Urban Sprawl and Public Health

Designing, Planning, and Building for Healthy Communities

By Howard Frumkin, Lawrence Frank, Richard Jackson

ISLAND PRESS

Copyright © 2004 Howard Frumkin, Lawrence Frank, and Richard Jackson
All rights reserved.
ISBN: 978-1-55963-305-5

Contents

ABOUT ISLAND PRESS,
Title Page,
Copyright Page,
PREFACE,
ACKNOWLEDGMENTS,
CHAPTER 1 - WHAT IS SPRAWL? WHAT DOES IT HAVE TO DO WITH HEALTH?,
CHAPTER 2 - THE ORIGINS OF SPRAWL,
CHAPTER 3 - THE EVOLUTION OF URBAN HEALTH,
CHAPTER 4 - AIR QUALITY,
CHAPTER 5 - PHYSICAL ACTIVITY, SPRAWL, AND HEALTH,
CHAPTER 6 - INJURIES AND DEATHS FROM TRAFFIC,
CHAPTER 7 - WATER QUANTITY AND QUALITY,
CHAPTER 8 - MENTAL HEALTH,
CHAPTER 9 - SOCIAL CAPITAL, SPRAWL, AND HEALTH,
CHAPTER 10 - HEALTH CONCERNS OF SPECIAL POPULATIONS,
CHAPTER 11 - FROM URBAN SPRAWL TO HEALTH FOR ALL,
NOTES,
BIBLIOGRAPHY,
INDEX,
ISLAND PRESS BOARD OF DIRECTORS,

CHAPTER 1

WHAT IS SPRAWL? WHAT DOES IT HAVE TO DO WITH HEALTH?

* * *

In 1956, the Federal Highway Act set out to "disperse our factories, our stores, our people, in short, to create a revolution in living habits." Within a year, writer and social critic William H. Whyte was already deeply disturbed by what he saw. Highways were allowing cities to expand rapidly into surrounding rural areas. In a short article published in Fortune magazine in January 1958, entitled simply "Urban Sprawl," Whyte observed that "huge patches of once green countryside have been turned into vast, smog-filled deserts that are neither city, suburb, nor country." "It is not merely that the countryside is ever receding," he warned, but "in the great expansion of the metropolitan areas the subdivisions of one city are beginning to meet up with the subdivisions of another."

Nearly a half century later, the term "sprawl" has entered the American vernacular. Originally a reference to a bodily position—"to lie or sit with arms and legs spread out"—the word has more recently assumed a broader meaning: "to spread or develop irregularly." The Vermont Forum on Sprawl (http://www.vtsprawl.org) offers a succinct definition of sprawl as "dispersed, auto-dependent development outside of compact urban and village centers, along highways, and in rural countryside."

In common use, sprawl has become a pejorative term. It seems to take on a variety of meanings: cheaply and quickly built neighborhoods at the edge of metropolitan areas, architecturally monotonous residential subdivisions, ugly feeder roads lined with strip malls, lifestyles that center around car trips. Critics of sprawl have unleashed a torrent of pungent prose. William H. Whyte, in his original Fortune magazine article, wrote:

Sprawl is bad aesthetics; it is bad economics. Five acres is being made to do the work of one, and do it very poorly. This is bad for the farmers, it is bad for communities, it is bad for industry, it is bad for utilities, it is bad for the railroads, it is bad for the recreation groups, it is bad even for the developers.

Forty years later, a less measured James Kunstler derided sprawl in The Geography of Nowhere as "depressing, brutal, ugly, unhealthy, and spiritually degrading."

In this book, we do not use sprawl as a pejorative term. Instead, we use it as a neutral descriptive term, as convenient shorthand for a complex set of characteristics of towns and cities. Sprawl refers to the way land is used, the way people travel from place to place, and even the way a place "feels." In sprawling metropolitan areas, the city expands outward over large geographic areas, sometimes in a "leapfrog" pattern (see Figure 1-1). Different land uses—residential, commercial, office, recreational, and so on—tend to be separated from each other. Busy arterial roads are lined with commercial strips, accessible only by car, and there is a relative scarcity of both walkable "town center" neighborhoods and public open space. Distances between things are large, which makes walking and biking impractical, and the low density makes mass transit uneconomical. There is a heavy reliance on the automobile, and the road system may provide few direct connections (see Figure 1-2). Oliver Gillham, in The Limitless City, provides a thorough review of various definitions of sprawl, and offers one of his own: "a form of urbanization distinguished by leapfrog patterns of development, commercial strips, low density, separated land uses, automobile dominance, and a minimum of public open space."

Land use and transportation interact to affect many aspects of human activity, well-being, and health. Heavy reliance on the automobile for transportation results in more air pollution, which contributes to respiratory and cardiovascular disease. More driving also means less physical activity, contributing to a national epidemic of overweight and associated diseases. More time on the roads means a greater risk of collisions with other cars and with pedestrians, with associated injuries and deaths. Sprawling cities threaten the quality of drinking water sources and the availability of green spaces. Even mental health and the network of social interactions and trust known as "social capital" may be affected. To come to grips with the health implications of sprawl and to develop better public policy requires, therefore, an understanding of the physical attributes of sprawl and how they affect people.

DEFINING AND MEASURING SPRAWL

"Urban form" refers to the amalgamation of individual elements of the towns and cities in which we live, work, play, and travel: the schools, houses, parking lots, shopping malls, gas stations, post offices, houses of worship, streets, parks, and stadiums, with which we are all familiar. Urban form is partly determined by natural features—the coastlines of Boston and San Francisco, the riverfronts of Pittsburgh and St. Louis, the mountains outside Denver and Salt Lake City. And urban form is partly the result of public and private decisions made over many years, some explicit, others unintended and even unrecognized. Some aspects of urban form, such as regional commuter train systems, exist on a very large scale, whereas others, such as courtyards and sidewalks, are very small and localized. Architects and urban planners have used many concepts to classify this seemingly infinite variety, to allow urban form to be ordered, studied, and understood. Terms such as density, concentration, centrality, diversity, mixed uses, connectivity, and proximity are all used to define and conceptualize urban form.

Sprawl is one kind of urban form (see Figure 1-3). In this book, as we explore the impact of sprawl on human health and well-being, we look to many sources of empirical evidence. To study the relationship between sprawl and health, a general definition of sprawl is not enough. Scientists need a definition that can be operationalized and measured. This allows them to test specific hypotheses about the impact of sprawl on people.

The literature on sprawl offers a wide variety of definitions. A recent review of many of these found "no common definition of sprawl, and relatively few attempts to operationally define it in a manner that would lead to useful comparisons" of metropolitan areas. Some definitions were narrowly oriented to a single metropolitan area such as Los Angeles. Some definitions were historical, based on the planning process that gave rise to a...