Baltimore Sun
November 25, 2005

TRACKING EFFECTS OF SUBURBAN LIFE ON HEALTH

By Timothy B. Wheeler

After a day on the run -- in and out of her son's day care center, up
and down two flights of stairs like a yo-yo at work -- Kathleen
Yancosek likes to unwind with a good, brisk walk.

But the wiry, 30-year-old occupational therapist rarely takes a stroll
around her Silver Spring neighborhood this time of year. It's dark by
the time she gets home from her job in Washington. Besides, there are
no sidewalks along her street.

So, when she can, after her two young children are tucked into bed,
Yancosek hops onto a treadmill in her split-level house.

"I try to do about 30 minutes every night," she says.

By keeping track of their every waking movement over a typical week,
Yancosek and dozens of other Montgomery County residents are helping
researchers with a sprawling question: Is suburbia harmful to your
health?

Results from this study of Montgomery residents won't be compiled and
published for a year or two. But previous research suggests that
suburbanites have reason to worry.

Studies have found that people living in spread-out suburban
communities tend to weigh more than city residents and to suffer more
from chronic health problems including arthritis, asthma, obesity and
headaches.

Critics of the nation's ever-expanding suburbs have been quick to cite
such health studies as another compelling reason to build more
compact, pedestrian-oriented communities. Research projects and
conferences devoted to improving people's health by changing their
"built environment" have become a cottage industry, fueled by a steady
stream of grants from foundations and government.

Some researchers caution that the evidence is a little too thin to
warrant counting cul-de-sacs and strip malls as major culprits in the
nationwide epidemic of obesity among adults and children.

A team of researchers from the University of Maryland, College Park
and from the University of North Carolina has set up the Montgomery
County study to see whether they can pinpoint features in the
workplace and at home that get some people moving while turning others
into couch potatoes.

"The whole point is to try to understand what types of environments
really support physical activity," says Kelly J. Clifton, an assistant
research professor at UM's National Center for Smart Growth Research
and Education in College Park.

Toward that end, the roughly 80 Montgomery residents who have been
recruited have kept detailed diaries of their activities at work and
leisure for a week. They also have worn pedometer-like devices that
recorded their movements, whether walking, dancing or just fidgeting
in a chair.

The research team hopes to gather data on 400 residents living in five
areas of the county. The areas were chosen because they cover a range
of neighborhood characteristics, from townhouses near a Metro stop in
Silver Spring to the more spread-out, car-oriented housing of Olney.

The three-year study is underwritten by a $473,000 grant from the
Robert Wood Johnson Foundation, which is financing a series of studies
aiming to promote "active living."

"We're hoping that the knowledge gained will provide a basis for
changing the way our neighborhoods are planned," Daniel Rodriguez, a
UNC planning professor and the study's principal investigator, said in
a statement.

A lack of physical activity has been linked, along with eating too
much of the wrong things, to obesity and a variety of health problems.
On the flip side, a recent study found that people who walk or
exercise daily tend to live a year to nearly four years longer.

Studies also have found that the amount of walking people do is
associated with whether their neighborhood has sidewalks and places
nearby to walk.

But that doesn't prove that sidewalks prompt people to be more
physically active, says Reid Ewing, another UM researcher and author
of a widely publicized study linking obesity and sprawl.

"We know that people who live in walk-able neighborhoods walk more,
but is that because the environment is causing them to walk more, or
is it because they want to walk and have chosen these neighborhoods?"
he asks.

Yancosek, who works at Walter Reed Army Medical Center, says she gets
plenty of exercise around her house, flitting up and down steps doing
housecleaning and looking after her children.

Jason Sartori, a self-employed planning consultant who took part in
the Montgomery County study, takes care of his 2-year-old daughter in
their Silver Spring townhouse. When weather permits, he walks her to a
playground a block away.

But, although stores also are a short walk away, he usually drives, he
says, and has no time to go to the gym. His exercise, he says, comes
from nearly constant pacing, even while on the phone.

"I don't work out on a regular basis, but I am a pretty active
person," says Sartori, who is 5 feet 10 and weighs 170 pounds.

Another study participant, Fred Proctor, 41, lives in a four-bedroom
Colonial in Olney, a typical suburban neighborhood with cul-de-sacs,
but also with sidewalks. Proctor walks his dogs before and after work
and rides his bicycle at lunchtime at his campuslike workplace, the
National Institute of Standards and Technology in Gaithersburg.

"I think I probably exercise more than I used to," Proctor says,
looking back to his youth.

UM's Ewing says new research is starting to find that the link between
sprawl and obesity might be more subtle than earlier studies
indicated.

In a study he just completed of children whose families moved from one
type of neighborhood to another, he found that the youngsters' weight
varied by only a few pounds, Ewing says.

"If you move from a more sprawling place to a more compact one,
there's a weak association. You're likely to lose a little weight,"
Ewing says. "If you move in the opposite direction, you're likely to
gain a little weight."

But the weight difference was too small to be significant
statistically, he concluded. "No researcher's going to take our
results and say, 'Voila! Now we know," he says.

One of Ewing's new findings, which await publication, runs counter to
conventional wisdom about suburbs being unhealthy places. Children
living on cul-de-sacs, it was found, might be more active than
youngsters living on a city street with sidewalks.

"They seem to have a little more freedom" to roam outdoors and play
than do children in urban neighborhoods, Ewing says.

Clifton has teamed up with another UM researcher to investigate the
personal, social and physical factors influencing the after-school
activities of teenage volunteers who are students at Baltimore's
Polytechnic Institute and Western high schools.

Clifton says that in the Baltimore study, she will use her engineering
and planning training to evaluate the physical environment in which
students live: "How does that affect everything from their exercise
levels to their getting to school or around town?"

Yet, for all the recent research focus on "built environment," UM's
Ewing says the evidence is that people's race, income and education
are far more likely predictors of their weight than where they live.

That bothers some skeptics, such as Robert E. Lang, director of the
Metropolitan Institute at Virginia Tech. For such a small effect, he
worries that all the funding and attention paid to the health
implications of suburban neighborhood layout distract from what are to
him more compelling concerns about the economic and environmental
impacts of sprawl.

"If you had any sense of history, you wouldn't waste time on this,"
Lang says, noting that urban planners once thought alleys contributed
to juvenile delinquency.

Even if neighborhood layout is a relatively small factor in people's
weight problems, counters Ewing, planners shouldn't forget about
trying to design healthful communities.

Suburbanites might be more able to compensate for their lack of
walking opportunities in the neighborhood -- by buying home gym
equipment, for instance, or exercising at lunch or driving to a park.
Planners also need to think about those who are less able to change
their circumstances.

"We can't change some of those other things," Ewing says of the larger
demographic links. "The built environment is something we believe we
can change."

timothy.wheeler@baltsun.com

Copyright 2005, The Baltimore Sun