Healthy City Living

Are suburbs making us sick?

Sam Staley from the June 2006 issue

(Page 2 of 2)

The weakest part of the book is not its summary of the literature. It’s the discussion of an area where none of the authors has much professional expertise: urban planning. Achieving their vision of cities—high-density, mixed-use, pedestrian-friendly, mass-transit-dependent neighborhoods—would require the kind of draconian housing, migration, and land use regulations they disavow in their preface. They proclaim: “We do not argue for removing choices; rather, we argue for more choices. It would be foolish to tell anybody where to live.” Yet this is exactly what would have to happen to achieve the changes in lifestyle and land use patterns necessary to obtain significant health benefits.

Judging from what people actually buy and what they say in consumer surveys, most families prefer to own their own homes with yards large enough for their kids (or future kids or grandchildren) to play in. The density of a typical U.S. suburb ranges from 2,500 to 3,000 people per square mile. By contrast, professional planners estimate that effective bus transit becomes viable at 10,000 people per square mile. Light rail becomes viable at 14,000 people per square mile.

Any way you slice it, that’s a major restructuring of the urban landscape, and it represents a significant move away from the preferred housing of most households. Rather than buying a 1,500-square-foot house on a quarter-acre lot, a lower-middle-income household will be buying a 1,000-square-foot townhouse or duplex. The families that will be limited the most will be lower- and middle-income households and first-time homebuyers. This rejiggering of the urban landscape seems pretty dramatic for the relatively small health benefits it might bring.

At times even the authors recognize the limited impact of the built environment on public health. They write, for example, that moving from the lowest-density metropolitan area to the highest-density metropolitan area in the United States reduces the probability of being obese by just 12 percent. Yet this qualification doesn’t stop them from claiming that sprawl is a major factor in America’s obesity epidemic, providing further justification for government control over housing and land use.

Frumkin, Frank, and Jackson display a classic analytical fallacy: comparing an ideal construct to the gritty reality of the way people actually behave. Real people don’t have the luxury of choosing idyllic settings. Owning a house with a large yard may mean I live too far from the grocery store to walk, but it provides a safe haven for my children to play in with their friends in the immediate neighborhood. I’m not forced to organize a trip to the public park, holding their hands tightly, food and toys strapped to my back, as we cross a busy urban street. I may be more distant from my neighbors, but I’m at less risk of being robbed or assaulted. Suburban cities are much safer than traditionally denser urban cores, reporting victimization and crime rates at one-third to 50 percent lower, according to the FBI’s Bureau of Justice Statistics. Victimization by strangers is also lower in the suburbs.

All of which brings us back to my community pool, and to the opportunity this book missed. Frumkin and his colleagues are fundamentally right that different problems emerged with different types of cities at different points in time. Large, dense urban centers faced significant problems, but these problems were solved through technological innovation, advances in health care, the establishment of urban sewer systems, and the economic shift away from heavy industry.

Modern suburbs pose new challenges. Community design may play an important supporting role in improving health, but larger, often unknown forces may exert more powerful influences on human health and behavior. Air quality has improved, notes the American Enterprise Institute’s Joel Schwartz, because fleet turnover has removed the cars that pollute the most. High density and mixed uses may raise the likelihood that children will walk to the store or to a neighbor’s house, but these effects are likely to be swamped by general trends toward poorer eating habits and more reliance on sedentary entertainment such as video games.

The active, overweight kids at my local community pool don’t fit into the public health model of community design advocated by anti-sprawl academics like Frumkin, Frank, and Jackson. They reflect a general reluctance on the part of parents and consumers to understand and respond to the health challenges implicit in lifestyles characterized by more wealth, greater consumer choice, higher mobility, and abundant land. A good book on sprawl and public health would also recognize the centrality of consumer choice and the productive capacity of market economies. That book, alas, has yet to be written.