The Built Environment’s influence Raymond Chetti

University at Buffalo

on Physical Activity
School of Architecture & Planning
rjchetti@buffalo.edu

ABSTRACT
Recent studies have proven that poor urban form fosters sedentary, inactive life-
styles that discourage routine physical activity. The purpose of this research was 1 out of every 3
to analyze the correlation between characteristics of urban form (such as resi-
dential density and land use mix) to determine their influence on the percentage American children
of adults who achieve the Surgeon General’s recommended levels of physical are obese
activity. A correlation analyses showed land use mix had a stronger correlation
with physical activity (r = .42) versus the lower, but yet positive correlation be- Health Impacts of Obesity
tween residential density and physical activity (r = .14). These results support
Obese individuals have a 10-to
50-
the need for policies that promote increased densities and land use mix as a Heart Diabetes
Disease percent increased risk of death from
means to promote active and healthier lifestyles that include walking, cycling, all causes compared with
Destruction of
and taking public transportation. Weight-Bearing
healthy weight individuals (BMI 18.5-24.9).9
Joints Depression
INTRODUCTION Orthopedic
Childhood
Obesity is associated with
112,000 excess deaths per year in
The prevalence of the childhood obesity epidemic has grown to a rate where Problems Obesity 2 Social
the U.S. population relative to healthy
weight individuals.9
approximately one out of every three American children are obese (BMI ≥ 95th Isolation
percentile);1 obese children are susceptible to increased risks for a number of Moderate obesity (BMI 30 to 35) short-
life threatening diseases as well as a higher risk for increased mortality risk High
Cardiovascular ens lives by 3 years and the seri-
Cholesterol
during their adult lives.2 For this reason the prevention of childhood obesity is Hypertension
Disease ously obese (BMI 40 to 50) will die 10
critical in preventing adult diseases that are associated with adult obesity. years before they should.10
Aside from the many direct health impacts of obesity, the economic cost of cov-
ering obesity related illnesses costs the average American family about 9% of Economic Impacts of Obesity3
their total medical costs.3 In light of the negative impacts of childhood obesity, Direct Costs Indirect Costs National Economic Costs
recent studies have proven that sprawl and poor urban form fosters sedentary, • Physician visits • Economic output lost pro- Associated with Obesity 3
inactive lifestyles that discourage routine physical activity.4-8 ductivity (missed work days
• Clinic services and future earnings lost)
The purpose of this study is to add to the need of community level studies on Direct Costs: $61 billion
how urban form affects people’s levels of physical activity. How does urban • Mediciations
• Premature death
Indirect Costs: $56 billion
form influence physical activity at the community level? • Hospitalization

LITERATURE REVIEW
The negative effects of poor urban form are endless and ranges from socio- obese (≥95 percentile) was associated with sprawl.4 Ewing et al. calculated
economic and quality of life impacts, more rapid consumption of natural re- sprawl by measuring residential density, land use mix, degree of centering,
sources and energy, the destruction of rural and natural areas, and the deple- and street accessibility.
tion of our ozone layer.12 Despite these impacts, none of them could influ- Frank et al. concluded that land use mix, residential density, and street ac-
ence us more directly than sprawl’s impact on our indiviudal, personal health cessibility (or intersection density) were positively related with the number of
as well as the health of our children. minutes of moderate physical activity per day, a person was able to
Supporting Frumkin’s inital argument,7 others have found relationships and as- achieve.5,6 Frank et al. (2004) found that land use mix had the strongest as-
sociations between the built environment, physical activity levels, and obesity sociation with obesity while also finding each additional hour spent in a car
levels. Lopez performed a multilevel analysis (cross-sectional study) to assess per day was associated with a 6% increase in being obese while each addi-
urban sprawl and obesity by gathering 2000 U.S. Census data and individual- tional kilometer walked was associated with a 4.8% reduction in being
level data from the CDC’s BRFSS and found that for each 1-point increase in his obese.5 Frank et al. (2005) found that 37% of the individuals living in denser
urban sprawl index (as urban areas tended to be less dense), the risk for being and more mixed use areas achieved the Surgeon General’s recommended
overweight increased by .2% and the risk for being obese increased by .5%.8 level of moderate intensity physical activity compared to only 18% in more
Ewing et al. found that the likelihood of U.S. adolescents (aged 12-17 years) sprawling neighborhoods.6
being overweight (≥85 percentile) and yound adults (18-23 years) being

METHODOLOGY
Research Design Dependent Variable
Develop research problem and question Perform literature review to Physical Activity Variable Source
study which factors of urban • Adults with 30+ minutes • Center for Disease
Gather data for variables form influence physical activity of moderate physical Control (CDC) - SMART:
activity five or more days BRFSS City and County
per week, or vigorous Data (2005)
physical activity for 20+
Depending on the limited data available, Perform correlation analysis minutes three or more
the dependent variable, the unit of analy- to determine each urban days per week.
sis (MSA) and sample size (12 MSA’s) form’s influence on health
were determined and physical activity Independent Variables

FINDINGS & ANALYSIS Land Use Mix Variable Source

Both independent variables were found to be correlated with the percentage • Percentage of residents • American Housing
of adults who achieve the recommended levels of physical activity. The find- within satisfactory Survey - Metropolitan
neighborhood shopping (2002)
ings of this study support the results from previous literature that argue resi- within 1 mile.
dential density and land use mix are correlated with public health.
While it is evident that land use mix has a stronger, positive correlation with Correlation coefficient of r = .42
physical activity as opposed to residential density, Frank et al. (2004) also w/ Physical Activity
found that land use mix had the strongest association with obesity (BMI≥
30kg/m2) as opposed to residential density and street connectivity.5 Residential Density Variable Source
Residential Density & Physical Activity Land Use Mix & Physical Activity • Gross population density in • American Housing
0.60 0.60
persons per square mile. Survey - Metropolitan
Physical Activity (% of people whom achieve recommended)

Physical Activity (% of people whom achieve recommended)

0.50 Buffalo
Charolotte
0.50 Buffalo
Charolette
(2002)
0.40 Columbus 0.40 Columbus
Dallas Dallas
Fort Worth Fort Worth
0.30 0.30

Correlation coefficient of r = .14

Kansas City Kansas City
Miami Miami
0.20 0.20
Milwaukee, WI
Phoenix, AZ
Milwaukee, WI
Phoenix, AZ
w/ Physical Activity
0.10 0.10
Portland, OR-WA Portland, OR-WA
Riverside-San Bernardino-Ontario Riverside-San Bernardino-Ontario
0.00

WORKS CITED
San Diego, CA 0.00
San Diego, CA
0 200 400 600 800 1000 1200 1400 0 20 40 60 80 100
Population Density (persons per square land mile) Mix of Uses (% within 1 mile of satisfactory shopping)

1. Robert Wood Johnson Foundation. (2010, January 14). Robert Wood Johnson Foundation Statement Regarding Release of Estimates of Obesity Prevalence Among U.S. Children and Teens. Retrieved from http://www.rwjf.org/

CONCLUSION & RECOMMENDATIONS

2. Gunnell, D., Frankel, S., Nanchanal, K., Peters, T., & Smith, G. (1998). Childhood obesity and adult cardiovascular mortality: a 57-y follow-up study based on the Boyd Orr cohort. The American Journal of Clinical Nutrition, 67(6), 1111-1118. Retrieved from http://www.ajcn.org
3. Alliance for a Healthier Generation. (2010). Childhood Obesity Costs. Retrieved from http://www.healthiergeneration.org/
4. Ewing, R., Brownson, R., & Berrigan, D. (2006, December). Relationship between urban sprawl and weight of United States youth. American Journal of Preventive Medicine, 31(6), 464-474. Retrieved from http://www.ajpm-online.net/
5. Frank, L., Andresen, M., & Schmid, T. (2004). Obesity relationships with community design, physical activity, and time spent in cars. American Journal of Preventive Medicine, 27(2), 87-96. Retrieved from http://www.ajpm-online.net/

Based upon the literature review and the results of this study, future policies should 6. Frank, L., Schmid, T., Sallis, J., Chapman, J., & Saelens, B. (2005). Linking objectively measured physical activity with objectively measured urban form: Findings from SMARTRAQ. American Journal of Preventive Medicine, 28(2), 117-125. Retrieved from http://www.ajpm-online.net/
7. Frumkin, H. (2002). Urban sprawl and public health. Public Health Reports, 117(3), 201-217. Retrieved from http://www.cdc.gov/

support high density and mixed use development to help promote more compact
8. Lopez, R. (2004). Urban sprawl and risk for being overweight or obese. American Journal of Public Health, 94(9), 1574-1579. Retrieved from http://ajph.aphapublications.org/
9. National Institute of Diabetes, Digestive, and Kidney Diseases. (2007, June). Statistics Related to Overweight and Obesity. Retrieved from www.win.niddk.nih.gov
10. Boseley, S. (2009, March 18). Obese die up to 10 years early, study of a million people finds. Guardian.co.uk. Retrieved from http://www.guardian.co.uk/

and walkable communities where residents will be more physically active. 11. ICF International. (2010). Childhood Obesity Prevention. Retrieved from http://www.icfi.com/
12. European Environment Agency. (2006). Urban Sprawl in Europe: The ignored challenge. Retrieved from http://www.eea.europa.eu/