Health Disparities, Transportation Equity and Complete Streets: a Case Study of a Policy Development Process through the Lens of Critical Race Theory.

Historic disinvestment in transportation infrastructure is directly related to adverse social conditions underlying health disparities in low-income communities of color. Complete Streets policies offer a strategy to address inequities and subsequent public health outcomes. This case study examines the potential for an equity-focused policy process to address systemic barriers and identify potential measures to track progress toward equity outcomes. Critical race theory provided the analytical framework to examine grant reports, task force notes, community workshop/outreach activities, digital stories, and stakeholder interviews. Analysis showed that transportation inequities are entrenched in historically rooted disparities that are perpetuated in ongoing decision-making processes. Intentional efforts to incorporate equity into discussions with community members and representatives contributed to explicit equity language being included in the final policy. The potential to achieve equity outcomes will depend upon policy implementation. Concrete strategies to engage community members and focus city decision-making practices on marginalized and disenfranchised communities are identified.

Contextualizing Walkability: Do Relationships Between Built Environments and Walking Vary by Socioeconomic Context?

PROBLEM RESEARCH STRATEGY AND FINDINGS: Supportive built environments for walking are linked to higher rates of walking and physical activity, but little is known about this relationship for socioeconomically disadvantaged (e.g., low-income and racial/ethnic minority) populations. We review 17 articles and find that most show that the built environment has weaker effects on walking and physical activity for disadvantaged than advantaged groups. Those who lived in supportive built environments walked more and were more physically active than those who did not, but the effect was about twice as large for advantaged groups. We see this difference because disadvantaged groups walked more in unsupportive built environments and less in supportive built environments, though the latter appears more influential. TAKEAWAY FOR PRACTICE: Defining walkability entirely in built environment terms may fail to account for important social and individual/household characteristics and other non-built environment factors that challenge disadvantaged groups, including fear of crime and lack of social support. Planners must be sensitive to these findings and to community concerns about gentrification and displacement in the face of planned built environment improvements that may benefit more advantaged populations. We recommend five planning responses: Recognize that the effects of the built environment may vary by socioeconomics; use holistic approaches to improve walkability; expand walkability definitions to address a range of social and physical barriers; partner across agencies, disciplines, and professions; and evaluate interventions in different socioeconomic environments.

Measuring perceptions of social environments for walking: A scoping review of walkability surveys.

The neighborhood pedestrian environment is an important determinant of physical activity and health. Despite widespread acknowledgment that neighborhoods' social and physical characteristics contribute to a walkable place, constructs and metrics remain focused primarily on the built environment. This scoping review documents the current state of the practice to measure perceived social elements of pedestrian environments in order to identify measurement strategies to understand and support walking, particularly in socially diverse neighborhoods. We identified 20 survey instruments focused on pedestrian environments, walkability, or physical activity at the local (neighborhood) scale and designed to capture residents' perceptions of outdoor walking environments. Across the 20 instruments, we identified and categorized 182 distinct items that measured social environments into four domains (social capital, personal safety, physical signifiers, and general neighborhood descriptors) and thirteen subdomains. Many items emphasized negative social elements, such as crime and disorder. Only a few items focused on community identity. Most instruments cover some aspects of the social environment well, but few provide a holistic inventory of the social environment across domains and subdomains. We also observe that the state of the practice seems frozen, with most instruments in use having originated in 2010 or earlier.

Differences in social and physical dimensions of perceived walkability in Mexican American and non-hispanic white walking environments in Tucson, Arizona.

INTRODUCTION: Physical activity patterns within the U.S. vary greatly across ethnicity, with data generally indicating lower rates among Hispanic/Latino adults. At the same time, Hispanic/Latino pedestrians face higher rates of injury and fatalities. Despite the importance of supportive physical activity environments on both health and safety outcomes, limited attention has been paid to ethnic or cultural differences in perceptions of supportive environments for walking. To fill this gap, we explore differences in physical and social environment contributors to perceived walkability between pedestrians in predominantly (> 70%) Mexican American and predominantly non-Hispanic white areas in Tucson, Arizona. METHODS: In early 2017 the research team conducted brief on-street intercept interviews with pedestrians (N = 190) to learn about the environmental attributes associated with pedestrian perceptions of walkability. Study locations were matched for similar physical walkability metrics, income, and poverty rates. Consensus-based thematic coding identified 14 attributes of the built and social environment that contributed, positively and negatively, to perceptions of walkability. RESULTS: Attributes of the social environment, both positive (i.e., social interaction, social cohesion, and community identity) and negative (i.e., crime/security), were more frequently expressed as components of walkability in Mexican American study areas while physical environment attributes (i.e., infrastructure, street crossings, and aesthetics) were more frequently mentioned in non-Hispanic white areas. CONCLUSIONS: Contributors to perceived walkability in non-Hispanic white study areas were largely consistent with existing built environment-focused walkability metrics. Differences seen in Mexican American areas suggest a need to better understand differences across populations, expand the construct of walkability to consider social environment attributes, and account for interactions between social and physical environments. Results highlight the need for collaboration between public health and planning professionals, to evaluate walkability using culturally relevant measures that account for the social environment, particularly in Mexican American and other communities of color.

Sociocultural perceptions of walkability in Mexican American neighborhoods: Implications for policy and practice.

Walking is the most fundamental form of active travel, as well as the most popular form of physical activity. The built and social environment, however, may not adequately support active living, especially in low-income communities. While improving the walking infrastructure is essential, assumptions regarding perceptions of walkability based on a standardized norm may fail to address preferences within specific populations. Particularly in low-income and ethnically diverse urban environments, it is not clear whether objective or perceived measures provide the best assessment of an environments' conduciveness to walkability. This qualitative study of five Mexican American neighborhoods used walk-and-talk focus groups (n=20) and intercept surveys (n=108) to investigate residents' perceptions of their walking environments. Respondents differentiated between physical and social attributes in assessing neighborhood walkability. Physical attributes, such as lack of infrastructure, maintenance and traffic, were more salient to residents when describing what discouraged them from walking. Perceptions of the social environment appeared to be of greater significance than the physical environment in encouraging individuals to walk. While respondents were concerned about personal safety, the overall sociability of the neighborhood, nearby family, familiarity between neighbors, and a sense of social activity all contributed to a positive assessment of walkability and expressed desire to walk, Findings revealed complex interactions between characteristics of the social, built, natural, and policy environments. The emphasis on sociocultural influences on perceptions of walkability underscores the importance of engaging neighborhoods in conversations about their walking environments to reveal strategies that better serve the needs of residents.