Neighborhoods and Fish Bowls

Can urban places make us healthier?

Most animals, if given the right environment, have no difficulty being active. That’s what animals are—they are animated life. But put them in the wrong environment, and their vitality will decline. Recent research from Dr. Julian Pittman of Troy University shows that a fish in a small glass bowl of water gets bored and depressed. Yes, depressed. It sinks to the bottom of the bowl and hardly moves. If antidepressants are put in the water, it will swim about. If you put a fish in a large aquarium with seaweed, bubbling castles, different-sized rocks, and other fish, it will perk up and actively swim. It doesn’t need antidepressants.

To borrow terms from photography, for decades health has been viewed in portrait mode, rather than landscape mode. In other words, health, or its absence, is viewed as a snapshot of a lone individual, as opposed to the symbiosis of the individual and the landscape he or she lives in. We looked for health in vitamins, yoga, salads, medicine—things the individual does or ingests. We didn’t look to the layout of the built landscape. Somehow, as “rational beings,” humans could float free of the influences of places.

Even nationally renowned health organizations have not fully grasped the hold that the built environment has on our health. To fully acknowledge this would mean advocating the rebuilding of much of America, a seemingly herculean task. (It is so much easier to encourage Americans to eat right and get a gym membership.) Meanwhile, America spends more on the health care of individuals than any other industrialized country, while our obesity, heart disease, and diabetes rates are among the highest, and getting worse. It is projected that by 2050, 46 percent of world-wide costs for treating obesity will fall on the United States.

Some background: The history of attending to health is one of a gradual accumulation of concerns. First there was concern for what went into our mouths: Ancient Athenians fussed over the health benefits of different foods. Adam Smith extolled the health benefits of beer in the 18th century. Graham crackers were the health food craze in mid-19th century. There wasn’t much evidence behind any of this, but since people maintained an active lifestyle by walking (there wasn't much choice), they maintained health—as long as they stayed away from the drinking water.

In the 1960s, spurred by the popularity of the Royal Canadian Air Force Exercise Plan, calisthenics grew as an addition to eating right. People were doing jumping jacks and sit-ups. Later, jogging and other aerobic exercise, a term coined by Dr. Kenneth Cooper, was added to the regimen. That health was related to eating right and exercise became common wisdom. Then sleep research acknowledged another dimension. So were the health benefits of strong family ties and friendships.

Eating right, exercise, adequate sleep, and strong personal ties can be conveniently targeted to the individual—portrait mode—without disturbing that sleeping giant, the built landscape. There have been some baby steps toward “landscape mode” with recent research on the benefits of walking. Health professionals exhort patients to walk for health in their tract developments, at the shopping mall, or in circles at the high-school running track. But overcoming the boredom is a big challenge. The solution: willpower. In America we make a religion of willpower, but it’s climbing a moral mountain with much backsliding. Back to the couch and television we go, like gold fish sinking to the bottom of their bowls.

The neuroscientist Antonio Damasio maintains that emotion and motion are linked. That's probably why interesting environments that inspire motion are exciting. Immobility and boredom are enervating and unhealthy. But what makes a place interesting? This open-ended question guarantees lively discussion—especially if people are encouraged to talk about their own neighborhood.

The photo-simulations I have displayed on this website offer hints as to what makes a place interesting. There are elements I have put into the images that guarantee almost universal satisfaction—trees are an easy example. My wish is that the photo-simulations are used to spur local discussions. I hope the public health community tunes in as well.