Downtown vibrancy influences public health and safety outcomes in urban counties

Aims: We explored the relationship between downtown vibrancy and county-level public health and safety outcomes in 48 large U.S. cities. Methods: We developed a composite vibrancy index for the downtown areas in our sample and used cross-sectional linear regression analysis to relate this index to seven public health and safety outcomes, measured for the county in which each downtown is located. We also constructed a series of regression models in which the vibrancy index was disaggregated into its individual components to explore various dimensions of accessibility and urban form. Results: Greater vibrancy was associated with lower prevalence of both physical inactivity and motor vehicle fatalities. Vibrancy was not significantly correlated with pedestrian or bicycle fatality risks or the prevalence of diabetes, obesity, or premature death. Individual measures of accessibility and connectivity had explanatory power comparable to the composite index for physical inactivity, and mixed land uses had comparable explanatory power for motor vehicle fatalities. Conclusions: Urban counties with more vibrant downtowns may have more favorable population-level health and safety outcomes. Both composite and individual measures of vibrancy offer useful insights when considering mobility-related health and safety outcomes. Investments in vibrant centers that improve walkability and accessibility may encourage active transportation.