In November 2005, I attended a Think Tank on obesity and public policy in Toronto.
I was surprised that obesity and the built environment was one of the main areas of discussion.
I was surprised for two reasons. Firstly while certainly improving the built environment might encourage people to walk and exercise more, as readers of this blog are aware, walking and exercise, while integral to health, don't really do it for obesity.
Last week Prevention Magazine named Madison, Wisconsin the United States' most walkable city in a study sponsored by the American Podiatric Medical Association.
Here's their list of the most walkable cities in the US:
- Madison, Wisconsin
- Austin, Texas
- San Francisco, California
- Charlotte, North Carolina
- Seattle, Washington
- Henderson, Nevada
- San Diego, California
- San Jose, California
- Chandler, Arizona
- Virginia Beach, Virginia
Looks good right? The more walkable cities are fitter right?
Austin, Texas - the 2nd most walkable city in the US, was also ranked their 21st fittest city. San Francisco, California - the 3rd most walkable city in the US, was also ranked their 7th fittest city. Charlotte, North Carolina - the 4th most walkable city in the US, was also ranked their 23rd fittest city. Seattle, Washington - the 5th most walkable city in the US, was also ranked their 2nd fittest city. Virginia Beach, Virginia - the 10th most walkable city in the US, was also ranked their 15th fittest city.
Where's Madison? Where are the other five top 10 cities?
Exceptions are bad for rules right?
For me exercise and fitness are crucial determinants of health; are integral in maintaining weight loss, but are generally not in and of themselves sufficient to dramatically impact upon weight.
San Diego, California - the 7th most walkable city in the US, was also ranked their 21st fattest city. San Jose, California - the 8th most walkable city in the US, was also ranked their 10th fattest city.
To walk a pound off a week would require you walk roughly 2 hours each day and I can't imagine there's anything we could do to our built environments that would lead to that (especially here in cold, snowy Canada). Moreover the likelihood is, in this Calorie blind environment that Health Canada has cultivated, folks who walk more will likely think they can eat more in compensation - likely a lot more. In fact I've often worried that if our government was successful at getting people more active without teaching about Calories that we'd actually see obesity rates rise faster as people ate what they felt they earned through exercise.
So while I'm all for improving on our built environments to encourage more activity, it concerns me that Think Tanks like the one I attended deal with built environment as potential tools to combat obesity. It's worrisome mainly because if obesity rates are used as a means to assess outcomes from these improvements, they'll likely stop recommending that we make them and frankly I think they're important in their own rite.