Sprawl and Health

Wong 2004 - "Assessing the Health Benefits of Air Pollution Reduction for Children"

Wong, Eva Y; Gohlke, Julia; et al.
"Assessing the Health Benefits of Air Pollution Reduction for Children"
Environmental Health Perspectives
February 2004; v.112, n.2; pp.226-232
On the Web
Relevance: low

The authors estimated the health and economic benefits to children of reductions in criteria air pollutants (except lead) due to the Clean Air Act from 1990 to 2010. They estimated a savings of $1-2 billion from fewer hospitalizations, emergency room visits, school absences, and low birth weight. The also estimated a savings of $0.6-$100 billion from decreased mortality.

Davies 2005 - "Economic Costs of Diseases and Disabilities Attributable to Environmental Contaminants in Washington State"

Davies, Kate; Hauge, Dietrich.
"Economic Costs of Diseases and Disabilities Attributable to Environmental Contaminants in Washington State"
Collaborative for Health and Environment-Washington Research and Information Working Group
July 2005
On the Web
Relevance: low

The authors estimated the health costs attributable to environmental contaminants in Washington (for selected diseases) by applying national and other state studies to Washington's population. They use national estimates of the Environmentally Attributable Fraction Range (EAFR) of diseases due to contaminants, disease and population rates for Washington, and disease cost estimates. They conclude that the total cost is $1.8 billion (2004$) for children and $2.7 billion for adults and children.

Unfortunately, this study does not really estimate the costs for Washington, but rather Washington's likely share of national costs because the study uses national attribution rates rather than WA specific ones.  For example, it may be that a higher or lower fraction of asthma in WA is due to environmental contaminants.

Hawe 2000 - "Social capital and health promotion: a review"

Penelope Hawe, Alan Shiell
"Social capital and health promotion: a review"
Social Science & Medicine    
September 2000; v51, n6, pp 871-885
On the Web
Relevance: Medium-low

This is a somewhat interesting perspective on the history of social capital. Written from a social science perspective it provides a different and broader context for social capital theory than the other scientific studies reviewed here. It also treats the metaphorical and rhetorical dimensions of the language of social capital.

The authors also briefly review the scientific literature on the relationship between social capital (and income inequality) and health. While the review is not as comprehensive or detailed as other studies reviewed here, it is clearly written and pithy, making it a handy reference.

Kawachi 1997 - "Social capital, income inequality, and mortality"

Kawachi, Kennedy, Lochner, Prothrow-Stith
"Social capital, income inequality, and mortality"
American Journal of Public Health
September 1997; v87, n9, pp 1491
On the Web
Relevance: High

This is perhaps the single most compelling study that social capital--in the broad sense of civic engagement--affects health. The authors use the General Social Survey's result to perform "ecologic" analyses of 39 states' levels of social capital and income inequality compared to mortality. Still, there are some important short-comings.

The authors claim that "income inequality leads to increased mortality via disinvestment in social capital" though it is not clear to me that they actually demonstrate this. Instead, they demonstrate that income inequality is correlated to social capital and also show a correlation between social capital and mortality. (It's relatively well-documented that income inequality is associated with higher mortality).

House 1998 - "Social Relationships and Health"

House, Landis, Umberson
"Social Relationships and Health"
Science
July 29, 1988; v241 n4865, pp 540-545
Relevance: Medium

This is essentially a review of the primary studies relating social connections to health. Because the article is now 7 years old it fails to mention any of Kawachi's studies, which are arguably some of the most compelling pieces of evidence for believing that there is a link. Still, while the article is largely confined to summarizing the findings of studies that we are familiar with (Alameda County, CA; Evans County, GA; Tecumseh, MI; Gothenberg, Sweden; eastern Finland, etc), it does make at least two  interesting points that are worth attending to.

"Social relationships, or the relative lack thereof, constitute a major risk factor for health--rivaling the effects of well-established health risk factors such as cigarette smoking, blood pressure, blood lipids, obesity, and physical activity."

"In Tecumseh, Evans County, and eastern Finland, mortality is clearly elevated among the most socially isolated, but declines only modestly, if at all, between moderate and high levels of social integration."

Kawachi 1999 - "Social capital and community effects on population and individual health"

Kawachi
"Social capital and community effects on population and individual health"
Annals of New York Academy of Sciences
1999; v896; pp 120-130
On the Web
Relevance: High

This paper references what is probably the single most convincing piece of evidence we have for believing that social capital affects health--Kawachi et al's 1997 analysis of the GSS survey for 39 states, conducted between 1986 and 1990. In two reported analyses, he finds a close state-by-state correlation between social capital and health. In particular, trust was important: "the level of trust explained 58% of the variance in total mortality across states, including statistically significant associations with most major causes of death including heart disease, malignant neoplasms, stroke, homicide, and infant mortality."

Kawachi 1996 - "A prospective study of social networks in relation to total mortality and cardiovascular disease in men in the USA"

Kawachi, Colditz, Ascherio, Rimm, Giovannucci, Stampfer, Willet
"A prospective study of social networks in relation to total mortality and cardiovascular disease in men in the USA"
Journal of Epidemiology and Community Health
June 1996; v50, n3; pp 245-251
On the Web
Relevance: High

A longitudinal study of roughly 32,000 male health professionals in the US. According to the authors, "socially isolated men... were at increased risk for cardiovascular disease mortality... and deaths from accidents and suicides... [and] risk of stroke incidence." These results were most strongly seen comparing the 50% of most socially-connected men to the 6% of least socially-connected. The study defined social networks as marrital status, number of friends and relatives, and membership in church or community groups--some of these features are conceivably affected by sprawl.

Seeman 1996 - "Social ties and health: the benefits of social integration"

Seeman
"Social ties and health: the benefits of social integration"
Annals of Epidemiology
September 1996; v6, n5; pp 442-451
On the Web
Relevance: Medium-high

An overview of major findings on social ties and health published since the mid-1970s. The upshot is that "social integration does appear to have a highly beneficial effect on post-myocardial infarction prognosis (functioning and longevity)." That is, while social ties do not affect the incidence of heart disease, they do affect recovery from it. Following, I limn the major findings recapitulated by Seeman.

Hirdes 1992 - "The importance of social relationships, socioeconomic status and health practices with respect to mortality among healthy Ontario males"

Hirdes, Forbes
"The importance of social relationships, socioeconomic status and health practices with respect to mortality among healthy Ontario males"
Journal of Clinical Epidemiology
February 1992; v45, n2; pp 175-182
On the Web
Relevance: Medium

The authors examined 2000 men in Ontario and found that social relationships had "a strong association with mortality." Unfortunately, their social relationships index was comprised of marital status, number of children, family contact, and participation in voluntary associations -- only the last of these is conceivably affected by sprawl. Also, the strong association of social capital to mortality is in the comparison between the highest scoring 10% in social capital and the lowest scoring 10%. It's not clear whether sprawl is affect social capital in these extremes or in the middle 80% (where, in turn, the effects on mortality are less pronounced).

Interestingly, the effect of income was greater than the effect of social capital (adjusted relative risk of 0.41 versus 0.30). The effect of income is even greater because the risk factors for income include the top 20% versus the bottom 20% (not just top and bottom deciles, as for social capital).

Veenstra 2002 - "Social capital and health (plus wealth, income inequality, and regional health governance)"

Veenstra
"Social capital and health (plus wealth, income inequality and regional health governance)"
Social Science and Medicine
March 2002; v54, n6; pp 849-868
On the Web
Relevance: Medium-high

Describes a study of 30 health districts in Saskatchewan, comparing population health with social capital, income inequality, wealth, and governance. Social capital meant associational and civic participation. Two findings stand out:

• The author found no evidence of a relationship between social capital and good governance in the health districts.
• Low social capital was correlated to high mortality; high income inequality was also correlated to high mortality. The author writes, "the two may be co-mingled somehow when it comes to population health, although they were not significantly related to one another."

Veenstra's findings are promising because his use of social capital--associational and civic participation--is the same kind that may be affected by sprawl. And while the effects of social capital on mortality are "co-mingled" with income inequality, there is a relationship.