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Enhancing Food Security and Physical Activity for Māori, Pacific and Low-income Peoplesmaintained and enhanced’. This recommendation was followed by a statement that ‘theAuckland Council should establish an Urban Design Panel to review all majordevelopments throughout the Auckland region, with sign-off for major projects’. Thereport also recommended governance structures that promote recreation, along with thebenefits of diversity and support culture. It is important that local government reformskeep a focus on well-being that include actions to enhance physical activity.The Department of Building and Housing is hosting an Urban Intensification Taskforcewhich was established in 2008. The purpose of the taskforce is to ‘propose a wayforward for achieving better urban intensification outcomes for New Zealand and, inparticular, the Auckland region’. 73 Characteristics of successful intensification wereidentified in a taskforce scoping paper and included that: ‘it provides access to openspaces and other civic amenities’; and that ‘it is integrated with the provision of publictransport and provides for a range of other transport options, including foot and bicycle’.The taskforce has set up a working party to develop proposals which will be discussed atthe next Construction Leaders Forum in the first half of 2009.In conclusion, the current development of an NPS may provide opportunities for inputfrom the ENHANCE research around improving open space and connectivity in favour ofMāori, Pacific and low income people. Work to date on the NPS shows support forinclusion of connectivity and open space as design issues. There are other areas ofwork related to urban design, outlined in this chapter, which may influence the NPSand/or provide further opportunities to enhance physical activity. Local governmentreforms appear to be a key area to watch to ensure that focus is kept on actions toenhance physical activity.DiscussionThe international research into the effects of the open space and connectivity onphysical activity and related health outcomes is promising. Residents living inneighbourhoods that are characterised by having good locational access to greenspaceand which have networks of streets, paths and cycleways that are highly connected areoften more physically active.Most research on the influence of the built environment (including open space andconnectivity) has been undertaken in the US. This work is generally supportive of asignificant and positive effect. However, due to the difficulty of capturing detailedlongitudinal data, the vast majority of studies are cross-sectional or, at best, use arepeated cross-sectional design. This study design is a major impediment to developingsuccessful urban design policy initiatives to combat low levels of physical activity. It isnot possible to determine causality from cross-sectional analyses due to the possibleeffects of reverse causality (or ‘endogeneity’). Reverse causality could occur, forexample, when residents who are physically active preferentially locate in areas that areconducive to physical activity.Further, the evidence base in New Zealand is extremely limited, with only threecompleted to date. Results have generally not found a significant relationship betweenthe built environment and physical activity. There has been no published research inNew Zealand on the built environment and health among the three target populations.However, there are a number of key pieces of work underway in New Zealand that are141
Enhancing Food Security and Physical Activity for Māori, Pacific and Low-income Peopleslikely to address this knowledge gap. It will be important that the results of these findingsunderpin the development of a National Policy Statement (NPS) on urban design. Thereis considerable scope for an NPS (underpinned by the Urban Design Protocol developedby the Ministry of the Environment) to support changes to the urban built environment toenhance physical activity.Feasibility (level of evidence of effectiveness)At an international level, there is reasonably strong evidence that localities with goodaccess to greenspace and high levels of connectivity have a positive effect on physicalactivity-related health outcomes, However, the evidence mainly comprises crosssectionalstudies (which in isolation cannot determine causality) and was almostexclusively conducted in the US and Australia. There has been very little researchcompleted in New Zealand on the relationship between any aspect of the builtenvironment and physical activity (or related health outcomes).SustainabilityAdapting the built environment (including open space and connectivity) is potentially along term and sustainable approach to addressing physical activity levels at thepopulation level. Interventions to alter aspects of the built environment are likely toprove far-reaching and durable. They are likely to support positive changes to behaviour,practices and attitudes to physical activity.Effect on equity for Māori, Pacific and low-income peoplesThere is a limited amount of international research examining the influence of the builtenvironment on the levels of physical activity (and related health outcomes) amongdisadvantaged populations. What research there is tends to be set in the US andexamines low income and/or African American populations. In New Zealand, there is adearth of information evaluating the effect of any component of the built environment(including open space and connectivity) on the three target populations. Whilst thespatial targeting of policy initiatives may address the physical activity levels of residentsin those localities, it is important to note that compared with North American cities forexample, Māori, Pacific and low-income peoples in New Zealand are not heavilysegregated.Acceptability to stakeholdersThere has been little New Zealand evaluation of the acceptability to various stakeholdersof altering the built environment for the purpose of addressing health concerns.Key components for effectivenessThere is little research in this area. Clearly though, addressing issues relating to the builtenvironment will require collaboration across a range of sectors, including those workingin planning/urban design at the national and local level, architects, sports and recreation,and transportation, as well as the public health community.Potential side-effectsThere is limited evaluation of the potential side-effects of adapting built environments toenhance physical activity. Possible side-effects may include changes to traffic flows inNew Zealand cities and the associated costs for businesses and households. However,these effects are likely to be minimal. A variety of positive side effects may also beenvisaged, such as the development of more sustainable cities and higher levels of142
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