Healthy city living: are suburbs making us sick?

• Author: Staley, Samuel R.
• Position: Urban Sprawl and Public Health: Designing, Planning, and Building for Healthy Communities - Book review

Urban Sprawl and Public Health: Designing, Planning, and Building for Healthy Communities, by Howard Frumkin, Lawrence Frank, and Richard Jackson, Washington, D.C.: Island Press, 338 pages, $30

DURING THE SUMMER, we often pack up our kids for a little sun and fun at the local pool, nestled in our low-density, sprawling suburb in the Midwest. My kids eat a balanced diet, are physically fit, and are certainly not overweight. The pool is one of our tactics for moderating their time in front of video games and the television. It also ensures that they get a little exercise.

Each year we're surprised to find that other parents don't see things the same way, at least to judge by their children's girth. As our kids frolic, we sit amazed that other parents let their overweight children walk up to the snack bar to consume ice cream, hot dogs, and other high-calorie snacks. We know American kids face an obesity problem--we see it every summer in the jiggling rolls of sunburned fat at our local pool.

So I welcome any book that wants to inform the public about ways to keep us and our children fit. That's what the authors of Urban Sprawl and Public Health seem to promise. Unfortunately, the book doesn't deliver, partly because authors Howard Frumkin, Lawrence Frank, and Richard Jackson can't solve the problems we see every summer.

They are, to be sure, well qualified to write this book. They are among the most prolific researchers on the subject of land use and public health, and they have strong credentials: Frumkin chairs Emory's Department of Environmental and Occupational Health, Frank holds an endowed chair in transportation planning at the University of British Columbia, and Jackson is an officer in California's Department of Health Services. And their book's basic premise is plausible: Choices about where and how people live have potentially significant implications for their health. Living on top of a toxic waste dump, to pick an obvious example, probably increases the odds of getting cancer.

The large lots with segregated residential and commercial land uses perpetuated by standard zoning codes and planning procedures work against good health, Frumkin and his colleagues argue. Low-density suburbs, they say, encourage automobile use and discourage walking, contributing to sedentary lifestyles while disrupting healthy fitness habits and spewing more pollutants into the air. Unfortunately, the evidence they provide isn't nearly as convincing as they claim, and they miss an opportunity to discuss how everyday habits such as...