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Obesity rates have skyrocketed in China over the last generation, at the same time that its cities have exploded. A group of researchers is now trying to pin down the relationship between the two.

Mariela Alfonzo just got back from a three-week trip to China, where she's been researching walkability in the rapidly expanding megalopolises of Beijing, Shanghai, and Guangzhou. And a lot of what she saw wasn’t exactly pedestrian-friendly. Kind of the opposite. In a scary way.

"Driving patterns are a real issue," says Alfonzo, a research fellow at NYU-Poly. "I almost got run over every single day I was there. And I was being attentive." She laughs about it now, but you can tell she's not kidding.

China’s urban areas are booming economically, but that trend is paralleled by another one with serious implications for public health: obesity rates have skyrocketed over the last generation. The number of Chinese people who are obese quintupled between 2005 and 2011, to nearly 100 million people. The World Health Organization estimates that 38.5 percent of the population was overweight in 2010, up from 25 percent in 2002. Male children from high-income families have an especially high rate of obesity.

Likely factors include everything from the availability of fast food to an increasingly sedentary lifestyle. Alfonzo and her colleagues, Kristen Day of NYU-Poly and Zhan Guo of NYU Wagner, are looking for connections between patterns of urbanization and walkability and the rise in obesity.

Alfonzo’s team is now laying the groundwork for what will be an unprecedented analysis of development patterns, density, and their relationship to physical activity in the booming new cities of China. Her travels took her to the farthest reaches of the sprawling cities, and although she knew what to expect, she was amazed by the pace of building she saw. “I just couldn’t believe the amount of development that wasn’t there 5 to 10 years ago,” says Alfonzo.

To start, she and her colleagues will develop a system that will describe the different categories of housing and commercial development in China, from high-rise tower blocks to traditional hutongs.

The work will be influenced by research Alfonzo has done in the United States. Most recently, she co-authored a paper for the Brookings Institution with Christopher Leinberger, “Walk This Way: The Economic Promise of Walkable Places in Metropolitan Washington, D.C.” (Emily Badger wrote about it last month in a piece called “Why We Pay More for Walkable Neighborhoods.”)

The Brookings work was based on data gathered using a tool called the Irvine Minnesota Inventory, which measures walkability based on 160 criteria in four domains: accessibility, pleasurability, perceived safety from traffic, and perceived safety from crime.

But Alfonzo and her fellow researchers realize that standards from the United States cannot be transferred wholesale to the Chinese setting. The tools will have to be modified and refined.

“Density doesn’t play the same role in getting people active as it does in the U.S.,” says Alfonzo. “In the rapidly urbanizing developing world, the relationship is not so clear. It’s all so dense to begin with, and people are still walking a ton relative to the U.S.”

As an example, Alfonzo noted an interesting design pattern that cuts across different types of housing: Chinese housing complexes are “interior-focused.” Gated high-rise and mid-rise communities echo the traditional walled neighborhoods of ancient Chinese cities. “The Forbidden City is an example,” says Alfonzo.

Within modern gated complexes, she says, there's a lot of walkability, a refuge from the 10-lane highways that roar outside the walls. “Even though outside was a barrier, inside were narrow paths, public spaces, people out and about,” she says. “The informal economy was flourishing – you can buy just about anything.”

In order to get past their assumptions about what makes a place walkable, Alfonzo and her team are working with Chinese planners and designers to create surveys that are sensitive to the local cultural context. They are also going to be looking beyond the health ramifications of walkability, including economic and environmental data in their studies. “One of the pushbacks we’ve gotten is that Chinese officials don’t care about health concerns,” she says. “We think the economic aspect might resonate more.”

Alfonzo says that there is increasing openness among officials to new ideas about what makes cities more livable and walkable. “There are a growing number of planners and urban designers who understand these issues,” she says. “Officials are more and more open to hearing about other policies, even if they’re Western.”

Top image: The 3rd Ring Road in Beijing. TonyV3112 / Shutterstock.com

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