A woman takes her child by the hand and proceeds to cross seven lanes of traffic. Cars are heading toward them at 50 mph as she and her child run across the street. It’s a terrifying sight, but a very common one here at the intersection of U.S.15-501 and Garrett Road. On one side of the highway, there’s a vast apartment complex with lots of Latino residents. On the other side of the highway, a busy strip mall beckons with restaurants, a clothing store, a music store and a handful of other shops. But there’s no crosswalk–in fact, the median itself is a narrow gully. Crossing this street means taking your life in your hands. Several pedestrians have been killed here. But the N.C. Department of Transportation says, even after researching the problem, they still have no plans to make the intersection more friendly to foot and bike traffic.

What is the impact of this kind of environment on the people who live in it? Public health experts think it’s partly to blame for the fact that 61 percent of Americans are overweight, and more than 5 million are “morbidly obese.” The problem is especially serious among low-income and minority communities.

Fat is making headlines these days. But what’s not making it into the conversation about the fattening of America is the foundation on which our lifestyle is built: our cities, our neighborhoods, our roads. Food is only half the problem; lack of physical activity is the other half.

Basic safety issues often keep people from being physically active. And when it isn’t safety, it’s convenience. Few of us walk down the street to the corner store, because we live in neighborhoods where sidewalks end as abruptly as they begin. How many times have you driven from one part of a shopping center parking lot to another? You drove not just out of laziness, but because the parking lot is designed for driving, not for walking. We go from cubicle to car to cul-de-sac. The sedentary lifestyle is as hard to escape as a freeway on-ramp.

Physical activity has been “engineered out of daily life,” says Rich Killingsworth, director of Active Living by Design, a joint endeavor of The Robert Wood Johnson Foundation and the UNC School of Public Health. The program will tackle the connection between obesity and the design of cities and neighborhoods with $16.5 million in grant money. The program will give 25 grants of up to $200,000 over five years to communities across the country.

“What we’re trying to promote is physical activity and this whole concept of active living, how you can do physical activity through normal routines,” says Killingsworth. The money will go toward partnerships between citizen and advocacy groups and public health agencies. He’s hoping that the outcomes will convince policy makers and politicians that better community design can have a profound, quantifiable impact on public health.

Walk to school programs, Rails to Trails, mixed-use public spaces with recreation areas–all of these are physical activity programs that The Robert Wood Johnson Foundation already funds. The Princeton-based foundation has been a major national grant source for public health for decades, funding everything from drug abuse prevention to biomedical research to better health care access. In 2001, the foundation gave over $561 million in grants and contracts–a big chunk of change–with 20 percent of that going to “programs that promote healthy communities and lifestyles.”

But Active Living by Design seems to have hit a very particular nerve. It received 966 applications–a record for any RWJF call for proposals–including at least one from every state and Puerto Rico. In rural counties, in inner-city enclaves and in California suburbs, community groups are eager to change the built environment to make it easier to be active.

Bill Roper, dean of the UNC School of Public Health, is also on the board of The Robert Wood Johnson Foundation. His efforts are partly to thank for bringing Active Living by Design’s headquarters to Chapel Hill. Roper says the foundation decided a couple of years ago to emphasize physical activity as a way to address the obesity epidemic.

“It’s important to reach not only individual Americans with the notion of being physically active. It’s important to reach people who design neighborhoods and cities and roads. We’re trying to broaden the scope of people who are focused on the public’s health so that it’s not just doctors and nurses but will include city planners and architects and engineers as well.”

Killingsworth explains the scope of the project’s goals: “Public health has specific mandates; designing how communities look is not one of them. We don’t want to be architects or city planners. The focus of our efforts should be how do we work with people who do that for a living.”

High price of bad design

The American Medical Association estimates that 280,000 Americans die prematurely each year due to obesity-related illnesses. Not surprisingly, the working poor are the worst affected, since they often have to spend more hours working, and they live in neighborhoods where it’s not safe to take a stroll and where there’s no grocery store to be found. The Surgeon General has called the problem an “obesity epidemic.” Our sedentary lifestyle is literally killing us.

We’re already throwing money at the problem–but not until people show up in our public hospitals dying of heart disease or suffering from diabetes. About $100 billion is spent each year for the treatment and care of diabetes–one dollar out of every four that Medicare spends goes to that disease.

Critics of smart growth say that sprawl actually offers low-income people more housing opportunities, and that it would be cheaper to buy everyone a car than build rail systems. Perhaps. But when you take into account the money that the public health system spends each year on fat-related illnesses, the economic impact of bad urban design and a sedentary lifestyle shows up in our public health system already.

What’s more, there is a cultural component that has to be addressed. Design affects the social life of a neighborhood. And it’s not enough to simply create bike paths and pedways if there isn’t any destination for them to reach. Killingsworth emphasized the need for people to be active in the course of their daily life, not just when they set aside time to exercise.

Many of the proposals Active Living by Design received from low-income urban communities asked for help getting more police patrols, crosswalks and other things that tony suburbs don’t have to worry about.

“That’s a story that we’ve heard for many, many years doing public health,” says Killingsworth. “You need to have these basic things in place. That’s why it’s so difficult to change these basic aspects in low-income communities, because many of these safety measures aren’t there.”

Yet many of the things suburbs lack are already in a downtown neighborhood–access to public transit, walkable streets laid out in a grid, nearness to offices and commercial centers. “While they might have the infrastructure, they don’t have the pulling forces that would get people out and about,” Killingsworth says.

10,000 steps a day

What does a healthy design look like? Take a look at the ideas for Durham Central Park. There’s not much to see there yet, just two empty fields between the new YMCA building and the old brick Liberty Warehouse. But there are lofty plans afoot, and Executive Director Leigh Scott shows off sketches that include a senior center, a police substation, a walking trail through the trees, and a new permanent home for the farmer’s market that also can be used as an amphitheater. There already have been active events like volunteer tree planting and dog days in the park. And running through the heart of the park–and the downtown streets–will be the North/South Greenway, which runs 12 miles, from West Point on the Eno Park to Garrett Road Park.

A mural of the spiffy red-and-white Durham Central Park logo has been painted on the side of the warehouse, and there are red-and-white street signs along the block as part of a kind of branding effort, to make visitors feel they’re in a special downtown zone, an inviting public place.

Durham Central Park is the brainchild of a group of volunteers who thought a public park would revitalize downtown Durham, a place that seems forever poised to take off but has yet to make it very far off the ground. Several years ago, the nonprofit partnered with the city’s Parks and Recreation department to buy $1.4 million worth of land walking distance from the Carolina Theatre, the Durham Arts Council, and West Village apartments, not to mention the neighborhoods of Walltown and Old North Durham.

Progress has been slow but steady. “A lot of people don’t understand why it can’t happen faster,” Scott says as she shows me the plans. Except for the land acquisition, the park’s funds have come almost entirely from private foundations, including The Robert Wood Johnson Foundation.

Scott frequently walks to the park from her downtown office because she’s trying to be more active. She’s wearing a pedometer, a small inexpensive device that clocks each step she takes. They’re all the rage with the active living crowd, since they train you to think of physical activity not just in terms of a morning jog, but as something that should happen throughout the day. A recent study suggested that 10,000 steps a day (about five miles) are enough to help the average adult stay healthy. Part of the appeal of the pedometer is that even if you miss that jog, you get extra credit for taking the stairs.

But Scott needs little extra credit. She lives in Woodcroft, a south Durham subdivision, and often rides her bike the six miles up the newly completed Tobacco Trail to downtown. It seems strange to think that someone living in sprawling south Durham could get to work on a bike. But she says many people use the trail, especially on the weekends.

Old habits die hard

When he worked for the Centers for Disease Control, Killingsworth and his family lived in Atlanta, a city famous for its battle with sprawl. “I lived right in the middle of it, yeah.” He drove 22 miles to work each day, and his wife drove 17. So when he came to the Triangle to work for Active Living by Design, he was delighted to buy a house in Southern Village, where he can walk or ride a bike to work.

The meticulously planned development was built in the late 1990s on a New Urbanist model, with smaller lots, houses closer to the street to encourage walking and neighborliness, interconnected streets instead of cul de sacs, and a paved trail around the perimeter. A row of shops and offices along Market Street is designed to function as the downtown, with a restaurant, dry cleaners, food market, church and movie theater. Public schools were built on site as well. While there’s no perfectly ideal active living community in the Triangle, this is as close as it gets, and the staff of Active Living by Design will always feel deeply invested in the neighborhood that is their home base.

The program’s own offices are designed to be an example of what they’re trying to make happen. During construction, they talked the developer into adding nice carpet and art in the stairwell, to make it more inviting. And there’s a shower, too, to make it easier for the staff to go jogging or play outside in the middle of the day without having to go home or to the gym to shower and change.

At lunch at the Weaver Street Market branch in Southern Village, Killingsworth discusses what he thinks works and doesn’t work about the meticulously planned neighborhood. “The unfortunate circumstance is that, if people move here, they’re still isolated. They still have to drive to many destinations.” They do it even when they don’t have to. “They often drive to locations even within Southern Village.” Old habits die hard.

As we stroll around, Killingsworth waves to people jogging and riding bikes along the trail that runs through the entire development. But he points out that everyone appears to be using the trail for planned exercise, not for getting from place to place. Southern Village was set up to be walkable, with no point more than half a mile from the farthest house to the commercial center. Three-quarters of the homes are a five-minute walk to the restaurant and movie theater. It’s that integration of activity into the mundane aspects of daily life that is the crux of what Active Living by Design is trying to achieve. They hope that eventually activity will be as second nature to us as hopping in the car–or, well, eating. But ridership is up on the free public buses to UNC campus, and a few parents walk their kids to school instead of driving.

He also acknowledges that people have to pay a premium to enjoy the amenities of this neighborhood. “While they try to make these mixed-income communities, it doesn’t turn out that way. There are apartments here and condos and row homes and single-family homes. But the income levels are pretty tight.”

There’s something utopian about the place. But Southern Village also exemplifies some of the problems with New Urbanist trends. It’s a development on a tract of land a few miles from town, connected by roads that aren’t walkable. It’s somewhat mixed use, but the vast majority of it is residential. Homes are expensive there–condos start at $130,000 and single family homes are anywhere from $300,000 to over a million dollars. Ultimately, it’s a very nice subdivision with excellent amenities for its residents, but its residents are a small, rather specific group of people, folks who like the ideas of New Urbanism but who prefer to live in a new house in a well-manicured, family-oriented neighborhood. A better description might be New Suburbanism.

But is that so bad? If affluent people want to buy new houses–and many do–isn’t it better for them to buy in a neighborhood like this than in someplace that makes no effort?

Walking around downtown Carrboro with Cara Crisler, executive director of N.C. Smart Growth Alliance, we pass offices, shops, apartments, bars and the big green space in front of Weaver Street Market. This neighborhood, built around an old textile mill village, isn’t master planned, but it’s arguably a better example of the mixed use New Urbanist ideal. “Communities that develop organically over time like Chapel Hill, Carrboro, Durham, they weren’t built overnight,” Crisler says. “That allowed for a lot of diversity in architectural style, affordability, accessibility to work and even recreation.”

Kara Pittman, a real estate agent with Terra Nova Properties of Chapel Hill, says the industry is getting the message. But Chapel Hill and Carrboro are about 90 percent built out, and Pittman points out that, upscale as it may be, Southern Village is more affordable and accessible than much of the older parts of Chapel Hill. Last year Pittman lived in a condo in the “commercial district” of Southern Village, beside the pizza parlor and the Lumina movie theater. She bought the condo as an investment property and lived there while building a place in downtown Carrboro. “I knew it would be a good investment,” she says, and it was.

Pittman says her contacts in the business were what enabled her to build a place in Carrboro. “For me, building was the only way to afford to live down there.” The small mill houses that give the area its character rarely go on sale, and when they do, they’re usually snatched up through word of mouth before they’re even advertised. “Where Southern Village can typically hit every audience, downtown Carrboro cannot. There are very few opportunities to live downtown.”

The market is ripe for more of exactly the type of housing that Smart Growth advocates like Crisler want to see. Pittman, who’s based in Carrboro but sells all over the Triangle, says many of her clients want to live in a downtown neighborhood. “A lot of people come, transplants from up north that are used to living in downtowns and taking mass transit to work. They’re kind of surprised at our suburbanized market, I think.”

“We’re trying to bring neighborhoods to downtown Carrboro and trying to bring density.” Pittman says the lengthy zoning approval process adds cost to in-fill projects and scares some developers off. Pittman’s selling a new set of condos called Wilshire Place, currently under construction just off Franklin Street, within walking distance of the Village Plaza shopping center. A two-bedroom, two-and-a-half-bath condo there costs $214,900. Eight of the 12 units are already sold.

“We’ve gotten several retirees calling about that property, specifically because they want to be able to walk to the grocery store and walk to dinner and don’t want to have any concern about yard work whatsoever.” And they don’t want to drive anymore. The response from seniors was kind of a surprise, she says. But it makes sense. A walkable neighborhood allows people to stay independent later into life.

If a real estate developer has to buy an investment property in Southern Village to afford a house in Carrboro, where does this leave the rest of us?

“That New Urbanism costs more, it’s a catch-22,” says Killingsworth. “Only one percent of all development that goes on now is New Urbanist-related, nationally. So when you have that small of a percentage of the development pie, it is going to cost more.”

“It’s easier to do a cookie-cut design–to go in, buy a parcel of land, develop a traditional post-1950 type of subdivision that isn’t connected to anything. To do things like this that require innovation and are essentially customized to the fabric of the community, it takes time and a lot of investment, and a developer who’s interested in improving the quality of life.”

Not everyone wants to live in a dense, compact neighborhood, either. “Fifty to 60 percent of the population, it really doesn’t matter to them. They don’t want to have to worry about these things, and for them, often they prefer separation because that’s the way they grew up and they think there’s nothing better than that. So it’s a challenge to make sure people are active in the suburbs, as well.”

Before and after

Some city governments are already getting the message that Active Living by Design wants to send, and it’s showing up in their public projects. In downtown Raleigh, a dense, mixed-income neighborhood has just opened its doors.

If Chavis Heights, the 50-year-old barracks-style public housing just south of downtown Raleigh, is the “before” picture, then nearby Capitol Park, which opened last month next to Peace College, is the “after” picture. A federal HOPE VI grant helped the Raleigh Housing Authority tear down Chavis Heights doppelganger Halifax Court, a plot of aging brick and cement public housing units, and replace them with brand new townhomes and single family houses, half of which will serve as public housing, the other half as slightly discounted market-rate rentals.

Alison Hapgood of the RHA thinks the new demographics of the neighborhood, along with its radically different design, will make Capitol Park highly desirable. “The concept really appeals to people who want to live in a diverse neighborhood, where there’s low income people next to high income people,” Hapgood says. She expects Peace College students and 20-somethings not quite ready to buy their first house will be drawn to the new downtown neighborhood. “There’s not another property in Wake County that can say that they’re a mixed income, mixed use, brand new community.”

Capitol Park’s pastel-painted houses and wide sidewalks are indeed inviting. It features a walking trail, a public park, and a nearby community center, as well as a senior facility that’s already full up with residents.

Architect Larry Zucchino of the J Davis Architects firm in Raleigh designed the land plan for Capitol Park. “Basically, we took a monolithic block that was geared toward planning in the ’40s and ’50s that we broke apart and recreated to make it more livable and usable.” The planners made sure to incorporate transportation stops and walkable links to the rest of the city. “I can’t tell you that [health] was a direct issue we were trying to resolve or plan for,” Zucchino says. “But certainly, good urban design and in-fill design of neighborhoods incorporate walkable, usable and safe environments where people will get out and use their urban environments, and that’s good for health, safety and welfare for everybody.” Zucchino is also working on a similar project to replace Durham’s Few Gardens projects.

Capitol Park is a pedestrian friendly neighborhood, but it’s not truly mixed use. There are no stores or restaurants on the site, for instance, and while the RHA will provide an impressive set of services at the community center (money management courses, computer training, day care), there’s not much else to walk to.

Still, it is one step in the right direction. And even though Capitol Park’s planners weren’t consciously thinking about health when they created the design, they are thinking along some of the same lines. If Active Living by Design’s efforts are successful at putting health on the Raleigh city planning radar screen–and if HOPE VI funding doesn’t completely dry up–maybe the next urban renovation will make activity an explicit goal.

“You need to look at the longer term,” Killingsworth says. “It took us 50, 60 years to get here. We’re not going to build our way out of it in 10. It’s going to take another four or five decades to get it to where we want it. And that’s the mindset we have to go in with. It’s not going to change overnight. If we expect that, we’re setting up for failure.” EndBlock