Journal of Urban Health

, Volume 89, Issue 2, pp 270–284 | Cite as

Complexity in Built Environment, Health, and Destination Walking: A Neighborhood-Scale Analysis

  • Cynthia CarlsonEmail author
  • Semra Aytur
  • Kevin Gardner
  • Shannon Rogers


This study investigates the relationships between the built environment, the physical attributes of the neighborhood, and the residents’ perceptions of those attributes. It focuses on destination walking and self-reported health, and does so at the neighborhood scale. The built environment, in particular sidewalks, road connectivity, and proximity of local destinations, correlates with destination walking, and similarly destination walking correlates with physical health. It was found, however, that the built environment and health metrics may not be simply, directly correlated but rather may be correlated through a series of feedback loops that may regulate risk in different ways in different contexts. In particular, evidence for a feedback loop between physical health and destination walking is observed, as well as separate feedback loops between destination walking and objective metrics of the built environment, and destination walking and perception of the built environment. These feedback loops affect the ability to observe how the built environment correlates with residents’ physical health. Previous studies have investigated pieces of these associations, but are potentially missing the more complex relationships present. This study proposes a conceptual model describing complex feedback relationships between destination walking and public health, with the built environment expected to increase or decrease the strength of the feedback loop. Evidence supporting these feedback relationships is presented.


Health Built environment Transportation Multi-level modeling Complex systems 


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Copyright information

© The New York Academy of Medicine 2012

Authors and Affiliations

  • Cynthia Carlson
    • 1
    Email author
  • Semra Aytur
    • 2
  • Kevin Gardner
    • 3
  • Shannon Rogers
    • 3
  1. 1.Environmental Science DepartmentNew England CollegeHennikerUSA
  2. 2.Department of Health Management and PolicyUniversity of New HampshireDurhamUSA
  3. 3.Natural Resources and Earth Systems Science Program, Department of Civil and Environmental EngineeringUniversity of New HampshireDurhamUSA

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