Sprawl and Health

Ewing 2003 - "Relationship Between Urban Sprawl and Physical Activity, Obesity, and Mortality"

Ewing, Reid; Schmid, Tom, et al
"Relationship Between Urban Sprawl and Physical Activity, Obesity, and Mortality"
American Journal of Health Promotion
September/October 2003; vol.18, n.1; pp.47-57
On the Web
Relevance: high

The authors estimated the impact of a county and metropolitan area sprawl index on obesity, physical activity, and related diseases. They found that the county  index significantly influenced the number of minutes spent in leisure-time walking, average BMI, obesity status, and prevalence of hypertension.

WA Dept. of Health 2004 - "The Economic Cost of Physical Inactivity Among Washington State Adults"

Chenoweth & Associates, Inc.
"The Economic Cost of Physical Inactivity Among Washington State Adults"
Washington State Department of Health
February 2004
On the Web (pdf)
Relevance: high

Chenoweth and Associates estimate the direct costs of physical inactivity in Washington to be $4.8 billion in 2002:

• $197.8 million for direct medical care
• $9.2 million for worker's compensation
• $4600 million for lost productivity

They also calculate the indirect costs at $593 million for medical care and $36.8 million for worker's compensation, bringing the total cost (direct + indirect) to $5.46 billion. Per Washington resident, this total cost of physical inactivity was $899 in 2002; per Washington adult, the cost was $1,232.

Thorpe 2004 - "The Impact of Obesity on Rising Medical Spending"

Thorpe, Kenneth E; Florence, Curtis S; et al
"The Impact of Obesity on Rising Medical Spending"
Health Affairs
October 2004, Web Exclusive W4-480
On the Web
Relevance: high

Comparing data from the 1987 National Medical Expenditure Survey and the 2001 Medical Expenditure Panel Survey, the authors estimate the impact of obesity on inflation-adjusted medical spending. They estimate that 27% of the increase was due to obesity, and that 12% was due to the increased obesity rate alone, exclusive of medical advances. In 2001, medical costs for an obese person were 37% higher than for a comparable normal weight person. The authors also calculate the effect of obesity on the increase in spending on diabetes (38%), hyperlipidemia (22%), and heart disease (41%).

Frank 2001 - "The Built Environment and Human Activity Patterns"

Frank, Lawrence D; Englke, Peter O
"The Built Environment and Human Activity Patterns: Exploring the Impacts of Urban Form on Public Health"
Journal of Planning Literature
November 2001; v.17, n.2; pp.202-218
On the Web
Relevance: low

Frank and Engelke reviews current literature to explore how physical activity affects public health and how urban form affects physical activity. The article is a good introduction to the subject with references to many useful studies (also reviewed in this  lit review), but a few of which are outdated.

Berrigan 1998 - "The Association Between Urban Form and Physical Activity in US Adults"

Berrigan, David; Troiano, Richard
"The Association Between Urban Form and Physical Activity in US Adults"
American Journal of Preventive Medicine
2002; v.23, n.2S; pp.74-79
On the Web
Relevance: medium

Using data from NHANES III, the authors found that people who lived in houses built before 1946 or between 1946 and 1973 were more likely to walk regularly than were people who lived in houses built after 1973. Those living in homes built before 1946 were 1.43 times more likely and those in homes built 1946-1973 were 1.36 times more likely to walk at least a mile at least 20 times a month than were those living in homes built after 1973.

B.C Health Planning 2004 - "The Cost of Physical Inactivity in British Columbia"

Colman, Ronald; Walker, Sally
"The Cost of Physical Inactivity in British Columbia"
B.C. Ministry of Health Planning
November 2004
On the Web (pdf)
Relevance: high

The authors use data from the Canadian Community Health Survey, the Economic Burden of Illness in Canada, and the literature to calculate the cost of physical inactivity in BC.  They estimate that physical inactivity costs the British Columbian health care system $211 million (2001CAN$) (1.8% of provincial health spendig) a year in direct costs.  They also estimate that indirect costs of productivity losses add up to $362 million a year due to premature death and disability, leading to a total cost of $573 million.  5% (1400) of all premature deaths are due to physical inactivity. This results in more than 4,380 potential years of life lost annually.

Birmingham 1999 - "The Cost of Obesity in Canada"

Birmingham, C. Laird; Muller, Jennifer L; et al
"The Cost of Obesity in Canada"
Canadian Medical Association Journal
February 23, 1999; v.160, n.4; pp.483-488
On the Web
Relevance: high

The authors reviewed the literature to calculate the direct medical cost of obesity in Canada.  They estimate that obesity cost over $1.8 billion, or 2.4% of the total health care expenditures, in Canada in 1997. The three top contributors were hypertension ($656.6 million), type 2 diabetes ($423.2 million), and coronary artery disease ($346.0 million).

Katzmarzyk 2000 - "The Economic Burden of Physical Inactivity in Canada"

Katzmarzyk, Peter T; Gledhill, Norman; Shephard, Roy J.
"The Economic Burden of Physical Inactivity in Canada"
Canadian Medical Association Journal
November 28, 2002; v.163, n.11; 1435-1440
On the Web
Relevance: high

The authors reviewed the literature to calculate the burden of physical inactivity in Canada. They conclude that physical inactivity costs Canada about $2.1 billion, or 2.5% of total direct health costs.  The also calculate the about 21,000 lives were lost prematurely in 1995 and that a 10% reduction in inactivity could save Canada $150 million a year.

Berkman 1995 - The Role of Social Relations in Health Promotion

Berkman, Lisa F.
"The Role of Social Relations in Health Promotion"
Psychosomatic Medicine - Special Issue: Superhighways for Disease
May/June 1995; v.57, n.3; pp.245-254
On the Web
Relevance: low/medium

Here's the nut of the article, from the abstract: "There is now a substantial body of evidence that indicates that the extent to which social relationships are strong and supportive is related to the health of individuals who live within such social contexts. A review of population-based research on mortality risk over the last 20 years indicates that people who are isolated are at increased mortality risk from a number of causes." According to Berkman, social isolation, "seemed to make people more vulnerable to a broad range of diseases and disabilities..." (This is in marked contrast to the standard medical etiological approach that specific causes for specific diseases.)

Must 1999 - "The Disease Burden Associated with Overweight and Obesity"

Must, Aviva; Spadano, Jennifer; et al
"The Disease Burden Associated with Overweight and Obesity"
Journal of the American Medical Association
October 27, 1999; v.282, n.16; pp.1523-1529
On the Web
Relevance: low/medium

Using NHANES III (1988-1994) the authors estimate the risk of having type 2 diabetes, gallbladder disease, coronary heart disease, high cholesterol, high blood pressure, or osteoarthritis for normal weight, overweight, obese groups.  Risk increased with BMI for all diseases except coronary hearth disease in men and cholesterol in both sexes.