Healthy Cities

Healthy Cities

Public Health through Urban Planning

Chinmoy Sarkar, Chris Webster and John Gallacher

Mounting scientific evidence generated over the past decade highlights the significant role of our cities’ built environments in shaping our health and well-being. In this book, the authors conceptualize the ‘urban health niche’ as a novel approach to public health and healthy-city planning that integrates the diverse and multi-level health determinants present in a city system.

Chapter 7: Built environment configuration and change in body mass index: the Caerphilly Prospective Study (CaPS)

Chinmoy Sarkar, Chris Webster and John Gallacher

Subjects: environment, environmental geography, geography, cities, social policy and sociology, health policy and economics, urban and regional studies, cities, urban studies


Physical activity has emerged as one of the key determinants of public health in our modernized technology-based society. Technological innovations have mechanized most of our daily routine tasks, resulting in sedentary lifestyles and unhygienic food habits (such as increased dependence on inexpensive, calorie-dense foods and beverages). The past three decades have witnessed a twofold increase in the prevalence of obesity (Caballero, 2007), posing serious public health risks. In 2008, approximately 34 per cent of adults (1.46 billion) worldwide were overweight, with a body mass index (BMI) of 25 kg/m2 or more, of which 502 million were obese, with a BMI of 30 kg/m2 or more (Kimokoti and Millen, 2011). Current trends project 65 million more obese adults in the USA and 11 million more obese adults in the UK by 2030 (Y. Claire Wang et al., 2011). In the UK, 7.3 per cent of all disability-adjusted life-years (DALYs) are directly attributable to overweight and obesity, accounting for 66 737 directly related deaths. The direct annual health costs of overweight and obesity to the NHS have been estimated to be around £3.23 billion, while a separate study attributed £1.06 billion towards the costs of physical inactivity (Allender and Rayner, 2007; Allender et al., 2007). In England, obesity levels increased from 13.2 per cent in 1993 to 24 per cent in 2008 in men, and from 16.4 per cent to 25 per cent in women over the same period.

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