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No city in the United States is probably less likely to be the poster child for healthy living through physical activity than Houston.

As the country’s fastest-growing large city over the last 40 years, Houston is perhaps the ultimate car-bound Sun Belt city. It is bigger than New York City and Chicago put together, but has only one-fifth the population. More than 90 percent of Houstonians drive to work. The Katy Freeway—as Interstate 10 is called locally—has grown to 26 lanes, including four toll lanes. Even in the most urban neighborhoods, gigantic parking garages abound. Almost 30 percent of adults are obese.

Yet things are changing, and these changes are making Houston a great laboratory that will help us figure out whether it is possible to change real estate development patterns in the Sun Belt in a way that increases physical activity and therefore improves public health.

While suburban subdivision development continues to hum along, a simultaneous increase in interest in the urban core—not just as a place to work, but also as a place to live, shop, and play—has materialized. According to the Houston Area Survey, produced by the Kinder Institute for Urban Research at Rice University, more than half of all households in the Houston area would prefer to live in close-in urban neighborhoods rather than more distant suburban neighborhoods. Countless dense, multistory apartment buildings have been built or are in the development pipeline. Older neighborhoods are seeing original single-family homes razed, replaced by twin four-story townhouses. Millions of dollars have been invested in parks, trails, and green space in the central city.

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On the transportation side, Houston METRO is in the process of expanding its existing one-line light-rail system to three lines, adding 15 miles (24 km) of new track and more than 20 new stations. METRO is also reimagining its bus route system, moving away from a downtown-centric hub-and-spoke model with limited appeal to those with other travel options, to one that will function in a more gridlike pattern. Houston had one of the first robust bike-share systems in the nation.

The city has also begun the process to update its bike master plan, and the mayor has recently mandated that plans to improve and redevelop city streets should consider the needs of all users—including walkers, bike riders, and transit users—and not just drivers. The result of these developments could be a dramatically different city than existed only a generation ago.

All of this should be good news for public health. Recent research from cities across the United States has found that urban form is strongly associated with physical activity—and, by extension, with improved public health. Importantly, these connections between urban form and physical activity are true for adults and children alike.

Buffalo Bayou. (Silvio Ligutti)

For example, research from southern California found that more extensive walking infrastructure (such as the presence and condition of sidewalks, streetlighting, crosswalks, and bike paths) and fewer culs-de-sac were correlated with more minutes per day of moderate to vigorous physical activity among school-age children. Also, national data indicate a clear, strong correlation between distance from home to school, and the probability that a child will walk or bike to school versus ride a bus or get dropped off by car. “Active commuting,” as this is called, has been identified as a potentially major source of daily physical activity for children.

This connection between distance and mode choice may sound rather obvious, but it is important to be cognizant of it as school districts focus on economies of scale by building larger, more isolated campuses, perhaps making permanent the shift away from the model of smaller neighborhood schools that existed decades ago. Similarly for adults, a review of recent research has found that use of public transit is associated with upwards of 30 minutes per day of additional physical activity.

This association is not uniform across environments, however. Much as we have seen with children, adults who live in neighborhoods with an urban form that is more conducive to physical activity are more likely to use transit and more likely to walk or bike to reach their stop. If one overriding lesson is to be learned here, it is that public health researchers are now intently interested in the role the environment plays in health behaviors like physical activity, making partnerships with urban planners and policy makers a natural fit—and indeed a requirement—to advance the state of the science.

While it is fair to characterize the research at the intersection of public health and urban planning as preliminary, this has not stopped policy makers from implementing changes to land use and zoning codes, transportation plans, and economic incentives to encourage more walkable, livable communities—a fortuitous side effect of which could be greater levels of physical activity and lower levels of obesity and chronic diseases across the whole population. That is part of the reason why Mayor Annise Parker and other public officials in Houston have been pushing “complete streets,” transit, and other changes to the built environment that might increase physical activity.

The rapidly changing situation in Houston has provided the opportunity for some “natural experiments” on the impact of urban form. For example, this spring the light-rail system will expand when the Green Line and Purple Line open to the east out of downtown, connecting for the first time the University of Houston and other important destinations to the rail system.

Taking advantage of this opportunity, a team of researchers at the University of Texas School of Public Health and the Texas A&M Transportation Institute are undertaking an innovative, multiyear study to understand how the expanded light-rail system will affect transportation patterns, physical activity, and quality of life in neighborhoods adjacent to the new lines. This is only one of several important research projects in Houston that will help create a well-rounded decision-making process for new public and private investments in the city and the surrounding areas—including unincorporated Harris County, where, increasingly, people with modest incomes are living far away from jobs, public transit, and services.

All these developments suggest how Houston—the fourth-largest city in the nation but often the most underappreciated as an urban place—is emerging as an unlikely leader in physical activity as in many other urban endeavors. Among other things, a growing number of local institutions and organizations are examining and tackling these issues. The emerging partnership between the Kinder Institute and the University of Texas School of Public Health is a good example.

So if you come to Houston for the 2015 ULI Spring Meeting, check out the city in a different way. Find a bike-share station downtown and ride to Hermann Park near the Texas Medical Center. Walk to a nearby light-rail station and visit the emerging warehouse and artist districts just a few minutes east of downtown. Walk or jog along the beautifully restored Buffalo Bayou just west of downtown. That way, you will be able to experience Houston in a whole new way—and get some physical activity in as well.