Does Sprawl Really Kill?

Sprawl/health studies don't live up to hype

Sprawl kills. That’s the bumper sticker that could go with a new report on suburban-style housing development and its impact on public health. Living in the suburbs cuts four years off your life, according to a new RAND Institute study published in the academic journal Public Health.

Unfortunately, the substance of the study, and others before it, doesn’t live up to the hype.

Sprawl critics make a leap that goes like this: People live in houses with garages. Because these houses sit on small open-air parks (yards), people are less inclined to walk to a transit stop and take a bus to work. So, they climb in their cars and drive. Because they drive, they don’t exercise. Since they don’t exercise, they have more health problems, get sick, and die sooner. Simply stated, it’s your house’s fault.

Needless to say, this analysis has numerous problems. The RAND researchers examined 11 health problems, including cancer, diabetes, hypertension, stroke, asthma and heart disease. These are serious illnesses afflicting millions of Americans each year. But, the study didn’t find these were related to sprawl.

The health problems dubiously associated with sprawl (statistically) were arthritis, trouble breathing (chronic lung disease), abdominal and digestive problems, headaches, and urinary track problems. Even the authors don’t quite understand why some of these illnesses (e.g., bladder problems) are related to sprawl, but a statistical relationship was there. Using my life as a case study, I would guess that arthritis comes from all the yard work, the headaches come from children, and the stomach and urinary problems are a result of too much fast food.

Of course, the fact that ill health might be related to our lifestyle choices is nothing new. The question is: What is the tradeoff? Do we really want to limit our housing choices based on the strength of this research on public health?

I don’t think so. This study, like earlier ones, still suffers from a number of very important limitations. They usually don’t control for what we eat, how we want to live, or whether people with healthier lifestyles just like living in certain places like downtowns rather than suburbs.

Also, the effects are small. Going from the relatively sprawling Rochester, New York to the less sprawling Chicago, Illinois would improve health outcomes by about 10 percent according to the RAND study. Is that worth dramatically reducing the size of our back yards, spending more time commuting by transit, or letting your mother in-law live over your garage?

Probably not. Many of us would much rather reduce the amount of time in front of the TV, go for a walk, or start eating healthier. That way, we can still play with our kids in the privacy of our yards and enjoy the single-family detached home that was once the American dream.

There are plenty of suburbanites eating right, exercising, and suffering no ill effects of their neighborhoods. It’s about personal choices. Some people actually choose an unhealthy, sedentary lifestyle filled with fast food and hours of television each day. Most pay the costs of that choice through deteriorating health and higher health insurance premiums. It’s the trade-off we each choose to make.

That said, the debate over land use and health is a good one. The RAND study provides empirical evidence that we need to be more receptive to how land development patterns might create barriers to increased physical activity, but that’s a long way from saying we need to sell the homestead and move back to the city.

We should be embracing sidewalks, allowing developers to build higher densities, and trying to connect neighborhoods to important local services such as the grocery store, pharmacy, and local restaurants. But we shouldn’t ignore the truth: Sprawl doesn’t kill, our choices about exercise, food, and overall lifestyle impact our health infinitely more than our decision to live in a downtown condominium or a detached home with a yard in suburbia.

Samuel Staley is director of urban and land use policy at Reason Foundation and co-editor of the book “Smarter Growth: Market-Based Strategies for Land-Use Planning in the 21st Century.”