So much of our time is spent making our way though public spaces that the influence they have on our lives cannot be denied. We are presented with options such as walking, standing, sitting, riding, and climbing at numerous points during our day.

Many people instinctively take the most direct route to their destination, if they know what that is. But in a new place, the most natural choice is the pathway that presents itself most clearly or invitingly. Once we make that choice, how does it effect our moods and energy levels for the rest of the day? What impact does it have on our mental and physical health for the rest of the year, or the rest of our lives?

Throughout history, design strategies for our built environment have often been used to improve public health and efficiency, as well as to fight infectious disease. For example, when the 1854 cholera outbreak in London discovered to have originated from a water pump problem, this “led in the next decade to the building of the London sewers — arguably the greatest engineering achievement of the 19th century — and to a number of other crucial public health reforms” (Johnson). In New York City “in the late 19th and 20th centuries, haphazard and relentless growth created an unhealthy urban landscape of dark, filthy streets and tenements… Not surprisingly New York was plagued by repeated epidemics of infectious diseases such as tuberculosis, cholera, and yellow fever” (Active Design Guidelines, 12).

Environmental designers and city officials combated these problems in a number of ways: by implementing the Croton aqua duct system in 1842 for fresh, clean water access, building Central Park in 1857 for clean air access, passing the Tenement House Act in 1881 to improve the quality of living, and constructing the subway in 1904 to disperse the population in overcrowded areas (Active Design Guidelines, 13).

In present day society, the greatest threat to our health is no longer cholera, dysentery, or malaria, but chronic diseases such as diabetes, asthma, cancer, strokes and heart disease. These conditions can be directly linked to obesity, poor diets and physical inactivity, which are the leading health risk factors after tobacco use (Active Design Guidelines, 13).

As shown in the bar graph above, the percentage of deaths attributed to chronic diseases almost quadrupled between 1880 and 2005, while deaths from infectious diseases have nearly diminished. And obesity, one of the largest factors in many of these diseases, has also increased exponentially in just the last 20 years. The national findings of the Centers for Disease Control show significant changes from 1990 to 2007, and an undeniable relationship between diabetes and obesity rates in adults.

The current state of chronic illness in the US also has a large impact on the economy and health care expenses. “Cancer, stroke, heart disease and arthritis are among the most common, costly and preventable health problems in the US” (CDC). If more focus was placed on keeping people healthy then less money would be spent on treating the sick. According to the Democratic Policy Committee “the cost of caring for individuals with chronic diseases accounts for approximately 75 percent of the more than $2 trillion Americans spend on health care each year. Reducing the incidence of chronic disease is a key to reducing the overall cost of health care” (DPC).

Public design is an integral part of our lives, it influences the way we view our society and government, the way we interact with our neighbors, and how or where we decide to spend our time.

Can public design inspire people to be more physically active, and make our communities healthier?

Can design in the public realm speak to the impatient travelers along a city street, and create an renewed appreciation for the physical experience of getting from one place to another?


CDC, Centers for Disease Control and Prevention. Chronic Diseases and Health Promotion. 7 July 2010. Web. http://www.cdc.gov/chronicdisease/overview/index.htm.

DPC, Democratic Policy Committee. “Health Care Reform: The Need for Prevention and Wellness Efforts”. Web. http://dpc.senate.gov/docs/fs-111-1-86.html.

Johnson, Steven. NYTimes.com. “Metropolis Rising”. November 15, 2006. Web. http://johnson.blogs.nytimes.com/2006/11/15/metropolis-rising/

The New York City Department of Design and Construction (DDC), Health and Mental Hygiene, Transportation (DOT) and City Planning. Active Design Guidelines. New York NY: City of New York, 2010. Print.

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