Local government planners have historically played an important role in preventing and curbing dangerous health conditions such as cholera, yellow fever and diphtheria. Today, planners have the opportunity to address chronic health issues, including coronary heart disease, type 2 diabetes and stroke.

In the mid to late 1800s, America suffered regular outbreaks of deadly diseases such as cholera, yellow fever, tuberculosis, typhoid, scarlet fever, and diphtheria. This health crisis was not happenstance.

During this time, the nation’s Industrial Revolution drew millions of individuals from the countryside and abroad to rapidly – and haphazardly – expanding cities. City dwellers crammed into unfit housing; the streets filled with manure, human refuse, and other unsanitary filth; and the air was choked with pollution. Such conditions provided fertile ground for fatal epidemics.

Americans responded by planning for community health: cities developed sanitary public water supplies, sewer systems, and building codes; village improvement associations implemented changes such as pavement, sidewalks, street lighting, public trash cans, and urban parks and gardens. Advisory planning commissions arose, and the nation shifted towards a comprehensive approach to urban problems. Public health improved dramatically.

Now, in the 21st century, America confronts a new epidemic: obesity. More than one-third of U.S. adults are obese, which can lead to increased risk for chronic diseases such as coronary heart disease, stroke, cancer, type 2 diabetes, and reproductive problems. This health crisis is also not happenstance.

In modern America, the average person sits for 13 hours a day and the average child spends more than seven and a half hours in front of a screen. Only one in three children are physically active every day and less than five percent of adults participate in 30 minutes of physical activity each day. Concurrently, Americans are consuming more calories – and exceeding the recommended limits on calories from added sugars, refined grains, certain fats, and sodium. And, Americans are eating less than the recommended amounts of other foods, including vegetables, fruits, and whole-grains; in fact, less than 60 percent of Americans consume produce regularly. The prevalence of sedentary behavior and unhealthy eating promote the spread of the nation’s new epidemic.

Once again, it is critical to plan for public health – and momentum is building. Local planners across the country have realized that the built environment influences physical activity levels. For example, streets designed only for automobiles encourage sedentary behavior (driving a car), while streets with sidewalks and bike lanes encourage active transportation. In response, planners are promoting active lifestyles in their local comprehensive plans – paving the way for various policies, such as “complete streets” ordinances aimed at increasing physical activity. Now, the complementary piece – increasing access to healthy food – is emerging as a priority in local plans. For example, Seattle is using its comprehensive plan to encourage the presence of grocery stores, farmers’ markets, and community gardens throughout the city. And other cities are adopting ordinances that limit the number of fast food restaurants. Such measures are grounded in realities like this: more than 23 million Americans, including 6.5 million children, live in food deserts – areas that are more than a mile away from a supermarket – and the number of fast food restaurants has more than doubled since the 1970s.

Planners are beginning to see that just as their predecessors used sewer systems and water pipes to improve public health, they too can help communities thrive by reconfiguring the food retail landscape – and other landscapes that contribute to inactivity or unhealthy eating. The trend towards planning for active lifestyles and healthy food access is another welcome development for public health!

July 31, 2015

Meghan Marrinan Feliciano, J.D., is a Staff Attorney at the Public Health Law Center at Mitchell Hamline School of Law. This post originally appeared on the Network for Public Health blog.