Urban Sprawl and Health

Healthy Public Policy Information Sheet

Urban sprawl and health Bigger doesn’t necessarily mean healthier Cities bring many of the things that we associate with good health together in one locale – employment and educational opportunities; accessible, nutritious foods; hospitals, clinics, and other healthcare facilities; cultural and economic diversity; and adequate housing. But when it comes to the physical size of a city, bigger doesn’t always mean healthier. Sprawling cities with low population densities can have a negative impact on health.

What is urban sprawl? There are many definitions of urban sprawl, but most suggest that sprawl is a development pattern characterized by the following features: !

Low-density development, with new growth appearing primarily on previously undeveloped or agricultural land (“greenfields”).

!

Outward development at the city edge, in contrast to a process of densification within the city’s existing boundaries.

!

Emphasis on separation of major land uses (residential, commercial, industrial) and on single-use development (in contrast to mixeduse development).

!

Disconnected residential development where new subdivisions are not contiguous with each other or with the rest of the city (sometimes referred to as “leapfrog” development).

!

Need for extensive road and transportation infrastructure, resulting in transportation networks biased towards automobile travel and with limited potential for multi-modal transportation and active transportation such as public transit, walking, biking, and wheeling.

Population densities and automobile dependence in major Canadian metropolitan areas 2

Population Density (persons/km2)

Percent of population aged 18 years and older making all trips by car (as driver or passenger)

Edmonton

109.9

77

Winnipeg

131.0

72

Ottawa-Gatineau

197.8

71

Calgary

211.3

75

Quebec City

218.4

74

Vancouver

735.6

69

Montreal

853.6

65

Toronto

866.1

66

Census Metropolitan Area (CMA)

Impact of urban sprawl on health Sprawl is associated with at least four major categories of population health risks,3 including physical inactivity, reduced air quality, increased motor vehicle collisions because of widespread automobile travel, and mental health issues. These risks can contribute to a range of negative health outcomes, from chronic and debilitating conditions to fatal and non-fatal injuries.

April 2009 / For more information contact: [email protected]

Impacts of sprawl on the health of the population Elements of sprawl

k

Development on greenfields at edges of urban areas

Transportation infrastructure biased towards automobiles

Health outcomes (examples)

Heart disease Diabetes Colon cancer Osteoporosis

k

Reduced air quality

k

! Respiratory disorders ! Heart disease ! Some cancer types

Motor vehicle collisions

k

! Fatal injury ! Non-fatal injury

Social isolation Loss of natural areas Commuting stress

k

! Mental health impacts

k k k

k

! ! ! !

Physical inactivity

Low density development

Separation of residential and commercial areas

Population health risks

Source: Prepared by Population Health, Population Health and Research, Capital Health, 2008.

Physical inactivity. The link between physical activity and health is well-established.4,5 Key elements of sprawl – including separation of residential areas from other land uses, high levels of automobile use and long commuting times – can make it difficult for people living in areas characterized by sprawl to get sufficient daily physical activity. Air quality. There is an abundance of evidence linking air pollution to increased rates of illness and premature death in populations.7,8,9 In Canadian cities, vehicle emissions such as nitrogen oxides, carbon monoxide, volatile organic compounds, and fine particulates are an important factor in local air quality. By creating neighborhoods far from the city core that necessitate automobile travel, sprawl contributes to poorer air quality and its related health impacts. Motor vehicle collisions. People who live in sprawling neighbourhoods spend more time in automobiles than do those who live in more compact neighbourhoods. This simple fact puts them at greater risk for injury and even death from automobile collisions.10 Mental health risks. Making a direct link between sprawl and mental health is difficult because of the

complex factors that contribute to mental health.12 We do know that sprawl can contribute to feelings of social isolation, stress and disconnection from the natural environment, which have been associated with mental health conditions.12

Addressing the negative health effects of urban sprawl The negative health effects of sprawl can be reduced through effective planning and development decisions. This requires collaboration across sectors and between groups—such as planning and health—that often work in isolation from each another. We need an adequate supply of compact, sustainable urban neighbourhoods that support active transportation, complemented by economic reforms so that land and housing prices better incorporate the full health, environmental, public infrastructure, and transportation costs of urban sprawl. Planning and development processes to reduce sprawl’s negative health impacts can be guided by research, which has found that: Neighbourhood features such as high street connectivity, relatively high population density and


mixed (residential, commercial, retail) land use have been linked to increased physical activity.3

Traffic-related deaths, “smart growth” cities and sprawling cities, United States, 2000

Compact cities with more extensive public transit systems often have dramatically lower automobile fatality rates than do more sprawling cities.11

" Smartest growth

Reduced auto travel and increased active transportation can reduce the vehicle exhaust that contributes to asthma, other respiratory conditions, and cardiovascular disease.13 There is already considerable demand for compact, mixed-use communities that support active transportation. Many people who currently live in automobile-dependent neighbourhoods would prefer to live in communities supportive of active “Sprawl impacts transportation.14 negatively on well-being by eroding social capital, robbing people of all ages of the opportunity to have a balanced healthy lifestyle, degrading the surrounding natural environment, and increasing the stress of commuting, which not only impacts mental health but also physical health.”13

With political will, public support and creative planning, we can make our major urban centres healthier, safer and more active places to live.

" Most sprawled

Per 100,000 population

New York City, NY

4.42

Kings County, NY

4.46

Bronx County, NY

4.20

Queens County, NY

4.58

San Francisco County, CA

6.31

Hudson County, NJ

5.91

Philadelphia County, PA Suffolk County, MA Richmond County, NY Baltimore City, MD Stokes County, NC

8.04 4.49 5.63 7.68 7.68 15.66

Miami County, KS

38.80

Davie County, NC Island County, MN Walton County, GA

25.84 12.78 19.77

Yadkin County, NC

38.52

Goochland County, VA

35.58

Fulton County, OH Clinton County, MI Geauga County, OH

28.01 16.99 20.9

Source: Ewing, Scheiber, and Zegeer, 2003

Find out more !

Johnson SA, Marko J. Designing healthy places: land use planning and public health. Edmonton, Alberta: Population Health – Capital Health; 2007. www.capitalhealth.ca/AboutUs/Resource Library/Other/default.htm

!

Ontario College of Family Physicians Report on Public Health and Urban Sprawl in Ontario. Environmental Health Committee, Ontario College of Family Physicians; 2005. www.ocfp.on.ca/English/OCFP/Urban-Sprawl/

!

Victoria Transport Policy Institute. www.vtpi.org/

!

Smart Growth Canada Network. www.smartgrowth.ca/home_e.html

!

Sightline Institute. www.sightline.org/research/sust_toolkit/ solutions/healthy-comm.

!

Canada Mortgage and Housing Corporation (CMHC) Comparing Neighbourhoods for Sustainable Features. www.cmhc-schl.gc.ca/ en/co/buho/sune/index.cfm


References 1.

Altshuler A, Gomez-Ibanez JA. Regulation for revenue: the political economy of land use exactions. Washington, DC: Brookings Institution; 1993.

2.

Turcotte M. Dependence on cars in urban neighbourhoods. Ottawa, Ontario: Statistics Canada; 2008. Available from URL: www.statcan.ca/english/freepub/11-008-XIE/ 2008001/article/10503-en.htm.

3.

Johnson SA, Marko J. Designing healthy places: land use planning and public health. Edmonton, Alberta: Population Health – Capital Health; 2007.

4.

United States Department of Health and Human Services. The Surgeon General’s call to action to prevent and decrease overweight and obesity. Rockville, MD: United States Department of Health and Human Services, Public Health Service, Office of the Surgeon General; 2001.

5.

Magnusson P, Torp-Pedersen CT, Backer V, Beyer N, Andersen LB, Hansen I-LK et al. 2004. Physical activity and chronic disease: epidemiology, biological mechanisms, practical recommendations and future research. III: the musculoskeletal system and the lungs. Ugeskrift for Laeger 2004;166(17):1552-1557.

6.

City of Edmonton Planning and Development. Monthly Economic Review. Edmonton: City of Edmonton; February 2006. Available from URL: www.edmonton.ca/portal/ server.pt/gateway/PTARGS_0_0_379_214_0_43/http%3B /CMSServer/COEWeb/infrastructure+planning+and+ building/economic+information/Monthly+Economic+ Review.htm.

7.

World Health Organization. Health aspects of air pollution: results from the WHO project “Systematic review of health aspects of air pollution in Europe. Denmark: WHO Regional Office for Europe; 2004.

8.

Toronto Public Health. Toronto air quality index: health links analysis. Toronto, Ontario: Toronto Public Health; 2001.

9.

McKeown D. Air pollution burden of illness from traffic in Toronto: problems and solutions. Toronto, Ontario: Toronto Public Health; 2007.

10.

Sightline Institute. Cascadia Scorecard. Seattle, Washington: Sightline Institute; 2006.

11.

Ewing R, Schieber RA, Zegeer CV. Urban sprawl as a risk factor in motor vehicle occupant and pedestrian fatalities. American Journal of Public Health 2003; 93(9):1541-1545.

12.

Sturm R, Cohen DA. Suburban sprawl and physical and mental health. Public Health 2004;118(7):488-496.

13.

Ontario College of Family Physicians. The health impacts of urban sprawl: social and mental health. Toronto: Ontario College of Family Physicians; 2005.

14.

Frank L, Chapman J and Levine J. Transportation and Land Use Preferences and Atlanta Residents’ Neighbourhood Choices. Atlanta GA: Georgia Tech Research Institute; March 2004.
