OPINION:IRELAND HAS been good in achieving firsts in the area of public health. We were the first to introduce a full workplace smoking ban, and first in various quality-of-life indices. However, we seem to be on the road to a less welcome first: we are second only to the UK in having the fattest people in Europe.
Historically, architects, urban thinkers and landscape architects designed our cities and neighbourhoods to address infectious diseases and even mental health issues. Today, obesity is such a serious issue that it demands a rethink in the way towns, cities and buildings are developed and designed.
Conditions in the built environment can affect participation in physical activity both negatively and positively.
York in England has won numerous awards for developing an integrated transport network that does not rely on private cars and meets local air quality objectives. An integral part of that strategy promotes sustainable active alternatives to the car that are both convenient and reliable by using public transport, walking and cycling.
York was one of the first local authorities to adopt a hierarchy of transport users when making decisions related to land use and transport, with pedestrians given top priority.
The decisions taken in York were a response to changes to our physical and social environments that have happened over decades and have contributed to today’s obesity epidemic. Approaches focused solely on changing individual behaviour have limited success. Increasingly, the evidence suggests that policies and practices intended to enable people to be physically active are more likely to be successful if they modify both the physical and social environments.
In Barcelona, city planning provides high-quality opportunities for people to live and work actively. Planners have accomplished this even though the site is small and topographical constraints in outward development restrict space for greenery and active living.
Faced with serious problems of urban decay, planners took a holistic approach and used the hosting of the 1992 Olympic Games as a vehicle for city-wide reforms. Olympic facilities were spread over four neglected urban areas, with the Olympic village developed on abandoned industrial land close to the coast.
At the same time, a radical transformation of inner-city districts began, with a policy of improving social capital and reducing crime. Inner-city reforms are continuing. Many of the residential blocks, which had lost their open space to industrial development, are gradually getting green spaces and small neighbourhood parks.
Human beings are not, generally, born fat. Nor are we born lazy – as any exhausted parent will tell you, small children have an abundance of energy. So what is going wrong?
Essentially, it is simple maths: if more calories are going in (through food and drink) than going out (through exercise), we will get fatter. For tens of thousands of years we have been programmed to be active because it was a matter of life and death. As hunter-gatherers we had to be able to chase potential food supplies and run away from potential predators.
Humans are and have always been very adaptable and we quickly adjust to the environment we are in. While this was an advantage in evolutionary terms, it has spelt bad news when the environment provides little opportunity for exercise.
Humans were designed to keep active. We are not designed for the modern, sedentary lifestyle that has become the norm, with a lot of incidental exercise designed out by means of technology and labour-saving devices.
Environment sustainability and health are inextricably linked. This needs to be recognised by politicians, public health officials, urban planners and architects, and definitive action needs to be taken in a united format.
Aspects of our urban environment can either inhibit or promote our ability to maintain a healthy weight. How a neighbourhood is designed dictates how people get around, for example walking or cycling versus car use. The built environment should support people to make healthy choices. It makes sense, for example, to locate shops, banks and post offices within walking or cycling distance of housing estates and to provide bike parking facilities.
We have seen cities such as Copenhagen and Amsterdam develop into cycling cities, with more than one-third of people commuting by bike. The health benefits are obvious.
While playgrounds appeal to younger children, accessible teen-friendly destinations such as cinemas and skate parks can motivate adolescents to get moving. This is exactly the kind of thinking that could result in measurable change.
Moving from an environment that promotes obesity to one that actively plans against it is our best hope of reversing the obesity trend.
Dr Muireann Cullen is manager of the Nutrition Health Foundation