Healthy places, active transport and path dependence: a review of the literature.

Children walking to school, people cycling to the shops or work and neighbours chatting in the street, these are some of the gauges of an active and healthy community that can be achieved through utilising good design principles. But are these principles being applied in urban developments or are policy-makers following a 'path dependent' trajectory that severely limits the best practice outcomes sought? This review examines current research on path dependence to determine how this concept advances our understanding of barriers to change in the built environment, active transport and healthy communities. An online database search of scholarly bibliographic records identified 22 relevant articles for a critical review of studies that evaluated path dependence in the urban and built environment literature with a focus on transport, urban planning and health. A thematic analysis of the articles showed that different types of path dependence have contributed to the dominance of policies and designs supporting car-based transport to the detriment of public transport and active transport modes, leading to sub-optimal development patterns becoming 'locked-in'. However, the outcomes for active transport and physical activity are not all dire, and path dependence theory does provide some guidance on changing policy to achieve better outcomes. This review suggests that path dependence is one of the best theoretical frameworks to help health promoters understand barriers to change and can provide insights into developing future successful public health interventions. Future studies could focus further on active transport, local neighbourhood development and physical activity.