Health woes, suburban living are linked in national study

Sprawl is cited as strong factor in obesity rate

By Anthony Flint, Globe Staff, 8/29/2003

People who live in spread-out suburbs are on average 6 pounds heavier than urban dwellers and are more likely to suffer from high blood pressure, hypertension, and other ills, according to the first national study linking health trends and where people live.

The authors of the study and accompanying reports being published in the American Journal of Health Promotion and the American Journal of Public Health, said the conclusions warranted changes in zoning and transportation financing to encourage compact development that enables more walking and biking.

"Building compact and walkable communities will become another strategy for fighting the US obesity epidemic," said Reid Ewing, principal researcher at the National Center for Smart Growth at the University of Maryland.

Although previous, smaller-scale studies have produced similar results, the findings from a survey of 200,000 Americans in 448 counties represent the first definitive link between sprawl and obesity and other health problems, Ewing said. While other factors such as age, ethnicity, education, and diet contribute to weight and health problems, he said, the study found a strong relationship between those problems and where the respondents lived.

In spread-out suburban areas where residential and commercial areas are separated by long distances, people must drive everywhere, Ewing said, and do not easily have opportunities for physical activity, even if they seek it. The study found that people in urban settings such as New York, Boston, or Philadelphia tend to walk and bike more as part of daily life, resulting in slimmer waistlines and fewer health problems.

"Someone in an apartment eating potato chips all day still has to climb stairs and walk to the bus stop," and thus burns more calories than a suburbanite seated comfortably in a car, Ewing said.

"We have not paid enough attention to how we build our homes, our office buildings, and our communities," said Richard Jackson, researcher and director of environmental health at the Centers for Disease Control and Prevention in Atlanta. Compact neighborhoods where homes and businesses are mixed together are not only healthier, but they also promote more "social engagement" that reduces crime, Jackson said.

"Ultimately, we're seeking to define a new paradigm," where local officials and developers think about the health effects of the design of communities, said Richard Killingsworth, director of the Active Living by Design program at the University of North Carolina at Chapel Hill.

Illnesses such as asthma and cardiovascular disease have long been understood as the result of genetic and environmental influences, said Allen Dearry, associate director of the National Institute of Environmental Health Sciences. "We're just now beginning to understand the impact of the physical environment" as one of the most important environmental influences, he said.

The National Association of Home Builders has dismissed attempts to link development patterns with health problems, alleging that researchers can pick out correlations to support the goal of restricting free development.

The study, associated reports, and other information can be found on the Internet at www.smartgrowthamerica.org, www.ajph.org, and www.healthpromotionjournal.com.

Anthony Flint can be reached at flint@globe.com.