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To get around Stapleton, Colorado, all you really need are your feet. Residents of the 4,700-acre Denver suburb stroll or cycle to downtown offices and schools within minutes, weaving through forested greenways and bike trails. Along the way, they can stop for a coffee or gaze at public art. On weekends, they can chat with neighbors while buying arugula at the local farmers’ market, take a bus to downtown Denver, or just settle into the grass of the 80-acre “Central Park,” an emerald gem of open space at the town’s core. The community’s mix of single-family homes, townhouses, and apartments—with units reserved for lower-income citizens—all meet state environmental building standards.

 

It’s no surprise the town touts itself as a model of smart growth and environmentally sensitive development. But recent research suggests that communities like Stapleton are not just more eco-friendly, they’re also healthier places to live.  “We hadn’t really looked into the way neighborhoods can impact health until recently, but it’s starting to look like one of the missing pieces to the public-health puzzle,” says Laura Brennan Ramirez, an assistant professor at Saint Louis University who recently authored a study on the issue.

 

To understand what makes a healthy neighborhood, it helps to know what makes an unhealthy one. In the past few years, public-health experts have been researching the effects of urban sprawl and car-dependent suburbs. What they’re finding is that people living in these areas—where homes and businesses are spaced far apart along roadways that require cars to get from place to place—face more health problems than those living in more compact neighborhoods that allow easy walking and biking.

 

The bulk of that research has focused on the relationship between neighborhoods and the levels of physical activity and obesity of their residents. People living in low-density neighborhoods, it turns out, are more sedentary and heavier than those who live in more compact suburbs or cities. In 2003, researchers at the University of Maryland published a study of nearly 200,000 people in 448 counties and metropolitan areas, and found that as the level of sprawl increased, so did the study participants’ high blood pressure, weight gain, and the likelihood of being obese. In a 2004 study led by Lawrence Frank, an urban planning professor at the University of British Columbia, researchers surveyed nearly 11,000 people in Atlanta, the most sprawled region in the U.S. They found that each additional hour spent in a car daily was associated with a six-percent increase in the risk of obesity.  

 

But weight gain and cardiovascular disease aren’t the only problems.  All that driving, of course, means high levels of vehicle emissions and pollution. People who live near busy streets can be exposed to two or three times more particulate matter, a harmful byproduct of car emissions, than those who don’t. Pollution can create respiratory ailments and other health problems, especially in sensitive populations such as children. 

 

An unhealthy neighborhood can also take a toll on mental health. Sprawl can isolate people in their homes, which is a risk factor for depression. Seniors are especially susceptible; their inability to drive often severs social ties. Commuting, especially in congested traffic, can also spark “road rage,” as well as raise a driver’s blood pressure and level of anxiety. More time spent in cars also denies people a less tangible need: a psychological sense of community. As writer-activist Jane Jacobs so fiercely believed, the casual, everyday conversations with people on the street or in the park reinforce a “feeling for the public identity of people.” Yet social capital—memberships in clubs, churches, or volunteer organizations, or on-the-fly card games with the next-door neighbor—has plummeted since the ’50s, when people first flocked to the suburbs, and one study showed commuters participated less than non-commuters in civic organizations.

 

It’s not a pretty picture—especially when you consider that for the moment, sprawl remains the model of choice for many developers because it tends to be cheaper and fits easily with local zoning ordinances. But the good news is experts are awakening to the need for change. “[We need] direct policies that are going to address this looming, monstrous issue,” says Frank.

 

As more data emerge on the ill effects of sprawl, momentum for healthier alternatives is growing.  In Portland, Oregon, the darling of the anti-sprawl movement, city officials have made aggressive moves to control development. Although the influx of new residents has some neighborhoods bursting at the seams, it has maintained its status as a healthy city where people can walk through neighborhoods with inviting porches and gardens. Extensive bike paths and a network of buses distribute people easily throughout the city, without cars. Meanwhile, in King County, Washington, local planners have built a “wall against sprawl,” which protects rural areas from development while promoting mixed-use areas around streetcars, buses, or rail stations. And in New Jersey, state agencies control 17 “transit villages,” revitalized areas of shops and apartments centered around public transit.

 

 In more suburban settings, New Urbanism, an urban planning movement that supports a reversion to pre–World War II building practices, also continues to gain popularity. Its strategies include a diverse range of housing, and involve retrofitting existing areas and planning for open space. Many of the original communities, such as Seaside and Celebration, both in Florida, are thriving, and today more than 210 New Urbanist developments like Stapleton are either completed or under construction in the United States.

 

Federal efforts are starting to take shape, too. The Centers for Disease Control and Prevention (CDC) has recently jumped on board with several programs that address the health effects of neighborhoods, or what urban planners call “the built environment.”  “We want to get health at the table when a lot of the built environment decisions are made,” says Andrew Dannenberg, MD, a CDC medical officer. The agency is pilot-testing a program that would collect “health impact assessments,” reports similar to environmental-impact statements, as well as funding the U.S. Green Building Council’s new LEED standard for neighborhoods, which will launch in 2008. The voluntary standard encourages developers to build neighborhoods that preserve parkland, protect wetlands and waterways, and promote health with compact development and walkable streets. “It’s a major step in the direction of getting builders and developers looking at: ‘How do we do the right thing?’” says Dannenberg.

 

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