Crossing the street while texting could cost you your life. If you live in Honolulu, even if you survive, thanks to legislation passed earlier this year, it could also land you a hefty fine.

The Hawaiian capital is not the only city trying to get us to look up from our phone. Hayward, California, introduced snarky signs in 2015, reminding us to “Cross the road, then update Facebook.” Singapore installed LED lights on the pavement at crossings to prevent accidents involving people who don’t look up from their phones. Antwerp in Belgium and Chongqing in China have text-walking lanes, and Mumbai and San Francisco have no-selfie zones, while Rexburg in Idaho banned pedestrians from using phones when crossing the street in 2011.

The increase of urban populations around the world is putting pressure on local governments to tackle the preventable health problems caused by air pollution and lifestyle, and some cities are stepping up to the challenge. In London, for example, TfL’s Planning for the Future is investing billions of pounds to develop the city’s transport and lower emissions. And almost 100 cities have joined the World Health Organisation’s European Healthy Cities Network, which aims to improve public health.

But traditional methods of improving a populations’ health – offering free cooking classes and handing out leaflets on how to stop smoking – aren’t enough any more. In these innovative times, cities are starting to play a more involved role in changing our behaviour. Public health researchers in California, for example, installed signs in San Diego International Airport, to encourage people to take the stairs instead of the escalator, which led to twice as many people opting for the former.

But Theresa M. Marteau, director of the behaviour & health research unit at the University of Cambridge, says that far more radical change is needed. “While information-based approaches to changing behaviour can raise awareness of a need for change,” she says, “they are generally, at best, weak interventions for achieving such change.


“There is no doubt that the design of cities and towns is key to population and planetary health. Re-designing these to reduce or remove the use of fossil-fuelled vehicles and increase walking and cycling is just one such change.”

Susan Claris, a transport planner with the consultancy Arup, agrees that cities need to adjust their infrastructure. “Buildings should be designed so that the stairs are the first thing you see and they are inviting to use.” At the moment, she notes, the lifts or escalator are often the first thing you see, “with the stairs hidden away behind closed doors”.

Such re-designs are important, because cities have the potential to reshape human behaviour. The Massachusetts Institute of Technology recently published a paper titled, “Persuasive Cities: Health Behavior Change at Scale”. It argued that, “according to social cognitive theory, any well-designed environment can become a strong influences of what people think and do”, concluding: “As cities continue to grow… the design of future urban places will become more dominant in impacting human behaviour.”

The key to this level of change lies not in brand new infrastructure, but in the use of technology, according to Arup’s Claris. “Thanks to new technologies, the physical city is changing,” she says. “With sensors and cloud computing, streets are becoming smarter and more interactive. The city can now monitor and analyse activity levels, actively advocate walking and cycling routes, as well as create a layer of play, fun and games onto the streetscape.”

All this, she says, is enabling cities to play a growing role in public health and wellbeing, “away from the traditional posters, leaflets and other traditional campaigns”. By combining better design and better incentives, cities can make sure that “the healthy choice is the fun, easy, convenient and attractive choice”.