Ewing R, Schmid T, Killingsworth R, Zlot A, Raudenbush S. Relationship between urban sprawl and physical activity, obesity, and morbidity. American Journal of Health Promotion. 2003;18:47 -57.
The authors of this study analyzed a large nationally representative sample of people to assess associations between urban sprawl and health problems. Sprawl was defined as any environment characterized by: 1) a population widely dispersed in low-density residential development; 2) rigid separation of homes, shops, and workplaces; 3) a lack of distinct, thriving activity centers; and 4) a network of roads marked by large block size and poor access from one place to another. To measure sprawl in metropolitan areas, the authors used a 22-variable metropolitan sprawl index. To measure sprawl in counties, the authors developed a separate measure that was able to assess, at the metropolitan level, residential density and street accessibility.
Using the county index of sprawl, the investigators found that residents of more compact places reported spending more leisure time walking than did residents of more sprawling places. The number of minutes people walked varied directly with the county index. The county index of sprawl was also associated with obesity and hypertension. According to the authors, this report has several limitations: using a cross-sectional design; measuring physical activity only by leisure activity (i.e., excluding occupation-, household-, and transportation-associated physical activity); not taking into consideration climate and topography; and not taking into consideration diet and food environment. The authors recommend further research on this topic.
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