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San Antonio’s built environment does not support physical activity, promoting lifestyles that lead to obesity and a number of health problems. The inclusion of a micromobility lane for bikes and e-scooters as a part of the Broadway Street redevelopment project – a project supported by Mayor Ron Nirenberg – could be a catalyst for urban design that promotes public health. But the benefits can only be reaped if every zip code is included, starting with the most disadvantaged.
Research has found land use mix, minutes in a car, and distance walked as significant indicators of Body Mass Index (BMI) across all gender and ethnic groups, underscoring the importance of urban design. However, the urban design of San Antonio discourages physical activity, prioritizing drivers over walkers or bikers. Without protected bike lanes, well-maintained sidewalks, and reduced vehicle lanes, San Antonio scores 131.2 on the Pedestrian Danger Index in comparison to the national average of 55.3.
According to the Active Living Council of San Antonio, 75 percent of Bexar county adults do not meet the 150-minute moderate-to-vigorous weekly physical activity requirement as cited by the Center for Health Statistics. While individual choices play a part, we must understand individual choices in the context of environment.
In Bexar County 65.7 percent of our adults and 32 percent of our adolescents are overweight or obese. What is even more alarming, is that the prevalence of obesity in Bexar County is disproportionately concentrated in the inner city (inside loop 410) and Southwest and Southside school districts. Not coincidentally, these areas, including zip codes 78202 and 78207, experience the city’s highest concentrations of low-income and uninsured individuals.
Health care, however, is only one factor contributing to good health and its impact is limited. Decades of compelling research suggests that social determinants such as physical environment, socioeconomic status, education, and social networks play an overwhelmingly important role in explaining our health status.
Yet, the zip codes with the most to gain from multimodal streets are not being included. While the road north of Interstate 35 to Hildebrand Avenue is included in these plans, the mile leading south into downtown from Interstate 35 extending access to 78202 is not. The obesity rate in San Antonio cannot be expected to change if intervention is not applied to areas experiencing the highest prevalence. All San Antonio citizens should get easy access to health-promoting neighborhood conditions that support us in reaching and maintaining healthy BMI, but we need to start with neighborhoods that need the most support.
It’s time we get serious about our health and the implementation of non-motorized linkages between residential, commercial, and employment areas as one important approach to improving the health of all San Antonio residents. Promoting active living spaces is important because evidence from Texas studies shows that school-based intervention promoting biking for students and parents has resulted in significantly increased recreational activity. Implementing urban design that promotes physical activity will simultaneously foster safety, equality, social cohesion, economic vibrancy, clean air, and employment in San Antonio.
San Antonio has already implemented an effective model of social and environmental change for public health. More than a decade ago, neighborhood groups, business associations, and residents joined together to support a tobacco ban in public areas. Preventing health risks attributed to obesity in the same way tobacco was identified as a leading cause of preventable disease must be a priority of San Antonio. Tobacco limits imposed from 2010 to June 2019 prioritize the health of those under 21 with limited restrictions of civil liberties for adults who choose to smoke. Our children deserve the same environmental protections from obesity as they do from tobacco.
The obesity epidemic will require changes social, economic, and built environments; the choice is to modify our society to accommodate obesity or health. Obesity intervention requires a social change from the individual to the collective. When we choose to value our health as well as our health care, we will collectively reap the physical, economic, and social benefits of health equity.