RAND Study Finds First Link Between Suburban Sprawl and Increase in Chronic Health Ailments

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September 27, 2004

Suburban sprawl is linked to the incidence of many chronic health ailments, according to a new RAND Corporation study issued today.

“This is the first study that analyzes suburban sprawl and a broad range of chronic health conditions,” said Roland Sturm, a RAND Health economist and co-author of the study. “We know from previous studies that suburban sprawl reduces the time people spend walking and increases the time they spend sitting in cars, and that is associated with higher obesity rates. This probably plays an important role in the health effects we observe.”

Researchers found that people who live in areas with a high degree of suburban sprawl are more likely to report chronic health problems such as high blood pressure, arthritis, headaches and breathing difficulties than people who live in less sprawling areas. The differences between people living in the two types of areas remained even when researchers accounted for factors such as age, economic status, race and the local environment that might explain the differences.

The findings suggest that an adult who lives in a more sprawling city such as Atlanta willhave a health profile similar to someone four years older — but otherwise similar — who lives in a more compact city such as Seattle, according to researchers.

The findings appear in the October edition of the journal Public Health, in an article titled: “Suburban sprawl and physical and mental health.”

“To improve our health the study suggests that we should build cities where people feel comfortable walking and are not so dependent on cars,” said Deborah Cohen, a RAND researcher and physician who co-authored the study. “This study gives the public a way to personalize the issue of sprawl in a way that hasn’t happened before.”

Researchers found the unhealthful impacts of suburban sprawl disproportionately affect the poor and the elderly, who often have fewer resources to make up for the limitations created by their environment.

In contrast, the study found no link between suburban sprawl and a greater incidence of mental health problems.

Many researchers have proposed that suburban sprawl results in social isolation that may lead to more mental health problems among suburbanites. But RAND researchers found no differences in the rate of depression, anxiety and psychological well-being among people who live in urban and suburban settings.

Researchers conducted their study by using information from Healthcare for Communities, a survey funded by the Robert Wood Johnson Foundation that queried a nationally representative group of adults about a variety of issues related to their physical and mental health in 1998 and 2001. The study analyzed information from more than 8,600 people in 38 metropolitan areas across the nation.

A more sprawling area has streets that are not well connected (cul-de-sacs are not as well connected as a grid), more separated land use mix (shopping, schools, work, and residential areas are far from each other), and a lower population density.

Regions that had the worst suburban sprawl include: the Riverside-San Bernardino region of California; Atlanta; Winston-Salem, N.C.; West Palm Beach, Fla.; Bridgeport-Danbury-Stamford, Conn.; Knoxville, Tenn.; Rochester, N.Y.; and Detroit.

Regions with the least amount of suburban sprawl include: New York City; San Francisco; Boston; Portland, Ore.; Miami; Denver; Chicago; and Milwaukee.

Funding for the study was provided by the National Institute of Environmental Health Sciences and the Robert Wood Johnson Foundation.

RAND Health is the nation’s largest independent health policy research organization, with a broad research portfolio that focuses on health care quality, costs, and delivery, among other topics.

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