Sturm 2004 - "Suburban sprawl and physical and mental health"

R. Sturm, D.A. Cohen
“Suburban sprawl and physical and mental health”
Public Health
2004; 118; pp488-496
Relevance: high

Sturm and Cohen analyzed Healthcare for Communities phone survey data from 1998 and 2000/2001 that assessed 16 chronic physical health conditions or symptom clusters (e.g., asthma, diabetes, hypertension, arthritis, etc.) and health-related quality of life, as well as depression and anxiety.

They correlated these findings with Reid Ewing/Smart Growth America's ranking of sprawl in major US metropolitan areas.  This ranking considered residential density, land use mix, degree of centering, and street accessibility. 

The result:  an increase in sprawl from one standard deviation less to one standard deviation more than average led to 96 more chronic medical problems per 1000 residents, which is approximately similar to an aging of the population of 4 years.  No correlation was found between sprawl and mental health.

  • "the overall sprawl index is a significant predictor of hte number of chronic medical conditions (P<0.01) and of physical health-related quality of life (P<0.05)."
  • "The change in chronic conditions associated with a 50-point change in sprawl is...larger than the corresponding change associated with a doubling of income."  [This seems like a very significant change to me.]
  • The street accessibility and land-use factors were most strongly correlated with health (P<0.001); population density was significant at P<0.05; degree of centering was not significant.
  • Biggest drops, based on level of sprawl, were for arthritis, trouble breathing (emphysema/chrnoic long disease), abdominal/digestive problems, migraine/chornic headaches, and urinary tract problems.
  • "Sprawl appears to have a disproportionate impact on the hpysical health of the elderly and possibly the poor.  This may be because the poor and the elderly have fewer resources to mitigate the limitations imposed by their environment, such as having less access to individual motorized transportation.
  • "In contrast to prominent hypotheses, we found no adverse effects on mental health."

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