Thursday, 7 February 2013

Unhealthy neighbourhoods play big role in obesity, diabetes epidemic




Cities' neighbourhoods have long been ranked, like Hollywood stars, according to their beauty and magnetic personalities.
But cities are now being increasingly divided into healthy and sick zones. If you live in downtown Geneva or Paris, where the tree canopy is lush and you can easily walk to an organic café or a yoga class, you belong to a privileged class not only because of the real estate values in your neighbourhood but because you're likely to have a higher life expectancy.
This is the new crisis of cities: Badly designed neighbourhoods are literally sapping people of their ability to live fully.
If, as a newly arrived immigrant, poverty has driven you to the inner or outer suburbs, where you live in a basement apartment or high above the concrete ground in a residential tower, you are far more likely to suffer from type 2 diabetes and its related consequences such as blindness and amputation. Most of Canada's growth comes from immigrants, but the troubling fact is that Hispanics, blacks and South Asians are genetically predisposed to diabetes. Because of the compounding of these forces, you and your neighbours can expect a lower life expectancy.
A poor diet, high in saturated fat and low on fruits and vegetables, causes excess weight. Once obesity sets in, especially if it develops at a young age, type 2 diabetes usually follows. A sedentary lifestyle fuels the problem. That's why some medical researchers and health offices are joining forces with urban planners to design neighbourhoods that are more conducive to activity. Healthy eating combined with increases in physical exercise - walking with the kids to school or biking to the cinema - would help to mitigate the rise in the prevalence of obesity over the last two decades. They say that we need to embrace the Danish model of urban wellness, or suffer a health disaster.
It's a cruel fate.
"Diabetes is extremely costly to manage. It places a huge burden on individuals and on the health-care system," said Gillian Booth, a lead author of the Diabetes Atlas created by St. Michael's Hospital's Centre for Research on Inner City Health and the Institute for Clinical Evaluative Sciences.
The first Canadian study of its kind, published in 2007, the Atlas investigated 140 Toronto neighbourhoods over three years to examine the role of several factors - including community design, population density, access to healthy and unhealthy food - on the diabetes epidemic. Poverty and ethnicity were found to be key in the development of type 2 diabetes. The researchers also concluded that walking and transit times to recreation facilities in the city's outlying neighbourhoods were as long as 40 minutes and 20 minutes, respectively, each way. It takes only 30 minutes of walking or moderate exercise, combined with a healthy diet, to cut the risk of diabetes in half. But a walk through a bleak or potentially dangerous neighbourhood is hardly inspiring, especially if the only nearby landmark is a highway.
"Among all the people being admitted for heart attack or stroke, one-third have diabetes. Two-thirds of all amputations that are caused not from trauma occur in people with diabetes," Dr. Booth said. "Clearly, we need to start thinking about prevention."
We used to call them ugly, but now social geographers and medical practitioners label the disconnected sections of the city "obesogenic," meaning environments that promote obesity.





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