Report finds suburban sprawl mirrored in residents' waistlines

By Seattle Times news services and staff

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And researchers named names. Geauga County, outside Cleveland, was deemed to have the heaviest residents. Fulton County, outside Toledo, was runner-up.

The study, reported in the American Journal of Health Promotion, argues that sprawling areas typically offer residents fewer chances to exercise or reasons to walk while doing daily chores. Therefore, people who live in those areas tend to drive more, be less physically active and gain weight.

Adding to the concern: Related research reported in the same journal shows that pedestrians and bicyclists are much more likely to be killed by cars in the United States than in parts of Europe, where cities are engineered to encourage physical activity — and whose residents typically are skinnier and live longer than the average American.

The new studies call on urban planners and zoning commissions to consider public health in designing neighborhoods.

"How you build things influences health in a much more pervasive way than I think most health professionals realize," said Dr. Richard Jackson of the Centers for Disease Control and Prevention, who helped edit the research.

"Look at many new suburbs — there are not any sidewalks at all. ... The result is we just don't walk," added John Pucher of Rutgers University, who uncovered the U.S.-European disparities that Jackson called shocking.

Rutgers University urban planner Reid Ewing used census data to rate the amount of sprawl in 448 metropolitan counties, then compared it with CDC data on the health of 200,000 residents in those counties.

After screening out other factors including age, education and diet, he concluded that each extra degree of sprawl meant extra weight, less walking and a little more high blood pressure. Someone living in the most sprawling county, Geauga County, would weigh 6.3 pounds more than if he or she lived in the most compact area, Manhattan.

Also faring poorly were cities in the Southeast, including Richmond, Va., the Greensboro-Winston Salem metro area in North Carolina and Atlanta's ever-growing suburbs.

Of four Washington counties analyzed by Ewing, Snohomish County fared worst. While it placed almost exactly at the midpoint of the 448 counties nationwide, the study suggests that Snohomish County's lower-density development patterns place residents at slightly higher risk of obesity and high blood pressure than residents of more-compact King County.

"King County has done a much better job of protecting its farmlands and keeping development inside the urban growth boundary," said John Healy of the anti-sprawl group 1000 Friends of Washington. "Snohomish County has not."

Ward Hinds, health officer for the Snohomish Health District, said he wasn't ready to finger sprawl as a cause of obesity, "although there is a certain logic to it." But he said his agency has been trying to persuade residents to exercise more.

In the 25 most compact counties, 22.8 percent of adults had high blood pressure and 19.2 percent were obese. In the 25 most sprawling counties, those rates were 25.3 percent and 21.2 percent, respectively.

Those aren't huge differences, Ewing acknowledged. But the risk from sprawl equaled certain other risk factors for obesity and hypertension, such as eating few fruits and vegetables, he said.

No statistically significant correlation was found between sprawl and diabetes or heart disease, both often linked with obesity.

Far worse were Pucher's findings that per trip, American pedestrians are roughly three times more likely to be killed by a car than German pedestrians — and more than six times more likely than Dutch pedestrians. For bicyclists, Americans are twice as likely to be killed as Germans and more than three times as likely as Dutch cyclists.

Europeans make 33 percent of their trips by foot or bicycle, Americans 9.4 percent.

In a written response to the research, the National Association of Home Builders said it supports higher-density residential development in or near cities. But the organization also said it rejects the argument "that the choices people make about where they live actually cause them to become obese."

Some health experts agree. "I don't buy it," said Dr. David Heber, director of the University of California, Los Angeles' Center for Human Nutrition. "I live in the 'burbs, and I see people all the time jogging and walking... "

Still, some groups plan to use the research to back so-called smart-growth initiatives, including a battle in Congress next month over whether $600 million in transportation funds should go for safer cycling and walking programs and other transit alternatives, or for highway construction.

Compiled from the Los Angeles Times, The Associated Press and Seattle Times staff reporter Eric Pryne.

Copyright © 2003 The Seattle Times Company