City planning

▪   The thesis of this article is that multilevel interventions based on ecological models and targeting individuals, social environments, physical environments, and policies must be implemented to achieve population change in physical activity. A model is proposed that identifies potential environmental and policy influences on four domains of active living: recreation, transport, occupation, and household. Multilevel research and interventions require multiple disciplines to combine concepts and methods to create new transdisciplinary approaches. The contributions being made by a broad range of disciplines are summarized. Research to date supports a conclusion that there are multiple levels of influence on physical activity, and the active living domains are associated with different environmental variables. Continued research is needed to provide detailed findings that can inform improved designs of communities, transportation systems, and recreation facilities. Collaborations wi...

This study evaluated a neighborhood environment survey and compared the physical activity and weight status of the residents in 2 neighborhoods. On 2 occasions, 107 adults from neighborhoods with differing "walkability" were selected to complete a survey on their neighborhood environment. Physical activity was assessed by self-report and by accelerometer; height and weight were assessed by self-report. Neighborhood environment characteristics had moderate to high test-retest reliabilities. Residents of high-walkability neighborhoods reported higher residential density, land use mix, street connectivity, aesthetics, and safety. They had more than 70 more minutes of physical activity and had lower obesity prevalence (adjusted for individual demographics) than did residents of low-walkability neighborhoods. The reliability and validity of self-reported neighborhood environment subscales were supported. Neighborhood environment was associated with physical activity and overweight prevalence.

This article presents results from the first statistically significant study of cost escalation in transportation infrastructure projects. Based on a sample of 258 transportation infrastructure projects worth US$90 billion and representing different project types, geographical regions, and historical periods, it is found with overwhelming statistical significance that the cost estimates used to decide whether such projects should be built are highly and systematically misleading. Underestimation cannot be explained by error and is best explained by strategic misrepresentation, that is, lying. The policy implications are clear: legislators, administrators, investors, media representatives, and members of the public who value honest numbers should not trust cost estimates and cost-benefit analyses produced by project promoters and their analysts.

Environmental determinants of health are receiving growing attention in the literature, although there is little empirical research in this area. The Study on Environmental and Individual Determinants of Physical Activity (known as the SEID project) was a social ecological project that examined the relative influence of individual, social environmental and physical environmental determinants of recreational physical activity. It involved a community survey of 1803 healthy workers and home-makers aged 18-59 years living in a 408 km 2 area of metropolitan Perth, Western Australia. Physical environmental determinants were mainly conceptualised as spatial access to popular recreational facilities. Overall, 59% of respondents exercised as recommended. Recreational facilities located near home were used by more respondents than facilities located elsewhere. The most frequently used facilities were informal: the streets (45.6%); public open space (28.8%) and the beach (22.7%). The physical environment's directs the influence on exercising as recommended was found to be secondary to individual and social environmental determinants. Nevertheless, accessible facilities determined whether or not they were used and in this way, support and enhance the achievement of recommended levels of physical activity behaviour by providing opportunities. The results suggest that access to a supportive physical environment is necessary, but may be insufficient to increase recommended levels of physical activity in the community. Complementary strategies are required that aim to influence individual and social environmental factors. Given the popularity of walking in the community, it is recommended that greater emphasis be placed on creating streetscapes that enhance walking for recreation and transport. r

Background: As a result of increasing urbanisation, people face the prospect of living in environments with few green spaces. There is increasing evidence for a positive relation between green space in people's living environment and self-reported indicators of physical and mental health. This study investigates whether physicianassessed morbidity is also related to green space in people's living environment. Methods: Morbidity data were derived from electronic medical records of 195 general practitioners in 96 Dutch practices, serving a population of 345 143 people. Morbidity was classified by the general practitioners according to the International Classification of Primary Care. The percentage of green space within a 1 km and 3 km radius around the postal code coordinates was derived from an existing database and was calculated for each household. Multilevel logistic regression analyses were performed, controlling for demographic and socioeconomic characteristics. Results: The annual prevalence rate of 15 of the 24 disease clusters was lower in living environments with more green space in a 1 km radius. The relation was strongest for anxiety disorder and depression. The relation was stronger for children and people with a lower socioeconomic status. Furthermore, the relation was strongest in slightly urban areas and not apparent in very strongly urban areas. Conclusion: This study indicates that the previously established relation between green space and a number of self-reported general indicators of physical and mental health can also be found for clusters of specific physicianassessed morbidity. The study stresses the importance of green space close to home for children and lower socioeconomic groups.

This article presents results from the first statistically significant study of traffic forecasts in transportation infrastructure projects. The sample used is the largest of its kind, covering 210 projects in 14 nations worth U.S.$59 billion. The study shows with very high statistical significance that forecasters generally do a poor job of estimating the demand for transportation infrastructure projects. For 9 out of 10 rail projects, passenger forecasts are overestimated; the average overestimation is 106%. For half of all road projects, the difference between actual and forecasted traffic is more than ±20%. The result is substantial financial risks, which are typically ignored or downplayed by planners and decision makers to the detriment of social and economic welfare. Our data also show that forecasts have not become more accurate over the 30-year period studied, despite claims to the contrary by forecasters. The causes of inaccuracy in forecasts are different for rail and road projects, with political causes playing a larger role for rail than for road. The cure is transparency, accountability, and new forecasting methods. The challenge is to change the governance structures for forecasting and project development. Our article shows how planners may help achieve this.

The focus for interventions and research on physical activity has moved away from vigorous activity to moderateintensity activities, such as walking. In addition, a social ecological approach to physical activity research and practice is recommended. This approach considers the influence of the environment and policies on physical activity. Although there is limited empirical published evidence related to the features of the physical environment that influence physical activity, urban planning and transport agencies have developed policies and strategies that have the potential to influence whether people walk or cycle in their neighbourhood. This paper presents the development of a framework of the potential environmental influences on walking and cycling based on published evidence and policy literature, interviews with experts and a Delphi study. The framework includes four features: functional, safety, aesthetic and destination; as well as the hypothesised factors that contribute to each of these features of the environment. In addition, the Delphi experts determined the perceived relative importance of these factors. Based on these factors, a data collection tool will be developed and the frameworks will be tested through the collection of environmental information on neighbourhoods, where data on the walking and cycling patterns have been collected previously. Identifying the environmental factors that influence walking and cycling will allow the inclusion of a public health perspective as well as those of urban planning and transport in the design of built environments. r

Biological, psychological, behavioral, and social factors are unable to fully explain or curtail the obesity epidemic. In this article we review research on the influence of the built environment on obesity. Studies were evaluated with regard to their methods of assessing the environment and obesity, as well as to their effects. Methods used to investigate the relationships between the built environment and obesity were found to be dissimilar across studies and varied from indirect to direct. Levels of assessment between and within studies varied from entire counties down to the individual level. Despite this, obesity was linked with area of residence, resources, television, walkability, land use, sprawl, and level of deprivation, showing promise for research utilizing more consistent assessment methods. Recommendations were made to use more direct methods of assessing the environment, which would include specific targeting of institutions thought to vary widely in relation to area characteristics and have a more influential effect on obesity-related behaviors. Interventions should be developed from the individual to the neighborhood level, specifically focusing on the effects of eliminating barriers and making neighborhood level improvements that would facilitate the elimination of obesogenic environments.

Given that recent literature reviews on physical activity in urban parks deliberately excluded qualitative findings, we reviewed qualitative research on this topic informed by a published classification scheme based on quantitative research. Twenty-one studies met our inclusion criteria. These studies relied mainly on semi-structured interviews with individuals or in focus groups; only five studies involved in situ observation. Our synthesis aligns with previous quantitative research showing that attributes including safety, aesthetics, amenities, maintenance, and proximity are important for encouraging park use. Furthermore, our synthesis of qualitative research suggests that perceptions of the social environment entwine inextricably with perceptions of the physical environment. If so, physical attributes of parks as well as perceptions of these attributes (formed in relation to broader social contexts) may influence physical activity patterns. Both qualitative and quantitative methods provide useful information for interpreting such patterns, and in particular, when designing and assessing interventions intended to improve the amount and intensity of physical activity.

The overarching goal of this article is to make explicit the multiple pathways through which the built environment may potentially affect health and wellbeing. The loss of close collaboration between urban planning and public health professionals that characterized the post-World War II era has limited the design and implementation of effective interventions and policies that might translate into improved health for urban populations. First, we present a conceptual model that developed out of previous research called Social Determinants of Health and Environmental Health Promotion. Second, we review empirical research from both the urban planning and public health literature regarding the health effects of housing and housing interventions. And third, we wrestle with key challenges in conducting sound scientific research on connections between the built environment and health, namely: (1) the necessity of dealing with the possible health consequences of myriad public and private sector activities; (2) the lack of valid and reliable indicators of the built environment to monitor the health effects of urban planning and policy decisions, especially with regard to land use mix; and (3) the growth of the "megalopolis" or "super urban region" that requires analysis of health effects across state lines and in circumscribed areas within multiple states. We contend that to plan for healthy cities, we need to reinvigorate the historic link between urban planning and public health, and thereby conduct informed science to better guide effective public policy.

“Sense of place” is a widely discussed concept in fields as diverse as geography, environmental psychology, and art, but it has little traction in the field of public health. The health impact of place includes physical, psychological, social, spiritual, and aesthetic outcomes.In this article, the author introduces sense of place as a public health construct. While many recommendations for “good places” are available, few are based on empirical evidence, and thus they are incompatible with current public health practice. Evidence-based recommendations for healthy place making could have important public health implications.Four aspects of the built environment, at different spatial scales—nature contact, buildings, public spaces, and urban form—are identified as offering promising opportunities for public health research, and potential research agendas for each are discussed.

In a time of increasing urbanization, the fundamental value of conserving urban biodiversity remains controversial. How much of a fixed budget should be spent on conservation in urban versus nonurban landscapes? The answer should depend on the goals that drive our conservation actions, yet proponents of urban conservation often fail to specify the motivation for protecting urban biodiversity. This is an important shortcoming on several fronts, including a missed opportunity to make a stronger appeal to those who believe conservation biology should focus exclusively on more natural, wilder landscapes. We argue that urban areas do offer an important venue for conservation biology, but that we must become better at choosing and articulating our goals. We explored seven possible motivations for urban biodiversity conservation: preserving local biodiversity, creating stepping stones to nonurban habitat, understanding and facilitating responses to environmental change, conducting environmental education, providing ecosystem services, fulfilling ethical responsibilities, and improving human well-being. To attain all these goals, challenges must be faced that are common to the urban environment, such as localized pollution, disruption of ecosystem structure, and limited availability of land. There are, however, also challenges specific only to particular goals, meaning that different goals will require different approaches and actions. This highlights the importance of specifying the motivations behind urban biodiversity conservation. If the goals are unknown, progress cannot be assessed.

Urban scholars have studied street networks in various ways, but there are data availability and consistency limitations to the current urban planning/street network analysis literature. To address these challenges, this article presents OSMnx, a new tool to make the collection of data and creation and analysis of street networks simple, consistent, automatable and sound from the perspectives of graph theory, transportation, and urban design. OSMnx contributes five significant capabilities for researchers and practitioners: first, the automated downloading of political boundaries and building footprints; second, the tailored and automated downloading and constructing of street network data from OpenStreetMap; third, the algorithmic correction of network topology; fourth, the ability to save street networks to disk as shapefiles, GraphML, or SVG files; and fifth, the ability to analyze street networks, including calculating routes, projecting and visualizing networks, and calculating metric and topological measures. These measures include those common in urban design and transportation studies, as well as advanced measures of the structure and topology of the network. Finally, this article presents a simple case study using OSMnx to construct and analyze street networks in Portland, Oregon.

Smart growth is an approach to urban planning that provides a framework for making community development decisions. Despite its growing use, it is not known whether smart growth can impact physical activity. This review utilizes existing built environment research on factors that have been used in smart growth planning to determine whether they are associated with physical activity or body mass. Searching the MEDLINE, Psycinfo and Web‐of‐Knowledge databases, 204 articles were identified for descriptive review, and 44 for a more in‐depth review of studies that evaluated four or more smart growth planning principles. Five smart growth factors (diverse housing types, mixed land use, housing density, compact development patterns and levels of open space) were associated with increased levels of physical activity, primarily walking. Associations with other forms of physical activity were less common. Results varied by gender and method of environmental assessment. Body mass was largely u...

The article first describes characteristics of major infrastructure projects. Second, it documents a much neglected topic in economics: that ex ante estimates of costs and benefits are often very different from actual ex post costs and benefits. For large infrastructure projects the consequences are cost overruns, benefit shortfalls, and the systematic underestimation of risks. Third, implications for cost–benefit analysis are described, including that such analysis is not to be trusted for major infrastructure projects. Fourth, the article uncovers the causes of this state of affairs in terms of perverse incentives that encourage promoters to underestimate costs and overestimate benefits in the business cases for their projects. But the projects that are made to look best on paper are the projects that amass the highest cost overruns and benefit shortfalls in reality. The article depicts this situation as ‘survival of the unfittest’. Fifth, the article sets out to explain how the problem may be solved, with a view to arriving at more efficient and more democratic projects, and avoiding the scandals that often accompany major infrastructure investments. Finally, the article identifies current trends in major infrastructure development. It is argued that a rapid increase in stimulus spending, combined with more investments in emerging economies, combined with more spending on information technology is catapulting infrastructure investment from the frying pan into the fire.

We investigate the dynamics and spatial distribution of land use fragmentation in a rapidly urbanizing region of the United States to test key propositions regarding the evolution of sprawl. Using selected pattern metrics and data from 1973 and 2000 for the state of Maryland, we find significant increases in developed and undeveloped land fragmentation but substantial spatial heterogeneity as well. Estimated fragmentation gradients that describe mean fragmentation as a function of distance from urban centers confirm the hypotheses that fragmentation rises and falls with distance and that the point of maximum fragmentation shifted outward over time. However, rather than outward increases in sprawl balanced by development infill, we find substantial and significant increases in mean fragmentation values along the entire urbanrural gradient. These findings are in contrast to the results of Burchfield et al. [Burchfield M, Overman HG, Puga D, Turner MA (2006) Q J Econ 121:587-633], who conclude that the extent of sprawl remained roughly unchanged in the Unites States between 1976 and 1992.

Background: Looking out on and being in the green elements of the landscape around us seem to affect health, well-being and feelings of social safety. This article discusses the design of a research program on the effects of green space in the living environment on health, well-being and social safety.

This paper focuses on problems and their causes and cures in policy and planning for large-infrastructure projects. First, it identifies as the main problem in major infrastructure developments pervasive misinformation about the costs, benefits, and risks involved. A consequence of misinformation is cost overruns, benefit shortfalls, and waste. Second, it explores the causes of misinformation and finds that political-economic explanations best account for the available evidence: planners and promoters deliberately misrepresent costs, benefits, and risks in order to increase the likelihood that it is their projects, and not those of their competition, that gain approval and funding. This results in the ‘survival of the unfittest’, in which often it is not the best projects that are built, but the most misrepresented ones. Finally, it presents measures for reforming policy and planning for large-infrastructure projects with a focus on better planning methods and changed governance structures, the latter being more important.

A majority of the world's population will live in urban areas by 2007. The most rapidly urbanizing cities are in less-wealthy nations, and the pace of growth varies among regions. There are few data linking features of cities to the health of populations. We ...

Urbanisation significantly impacts on water environments with increased runoff and the degradation of water quality. The management of quantity impacts are straight forward, but quality impacts are far more complex. Current approaches to safeguard water quality are largely ineffective and guided by entrenched misconceptions with a primary focus on 'end-of-pipe' solutions. The outcomes of a research study presented in the paper, which investigated relationships between water quality and six different land uses offer practical guidance in the planning of future urban developments. In terms of safeguarding water quality, high density residential development which results in a relatively smaller footprint would be the preferred option. The research study outcomes bring into question a number of fundamental concepts and misconceptions routinely accepted in stormwater quality management. The research findings confirmed the need to move beyond customary structural measures and identified the key role that urban planning can play in safeguarding urban water environments.

Green infrastructure (GI) and ecosystem services (ES) are promoted as concepts that have potential to improve environmental planning in urban areas based on a more holistic understanding of the complex interrelations and dynamics of social-ecological systems. However, the scientific discourses around both concepts still lack application-oriented frameworks that consider such a holistic perspective and are suitable to mainstream GI and ES in planning practice. This literature review explores how multifunctionality as one important principle of GI planning can be operationalized by approaches developed and tested in ES research. Specifically, approaches developed in ES research can help to assess the integrity of GI networks, balance ES supply and demand, and consider trade-offs. A conceptual framework for the assessment of multifunctionality from a social-ecological perspective is proposed that can inform the design of planning processes and support stronger exchange between GI and ES research.

A major source of risk in project management is inaccurate forecasts of project costs, demand, and other impacts. The paper presents a promising new approach to mitigating such risk, based on theories of decision making under uncertainty which won the 2002 Nobel prize in economics. First, the paper documents inaccuracy and risk in project management. Second, it explains inaccuracy in terms of optimism bias and strategic misrepresentation. Third, the theoretical basis is presented for a promising new method called "reference class forecasting," which achieves accuracy by basing forecasts on actual performance in a reference class of comparable projects and thereby bypassing both optimism bias and strategic misrepresentation. Fourth, the paper presents the first instance of practical reference class forecasting, which concerns cost forecasts for large transportation infrastructure projects. Finally, potentials for and barriers to reference class forecasting are assessed.

Life Cycle Assessment (LCA) is useful as an information tool for the examination of alternative future scenarios for strategic planning. Developing a life cycle assessment for a large water and wastewater system involves making methodological decisions about the level of detail which is retained through different stages of the process. In this article we discuss a methodology tailored to strategic planning needs which retains a high degree of model segmentation in order to enhance modeling of a large, complex system. This is illustrated by a case study of Sydney Water, which is Australia's largest water service provider. A prospective LCA was carried out to examine the potential environmental impacts of Sydney Water's total operations in the year 2021. To our knowledge this is the first study to create an LCA model of an integrated water and wastewater system with this degree of complexity. A "base case" system model was constructed to represent current operating assets as augmented and upgraded to 2021. The base case results provided a basis for the comparison of alternative future scenarios and for conclusions to be drawn regarding potential environmental improvements. The scenarios can be roughly classified in two categories: (1) options which improve the environmental performance across all impact categories and (2) options which improve one indicator and worsen others. Overall environmental improvements are achieved in all categories by the scenarios examining increased demand management, energy efficiency, energy generation, and additional energy recovery from biosolids. The scenarios which examined desalination of seawater and the upgrades of major coastal sewage treatment plants to secondary and tertiary treatment produced an improvement in one environmental indicator but deteriorations in all the other impact categories, indicating the environmental tradeoffs within the system. The desalination scenario produced a significant increase in greenhouse gas emissions due to coalfired electricity generation for a small increase in water supply. Assessment of a greenfield scenario incorporating water demand management, on-site treatment, local irrigation, and centralized biosolids treatment indicates significant environmental improvements are possible relative to the assessment of a conventional system of corresponding scale.

"Over budget, over time, over and over again" appears to be an appropriate slogan for large, complex infrastructure projects. This article explains why cost, benefits, and time forecasts for such projects are systematically over-optimistic in the planning phase. The underlying reasons for forecasting errors are grouped into three categories: delusions or honest mistakes; deceptions or strategic manipulation of information or processes; or bad luck. Delusion and deception have each been addressed in the management literature before, but here they are jointly considered for the first time. They are specifically applied to infrastructure problems in a manner that allows both academics and practitioners to understand and implement the suggested corrective procedures. The article provides a framework for analyzing the relative explanatory power of delusion and deception. It also suggests a simplified framework for analyzing the complex principal-agent relationships that are involved in the approval and construction of large infrastructure projects, which can be used to improve forecasts. Finally, the article illustrates reference class forecasting, an outside view de-biasing technique that has proven successful in overcoming both delusion and deception in private and public investment decisions.

This paper reviews the uses of cultural policy and planning as tools of urban regeneration in western European cities. Following a brief assessment of the evolution of European cultural policy in recent decades, the paper studies the origins and development of the European City/Capital of Culture programme and explores the experience of cities considered to have succeeded in re-imaging and regenerating themselves through cultural activity and special events. The paper ends with a reflection on the notion of cultural planning and its potential as an integrated alternative to urban cultural policy, and offers recommendations for further development within the UK context.

Sustainable urban water management (SUWM) requires an integrated, adaptive, coordinated and participatory approach. Current urban water policies are beginning to reflect this understanding yet the rhetoric is often not translated to implementation. Despite the ‘new’ philosophy, urban water management remains a complex and fragmented area relying on traditional, technical, linear management approaches. Despite widespread acknowledgement of the barriers to change, there has been little systematic review of what constitutes the scope of such barriers and how these should be addressed to advance SUWM. To better understand why implementation fails to occur beyond ad hoc project interventions, an extensive literature review of observed and studied barriers was conducted. Drawing on local, national and international literature from the field of integrated urban water management and other similar fields, 53 studies were assessed, resulting in a typology of 12 barrier types. The analysis rev...

Background. The presence and mix of destinations is an important aspect of the built environment that may encourage or discourage physical activity. This study examined the association between the proximity and mix of neighbourhood destinations and physical activity.

The aim of this study is to examine the association between sense of community, walking, and neighborhood design characteristics. The current study is based on a sub-sample of participants (n ¼ 609) from the US Atlanta SMARTRAQ study who completed a telephone survey capturing physical activity patterns, neighborhood perceptions, and social interactions. Objective measures of neighborhood form were also computed. Univariate and multivariate models (General Linear Models (GLM)) were used to examine the association between sense of community (SofC) and aspects of the built environment, physical activity, and neighborhood perceptions. In multivariate models the impact on SofC was examined with progressive adjustment for demographics characteristics followed by walking behavior, neighborhood design features, neighborhood perceptions and time spent traveling in a car.

Purpose. This paper reviews existing environmental audit instruments used to capture the walkability and bikability of environments. The review inventories and evaluates individual measures of environmental factors used in these instruments. It synthesizes the current state of knowledge in quantifying the built environment. The paper provides health promotion professionals an understanding of the essential aspects of environments influencing walking and bicycling for both recreational and transportation purposes. It serves as a basis to develop valid and efficient tools to create activityfriendly communities.

Associations between access to destinations and walking for transport were examined. Households (N ¼ 2650) were selected from 32 urban communities varying in walkability and socio-economic status. Respondents reported perceived proximity of destinations, transport-related walking, reasons for neighbourhood selection, and socio-demographic characteristics. Geographic Information Systems data defined objective measures of access to destinations. Measures of access to destinations were associated with transport-related walking. Associations depended on socio-demographic factors and type of destinations. Workplace proximity was the most significant contributor to transport-related walking, especially among women. Regular walking to work resulted in the accrual of sufficient physical activity for health benefits. r

Geographical Information System (GIS) technology has been a popular tool for visualization of accident data and analysis of hot spots in highways. Many traffic agencies have been using GIS for accident analysis. Accident analysis studies aim at the identification of high rate accident locations and safety deficient areas on the highways. So, traffic officials can implement precautionary measures and provisions for traffic safety. Since accident reports are prepared in textual format in Turkey, this situation makes it difficult to analyze accident results. In our study, we developed a system transforming these textual data to tabular form and then this tabular data were georeferenced onto the highways. Then, the hot spots in the highways in Afyonkarahisar administrative border were explored and determined with two different methods of Kernel Density analysis and repeatability analysis. Subsequently, accident conditions at these hot spots were examined. We realized that the hot spots determined with two methods reflect really problematic places such as cross roads, junction points etc. Many of previous studies introduced GIS only as a visualization tool for accident locations. The importance of this study was to use GIS as a management system for accident analysis and determination of hot spots in Turkey with statistical analysis methods.

Background-Few studies have investigated the built environment and its association with health -especially excess adiposity-and physical activity in the immediate pre-Baby Boom/early-Baby Boom generations, soon to be the dominant demographic in the U.S. The purpose of this study was to examine this relationship.

As automobile transportation continues to increase around the world, bicyclists, pedestrians, and motorcyclists, also known as vulnerable road users (VRUs), will become more susceptible to traffic crashes, especially in countries where traffic laws are poorly enforced. Many countries, however, are employing innovative strategies to ensure that road users can more safely navigate the urban landscape. While bicyclists and motorcyclists are important road users, this paper will focus on pedestrian crash problems and solutions. Pedestrians are most at risk in urban areas due in part to the large amount of pedestrian and vehicle activity in urban areas. With this in mind, designing safe, accessible, and comprehensive facilities for pedestrians is vital to reducing pedestrian crashes. This paper will provide some insight into the magnitude of the pedestrian crash problem around the world, and will offer some lessons learned from several countries, particularly in Europe and the U.S., for improving pedestrian safety. Beginning with pedestrian safety statistics at the global, regional, and national levels, this paper will address potential countermeasures and strategies for improving pedestrian safety from an international perspective.

Objective: This study aimed to examine the association among adverse childhood experiences, health-risk behaviors, and chronic disease conditions in adult life. Study population: One thousand and sixty-eight (1,068) males and females aged 35 years and older, and residing in selected urban communities in Metro Manila participated in the cross-sectional survey. Methods: A pretested local version of the Adverse Childhood Experiences Questionnaires developed by the Centers for Disease Control and Prevention, USA, was used. Data were collected through self-administration of the questionnaire. Prevalence and estimates of odds ratio were computed to obtain a measure of association among variables. Logistic regression analysis was employed to adjust for the potential confounding effects of age, sex, and socio-economic status. Results: The results indicated that 75% of the respondents had at least 1 exposure to adverse childhood experiences. Nine percent had experienced 4 or more types of abuse and household dysfunctions. The most commonly reported types of negative childhood events were psychological/emotional abuse, physical neglect, and psychological neglect of basic needs. Majority of respondents claimed to have experienced living with an alcoholic or problem drinker and where there was domestic violence. Health-risk behavior consequences were mostly in the form of smoking, alcohol use, and risky sexual behavior. The general trend shows that there was a relatively strong graded relationship between number of adverse childhood experiences, health-risk behaviors, and poor health. Conclusion: This study provided evidence that child maltreatment is a public health problem even in poorer environments. Prevention and early intervention of child maltreatment were recommended to reduce the prevalence of health-risk behavior and morbidity in later life.

The authors explore the relationship between design and noncommunicable diseases, first by highlighting how design knowledge and practice can have a direct and indirect effect on these diseases. They then review the literature on the link between the physical environment (e.g., dwellings, the neighborhood, cities) and noncommunicable diseases. Last, they illustrate the links between design and noncommunicable diseases by exploring in greater detail how designers and the design of the urban environment can play a positive role in the reduction of noncommunicable diseases.