Abstract

Australians take mischievous pleasure from a postcard showing how the continent of Europe with its huge population can be fitted within the borders of their own country of less than 21 million people. However, maps of population density give a different picture. Most Australians live in a handful of metropolitan areas hugging the south-eastern, south-western, and eastern coasts; and these urban developments, as elsewhere in the world, have grown and grown. “Urban sprawls” bring their own problems, including dependence on private motor vehicles for transport, and planners have been trying to correct these via movements such as “new urbanism.” The umbrella organization in Australia (and New Zealand) is the Australian Council for New Urbanism, and similar bodies exist in the USA and Europe. In Western Australia, the state’s Planning Commission has been drawing on the principles of new urbanism and experimenting with the concept of “liveable neighborhoods,” notably in the state capital, Perth.1 This became a legally binding planning tool in late 2007. It would be wrong to suggest that a healthier population is the only objective of such projects but improved opportunities for exercise and their corollary, subtle disincentives to using private cars, are part of the formula, as is more local employment. Prof. Billie Giles-Corti and colleagues are studying the effects of this policy in a natural experiment called RESIDE, the RESIDential Environment Project. As a contrast to inner or outer suburban sprawl, they see liveable neighborhoods as creating “safe, convenient pedestrian-friendly neighborhoods with access to shops, transit and parkland which encourage more walking, cycling and transit use.”2,3 No randomized controlled trial is feasible, of course, so RESIDE, which began in 2003, is taking advantage of the fact that people moving into new homes will end up in developments that are liveable (as defined by the new code) or conventional or a hybrid of the two. Physical activity, as judged by questionnaire and 7 days of pedometer use by the 1,813 participants, will be one end-point. So far, we have only the baseline data.2 Follow-up 12 months after moving into the new home has been done but not yet published, and the final data collection is set for December of this year. The results of two previous studies cited by Giles-Corti et al. appear to point in opposite directions, and these researchers are well aware of the risk of self-selection—i.e., those already disposed to walking, for health or other reasons, may, when contemplating moving home, opt for a development in which opportunities for pedestrian activity have been deliberately enhanced. Indeed, a hypothesis being tested in RESIDE is precisely that. The baseline data do hint at some evidence for such selection but there were not many big, let alone statistically significant, differences between the three groups; this first round of questionnaires will allow any such biases to be corrected for in subsequent analyses. Also worrying, although understandable given the nature of the study design, is the low response rate of 33.4%. A premise in this type of urban planning is that walking for any reason is a good thing, and that includes pedestrian activity for purposes other than exercise. So, there must be somewhere to walk to, be it shops, employment, recreation, or even a neighborhood bus stop. A recent study from Montreal, Canada has confirmed the association between walking and local destinations,4 whereas another from Australia links local walkability with walking for transport.5 Outsiders see Australia as having a fit population benefiting from an outdoor life, and they may find it a little odd that so much effort there is being put into encouraging urban walking. However, one survey has indicated that only 50% or so of Australians are “sufficiently” physically active,6 so they are not so different after all.

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