City Know-hows
We tested whether living closer to daily destinations is associated with improved health across major U.S. cities. Neighborhoods with stronger 15-minute accessibility consistently showed lower rates of chronic disease, suggesting that planning for proximity might support healthier urban living.
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Target audience
City planners, public health officials, and metropolitan/regional policy leaders responsible for land use, transportation, and community health strategies.
The problem
Chronic diseases such as heart disease remain unevenly distributed across urban neighborhoods. Built-environment features like walkability and access to services are known to influence physical activity and long-term health. Widely used walkability metrics capture density, land-use mix, or connectivity but may overlook whether residents can realistically reach daily needs within a short walk or bike trip. This gap may limit the effectiveness of health-oriented planning.
What we did and why
We compared three common measures of neighborhood accessibility and walkability across five large U.S. metropolitan areas and multiple chronic disease outcomes to determine whether proximity-based planning provides guidance for improving public health rather than density-based or spatial form-based indicators.
Our study’s contribution
We found that the 15-minute city index and Walk Score were the most consistent predictors of neighborhood health, while the National Walkability Index showed weaker and less stable relationships. Greater proximity to daily destinations was generally associated with lower modelled prevalence of heart disease, obesity, and diabetes across metropolitan areas.
Impacts for city policy and practice
Our findings suggest health-focused planning should prioritize improving access to essential daily destinations rather than relying only on density or land-use mix. Location-specific strategies are critical because accessibility–health relationships differed among metropolitan areas with varying urban morphologies.
Further information
Full research article:
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