM

"in a censored post, I searched and found gis based analysis of crime statistics. There were many more crime events per square mile than those found in suburbia."
That makes sense since a majority of American urban centers a populated with the poor and minorities. It would make more sense to look at data from European cities because they would show a greater mixture of people that are on different socioeconomical levels.

"this is probably because of gentrification. Another exclusionary technique used to separate groups of people by economic strata."

And I never said that gentrification wasn't a problem. It's a reality and if you looked at my response that is what is typical of urban centers in Europe. High property values in the inner city.

Finally I'm not saying the future isn't going to be some kind of Judge Dread type of wasteland, it could be. But it could be some kind of utopida with discoveries in fusion and maybe biofuels as an intermediary. But the idea of petroleum reaching $100 a barrel, I rather live in a dense urban center.

Posted by: Rithy on July 27, 2006 5:38 PM

CM wrote, "in a censored post, I searched and found gis based analysis of crime statistics. There were many more crime events per square mile than those found in suburbia."

Censored post, eh? Convenient.

Regardless, if we are comparing only by density obviously crime will appear to happen more frequently in a dense city.

That's *not* the measure we should be using. We should be using a per person measure. Are the odds higher, per person, of crime happening in a city or a suburb? I'm guessing, although I have no data to prove this, that the odds are about the same.

CM wrote, "this is probably because of gentrification. Another exclusionary technique used to separate groups of people by economic strata."

We all agree that gentrification can be a problem. Gentrification can happen anywhere people live, not just cities. How do we reduce those negative results from gentrification in the suburbs and elsewhere? You never answered that question.

CM wrote, "in england (oxford, london), and sweden (various cities in the south), urban housing was cramped, expensive and poorly maintained. suburban housing was nicer and had larger living space. at least that is what I was exposed to."

Annecdote and generalization from personal experience. Next.

CM wrote, "may be true but prove how the future will not be slums like rio as billions dollare of failed suburban real estate inventments sink banks and individuals alike."

The best way to prevent that future is improve the present. A good 15 to 20 percent of the articles here at WC are about ways to improve cities, suburbs and all urban environments both in the developing world and the post-industrial world. If you've got better ways to avoid the horrors of Soylent Green, we really would like to hear them. Honestly, we really would.

Posted by: Pace Arko on July 27, 2006 7:23 PM

Crime events per square mile is not exactly a useful comparison. If you have one crime event per year per square mile and there are two people living there, you have the impact of a crime on (at minumum, of course) 50% of your residents. If there are 4,000 people living in a square mile and you have 100 crime events, you have the impact of a crime on at minimum only 2.5% of your population. While I obviously made up numbers for this example, you can see that saying 2 versus 100 crimes per square mile is misleading.

Posted by: Ben Schiendelman on July 28, 2006 3:40 PM

Oh, potentially fewer than 2.5%, because multiple events could affect the same population.

Posted by: Ben Schiendelman on July 28, 2006 3:41 PM

CM, Pace Arko has it right, your arguments really don't hold water. Rather than do a point by point, the central point is this: we can't all live in the country (or in the rural sprawl version of the country). There are too many people using too many resources. So we either need far fewer people, or a better way to utilize resources.
Your pessimism regarding city life is unfounded and a little antiquated. Urban Renewal ended thirty years ago.
I get the feeling you're threatened by this site's urban focus - that you will be "made" to live in a hi-rise tower. I think there's room for us all, but we will have to live more densely. And there are many of us who love that. I live in a dense, diverse city with high quality of life, complex issues, and a sense of life that I've never found in any suburb. It reminds me of the city my grandparents lived in, when they were alive.

Posted by: justus on August 1, 2006 6:36 PM