Sprawl and Health

Lund 2002 - "Pedstrian Environments and Sense of Community"

Lund, Hollie
"Pedestrian Environments and Sense of Community"
Journal of Planning Education and Research   
2002 Associate of Collegiate Schools of Planning
On the Web
Relevance: medium-high

Lund's study is intended to gauge the community effects of New Urbanism-style architecture and neighborhood design. The study is conducted in two Portland neighborhoods, an inner-city neighborhood with traditional design and a modern-style suburban neighborhood (post-WWII). Researchers distributed questionaires door-to-door in the two neighborhoods using questions similar to the Nasar study. They got 57 responses (22 percent) in the traditional neighborhood and 49 (18.8 percent) in the suburban neighborhood.

The study found more sense of community in the traditional neighborhood than in the modern suburb. The most powerful subjective explanatory variable was "perception of walking"--the better that people felt about walking in the neighborhood, the higher their sense of community. Interestingly, there is one big counterpoint to this: the study found a negative correlation between destination trips (walking to the store or for other errands) and sense of community. That is, the more likely people are to walk to destinations, the lower their sense of community. Strolling trips--walking for pleasure--are positively associated with community, but destination trips are negatively associated.

One failing of this research is that the respondents are self-selected and many not be statistically accurate representations of their communities. Also, the number of respondents is relatively low and it may be difficult to obtain statistically valid results when using controls or regressions. Finally, we cannot be sure whether people's behavior and attitudes are determined by their urban environment, or whether people self-select into neighborhoods that reflect their values and preferences.

Nasar 1995 - "The Psychological Sense of Community in the Neighborhood"

Nasar, Julian
"The Psychological Sense of Community in the Neighborhood"
Journal of the American Planning Association
Spring 1995; v61, n2; pp 178-184
Relevance: high

There is more social capital--at least as conceived as neighborhood social ties--in mixed-use (and presumably higher density) communities than in single use communities. From the abstract: This paper describes the development and testing of an 11-item Likert scale of the sense of neighborhood community, using responses from 54 residents in three suburbs in Columbus, Ohio. One test of the scale with 100 residents in single-use and mixed-use areas near one another found significantly more sense of community in the mixed-use neighborhood. More sense of community emerged among married persons and couples with children as compared to singles and childless couples.

Much of this paper is devoted to justifying its research methodologies. Of particular interest is a list of 15 questions on page 181 that researchers used to ascertain neighborhood social ties. This could be of use in future primary research on social capital.

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.

Guest 1999 - "Social ties at the neighborhood level: Two decades of GSS evidence"

Guest, Wierzbicki
"Social ties at the neighborhood level: Two decades of GSS evidence"
Urban Affairs Review   
September 1, 1999; v35, n1, pp 92-111
On the Web
Relevance: Medium-low

This article is mostly a by-the-book summary of the General Social Survey's findings on social capital from 1972 to the 1990s. It appears to question many of Putnam's findings about the seriousness and quality of the decline of US social capital. It also examines many of the theories about why social capital is eroding--urban form/highways, women in the workforce, structural social changes, etc. There's not much that's terribly relevant to our work, but two things bear mentioning.

The headline: "The data show a relatively continuous, albeit slow, decline in the importance of social ties on the basis of neighborhood and, in turn, an even smaller upward growth in the importance of nonneighborhood social ties."

There was no difference between central cities and suburbs (or other areas for that matter). The authors divided the GSS samples into four urban-form categories: central city of large metro area, suburbs of large metro area, other urban areas, and rural areas. "We examined the effect of locale over the three decades but found no significant interaction."

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).