The Built Environment and Actual Causes of Death

Promoting an Ecological Approach to Planning and Public Health


Changes to the built environment can be an upstream intervention opportunity for determinants of high-priority health challenges like childhood obesity and should be an important consideration for planners.


  • Physical inactivity is the second highest actual cause of death (meaning it is the second highest risk factor linked to leading causes of death such as heart disease, cancer, and diabetes).
  • Built environment features like street connectivity, safety, and pedestrian and bicycling infrastructure can affect physical activity.
  • School environments, including street trees along routes to school and higher land use mix, have been associated with higher rates of walking among children ages 11-13 living within one mile of school.
  • The researchers provided recommendations for planners to adopt an ecological perspective of actual causes of death to foster collaboration between the fields of planning and public health.


  • This article summarized research associated with actual causes of health, focusing specifically on physical activity, nutrition, and injury, and their relationship to the built environment.

Botchwey, N., Falkenstein, R., Levin, J., Fisher, T., & Trowbridge, M. (2014). The Built Environment and Actual Causes of Death: Promoting an Ecological Approach to Planning and Public Health.Journal of Planning Literature, 1-21.

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