Sprawl and Health

Frank 2006 - "Many Pathways from Land Use to Health"

Lawrence D. Frank, James F. Sallis, et al.
"Many Pathways from Land Use to Health"
Journal of the American Planning Association
72(1):75-87 (Winter 2006)
On the Web
Relevance: high

From the abstract: in King County neighborhoods and found that a 5% increase in walkability was associated with:

• a per capita 32.1% increase in time spent in physical activity
• 0.23 point reduction in average body mass index
• 6.5% fewer vehicle miles traveled
• 5.6% fewer grams of nitrogen oxides emitted
• 5.5% fewer grams of volatile organic compounds emitted

See study for more details.

Lopez n/a - "Urban Sprawl and the Risk of Physical Inactivity"

Lopez, Russ
"Urban Sprawl and the Risk of Physical Inactivity"
Unpublished
Not on the web (received from author)
Relevance: high

The author combines his sprawl index with 2001 BRFSS data on physical inactivity to estimate the sprawl connection. From the abstract

"For each one point increase in sprawl, the risk of being physically inactive [defined as no physical activity] increased by .04% ... Physical inactivity is associated with urban sprawl and other factors of the metropolitan social/physical environment, but the effect is small and minor changes in the overall metropolitan environment may not result in large changes in levels of physical activity."

Also see his published article on obesity.

McCann 2003 - "Measuring the Health Effects of Sprawl"

McCann, Barbara; Ewing, Reid
"Measuring the Health Effects of Sprawl: A National Analysis of Physical Activity, Obesity, and Chronic Disease."
Smart Growth America and Surface Transportation Policy Project
September 2003
On the Web
Relevance: high

This report is based on Ewing et al's earlier article (2003) and is longer with more details and sidebars. The conclusions, of course, are the same, but the report includes sprawl scores for all 448 counties and the web page has fact sheets for counties in most states.

Kelly-Schwartz 2004 - "Is Sprawl Unhealthy?"

Kelly-Schwartz, Alexia; Stockard, Jean, et al
"Is Sprawl Unhealthy? A Multilevel Analysis of the Relationship of Metropolitan Sprawl to the Health of Individuals"
Journal of Planning Education and Research
December 2004; v.24, n2; pp.184-196
On the Web
Relevance: high

The authors replicated and extended Ewing et al's work on the effect of sprawl on health. They compared self- and physican-rated health as well as a variety of chronic conditions across metropolitan areas while controlling for income, education, sex, etc. They found that sprawl does affect health somewhat, but in a complex way that is difficult to track.  It appears that a highly gridded street network is associated with better health while more density is associated with poorer health.  While sprawl was not significantly associated with a higher prevalence of chronic conditions, among those with those conditions, the gridded street network was associated with better health.

Ewing 2005 - "Can the Physical Environment Determine Physical Activity Levels?"

Ewing, Reid
"Can the Physical Environment Determine Physical Activity Levels?"
Exercise and Sport Sciences Reviews
April 2005; v.33, n.2; pp.69-75
On the Web (pdf)
Relevance: medium high

Ewing seems to be primarily reviewing and re-presenting earlier work, but does so in a concise, easy-to-grasp way. Although he doesn't show any of the data or analysis, Ewing offers elasticity estimates for the effect of the physical environment on physical activity and its mediators. The effects are greatest for the mode share of walking and public transportation. CAVEAT: Ewing shows no statistical tests or analysis, so the accuracy of these estimates is unknown.

Bauman 2002 - "Toward a Better Understanding of the Influences on Physical Activity: The Role of Determinants, Correlates, Causal Variables, Mediators, Moderators, and Confounders"

Bauman, Adrian E; Sallis, James F; et al
"Toward a Better Understanding of the Influences on Physical Activity: The Role of Determinants, Correlates, Causal Variables, Mediators, Moderators, and Confounders"
American Journal of Preventive Medicine
August 2002; v.23, n.2 (supplement); pp.5-14
On the Web (pdf)
Relevance: very low

The authors discuss and define the terms mentioned in the title. They show how complex are the influences on physical activity and demonstrate how they require careful thinking and vocabulary.

Handy 2002 - "How the Built Environment Affects Physical Activity: Views from Urban Planning"

Handy, Susan L.; Boarnet, Marlon G. et al
"How the Built Environment Affects Physical Activity: Views from Urban Planning"
American Journal of Preventive Medicine
August 2002; v.23, n.2 (supplement)
On the Web (pdf)
Relevance: low

The authors give a good overview of how urban planners think about how the built environment impacts physical activity, namely walking and biking.  They cover how to measure the built environment and travel behavior, how the built environment affects travel by foot differently from travel by car, and some tips on how empirically to connect the built environment to physical activity.

Giles-Corti 2005 - "How Important is Distance To, Attractiveness, and Size of Public Open Space?"

Giles-Corti, Billie; Broomhall, Melissa; et al
"How Important is Distance To, Attractiveness, and Size of Public Open Space?"
American Journal of Preventive Medicine
February 2005; vol.28, n.2 (supplement 2); pp.169-176
On the Web
Relevance: low

The authors surveyed Australian adults in Perth and used some sort of GIS to conclude that people walk more if they have more access to large, attractive public open space with facilities for multiple types of users. While access alone to open space was not significantly associated with achieving recommended levels of physical activity, access to large, attractive open space increased the likelihood of walking at least 6 times per week totaling >180 minutes by 50%.

Humpel 2004 - "Perceived Environment Attributes, Residential Location, and Walking for Particular Purposes"

Humpel, Nancy; Owen, Neville; et al.
"Perceived Environment Attributes, Residential Location, and Walking for Particular Purposes"
American Journal of Preventive Medicine
February 2004; vol.26, n.2; pp.119-125
On the Web
Relevance: medium-low

The authors conducted a survey of 400 Australian adults (mean age 60) on their walking habits and environmental perceptions. "Aesthetics, convenience of facilities, and access to services were positively associated with the neighborhood walking for men; convenience was associated with neighborhood walking for women."  People who walked more were more likely to say that weather did not influence their decision to walk.  Women were also more likely to walk if they lived near the coast.

Owen 2000 - "Environmental Determinants of Physical Activity and Sedentary Behavior"

Owen, Neville; Leslie, Eva; et al.
"Environmental Determinants of Physical Activity and Sedentary Behavior"
Exercise and Sport Sciences Review
October 2000; vol.28, n.4; pp153-158
On the Web
Relevance: low

The authors describe a basic model for describing the environmental determinants of physical activity and sedentary behavior. They cite the limited research that had been done so far. One interesting nugget is that one study showed that even among those who are highly physically active, those who watched 4+ hours of TV per day were twice as likely to be overweight as were those who watched less than 1 hour of TV per day.