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