A Mixed-Method Study on the Walkability of Streets in Hospital-Anchored Neighborhoods

The field of healthcare design is adopting planning and design principles from the Healthy Communities movement to connect hospitals to their adjacent communities. This research explores the impact of neighborhood and street design on the walkability of Hospital-Anchored Neighborhoods (HANs), a concept integrating hospitals and satellite services with their surrounding communities to enhance public health. Walkability, a crucial marker of healthy and vibrant communities, was investigated through a mixed-method study across three HANs. A comprehensive Walkability Framework with 17 built environment dimensions was developed from the literature to inform data collection utilizing GIS archival data, ethnographic observations, street audits, and interviews. Findings indicate that multiple factors influence walkability at the neighborhood, street, building, and experiential levels. The walkability scores differed from those provided by the Environmental Protection Agency’s National Walkability Index. 6 of the 7 street-level dimensions (compactness, mixed-uses, imageability, enclosure, human scale, and transparency of streets, but not complexity) were correlated with pedestrian counts. Out of 40 street features studied, 27 significantly influenced the number of pedestrians on the street. Active and inactive building uses also showed significant variance in pedestrian counts. Furthermore, pedestrian interviews highlighted convenience, comfort, and safety, not visual attraction, as key experiential factors influencing walkability. This research underscores the importance of built environment factors in creating walkable streets on health campuses. It advocates for including specific design features, active street life planning, pleasant outdoor experiences, and safety measures. This study presents a Street Walkability Framework and evidence-based design guidelines to improve walkability in Hospital-Anchored Neighborhoods