Content uploaded by Nancy M Wells
Author content
All content in this area was uploaded by Nancy M Wells on Nov 26, 2014
Content may be subject to copyright.
Environment, Design,
and Obesity
Opportunities for Interdisciplinary
Collaborative Research
Nancy M. Wells
Susan P. Ashdown
Elizabeth H. S. Davies
F. D. Cowett
Cornell University
Yizhao Yang
University of Oregon
This article presents a framework for considering the relevance of the physical
environment to obesity. The authors adopt the notion that the “environment”
constitutes the space outside the person and therefore broaden the common
conceptualization of the “environment” to encompass a full spectrum from
small-scale design elements to large-scale community infrastructure. An
energy balance approach is also adopted. The energy balance perspective rec-
ognizes the equilibrium of food consumption and energy expenditure, rather
than focusing solely on one or the other side of the equation. The authors con-
sider how environmental characteristics present either barriers (that hinder), or
supports (that promote) healthy habits. Thus, they describe a range of obesity-
related environmental themes that provide opportunities for innovative collab-
orative research between environmental psychologists and colleagues in fields
ranging from apparel design to landscape architecture. Last, conceptual and
methodological considerations are briefly presented.
Keywords: environment; dietary intake; interdisciplinary; obesity; physical
activity
Environment and Behavior
Volume 39 Number 1
January 2007 6-33
© 2007 Sage Publications
10.1177/0013916506295570
http://eab.sagepub.com
hosted at
http://online.sagepub.com
6
Authors’ Note: An earlier version of this article was presented at the Ecology of Obesity:
Linking Science and Action conference at the College of Human Ecology (Wells & Ashdown,
2005). Correspondence concerning this article should be addressed to Nancy M. Wells, Department
of Design and Environmental Analysis, E220 Martha Van Rensselaer Hall, Cornell University,
Ithaca, NY 14850; e-mail: nmw2@cornell.edu.
The purpose of this article is to describe and illustrate the broad relevance
of environments to the study of obesity. Although the physical environ-
ment may influence obesity in a variety of ways, research efforts linking the
environment and obesity within the fields of environmental psychology,
urban planning, and the hybrid “active living research” have primarily
focused on the associations of neighborhood design and streetscape charac-
teristics with physical activity patterns (Alfonzo, 2005; Humpel, Owen, &
Leslie, 2002; Saelens, Sallis, & Frank, 2003) and how sprawl is correlated
with obesity (Ewing, Schmid, Killingsworth, Zlot, & Raudenbush, 2003).
This article provides a framework to facilitate a broadening of research
themes associating the environment with obesity but is not intended to be an
exhaustive review of the literature.
Three themes provide parameters for this article and contribute to a broad-
ened perspective intended to enable and inspire environment-behavior
researchers to contribute more fully to obesity-related research. First, according
to ecological models of behavior, environment refers to the space outside of the
person (Sallis & Owen, 2002). This definition of environment provides a start-
ing point for consciously expanding our perspective on environment–obesity
linkages. Although ecological models do include a cross-context perspec-
tive, most empirical research in environmental psychology applying an
ecological model has focused on neighborhoods. Herein, we consider envi-
ronment to include clothing, food packaging and presentation, technology,
buildings, natural areas, neighborhoods, and urban design. This broad
conceptualization of environment is intentionally employed in an effort to
allow environment-behavior researchers to stretch beyond the familiar to
consider a wider spectrum of possible applications and collaborations and
thereby to extend the potential contribution of environmental psychologists
in addressing the obesity epidemic. Second, it is useful to note that there are
two sides to the energy balance equation: energy in (dietary intake) and
energy out (basal metabolism and, more tractable, physical activity). This
equation focuses on the equilibrium of food consumption and energy
expenditure, rather than targeting just one side of the equation (Hill &
Peters, 1998). Much of the research effort within environmental psychol-
ogy has focused on energy expenditure—that is, physical activity. However,
environmental psychology researchers can also contribute to the study of
dietary intake, the other side of the obesity equation. A third perspective
adopted in this article is the consideration of environmental barriers that
hinder healthy eating and discourage physical activity as well as environ-
mental supports that encourage these healthy behaviors. Barriers are
obstacles. In this case, barriers are features in the environment that deter a
Wells et al. / Environment, Design, and Obesity 7
8 Environment and Behavior
person from physical activity and/or healthy eating. Supports,1on the other
hand, are environmental elements that foster or promote certain actions or
behaviors—that is, physical activity and healthy eating. In this article, we
consider the role of a wide range of environmental variables in promoting
and discouraging physical activity and healthy diet across a variety of con-
texts and scales.
Figure 1 provides a conceptual framework integrating the three themes: a
broad definition of the environment, energy balance, and environmental bar-
riers and environmental supports. Consistent with an ecological perspective,
we recognize factors such as biology, demographic variables, social and cul-
tural influences, psychological factors, organizational influences, and policy
(National Heart, Lung, and Blood Institute, 2004); however, they are not the
focus in this framework. As Figure 1 shows, physical environment charac-
teristics that present barriers to healthy eating and physical activity are asso-
ciated with increased energy intake and decreased energy output,
respectively, yielding an imbalance in favor of energy input. Conversely,
environmental characteristics that support physical activity and foster
healthy eating are likely to be associated with lower caloric intake and
greater energy expenditure, making energy balance more probable. Energy
balance or imbalance, in turn, is associated with weight status (i.e., healthy
weight, overweight, obese) and related health risks. It is worth pointing out
Figure 1
Conceptual Framework Linking the Environment
With Weight and Health Outcomes
++−−
Healthy
Eating
Physical
Activity
Energy (Im)Balance
Other Factors:
Biological
Demographic
Psychological
Social/Cultural
Organizational
Policy
Physical Environment
Clothing… Plates + Portions... Food Environment… Natural Areas… Neighborhood… Transportation…
Weight Status & Health Outcomes
Energy In Energy Out
Environmental Barriers to Environmental Supports for
and Healthy
Eating
Physical
Activity
and
Wells et al. / Environment, Design, and Obesity 9
that this framework is not intended to suggest an environmental determinis-
tic perspective. Rather than ensuring that healthy habits will occur or dictat-
ing that they will not, we suggest that environmental supports and barriers
will make such behaviors more or less likely.
The Physical Environment
Our conceptualization of the designed environment begins with cloth-
ing. We then consider the food environment and packaging, technology,
buildings, neighborhoods and urban design, and finally, the natural envi-
ronment. Within each of these categories of the environment, we explore
connections to energy expenditure and/or energy intake, the extent to which
the environment presents barriers to or supports for healthy eating and
physical activity, and a variety of possible directions for research and inter-
disciplinary collaboration.
Clothing
Clothing is our closest environment, and yet relatively little research has
focused on how clothing might be related to obesity. In particular, clothing
may create barriers against, or provide supports for, physical activity.
The historical changes that have occurred in clothing are extreme. In the
1880s a typical woman’s ensemble consisted of as many as five layers and
weighed 9.8 lbs. Today, a contemporary women’s outfit is just two layers
and weighs 2.4 lbs (L. M. Lyman-Clarke, personal communication, August
10, 2006). The clothing we wear every day is less layered, is made of less
fabric, and is lighter in weight than in the past, so the caloric expenditure in
simply donning and wearing clothing for daily activities is less than it was
years ago. Researchers have documented that the weight (Duggan, 1988)
and the bulk (Teitlebaum & Goldman, 1972) of wearing additional clothing
layers is associated with increased energy expenditure. In a study of men
with an average weight of 166 lbs, an additional 10 lbs of clothing resulted
in a 6% higher energy output in watts for a 6-min stepping task (Duggan,
1988). In addition, acquiring and caring for clothing in the past generally
required the expenditure of more calories than today. Clothing was once
made primarily in the home, and the process of laundering clothing and
household fabrics was a physically demanding, all-day procedure. The
shifts to ready-to-wear clothing, Internet ordering, and the use of easy-care
10 Environment and Behavior
fabrics and appliances have reduced the energy required so that minimal
physical activity is associated with clothing ourselves today.
On the other hand, contemporary clothing may also encourage physical
activity. Free from the bulk and constraints of clothing from the past, and
with comfortable, ergonomically designed footwear, fashionable clothing is
now available that makes everyday activities such as walking and climbing
stairs easier. Modern fabrics are durable and easily laundered, making
active pursuits more practical. Moreover, clothing that has been specifically
designed for activities such as hiking, biking, walking, tennis, aerobics, and
yoga help to make these activities more comfortable and convenient.
Clothing has the capacity to provide its wearer with feedback that may
encourage physical activity. For example, sneakers designed for children
light up as the child runs or walks. Researchers have begun to examine the
effect of such feedback on physical activity. Cornell University graduate
student Lindsay Lyman Clarke designed orange capes with wrist-mounted
pinwheels for children (see Figure 2). The pinwheels spin, and the orange
fabric flaps as the child runs. Preliminary evidence from a pilot study
Figure 2
Clothing That Provides Feedback: Motivation for Physical Activity?
Wells et al. / Environment, Design, and Obesity 11
suggests that children in a day care were more physically active on the days
they wore the capes than on the noncape days (Lyman Clarke & Wells,
2005). Clothing can also provide physical activity feedback to the wearer
through technological sophistication. Nike and Apple have recently devel-
oped a device that feeds physical activity data to an iPod. An accelerome-
ter placed in a shoe wirelessly transmits information on distance, pace, and
calories burned to a receiver attached to an iPod nano contained in a pocket
in the sleeve or an armband. Real-time spoken feedback at specific mile-
stones can also be implemented (Apple Computer, 2006). Future research
in textile science might include the development of “smart” fabrics and
clothing ensembles that provide feedback on energy intake and energy
expenditure throughout the day, giving the wearer an on-demand assess-
ment of energy balance (Solaz et al., 2006). Further research is needed to
explore the efficacy of clothing interventions to encourage physical activity
among various ages and population groups.
As clothing becomes more technologically advanced it might also
facilitate physical activity by making us more mobile. For example, a solar
jacket marketed by Scott eVest (www.scottevest.com) allows its wearer to
travel, untethered to a physical home base, while charging cell phone, per-
sonal digital assistant, and other electronic devices. Textile and apparel
developments are under way to incorporate everything from entertainment
and communication devices to computers into clothing (Tao, 2005). Might
such technologically sophisticated clothing encourage people to walk to the
park or local coffee shop—to keep moving—rather than staying stationary
in their office chair? The influence of high-tech clothing on the expansion
of people’s geographic territorial range and physical activity is an area for
potential research collaboration among environmental psychologists and
colleagues in the fields of textiles and apparel design. Past environmental
psychology research has included the study of individuals’ territorial or
home ranges (R. B. Taylor, 1988). Research strategies such as behavior
mapping (Zeisel, 1984) and cognitive mapping (Coulton, Korbin, Chan, &
Su, 2001; Lynch, 1960) would be useful in examining the extent to which
mobility-enhancing clothing technologies do indeed increase geographical
home range and lead to higher rates of physical activity. Today, such stud-
ies can employ Global Positioning Systems (GPS) to chart movement as
well as Geographic Information Systems (GIS) to map the location of that
movement and pedometers or accelerometers to measure physical activity.
In collaboration with apparel designers and/or fiber scientists, environ-
mental psychology researchers might explore the efficacy of high- and low-
technology mechanisms through which clothing can provide energy balance
and weight feedback. Evidence from previous environmental psychology
12 Environment and Behavior
research examining the efficacy of feedback related to home energy con-
sumption suggests such strategies might be effective. For example, house-
holds that were given energy use feedback 4 times per week reduced their
electricity usage by 10%, compared to a nonfeedback control group
(Seligman & Darley, 1977). Studies examining the effects of energy balance
feedback would also build on recent work by nutrition researchers indicating
that frequent weight feedback enhances weight loss efforts (Levitsky, Garay,
Nausbaum, Neighbors, & DellaValle, 2006).
Clothing designs can be developed that remove barriers to physical activity
in other ways. Apparel designers might develop business attire that transitions
to active wear. For example, shirts might have zip-off sleeves or women’s
business shoes could have retractable heels. Researchers might also examine
how clothing design can be tailored to the needs of individual groups—to help
reduce the psychological and physical barriers that might confront an over-
weight or obese individual who contemplates exercise, for example.
Concepts such as feedback and territorial range fall at the intersection
of environmental psychology and textiles and/or apparel research related to
obesity, providing new avenues for research examining how clothing inno-
vations influence physical activity and dietary intake.
The Food Environment
Like the clothing environment, the food environment exists as part of the
small-scale, near environment, as manifested in portion sizes and packag-
ing. However, research related to the “food environment” also includes
broad patterns of food availability and affordability across regions. We
examine the food environment at both the small and large scale.
Portion size and packaging. As the movie Super Size Me clearly illus-
trated, portion sizes have increased dramatically in recent decades (Rolls,
2003; Young & Nestle, 2002). For instance, Coca Cola was sold in 6.5-oz
bottles in 1916, reached “king-sized” 10 or 12 ozs in the 1950s, and today
is sold in 20- or 32-oz bottles for individual consumption (French, Story, &
Jeffery, 2001). A 1954 burger from Burger King was 2.8 ozs, 202 calories,
whereas today their burger is 4.3 ozs, 310 calories (Newman, 2004). Several
experimental studies have shown that large plates, portions, and packages
influence people to eat more (Rolls, Morris, & Roe, 2002; Wansink, 2004;
Wansink, Painter, & North, 2005). Wansink (2004) reported that doubling
package size generally results in a 18% to 25% increase in consumption for
meal-related foods, such as a plate of spaghetti, and 30% to 45% for snack-
related foods. Rolls (2003) pointed out that people tend to eat in units—so
Wells et al. / Environment, Design, and Obesity 13
regardless of the size of the cookie or muffin, a person is likely to eat the
whole thing. Conversely, modest changes in the personal environment—such
as the size of plates and portions—can reduce “unknowing overconsump-
tion” of food (Wansink, 2004).
Neighborhoods and food. Several areas of research examine the influence
of the neighborhood food environment on healthy eating. Inequalities have
been documented regarding healthy food availability across neighborhoods
that differ in economic and racial character. Heart-healthy food availability in
neighborhoods and the mean number of heart-healthy foods at local stores
were correlated with neighborhood socioeconomic status (SES) in San Diego
(Sallis, Nader, Rupp, Atkins, & Wilson, 1986). Similar patterns have been
documented with respect to fruit availability in restaurants (Edmonds,
Baranowski, Baranowski, Cullen, & Myres, 2001). Wealthier neighborhoods
also have significantly more supermarkets and gas stations with convenience
stores than poorer neighborhoods; and the poorest neighborhoods had 3 times
the number of venues for alcohol consumption than the wealthiest neighbor-
hoods. Moreover, supermarkets were more prevalent within White than Black
neighborhoods (Morland, Wing, Diez Roux, & Poole, 2002).
A few studies have examined connections between the local food envi-
ronment and dietary intake—particularly among populations at risk for
obesity. Greater availability of juice and vegetables in local restaurants was
associated with higher reported juice and vegetable consumption among
African American boys (Edmonds et al., 2001). Among Black Americans, the
presence of a supermarket in the census tract was associated with a 30%
increase in the likelihood of consuming the recommended number of daily
fruit and vegetable servings and a 38% increase in likelihood of consum-
ing the recommended amount of saturated fat (Morland et al., 2002). Other
researchers have documented that easy access to supermarket shopping is
associated with household fruit consumption (though not statistically signif-
icant; Rose & Richards, 2004). In a rare natural experiment, Wrigley, Warm,
and Margetts (2003) examined changes in diet following the construction of
a supermarket in a “retail-poor” area. Among the 45% of the sample that
switched to the new store, there was a threefold increase in walking for trans-
portation to buy food. Moreover, consumption of fruits and vegetables
increased among 60% to 75% of individuals with poor diets prior to the inter-
vention. On a more microscale, Cheadle et al. (1991) found a correlation
between individual dietary practices and the proportion of shelf space within
local stores devoted to healthy products such as low-fat milk and dark bread.
There is also potential for characteristics of the food environment to
influence physical activity, the other side of the energy balance equation.
14 Environment and Behavior
This idea is illustrated by a study conducted by Wrigley et al. (2003) doc-
umenting an increase in walking for food purchases when a neighborhood
grocery store opened. The fact that this intervention resulted in a 300%
increase in walking for food purchases illustrates that the configuration of
the food environment may influence physical activity and diet. Future stud-
ies might further examine the effect of the neighborhood food environment
on physical activity and the influence of supermarket interior design on
physical activity and the efficacy of the signage placed in the lots of some
grocery stores stating “this parking spot reserved for people who want to
increase their daily steps.”
The need to understand better how the local food environment influ-
ences dietary intake and physical activity of individuals and families pro-
vides an opportunity for environmental psychologists to collaborate with
researchers in nutrition, urban planning, interior design, and economics. In
particular, environmental psychologists might create partnerships to conduct
studies of environmental interventions—such as manipulating packaging and
portion characteristics, removing vending machines with high-calorie options,
altering store layout, or introducing a neighborhood farm stand. Such
experimental and quasi-experimental research would help us to move from
aggregate-level correlational evidence toward an understanding of causal
relationships between environment, diet, and activity.
Technology
Technological developments during the past 100 years have played a
tremendous role in easing the burden of a wide range of tasks from the home
environment to the workplace. Innovations have been aimed at making life
easier by reducing our energy expenditure. We have strategically engineered
physical activity out of our lives. For example, early research by Martha Van
Rensselaer, founder of the College of Home Economics (now The College of
Human Ecology) at Cornell University, was aimed at enabling housewives to
“save steps” while completing daily chores (Van Rensselaer, 1901). This
research culminated in the development of guidelines that specify the optimal
geometry between the stove, sink, and refrigerator. This standard is known
as the “Cornell kitchen triangle” (Child & Boynton, 1914). Today, energy-
saving technologies reduce the caloric expenditure necessary to prepare
meals, do laundry, wash dishes, bake bread, mow the lawn, change the tele-
vision channel, and plant crops. The cumulative effect of technology on phys-
ical activity is illustrated by a study of the old-order Amish, who use very
little modern technology. The Amish walk approximately 2.5 times more than
people living in modern American culture—18,425 steps per day for the
Wells et al. / Environment, Design, and Obesity 15
average Amish man; 14,196 steps per day, on average, for Amish women
(Bassett, Schneider, & Huntington, 2004).
It is ironic to note that more than 100 years after the publication of the
“Savings Steps” document (Van Rensselaer, 1901, see Figure 3), the tide has
turned. We now wear pedometers, striving to reach 10,000 steps per day and,
we see the advent of homes designed to increase our physical activity. A recent
book, High Fit Home: Designing Your Home for Health and Fitness,offers
examples including the “stairmaster” house designed to promote aerobic activ-
ity; a house with interior and exterior climbing walls; and a home with a ten-
nis court flowing seamlessly from the living room (MacDonald, 2005).
The kinds of changes found in the home environment are paralleled in the
workplace. Sobal (2001) pointed out that a great deal of technological devel-
opment is oriented toward the “substitution of mechanically produced energy
for human generated energy,” with the goal of more efficient, productive, and
profitable workplace activities (p. 317). Office chairs have increasingly been
designed to be comfortable and ergonomically sound, resulting in fewer calorie-
burning micromovements (e.g., shifting or repositioning oneself in the chair)
than decades ago (Hedge, 2005). We spend much of our time at the computer.
We send e-mails rather than stroll to a colleague’s office, and we roll across
the room rather than stand to retrieve a book.
To explore how physical activity might be encouraged through design and
technology within the workplace or home environment and to identify poten-
tial intervention strategies to encourage greater activity, environmental psy-
chologists might collaborate with interior designers, industrial designers,
engineers, and architects. It is not realistic that we will undo our connection
to technology and return to horse-and-buggy, typewriters, manual laundry,
and similar practices of the past; however, there may be lessons in the past
and opportunities to increase human energy expenditure by returning to some
activities that are appropriate to integrate into a modern lifestyle. What might
motivate people to use the “solar dryer” (clothesline) for example?
Environmental psychology has a long history of research examining how
to motivate people to behave in environmentally responsible ways (e.g., Cook
& Berrenberg, 1981; De Young, 1996) including participation in recycling
(De Young, 1986), water conservation (Corral-Verdugo, Frias-Armentia,
Perez-Urias, Orduna-Cabrera, & Espinoza-Gallego, 2002), and reduction
of household chemical use (Werner & Adams, 2001). This work can now pro-
vide direction for research and intervention strategies aimed at encouraging
individuals to expend their own physical effort rather than using devices pow-
ered by electricity or gasoline (e.g., use the clothesline rather than the dryer,
walk rather than drive to the corner store). For example, prior research
16 Environment and Behavior
Figure 3
“Saving Steps: Cornell Reading Course for
Farmers’ Wives”(Van Rensselaer, 1901)
suggests that environmentally responsible behaviors (ERBs) may be more
likely if people’s sense of intrinsic motivation or satisfaction is engaged (De
Young, 1996, 2000; Kaplan, 2000; Parnell & Larsen, 2005) rather than pre-
senting ERBs as onerous and/or altruistic acts. This approach may fit well
with encouraging the use of low-tech, human-powered options. Initial stud-
ies might survey people who engage in such activities to assess their motives.
Subsequent research, in collaboration with transportation planners or interior
designers, for example, could examine the efficacy of intervention strategies
employing different types of motivational tactics or messages.
Through innovative design interventions and research, physical activity
also might be incorporated into tasks that are typically sedentary. An inter-
esting analogy is the “Dance, Dance, Revolution” video game that trans-
forms stationary video game play into a fun, intense workout. One intriguing
opportunity for research is offered by currently available computer technol-
ogy that projects a laser image of a keyboard onto a flat surface such as a
table or floor. The image can be projected quite large, potentially allowing
Wells et al. / Environment, Design, and Obesity 17
individuals with upper body disabilities or people seeking alternatives to
sedentary typing, the option of “step typing”—similar to the stepping and
dancing to play the piano keyboard in the movie Big. Although “step typing”
may not be an appealing or practical alternative for the average computer
user, it may be an active, engaging way for children to learn the alphabet and
the keyboard layout. The efficacy of this idea could be studied in collabora-
tion with ergonomists and/or early childhood researchers.
Building Design
“We shape our buildings, and afterwards, our buildings shape us.”
Perhaps never before in history has Winston Churchill’s observation been
so literally true. During the past 100 years, building construction practices
along with a wide range of technological developments may have con-
tributed to the obesity epidemic by enabling us to expend less energy. As
Sobal (2001) pointed out, the evolution of building materials such as insu-
lation and thermal windows has more completely separated humans from
the natural elements—protecting us from cold and heat. Relatively sophis-
ticated heating devices and technologically controlled indoor climates have
reduced the need for people to generate body heat to stay warm during cold
weather (Sobal, 2001, p. 316). Moreover, the physical configuration of
buildings reflects a bias toward human energy conservation—and against
physical activity. In modern buildings, stairways are typically unattractive
and inaccessible, whereas elevators and escalators are saliently located and
inviting. Seldom do we find a contemporary building with a wide, stately,
inviting stairway gracefully winding from one floor to another. The place-
ment of stairs in obscure locations surely reduces their use. And yet,
increasing use of stairs has the potential to profoundly affect public health.
Paffenbarger, Hyde, Wing, and Hsieh (1986) studied 11,000 Harvard
University alumni and found that those who climbed at least 20 floors per
week had 20% lower risk of stroke or death from all causes, after control-
ling for a large number of demographic and other risk factors. It has been
estimated that an additional 2 mins of stair climbing per day would trans-
late to a weight reduction of more than 1.2 lbs per year, effectively elimi-
nating the 1 lb typically gained by each adult in the United States each year
(Zimring, Joseph, Nicoll, & Tsepas, 2005).
A few studies have begun to examine the effect of stairway location and
stairway design on use and physical activity levels. For example, research is
now being launched to examine how “skip-stop” elevators2—that stop every
fourth floor—might influence physical activity levels of office building
18 Environment and Behavior
occupants (Zimring, Kohl, Fuller, & Dogan, 2006). Studies conducted at the
Centers for Disease Control (CDC) documented that color, painting, and
music can increase stair usage (Kerr, Yore, Ham, & Dietz, 2004). Moreover,
several studies have documented the efficacy of motivational signs, banners,
and point-of-decision prompts to encourage stair use (Kerr, Eves, Carroll,
2000, 2001; Webb & Eves, 2005). For example, Anderson, Frankowiak,
Snyder, Bartlett, and Fontaine (1998) observed more than 17,000 shoppers in
a mall and found that health and weight-control signs placed beside escala-
tors with adjacent stairs were effective in increasing stair use rates.
Relatively little is known about how specific stairway design features
might encourage stair use. Researchers have only begun to examine this
question (Nicoll, Zimring, & Peponis, 2006). For example, further research
is needed to determine how stairway width, steepness, or other design char-
acteristics influence stairway usage. Such studies might focus on specific
user groups. What stairway characteristics are most likely to promote stair
use among young children, among adolescents, and among elders, for
example? If possible, such inquiries might include longitudinal data and
adopt a life course perspective (Gotlib & Wheaton, 1997; Wethington,
2005). For example, if design elements can encourage the development of
healthy habits such as using the stairs in early childhood, to what extent do
the habits have “staying power” as children grow and move on to other
physical settings?
In addition to building design and stairway design, little is known about
the effects of site design on physical activity (Zimring et al., 2005). On this
larger scale, corporations such as telecom giant Sprint are now beginning to
create corporate campuses with the goal of promoting physical activity
(Kay, 2004; Sparling, 2005). Such campus designs include intentionally
significant distances between the parking areas and offices, longer treks
between buildings, and greater distances to centralized conference and
cafeteria facilities, as well as recreational walking trails. Follow-up research
is necessary to examine the efficacy of such design efforts. Preliminary
research suggests that the amount of utilitarian walking to destinations was
increased due to the strategy of separating locales; however, recreational
walking was not greater (Yao, 2005).
Neighborhoods and Urban Design
The physical layout of the residential environment has evolved toward a
pattern of low-density sprawl, separation of land uses due to zoning, and
Wells et al. / Environment, Design, and Obesity 19
settings designed for and dominated by the automobile. The irony is that
although much of urban planning policy is rooted in a concern for public
health (Frank, Engelke, & Schmid, 2003), the ultimate result has contributed
to major contemporary health problems—inactivity and obesity. Neighbor-
hood design and urban or regional design have been posited to influence
physical activity, diet, obesity (Ewing et al., 2003; Lopez, 2004), and health
(Ewing et al., 2003). Because these connections have received more research
attention than other environment—obesity linkages and are also addressed by
articles in this special issue (Brown, Werner, Amburgey & Szalay, 2007 [this
issue]; Joseph & Zimring, 2007 [this issue]), we discuss the neighborhood
and urban planning theme relatively briefly. For reviews, see Alfonzo (2005),
Humpel et al. (2002), and Saelens et al. (2003).
One promising avenue for further collaborations between environmental
psychologists and urban planners involves the use of simulation studies
(Marans & Stokols, 1993). Simulations using still photographs, computer
animations, or virtual reality laboratories would allow researchers to more
clearly examine individual neighborhood or streetscape variables such
as the presence and character of benches, views, trees, and storefronts. By
helping to isolate the role of individual environmental features, this kind of
research would help to address the challenge of “spatial covariance”—the
fact that various environmental features (such as mixed use, gridded street
networks, etc.) tend to co-occur (analogous to multicollinearity in statis-
tics). Simulation studies offer a valuable complement to “real-world” stud-
ies that are stronger in external validity.
The Natural Environment
From William Penn’s plan for Philadelphia to the Olmsted-Vaux design for
Central Park, promoting public health has been a guiding tenet of landscape
design. It is somewhat surprising to note that, until recently, this tenet has been
largely overlooked in the discussion of strategies for combating obesity.
However, studies have begun to examine linkages between the natural envi-
ronment and obesity, overweight, and physical activity. The evidence suggests
that nature may provide an important support for physical activity. For
example, a study conducted in Japan among senior citizens found that having
space for taking a stroll and the presence of parks and tree-lined streets near
the residence were significant predictors of survival in a follow-up 5 years
later (Takano, Nakamura, & Watanabe, 2002). Although this study did not
include an examination of mediating variables that would clearly explain the
20 Environment and Behavior
mechanisms connecting these two residential characteristics to longevity, use
of the space and increased physical activity levels are likely candidates.
Another study of older adults documents that longer visits to a park were asso-
ciated with lower blood pressure than shorter visits (Mowen, 2003).
The notion that natural areas encourage physical activity is supported by
evidence that people with easy access to natural areas are more likely to use
the spaces (Coley, Kuo, & Sullivan, 1997; Giles-Corti et al., 2005; Troped
et al., 2001). In a study of nearly 7,000 adults living in European cities, res-
idents of areas with the highest levels of greenery were 3 times as likely to
be physically active and 40% less likely to be overweight or obese, than
those living in the least green setting (Ellaway, Macintyre, & Bonnefoy,
2005). Similarly Giles-Corti et al. (2005) found that people who use public
open spaces are 3 times more likely to achieve recommended levels of
physical activity than those who do not use the spaces.
Gaining a clearer understanding of the role of parks, greenways, and open
spaces in physical activity levels and obesity rates is particularly critical to
our efforts to address these issues among vulnerable populations such as
people living in poverty, women, and ethnic minorities. Within cities, low-
income families typically have less access to natural areas. For example, in
New York City, poor families live in neighborhoods with less than one half
the park space (17 square yards/child) as nonpoor families (40 square yards/
child; Sherman, 1994). A similar association has been documented in rural
New York State, where children from low-income families were found to
have less access to nearby nature than children from higher SES families
(Wells & Evans, 2003); and a similar pattern was found among professional
versus manual laborers in the United Kingdom (Townsend, 1979). Further
research is needed to clearly identify specific park and natural environment
features that will encourage people to visit and use natural areas and to
engage in physical activity (Bedimo-Rung, Mowen, & Cohen, 2005), with
particular attention to tailoring environments to engage diverse vulnerable
groups. Research suggests that providing individuals with greater access to
green space may help to increase activity levels but does not guarantee
greater activity. Residents in low SES areas of Perth, Australia, had good
access to recreation facilities, in some cases better access than high SES res-
idents, and yet, were less likely to use them than were high SES residents
(Giles-Corti & Donovan, 2002). Consequently, on a more microscale, further
research is needed on the specific design elements of parks and streetscapes
that will make the outdoor spaces more likely to meet the needs and prefer-
ences of specific subpopulations.
Wells et al. / Environment, Design, and Obesity 21
Further research might examine how the configuration of green space
influences use and physical activity. It has been suggested that green infra-
structure—including parks, trails, and greenways—needs to provide connec-
tivity between destinations, enabling people to integrate physical activity
more easily into daily routines (Killingsworth, James, & Morris, 2003). One
element in such an infrastructure is multiuse recreational trails including rail-
to-trail conversions and other greenways. As of April 2005, rail-to-trail con-
versions totaled more than 12,000 miles (Rails-to-Trails Conservancy, 2005).
However, given that these routes were originally designed for trains, envi-
ronmental psychologists could help identify the features most likely to
encourage active use by cyclists and pedestrians.
Similarly, environment-behavior researchers might collaborate with
landscape architects to test the efficacy of creative landscape features to
help draw people to the outdoors. Design might help to make sedentary
activities like chess active (Figure 4). Other strategies to draw people out-
doors and promote activity include interactive gardens and sculptures, and
“play equipment” suitable for people of various ages. The design of these
gardens and structures might be informed by interdisciplinary research
pairing environmental psychologists with landscape architects, industrial
designers, and developmental psychologists to test the appeal and efficacy
of various design options.
In addition, research concerning the design of parks and natural areas
to encourage children and adults alike to get outdoors and spend time in
nature is a clear opportunity to apply theory related to environmental pref-
erence (Kaplan & Kaplan, 1982; Kaplan, Kaplan, & Ryan, 1998). Kaplan
and Kaplan (1982) proposed that people tend to prefer environments that
provide an opportunity for involvement through mystery and the chance to
“make sense” through legibility. The application of this theory to the design
of parks, greenways, and other natural areas could be further tested, partic-
ularly with members of a vulnerable “target group.” This would be an apt
response to the suggestion from urban planners that aesthetic improvements
will increase park visitation and pedestrian activity (Addy et al., 2004;
Handy, Boarnet, Ewing, & Killingsworth, 2002; Pikora, Giles-Corti, Bull,
Jamrozik, & Donovan, 2003).
Across a wide range of environments, numerous interdisciplinary
research opportunities exist for environment-behavior researchers to exam-
ine barriers or supports for healthy eating and physical activity. In addition
to topics for future research directions, it is also important to consider con-
ceptual and methodological issues relevant to such undertakings.
22 Environment and Behavior
Conceptual and Methodological Considerations
Finally, we turn briefly to some conceptual and methodological considera-
tions that may enhance the research endeavors of environment-behavior schol-
ars seeking to partner with those in other disciplines to examine environmental
influences on obesity. We address three specific issues: the importance of lon-
gitudinal research, the value of examining mediating mechanisms, and the rel-
evance of incorporating moderators in research design.
Longitudinal Research
An important theme throughout the environment—obesity research is
the need to establish causality. Whether we are interested in the relation
between clothing design and physical activity or vegetable availability and
diet, establishing causal relationships is an important goal because it pro-
vides a foundation for more confident policy and practice recommenda-
tions. However, an overwhelming majority of studies are cross-sectional in
Figure 4
Large-Scale Chess: The Transformation of Sedentary Indoor
Activities into Active, Outdoor Activities
Wells et al. / Environment, Design, and Obesity 23
nature. Cross-sectional studies are a practical, valuable, and appropriate start-
ing point. They suggest relations among correlates or covariates and often
lead to causal hypotheses (Bauman, Sallis, Dzewaltowski, & Owen, 2002).
Ultimately, however, longitudinal studies are necessary to establish causality.
Several authors have recognized the dearth of longitudinal or pretest–posttest
intervention studies (particularly with respect to the built environment and
physical activity) and have called for more work in this direction (Handy
et al., 2002; A. C. King, Bauman, & Abrams, 2002; Sallis, Bauman, & Pratt,
1998). Very few studies have employed longitudinal designs to examine
changes in either physical activity (e.g., Krizek, 2000) or diet (e.g., Wrigley
et al., 2003). Unlike cross-sectional research, longitudinal or multiwave stud-
ies allow for within-subjects comparisons whereby individuals serve as their
own controls. Because the study sample is the same throughout the investi-
gation, threats to internal validity due to between-groups differences (e.g., in
ethnicity, SES, or propensity to be physical active or eat healthfully) are
greatly reduced.
One opportunity for longitudinal research is provided by “natural exper-
iments” whereby some environmental or policy change allows for data
collection prior to and following a change. Opportunities for natural exper-
iment research related to physical activity and diet include the construction
(or demolition) of a grocery store, the opening of a vegetable stand or farm-
ers’ market, a new policy making the high school gym available to com-
munity members in the evening, a community tree-planting campaign, the
launching of a community gardening program, the widening (or narrowing)
of a street, the incorporation of “traffic-calming” measures such as cross-
walks and speed bumps, and the relocation of individuals or families from
one neighborhood to another. These are just a few examples of natural
experiment opportunities to examine the causal effects of an environmental
intervention. Longitudinal studies are time intensive and demanding;
however, the clarity they can provide regarding causality makes them a
worthy goal.
Mediating Mechanisms
A mediator explains how or why an independent variable affects a depen-
dent variable, as shown in Figure 5. Mediators provide insight regarding the
mechanism or process underlying a relationship between variables (Baron &
Kenny, 1986). For example, physical characteristics of a neighborhood may
lead to neighborhood perceptions such as sense of community, which in turn
influence physical activity participation (e.g., walking). Similarly, food envi-
ronment characteristics may influence food-purchasing attitudes and behaviors
24 Environment and Behavior
that in turn affect diet. Thus, mediators operate as dependent variables (affected
by neighborhood design, for example) and independent variables (influencing
physical activity, for example).
One potential mediator familiar to environment-behavior research is
attention restoration (Kaplan, 1995). For example, the natural characteris-
tics of a neighborhood or street such as trees and vegetation are likely to be
associated with residents who are more cognitively restored and have
greater cognitive clarity, even if primarily due to a natural view from their
windows (Tennessen & Cimprich, 1995). With enhanced attentional capac-
ity, people may be more likely to venture out for a walk. In this case, cog-
nitive restoration would mediate (explain) the relationship between nearby
nature and physical activity.
By providing insight regarding the pathway or mechanism underlying
relations among variables, mediating variables are valuable to theory and
practice. From a theoretical standpoint, it is critical to understand how or
why variables are related. This allows for a clearer conceptualization of the
behavior being studied. From a practical standpoint, the identification of
mediators provides greater insight regarding the potential leverage points
(Booth et al., 2001) for intervention or policy change. Achieving a greater
understanding of the pathways and leverage points through which the envi-
ronment might influence physical activity and diet will bring us one step
closer to an active, healthy population (Stokols, 1996).
Moderators
Another important direction for research among environmental psycho-
logists interested in issues related to obesity is to examine more fully the
Figure 5
Mediators Address “How” or “Why” Questions by Elucidating the
Process or Mechanism Through Which an Independent Variable
Affects a Dependent Variable
Independent
Variable e.g.,
clothing…
food environment…
neighborhoods, etc.
Mediator
Why? How?
e.g., territorial
range, nutritional
knowledge,
sense of community
Dependent
Variable
e.g., physical activity +
dietary intake
Wells et al. / Environment, Design, and Obesity 25
circumstances under which relationships exist between the environment and
physical activity or dietary habits. Moderators (or “effect modifiers”) affect the
relationship between an independent variable (e.g., proximity to a farmers’
market) and a dependent variable (e.g., vegetable consumption). Moderators
address questions such as “for whom,” “when,” or “under what circum-
stances” (Baron & Kenny, 1986), as illustrated in Figure 6. A study examining
changes in fruit and vegetable consumption before and after the construction
of a new grocery store illustrates the notion of a moderator. Wrigley et al.
(2003) found that although on an aggregate level there was no significant
increase in daily fruit and vegetable consumption among people living near
the new store, among people with the poorest diet, there was a 60% increase—
from 1.31 to 1.75 servings for fruits and vegetables per day. In this example,
the moderator answers the question “for whom” is there an effect.
More generally, moderators address “it depends” types of relations; the
effect of A on B depends on the level or category of a third variable, the
moderator. The association between the independent variable and the depen-
dent variable may depend on factors such as characteristics of people in the
sample, where the sites are located, or when the data are collected. Moderators
“interact” with an independent variable—that is, an interaction effect.
With respect to environment—physical activity and environment—diet
research, there is a need to know what kinds of design or environmental
intervention strategies are effective for whom, under what conditions. For
example, might proximity to a park or natural area only encourage physical
activity among people of a certain age, ethnicity, or marital status? Perhaps
proximity to a park influences park use only among children of a certain
Figure 6
Moderators Are Involved When the Nature or the Direction of the
Relation Between an Independent Variable and a Dependent Variable
“Depends” on a Third Variable (the Moderator)
Moderators
For whom? When?
Under what circumstances?
e.g., age, gender, weather /
season, health habits +
history, etc.
Independent
Variable
e.g., clothing…
food environment…
neighborhoods, etc.
Dependent Variable
e.g., physical activity +
dietary intake
26 Environment and Behavior
age (who are old enough that they are allowed to cross the intervening
streets on their own). Might the effects of portion size or plate size vary
according to age or SES? Affecting change and improving population
health is unlikely to have a “one-size-fits-all” solution. For this reason, it is
critical to strive toward a more nuanced understanding of the efficacy of
environmental variables. Important moderator variables include demo-
graphic characteristics (e.g., age, ethnicity, marital status, employment
status), health history (e.g., history of major illness) and family context.
One of the particular merits of incorporating moderators into one’s
research design is the opportunity to consider how the effect of environmen-
tal features on the physical activity or diet might differ for various at-risk
members of our society. We know that the occurrence of obesity, as well as
rates of physical activity and poor diet, is not randomly distributed through-
out the population (W. C. Taylor, Poston, Jones, & Kraft, 2006). The pre-
valence of obesity is higher in non-Hispanic Black women than it is in
non-Hispanic White women, for example (Flegal, Carroll, Ogden, &
Johnson, 2002). Rising rates of obesity or overweight among children is par-
ticularly a concern (Ogden, Flegal, Carroll, & Johnson, 2002). Moreover,
people of lower SES and low education are more vulnerable to overweight
and obesity (Drewnowski & Specter, 2004). Researchers might examine how
factors such as race, age, SES, or gender moderate the relations between the
streetscape characteristics and walking or grocery store layout and dietary
intake. Streetscape features are unlikely to influence the activity of a teenage
male the same way they affect those of an elderly woman, for instance.
Conceptualizing and testing for moderator effects can contribute to our
understanding of environmental influences on the healthy habits of vulnera-
ble populations and provide data to allow for appropriate tailoring of inter-
ventions—such as sidewalk modifications, grocery store construction, or
provision of nutritional information—to best match a given target audience,
setting, or circumstance.
Conclusion
This article presents a variety of potential connections between the envi-
ronment and physical activity or diet. These linkages offer vast opportuni-
ties for environmental psychology research. Environmental psychologists
might collaborate with researchers in fields such as apparel design, engi-
neering, industrial design, nutrition, interior design, architecture, urban
Wells et al. / Environment, Design, and Obesity 27
planning, horticulture, and landscape design. Researchers in the area of
environment-behavior studies are well poised to help identify barriers and
supports related to healthy diet and physical activity. Through creative,
interdisciplinary collaboration and thoughtful research design, the field of
environmental psychology can make substantial contributions toward a
healthier population.
Notes
1. We use the term environmental supports (Addy et al., 2004; Brownson, Baker,
Housemann, Brennan, & Bacak, 2001; Kirtland, Porter, Addy, & Neet, 2003). Others have
used affordances—perceived environmental factors (Alfonzo, 2005), and facilitators (Sallis &
Owen, 2002; Sallis, et al., 1998).
2. Skip-stop elevators have a somewhat notorious association with Pruitt Igoe, the St.
Louis public housing complex that was ultimately demolished (Yancey, 1971).
References
Addy, C. L., Wilson, D. K., Kirtland, K. A., Ainsworth, B. E., Sharpe, P., & Kinsey, D. (2004).
Association of perceived social and physical environmental supports with physical activ-
ity and walking behavior. American Journal of Public Health, 94(3), 440-443.
Alfonzo, M. A. (2005). To walk or not to walk? The hierarchy of walking needs. Environment
and Behavior, 37(6), 808-836.
Anderson, R. E., Frankowiak, S. C., Snyder, J., Bartlett, S., & Fontaine, K. R. (1998). Can
inexpensive signs encourage the use of stairs? Results from a community intervention.
Annals of Internal Medicine, 129(5), 363-369.
Apple Computer. (2006). Tune your run. Retrieved October 5, 2006, from www.apple.com/
ipod/nike/
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social
psychological research: Conceptual, strategic, and statistical considerations. Journal of
Personality and Social Psychology, 51(6), 1173-1182.
Bassett, D. R., Schneider, P. L., & Huntington, G. E. (2004). Physical activity in an old order
Amish community. Medicine and Science in Sports and Exercise, 36(1), 79-85.
Bauman, A. E., Sallis, J. F., Dzewaltowski, D. A., & Owen, N. (2002). Toward a better under-
standing of the influences on physical activity: The role of determinants, correlates, causal
variables, mediators, moderators, and confounders. American Journal of Preventive Medicine,
23(2S), 5-14.
Bedimo-Rung, A. L., Mowen, A. J., & Cohen, D. A. (2005). Significance of parks to physical
activity and public health: A conceptual model. American Journal of Preventive Medicine,
28(2S2), 159-168.
Booth, S. L., Sallis, J. F., Ritenbaugh, C., Hill, J. O., Birch, L. L., Frank, L. D., et al. (2001).
Environmental and societal factors affect food choice and physical activity: rationale,
influences, and leverage points. Nutrition Reviews, 59(3), S21–S39.
28 Environment and Behavior
Brown, B. B., Werner, C. M., Amburgey, J. W., & Szalay, C. (2007). Walkable route percep-
tions and physical features: Converging evidence for enroute walking experiences.
Environment and Behavior, 39(1), 34-62.
Brownson, R. C., Baker, E. A., Housemann, R. A., Brennan, L. K., & Bacak, S. J. (2001).
Environmental and policy determinants of physical activity in the United States. American
Journal of Public Health, 91(12), 1995-2003.
Cheadle, A., Psaty, B. M., Curry, S., Wagner, E., Diehr, P., Koepsell, T., et al. (1991).
Community-level comparisons between the grocery store environment and individual
dietary practices. Preventive Medicine,20(2), 250-261.
Child, G. B., & Boynton, L. (1914). The efficient kitchen: Definite directions for the planning,
arranging and equipping of the modern labor-saving kitchen—A practical book for the
homemaker. New York: McBride, Nast & Company.
Coley, R. L., Kuo, F. E., & Sullivan, W. C. (1997). Where does community grow? The social
context created by nature in public housing. Environment and Behavior, 29(4), 468-494.
Corral-Verdugo, V., Frias-Armentia, M., Perez-Urias, F., Orduna-Cabrera, V., & Espinoza-
Gallego, N. (2002). Residential water consumption, motivation for conserving water and the
continuing tragedy of the commons. Environmental Management, 30(4), 527-535.
Coulton, C. J., Korbin, J., Chan, T., & Su, M. (2001). Mapping residents’ perceptions of neigh-
borhood boundaries: A methodological note. American Journal of Community Psychology,
29(2), 371-383.
Cook, S. W., & Berrenberg, J. L. (1981). Approaches to encouraging conservation behavior:
A review and conceptual framework. Journal of Social Issues, 37(2), 73–107.
De Young, R. (1986). Some psychological aspects of recycling: The structure of conservation
satisfactions. Environment and Behavior, 18(4), 435-449.
De Young, R. (1996). Some psychological aspects of a reduced consumption lifestyle: The role
of intrinsic satisfaction and competence. Environment and Behavior, 28(3), 358-409.
De Young, R. (2000). Expanding and evaluating motives for environmentally responsible
behavior. Journal of Social Issues, 56(3), 509-526.
Drewnowski, A., & Specter, S. E. (2004). Poverty and obesity: The role of energy density and
energy costs. American Journal of Clinical Nutrition, 79(1), 6-16.
Duggan, A. (1988). Energy cost of stepping in protective clothing ensembles. Ergonomics,
31(1), 3-11.
Edmonds, J., Baranowski, T., Baranowski, J., Cullen, K. W., & Myres, D. (2001). Ecological
and socioeconomic correlates of fruit, juice, and vegetable consumption among African-
American boys. Preventive Medicine, 32(6), 476-481.
Ellaway, A., Macintyre, S., & Bonnefoy, X. (2005). Graffiti, greenery, and obesity in adults:
Secondary analysis of European cross sectional survey. British Medical Journal, 331(7517),
611-612.
Ewing, R., Schmid, T., Killingsworth, R., Zlot, A., & Raudenbush, S. (2003). Relationship
between urban sprawl and physical activity, obesity, and morbidity. American Journal of
Health Promotion, 18(1), 47-57.
Flegal, K. M., Carroll, M. D., Ogden, C. L., & Johnson, C. L. (2002). Prevalence and trends
in obesity among U.S. adults, 1999-2000. Journal of the American Medical Association,
288(14), 1723-1727.
Frank, L. D., Engelke, P. O., & Schmid, T. L. (2003). Health and community design: The
impact of the built environment on physical activity. Washington, DC: Island Press.
French, S. A., Story, M., & Jeffery, R. W. (2001). Environmental influences on eating and
physical activity. Annual Review of Public Health, 22, 309-335.
Wells et al. / Environment, Design, and Obesity 29
Giles-Corti, B., Broomhall, M. H., Knuiman, M., Collins, C., Douglas, K., Ng, K., et al.
(2005). Increasing walking: How important is distance to, attractiveness, and size of public
open space? American Journal of Preventive Medicine,28(2S2), 169-176.
Giles-Corti, B., & Donovan, R. J. (2002). Socioeconomic status differences in recreational
physical activity levels and real and perceived access to a supportive physical environment.
Preventive Medicine,35(6), 601-611.
Gotlib, I. H., & Wheaton, B. (Eds.). (1997). Stress and adversity over the life course.
Cambridge, UK: Cambridge University Press.
Handy, S. L., Boarnet, M. G., Ewing, R., & Killingsworth, R. E. (2002). How the built envi-
ronment affects physical views from urban planning. American Journal of Preventive
Medicine, 23(2S), 64-73.
Hedge, A. (2005, June 5-7). Work and workstation design and obesity risks. Paper presented at
Ecology of Obesity Conference, College of Human Ecology, Cornell University, Ithaca, NY.
Hill, J. O., & Peters, J. C. (1998). Environmental contributions to the obesity epidemic.
Science, 280(5368), 1371-1374.
Humpel, N., Owen, N., & Leslie, E. (2002). Environmental factors associated with adults’ partici-
pation in physical activity: A review. American Journal of Preventive Medicine,22(3), 188-199.
Joseph, A., & Zimring, C. (2007). Where active older adults walk: Understanding the factors
related to path choice for walking among active retirement community residents. Environment
and Behavior, 39(1), 75-105.
Kaplan, S. (1995). The restorative benefits of nature: Toward an integrative framework.
Journal of Environmental Psychology, 15, 169–182.
Kaplan, S. (2000). Human nature and environmentally responsible behavior. Journal of Social
Issues, 56(3), 491-508.
Kaplan, S., & Kaplan, R. (1982). Cognition and environment: Functioning in an uncertain
world. Ann Arbor, MI: Ulrich’s.
Kaplan, R., Kaplan, S., & Ryan, R. (1998). With people in mind: Design and management of
everyday nature. Washington, DC: Island Press.
Kay, K. (2004, March 27). Architects join fight against flab. BBC News. Available at
http://news.bbc.co.uk/2/hi/americas/3575159.stm
Kerr, J., Eves, F., & Carroll, D. (2000). Posters can prompt less active people to use the stairs.
Journal of Epidemiology and Community Health,54(12), 942-943.
Kerr, J., Eves, F., & Carroll, D. (2001). Encouraging stair use: Stair-riser banners are better
than posters. American Journal of Public Health, 91(8), 1192–1193.
Kerr, N. A., Yore, M. M., Ham, S. A., & Dietz, W. H. (2004). Increasing stair use in a worksite
through environmental changes. American Journal of Health Promotion,18(4), 312–315.
Killingsworth, R., James, K., & Morris, H. (2003). Promoting active living. Parks and Recreation,
38(3), 48-53.
King, A. C., Bauman, A., & Abrams, D. B. (2002). Forging transdisciplinary bridges to meet
the physical inactivity challenge in the 21st century. American Journal of Preventive
Medicine, 23(2S), 104-106.
Kirtland, K. A., Porter, D. E., Addy, C. L., & Neet, M. J. (2003). Environmental measures of
physical activity supports: Perceptions versus reality. American Journal of Preventive
Medicine, 24(4), 323-331.
Krizek, K. J. (2000). Pretest-posttest strategy for researching neighborhood scale urban form
and travel behavior. Transportation Research Record, 1722, 48-55.
30 Environment and Behavior
Levitsky, D. A., Garay, J., Nausbaum, M., Neighbors, L., & DellaValle, D. M. (2006).
Monitoring weight daily blocks the freshman weight gain: A model for combating the epi-
demic of obesity. International Journal of Obesity, 30(6), 1003-1010.
Lopez, R. (2004). Urban sprawl and risk for being overweight or obese. American Journal of
Public Health,94(9), 1574-1579.
Lyman Clarke, L., & Wells, N. M. (2005, June 5-7). Action clothing: Using clothing to inspire
physical activity for children. Paper presented at The Ecology of Obesity, College of
Human Ecology Conference, Cornell University, Ithaca, NY.
Lynch, J. (1960). Image of the city. Cambridge, MA: MIT Press.
MacDonald, J. V. (2005). High fit home: Designing your home for health and fitness. New
York: HarperCollins.
Marans, R. W., & Stokols, D. (1993). Environmental simulation: Research and policy issues.
New York: Plenum.
Morland, K., Wing, S., Diez Roux, A. D., & Poole, C. (2002). Neighborhood characteristics
associated with the location of food stores and food service places. American Journal of
Preventive Medicine, 22(1), 23-29.
Mowen, A. (2003). Community efforts, community health. Parks and Recreation, 38(5), 36-39.
National Heart, Lung, and Blood Institute. (2004). Predictors of obesity, weight gain, diet, and
physical activity workshop, Bethesda, MD, August 4-5, 2004. An ecological model of diet,
physical activity, and obesity. Available from http://www.nhlbi.nih.gov/meetings/workshops/
predictors/abstracts/fig1.gif
Newman, C. (2004). Why are we so fat? National Geographic,206(2), 46-62.
Nicoll, G., Zimring, C., & Peponis, J. (2006). Environmental factors for promoting the
voluntary use of stairs [Abstract]. Robert Wood Johnson Foundation, Active Living
Research Program. Retrieved April 5, 2006, from www.activelivingresearch.org/downloads/
nicollabstract.pdf
Ogden, C. L., Flegal, K. M., Carroll, M. D., & Johnson, C. L. (2002). Prevalence and trends
in overweight among U.S. children and adolescents, 1999-2000. Journal of the American
Medical Association, 288(14), 1728-1732.
Paffenbarger, R. S., Jr., Hyde, R. T., Wing, A. L., & Hsieh, C. C. (1986). Physical activity, all-
cause mortality, and longevity of college alumni. New England Journal of Medicine,
314(10), 605-613.
Parnell, R., & Larsen, O. P. (2005). Informing the development of domestic energy efficiency
initiatives an everyday: Householder-centered framework. Environment and Behavior,
37(66), 787-807.
Pikora, T., Giles-Corti, B., Bull, F., Jamrozik, K., & Donovan, R. (2003). Developing a frame-
work for assessment of the environmental determinants of walking and cycling. Social
Science and Medicine, 56(8), 1693-1703.
Rails-to-Trails Conservancy. (2005). Retrieved September 16, 2006, from www.railtrail.org
Rolls, B. J. (2003). Supersizing of America: Portion size and the obesity epidemic. Nutrition
Today,38(2), 42-53.
Rolls, B. J., Morris, E. L., & Roe, L. S. (2002). Portion size of food affects energy intake in
normal-weight and overweight men and women. American Journal of Clinical Nutrition,
76(6), 1207-1213.
Rose, D., & Richards, R. (2004). Food store access and household fruit and vegetable
use among participants in the US Food Stamp Program. Public Health Nutrition,7(8),
1081-1088.
Wells et al. / Environment, Design, and Obesity 31
Saelens, B. E., Sallis, J. F., & Frank, L. D. (2003). Environmental correlates of walking and
cycling: Findings from the transportation, urban design, and planning literatures. Annals
of Behavioral Medicine, 25(2), 80-91.
Sallis, J. F., Bauman, A., & Pratt, M. (1998). Environmental and policy interventions to pro-
mote physical activity. American Journal of Preventive Medicine, 15(4), 379-397.
Sallis, J. F., Nader, P. R., Rupp, J. W.,Atkins, C. J., & Wilson, W. C. (1986). San Diego surveyed
for heart-healthy foods and exercise facilities. Public Health Reports,101(2), 216-219.
Sallis, J. F., & Owen, N. (2002). Ecological models of health behavior. In K. Glanz, B. K.
Rimer, & F. M. Lewis (Eds.), Health behavior and health education (3rd ed., pp. 462-484).
New York: John Wiley.
Seligman, C., & Darley, J. M. (1977). Feedback as a means of decreasing residential energy
consumption. Journal of Applied Psychology, 62(4), 363-368.
Sherman, A. (1994). Wasting America’s future: The Children’s Defense Fund report on the
cost of child poverty. Boston: Beacon.
Sobal, J. (2001). Social and cultural influences on obesity. In P. Björntorp (Ed.), International
textbook of obesity (pp. 301-318). New York: John Wiley.
Solaz, J. S., Belds-Lois, J. M., Garcia, A. C., Barbera, R., Dura, J. V., Gomez, J. A., et al.
(2006). Intelligent textiles for medical and monitoring applications. In H. Mattila (Ed.).
Intelligent textiles and clothing (pp. 369-398). Cambridge, UK: Woodhead Publishing.
Sparling, P. B. (2005, March 25). The walkable campus. Chronicle of Higher Education
(Special Supplement: Campus Architecture), p. B31.
Stokols, D. (1996). Translating social ecological theory into guidelines for health promotion.
American Journal of Health Promotion,10(4), 282-298.
Takano, T., Nakamura, K., & Watanabe, M. (2002). Urban residential environments and senior
citizens’ longevity in megacity areas: The importance of walkable green spaces. Journal of
Epidemiology and Community Health,56(12), 913-918.
Tao, X. M. (2005). Wearable electronics and photonics. Cambridge, UK: Woodhead
Publishing.
Taylor, R. B. (1988). Human territorial functioning: An empirical, evolutionary perspective
on individual and small group territorial cognitions, behaviors, and consequences. New
York: Cambridge University Press.
Taylor, W. C., Poston, W. S. C., Jones, L., & Kraft, K. M. (2006). Environmental justice: obe-
sity, physical activity and healthy eating. Journal of Physical Activity, 3(1), S30-S54.
Teitlebaum, A., & Goldman, R. F. (1972). Increased energy costs with multiple clothing lay-
ers. Journal of Applied Physiology, 32(6), 743–744.
Tennessen, C. M., & Cimprich, B. (1995). Views to nature: Effects on attention. Journal of
Environmental Psychology, 15, 77-85.
Townsend, P. (1979). Poverty in the United Kingdom. Berkeley: University of California Press.
Troped, P. J., Saunders, R. P., Pate, R. R., Reininger, B., Ureda, J. R., & Thompson, S. J.
(2001). Associations between self-reported and objective physical environment factors and
use of a community rail-trail. Preventive Medicine,32(2), 191-200.
Van Rensselaer, M. (1901). Saving steps (Cornell Reading Course for Farmers’ Wives,
Supplement No. 1). Ithaca, NY: Cornell University, College of Agriculture.
Wansink, B. (2004). Environmental factors that unknowingly increase food intake and con-
sumption volume of unknowing consumers. Annual Review of Nutrition, 24, 455-479.
Wansink, B., Painter, J. E., & North, J. (2005). Bottomless bowls: Why visual cues of portion
size may influence intake. Obesity Research, 13(1), 93-100.
32 Environment and Behavior
Webb, O. J., & Eves, F. F. (2005). Promoting stair use: Single versus multiple stair-riser mes-
sages. American Journal of Public Health, 95(9), 1543-1544.
Wells, N. M., & Ashdown, S. P. (2005, June 6-7). Environment, design and obesity: from micro to
macro. Paper presented at the Ecology of Obesity: Linking Science to Action Conference,
Ithaca, NY.
Wells, N. M., & Evans, G. W. (2003). Nearby nature: A buffer of life stress among rural
children. Environment and Behavior, 35(3), 311-330.
Werner, C. M., & Adams, D. (2001). Changing homeowners’behaviors involving toxic house-
hold chemicals: A psychological, multilevel approach. Analyses of Social Issues and
Public Policy, 1(1), 1-32.
Wethington, E. (2005). An overview of the life course perspective: Implications for health and
nutrition. Journal of Nutrition Education and Behavior, 37(3), 115-120.
Wrigley, N., Warm, D., & Margetts, B. (2003). Deprivation, diet and food retail access: Findings
from the Leeds “food deserts” study. Environment and Planning A, 35(1), 151-188.
Yancey, W. L. (1971). Architecture, interaction, and social control: The case of a large-scale
public housing project. Environment and Behavior, 3(1), 3-21.
Yao, Y. (2005). The effects of physical environment on walking at a corporate campus.
Unpublished master’s thesis, Cornell University, Ithaca, NY.
Young, L. R., & Nestle, M. (2002). Contribution of expanding portion sizes to the US obesity
epidemic. American Journal of Public Health,92(2), 246-249.
Zeisel, J. (1984). Inquiry by design: Tools for environment-behavior research. New York:
Cambridge University Press.
Zimring, C., Joseph, A., Nicoll, G. L., & Tsepas, S. (2005). Influences of building design
and site design on physical activity: Research and intervention opportunities. American
Journal of Preventive Medicine, 28(2S2), 186-193.
Zimring, C., Kohl, H., Fuller, C., & Dogan, F. (2005). Increasing physical activity through
innovative stair design: Evaluating skip-stop elevators combined with spacious stairs.
Robert Wood Johnson Foundation, Active Living Research Program. Retrieved October 5,
2006, from www.activelivingresearch.org/downloads/zimringabstract.pdf
Nancy M. Wells is an assistant professor in the Department of Design and Environmental
Analysis at Cornell University. She is an environmental psychologist interested in the impact
of the built and natural environment on human well-being through the life course. Her work
focuses on housing quality and mental health, the impact of nearby nature on health and well-
being, and the relationship between neighborhood design and physical activity.
Susan P. Ashdown is a professor in the Department of Textiles and Apparel and the Helen G.
Canoyer Professor of Human Ecology at Cornell University. Her research is in functional apparel
design, anthropometrics for design, the sizing and fit of apparel, the perception of body size and
fit of clothing, and the development and use of the 3-D body scanner in the apparel industry.
Elizabeth H. S. Davies is an undergraduate in the Department of Policy Analysis and
Management at Cornell University. Her research focuses on the impact of environmental design
on mental health and physical activity. After graduation, she hopes to work in a field that incor-
porates environmental psychology, criminology, social policy, and community outreach.
F. D. Cowett is a doctoral student in the Horticulture Department at Cornell University where
he also received an MLA in landscape architecture. His research interests include visual pref-
erence for street tree characteristics and the role that the urban forest can play in promoting
healthy, walkable communities.
Yizhao Yang is an assistant professor in the Department of Planning, Public Policy and
Management at the University of Oregon. Her research focuses on social and environmental
aspects of physical planning, particularly issues related to good urban form pertaining to more
healthy, affordable, and sustainable environments.
Wells et al. / Environment, Design, and Obesity 33
