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Sprawl May Harm Health, Study Finds

By Rob Stein
Washington Post Staff Writer
Monday, September 27, 2004; Page A03

People who live in sprawling communities tend to suffer more health problems, according to the first study to document a link between the world of strip malls, cul-de-sacs and subdivisions and a broad array of ailments.

The study, which analyzed data on more than 8,600 Americans in 38 metropolitan areas -- including the Washington region -- found that rates of arthritis, asthma, headaches and other complaints increased with the degree of sprawl. Living in areas with the least amount of sprawl, compared with living in areas with the most, was like adding about four years to people's lives in terms of their health, the study found.

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"Suburban sprawl affects your health," said Roland Sturm, a senior economist at the Rand Corp. of Santa Monica, Calif., who led the study, which is being released today. "That's really the take-home message."

As suburbia has spread across the American landscape, health experts have become increasingly concerned that the fast-food, car-dependent lifestyle may be contributing to a host of health problems. Previous studies have linked sprawl to an increased risk of being overweight and obese and certain related health problems, such as high blood pressure. The new study, published in the journal Public Health, is the first to directly examine the relationship between sprawl and a wide spectrum of chronic illnesses.

"This is the first one where we assess a whole set of conditions," Sturm said. "That's the new angle."

The increase in health problems is presumably due to the fact that sprawl discourages physical activity, increasing the chances of being overweight or obese. In addition, sprawling communities tend to have more air pollution, Sturm said.

"This really seems to be due mainly to air pollution and physical activity," Sturm said.

Sturm and colleague Deborah Cohen analyzed data collected by Healthcare for Communities, a survey that in 1998 and 2001 questioned a nationally representative sample of 8,686 adults in 38 areas about a range of health issues. The researchers then examined whether there was an association between 16 health problems and the amount of sprawl where participants lived, using a scale that includes such measures as population density, street patterns and proximity of businesses and workplaces to residences.

The least compact community was the Riverside-San Bernardino area in California, while the most was Manhattan. The Washington area ranked 15th most sprawling; Baltimore ranked the ninth least sprawling.

People living in areas that scored highest on the sprawl scale reported the most problems, with the unhealthful effects appearing to disproportionately affect the poor and the elderly. The association was particularly significant with arthritis, respiratory problems such as asthma, stomach problems, headaches and urinary tract infections. But the researchers also found some evidence of an association with heart disease and high blood pressure.

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