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WASHINGTON (AP) -- People who live in sprawled-out suburbs where they must drive to school, work or the store are likely to weigh 6 more pounds than their counterparts in old-fashioned, walkable cities.
For those who still try to exercise, sprawl brings added concern: Pedestrians and bicyclists are much more likely to be killed by passing cars in the United States than in parts of Europe where cities are engineered to encourage physical activity -- and residents typically are skinnier and live longer than the average American.
Major studies published Thursday 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, published in the American Journal of Public Health and the American Journal of Health Promotion.
"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.
There is growing recognition that ever-fatter Americans' tendency to be sedentary is at least partially due to an environment that discourages getting off the couch and out of the car. Do adults walk three blocks to the bus stop, or drive to work? Can kids walk to school? Is there a walking or biking path to the post office, a restaurant, a friend's house?
In a sprawling community, homes are far from work, stores and schools, and safe walking and biking is difficult. This current research marks the first attempt to pinpoint just how much that matters.
Tracking degrees of health
While at Rutgers, urban planner Reid Ewing rated the amount of sprawl in 448 counties that surround metropolitan areas -- counties home to two-thirds of the population -- and then tracked CDC data on the health of 200,000 area residents.
All other factors being equal, each extra degree of sprawl meant extra weight, less walking and a little more high blood pressure, he concluded. Someone living in the most sprawling county -- Geauga County outside Cleveland -- would weigh 6.3 pounds more than if that same person lived in the most compact area, Manhattan.
The nation's most compact areas were four boroughs of New York City -- Manhattan, Brooklyn, the Bronx and Queens; San Francisco County; Jersey City, New Jersey's Hudson County; Philadelphia; and Boston's Suffolk County.
Most sprawling were outlying counties of Southeast and Midwest metro areas: Cleveland's Geauga; Goochland County outside Richmond, Virginia; and Clinton County near Lansing, Michigan.
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, acknowledged Ewing, now at the University of Maryland. But the risk from sprawl equaled certain other risk factors for obesity and hypertension, such as eating few fruits and vegetables.
Pedestrian caution
Worse were Pucher's findings that per trip, American pedestrians are roughly three times more likely to be killed in traffic than German pedestrians -- and over six times more likely than Dutch pedestrians. For bicyclists, Americans are twice as likely to be killed as Germans and over three times as likely as Dutch cyclists.
In Europe, people make 33 percent of their trips by foot or bicycle, compared with just 9.4 percent of Americans' trips.
Pucher said the extra activity had to be healthy, as life expectancy in the Netherlands and Germany is about two years longer than in the United States, and obesity rates are lower.
Why can these Europeans walk and bike more, and more safely, than Americans? It's not just travel distance -- 41 percent of U.S. trips are shorter than 2 miles, yet most are by car.
Instead, Pucher cited Dutch and German policies that encourage more sidewalks and bike paths; traffic-calming and auto-free zones in cities; extensive road-sharing education for drivers and cyclists; and pedestrian-friendly urban design.
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.
Some U.S. cities are copying Europe's policies, said Andy Clarke of the League of American Bicyclists. Education and urban design let Portland, Ore., for instance, increase ridership by 143 percent in the last decade without increasing crashes, he said.
For those who still try to exercise, sprawl brings added concern: Pedestrians and bicyclists are much more likely to be killed by passing cars in the United States than in parts of Europe where cities are engineered to encourage physical activity -- and residents typically are skinnier and live longer than the average American.
Major studies published Thursday 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, published in the American Journal of Public Health and the American Journal of Health Promotion.
"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.
There is growing recognition that ever-fatter Americans' tendency to be sedentary is at least partially due to an environment that discourages getting off the couch and out of the car. Do adults walk three blocks to the bus stop, or drive to work? Can kids walk to school? Is there a walking or biking path to the post office, a restaurant, a friend's house?
In a sprawling community, homes are far from work, stores and schools, and safe walking and biking is difficult. This current research marks the first attempt to pinpoint just how much that matters.
Tracking degrees of health
While at Rutgers, urban planner Reid Ewing rated the amount of sprawl in 448 counties that surround metropolitan areas -- counties home to two-thirds of the population -- and then tracked CDC data on the health of 200,000 area residents.
All other factors being equal, each extra degree of sprawl meant extra weight, less walking and a little more high blood pressure, he concluded. Someone living in the most sprawling county -- Geauga County outside Cleveland -- would weigh 6.3 pounds more than if that same person lived in the most compact area, Manhattan.
The nation's most compact areas were four boroughs of New York City -- Manhattan, Brooklyn, the Bronx and Queens; San Francisco County; Jersey City, New Jersey's Hudson County; Philadelphia; and Boston's Suffolk County.
Most sprawling were outlying counties of Southeast and Midwest metro areas: Cleveland's Geauga; Goochland County outside Richmond, Virginia; and Clinton County near Lansing, Michigan.
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, acknowledged Ewing, now at the University of Maryland. But the risk from sprawl equaled certain other risk factors for obesity and hypertension, such as eating few fruits and vegetables.
Pedestrian caution
Worse were Pucher's findings that per trip, American pedestrians are roughly three times more likely to be killed in traffic than German pedestrians -- and over six times more likely than Dutch pedestrians. For bicyclists, Americans are twice as likely to be killed as Germans and over three times as likely as Dutch cyclists.
In Europe, people make 33 percent of their trips by foot or bicycle, compared with just 9.4 percent of Americans' trips.
Pucher said the extra activity had to be healthy, as life expectancy in the Netherlands and Germany is about two years longer than in the United States, and obesity rates are lower.
Why can these Europeans walk and bike more, and more safely, than Americans? It's not just travel distance -- 41 percent of U.S. trips are shorter than 2 miles, yet most are by car.
Instead, Pucher cited Dutch and German policies that encourage more sidewalks and bike paths; traffic-calming and auto-free zones in cities; extensive road-sharing education for drivers and cyclists; and pedestrian-friendly urban design.
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.
Some U.S. cities are copying Europe's policies, said Andy Clarke of the League of American Bicyclists. Education and urban design let Portland, Ore., for instance, increase ridership by 143 percent in the last decade without increasing crashes, he said.
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