Investigating how the design of cities can reduce the risk of type 2 diabetes

South LondonMetabolic and Endocrine
Start Date: 23 Jul 2012 End Date: 31 Dec 2018

Does moving into an environment designed for health active living facilitate high physical activity levels and low risks of obesity and type 2 diabetes?  Evaluation of a natural experiment.

How does where we live affect our health? In particular, what role does the design of our cities and towns – the housing, roads, pavements and outdoor spaces – play in how much physical activity we do?

Guidelines produced by the UK’s Chief Medical Officer state that physical activity can reduce risks of obesity and type 2 diabetes by up to 40 per cent, as well as reducing the risk of other adverse health outcomes. However, levels of physical activity are low in the UK, both in adults and children.

The potential for the built environment to make small differences in levels of physical activity across a large population therefore has significant implications for public health. At the moment though, there is little high-quality evidence available examining the effect of the built environment on health.

The Examining Neighbourhood Activities in Built Living Environments in London (ENABLE London) project, which was adopted by the CLAHRC in June, aims to fill this gap. A team of 15 researchers from universities including St George’s, University of London, the London School of Hygiene and Tropical Medicine, Glasgow University, University of Bristol, and RMIT University in Australia, are taking advantage of the opportunity offered by the developments around the London 2012 Olympic Games site in east London to examine how rapid changes in the local built environment can impact on health.

How are the researchers doing it?

The research project is focussed on East Village, a new residential neighbourhood in Stratford, which includes 2,800 new homes, new offices, the Westfield Stratford Shopping Centre, a purpose-built Academy for students aged three to 18 years and extensive public transport connections, developed on what was the Athlete’s Village in the London 2012 Olympic and Paralympic Games.

East Village has been specifically designed to encourage healthy active living, with easy access to the Queen Elizabeth Olympic Park, which includes facilities such as the VeloPark and the London Aquatic Centre, and extensive walking and cycling paths linked to the surrounding area. Residents are also encouraged to use public transport, with very limited residents’ car parking available.

The research team, which is made up of epidemiologists, diabetes researchers, scientists, statisticians, and experts in public health, is studying the physical activity levels of 1,278 adults who live either in East Village itself or in the surrounding area. These adults, who come from 1,006 homes, include those from hard-to-reach groups, such as those living in social housing.

In addition, the research team are monitoring changes in participants’ body mass index and other detailed measures of body size over time. They are also using detailed questionnaires to collect information on general well-being, mental health, and attitudes to leisure time activities, as well as markers of socioeconomic position and general health.

What is the ultimate goal of the project?

The researchers want to identify the specific design features of East Village such as its pathways, cycle lanes, links to public transport and open spaces in East Village that encourage physical activity and improve health. In particular, the researchers want to provide new evidence that shows how socioeconomic differences might play a role in the effect of the built environment on health.

The first phase of this Medical Research Council and NIHR-funded research began in 2013 and finished at the end of 2015. The researchers are now conducting two-year follow up assessments, which are due to finish at the end of 2017.

Professor Christopher Owen