To Control Health Costs, Build Sidewalks

Each month new research emerges linking public health with the built environment. Yet just a small fraction of healthcare spending goes toward reducing our exposure to unhealthy environments. Under the Affordable Care Act, that could soon change.

1 minute read

August 13, 2013, 6:00 AM PDT

By bmaryman


Street With No Sidewalk

SvR /

"Public health practitioners look at streets like the one above and have gradually come to the conclusion–based on reams of studies–that exposure to streetscapes like it are one of the causes of Americans’ ever-increasing rise chronic disease," writes Brice Maryman. "In fact, the New England Health Care Institute estimates that our environments influence as much as 20% of our public health outcomes."

"All of this evidence begs the question: if the built environment is a significant determinant of our public health outcomes, why aren’t health entities–hospitals, HMO’s and clinics–helping to build a better infrastructure that supports sound health outcomes? While public health agencies like PHSKC and the CDC have been leading the way, the private sector has been generally hesitant to directly intervene in the built environment."

Friday, August 9, 2013 in SvR Design Company Blog

portrait of professional woman

I love the variety of courses, many practical, and all richly illustrated. They have inspired many ideas that I've applied in practice, and in my own teaching. Mary G., Urban Planner

I love the variety of courses, many practical, and all richly illustrated. They have inspired many ideas that I've applied in practice, and in my own teaching.

Mary G., Urban Planner

Get top-rated, practical training

High-rise apartment buildings in Waikiki, Hawaii with steep green mountains in background.

Study: Maui’s Plan to Convert Vacation Rentals to Long-Term Housing Could Cause Nearly $1 Billion Economic Loss

The plan would reduce visitor accommodation by 25,% resulting in 1,900 jobs lost.

April 6, 2025 - Honolulu Civil Beat

People sitting and walking in plaza in front of historic Benton County Courthouse in Bentonville, Arkansas.

Placekeeping: Setting a New Precedent for City Planners

How a preservation-based approach to redevelopment and urban design can prevent displacement and honor legacy communities.

March 28, 2025 - Emily McCoy

Two yellow and white Dallas Area Rapid Transit light rail streetcars at station in Dallas, Texas.

North Texas Transit Leaders Tout Benefits of TOD for Growing Region

At a summit focused on transit-oriented development, policymakers discussed how North Texas’ expanded light rail system can serve as a tool for economic growth.

April 3, 2025 - KERA News

Two people on bikes riding down paved Burke-Gilman bike trail in King County, Washington on a sunny day.

Washington State Plans Ambitious ‘Cycle Highway’ Network

The state is directing funding to close gaps in its existing bike network and make long-distance trips more accessible.

April 8 - Momentum Magazine

Small green ADU cottage in lush backyard in San Jose, California.

Homeowners Blame PG&E for Delays in ADU Permits

The utility says it has dramatically reduced its backlog, but applicants say they still face months-long delays for approvals for new electrical work.

April 8 - San Francisco Chronicle

Large oak tree in meadow with sun filtering from behind it in Angeles National Forest.

Rethinking Wildfire Defense: How a Landscape Approach Can Protect Neighborhoods

Post-fire analysis of the Eaton Fire reveals that a landscape approach — including fire-resistant vegetation, home hardening, and strategic planning — can help reduce wildfire risk, challenging assumptions that trees and plants are primary fire hazards.

April 8 - ASLA The Dirt