What's health got to do with it? As Americans grow in girth, policymakers are looking at community design to encourage physical activity and lower obesity rates.

• Author: Robbins, Leslie

Sixty percent of adults and 15 percent of children in the United States are overweight or obese. While nutrition is a large factor, sedentary lifestyles also contribute to the problem.

"A pressing question for public health officials," noted a study in the September 2003 American Journal of Health Promotion, "is whether the design of our communities makes it more difficult for people to get physical activity and maintain a healthy weight."

SPRAWL DOESN'T HELP

The study--"Relationship Between Urban Sprawl and Physical Activity, Obesity and Morbidity,"--found that "people living in counties marked by sprawling development are likely to walk less and weigh more than people who live in less sprawling counties." Researchers used Census Bureau statistics to measure development in 448 urban areas. They concluded that the people living in the most sprawling areas are "likely to weigh six pounds more than people in the most compact county." In addition to weight gain, the study found a direct relationship between sprawl and high blood pressure.

There is other evidence to suggest that a decline in physical activity has been at least partly responsible for the nation's obesity epidemic. Americans consume at least as many calories as they did a decade ago, yet over the past 20 years, the average adult took 42 percent fewer trips on foot. Kids are also burning fewer calories. The frequency with which children walked or biked to school dropped by 40 percent during the same period.

PAYING THE PRICE

Obesity costs individuals and society. The price of obesity was pegged at $117 billion nationwide in 2002, with a large portion being state Medicaid money to treat diabetes, coronary heart disease and high blood pressure. A 2003 report commissioned by the Michigan Governor's Council on Physical Fitness, Health and Sports found that a lack of adequate physical activity among 55 percent of the state's adults cost nearly $8.9 billion in medical care, workers' compensation and lost productivity.

State and local governments working together can help mitigate the adverse effects of physical inactivity by incorporating walking and biking into community design. An active living community is designed on a pedestrian scale and provides opportunities for people of all ages and abilities to engage in routine daily physical activity. Routine is the key--smart land use and transportation decisions can encourage physical activity as part of the community's fabric.

OBSTACLES TO PLANNING

It's ironic that public health concerns have changed land use laws in ways that both hinder and enhance physical activity. Traditional zoning separated different types of development--residential, retail, commercial and industrial--into areas far removed from one another.

The original logic was sound when people lived close to the factories in which they worked--the lack of environmental controls on smokestacks or sewers created public health problems for nearby residents. As technology helped control pollution and manufacturing was replaced by...