142nd APHA Annual Meeting and Exposition

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Urban sprawl and health in the United States: Review of challenges to causal inference and updated sprawl index data release

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

David Berrigan, PhD, MPH , Applied Research Program, National Cancer Institute, Bethesda, MD
Gail Meakins, MUP, MA , Department of City and Metropolitan Planning, College of Architecture and Planning, University of Utah, Salt Lake City, UT
Reid Ewing, PhD , Department of City and Metropolitan Planning, College of Architecture and Planning, University of Utah, Salt Lake City, UT
Shima Hamidi, MA , Department of City and Metropolitan Planning, College of Architecture and Planning, University of Utah, Salt Lake City, UT
Zaria Tatalovich, PhD , Surveillance Research Program, DCCPS, National Cancer Institute, Bethesda, MD
Purpose:  Sprawl, epitomized by low density development around urban areas, is common in the United States and other countries. In 2003, Ewing et. al. described a sprawl index based on principal components analysis of six variables concerning residential density and street characteristics for 448 US counties. Recent work on urban sprawl and health has focused on associations between sprawl and energy balance (especially physical activity and obesity).  Here we discuss efforts to document causal associations between sprawl and energy balance and describe newly released urban sprawl data and an updated sprawl index for the United States at the county and metropolitan level.

Methods:  A literature review of studies examining sprawl and energy balance related health outcomes was conducted. Values of the 2000 county sprawl index for 994 urban and suburban counties were updated, using data from 2010 and a revised county sprawl index for 2010, and incorporating four dimensions of sprawl derived from 17 variables—density, land-use mix, population or employment concentrations (“centering’), and street characteristics (supported by NCI, Smart Growth America and the Ford Foundation.

Results and Conclusions: Despite convincing evidence that urban sprawl has negative environmental consequences, results concerning causal associations between sprawl and health outcomes have been mixed.  Our work and the literature contain disparate results for cross-sectional and longitudinal analyses of sprawl and health and document regional heterogeneity in associations between sprawl and health. New data on urban sprawl and the availability of data from multiple decades should allow further explorations of potential causal relationships between sprawl and health.

Learning Areas:

Chronic disease management and prevention
Environmental health sciences
Other professions or practice related to public health
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Public health or related research

Learning Objectives:
Discuss challenges to causal inference concerning associations between urban sprawl and health Describe availability and characteristics of updated urban sprawl index

Keyword(s): Built Environment, Urban Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an active researcher in the area of built environment and health, I am the author/coauthor of 100+ papers concerning ecology, evolution, public health and the built environment. I have been a program officer at NCI for ten years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4277.0: Improving health through built environments and healthy communities