A few weeks ago, at the launch of World Heart Day 2026 at Korle Bu Teaching Hospital in Accra, the Director of the National Cardiothoracic Centre (NCC), Dr Kow Entsua-Mensah, made some pronouncements about “the growing threat of cardiovascular diseases,” which set a lot of Ghanaians on edge. Dr Entsua-Mensah cautioned that diabetes, high cholesterol, obesity, physical inactivity, unhealthy diets, tobacco use and harmful alcohol consumption could progressively damage the cardiovascular system long before an individual became aware of the danger. He said the fight against cardiovascular diseases required collaboration among the government, healthcare institutions, corporate organisations, schools, workplaces, faith-based organisations, civil society and the media.Dr Entsua-Mensah’s revelation was a rude awakening that should shock all of us into a beeline for healthy living. What I find encouraging about the good doctor’s admonishment is the call for collaboration among all facets of society to cure the canker, because getting out of these health woods will require an assessment of our lifestyles in their totality. The plinth of my rant today is this: even though our lifestyles contribute hugely to what is happening with cardiovascular diseases, we as a society have not internalised the importance of healthy living, especially in our spatial planning. If you have ever tried brisk walking along our streets and neighbourhoods, you will realise that regular exercise was never a consideration when those streets were mapped and built.Any time one decides to engage in any form of outdoor exercise, one has to contend with narrow streets bursting at their seams with shops, hawkers, errant motorbikes and, lately, tricycles without side mirrors or any form of safety or warning mechanism. People actually get angry when you courteously ask them to step aside so you can pass. One time when I tried it, the retort I got was both funny and annoying. A gentleman (if he qualifies for that privilege) told me as I tried to pass: “After eating by heart, you are now concerned about your health.”If we stand any chance of curing this canker, we have to be deliberate about providing spaces where people can engage in outdoor exercise.Look around any fast-growing suburb and ask yourself a simple question: where exactly is a resident supposed to take a walk? Our estates are marvels of high walls, electric fencing and gates bigger than the houses they guard. What they lack are parks, walkways and open fields. The space that planners once set aside for recreation has a curious way of disappearing. One day it is a green patch on the layout; the next it has a container shop, a car wash, a church with a public address system and a signboard boldly declaring, “This Land Is Not For Sale.” By the time the neighbourhood realises it needs a place for children to run and adults to stretch, the open space has become a plot, the plot has become a building, and the building has become a very loud nightclub.The evidence that Ghanaians want to exercise is everywhere, if we care to look. Every Saturday at dawn, keep-fit clubs in matching T-shirts take to our highways and the Aburi Mountains, singing and jogging in formation while articulated trucks and impatient taxi drivers thunder past them. Some clubs have to arrange police escorts just to go for a run. Think about that for a moment: in our country, a person who simply wants to lower his/her blood pressure needs the same security arrangements as a visiting dignitary. That is not a fitness culture. That is a survival sport.Then there is the sidewalk, that endangered species of Ghanaian infrastructure. Where it exists at all, it has been converted into a furniture showroom, a mechanic’s workshop, a tomato market, or a parking lot for vehicles whose owners believe the pavement is an extension of their compound. The pedestrian, evicted from the space meant for him, is forced onto the road to compete with vehicles, or into a balancing act along the edge of an open gutter. One wrong step and your brisk walk ends not at home but at the emergency ward. We cannot tell people to walk for thirty minutes a day and then build cities where thirty minutes of walking is an extreme sport.Our spatial planning also shapes what we eat. At nearly every junction, lorry station and school gate, what is most readily available is fried, salted and sugared. Fresh fruit and vegetables are sold further away, often at prices that make the fried option look like financial wisdom. When the healthy choice is the harder, costlier and less convenient choice, we should not be surprised that many people do not make it. A city that places a fried-food stall at every corner and a fruit stall at none has, in effect, written a prescription, and it is not a healthy one.None of this is beyond fixing, and the fix does not require us to reinvent the wheel. We already have planning laws and a Land Use and Spatial Planning Authority. What we lack is the enforcement and the political will. The Metropolitan, Municipal and District Assemblies must protect the open spaces on approved layouts as jealously as they collect property taxes. Every new estate should be required to provide parks and walkways before it is granted a permit, not promised them after the last house is sold. Every new road should come with a proper sidewalk and, where possible, a cycle lane, because a road built only for cars is half a road. Existing sidewalks must be reclaimed from traders and parked vehicles, with traders relocated to designated markets rather than simply chased away to return the next morning. Streetlights matter too; nobody will walk in the evening on a road so dark that they cannot tell a pothole from a python.Our schools must guard their playing fields against the temptation to sell them off or fill them with buildings, because a child who never learns to enjoy movement becomes an adult who never moves. Workplaces can encourage staff to walk, provide showers and give time for exercise without treating it as idleness. Our churches and mosques, many of which sit on large compounds that lie empty for most of the week, could open those grounds for community fitness activities. Here, too, the call for collaboration by Dr Entsua-Mensah makes perfect sense: the planner, the pastor, the headteacher, the employer and the assembly member all hold a piece of the solution.Of course, spatial planning is not a convenient scapegoat for personal choices. No town planner forced that third ball of kenkey down your throat, and no assembly bye-law requires you to wash down your ‘waakye’ with two bottles of sugary drink. We must each take responsibility, eat more vegetables and less salt, quit tobacco, drink responsibly, take the stairs instead of the lift, and, crucially, check our blood pressure and blood sugar regularly. Cardiovascular disease is a quiet thief; it rarely announces itself before it strikes. But personal responsibility works best when the environment makes the right choice the easy one. It is unfair to preach exercise to a population and then give it nowhere to exercise.As for the gentleman who mocked me on that narrow street, I have thought about his words many times since. He was right, in a way. I have indeed eaten by heart. But that is precisely why I would like to keep that heart beating, and I would appreciate a little space on the road to do so. If we get our planning right, perhaps the next generation will not have to dodge tricycles, hawkers and open gutters just to stay alive. Our lifestyles may be killing us, but our cities do not have to be accomplices. ***About the author; Benjamin Joe Danso is an Associate PR Director at Touchpoint Magna Carta.