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Planning Healthier Suburbs, Where Cars Sit Idle and People Get Moving

By Jane E. Brody

The goal is to engineer more physical activity into American life to reduce both spreading obesity and the chronic, often lethal health problems linked to sedentary living.

I grew up in Brooklyn, N.Y., where the streets were my playground. Virtually every day my friends and I played outdoors, roller skating, bicycling, playing ball, running races and the like. As a grown-up, I resisted a move to the suburbs and instead my husband and I raised our twin sons in Brooklyn, a block from Prospect Park. 536 acres replete with ball fields, cycling and walking paths, an ice rink, tennis courts and wooded trails. The boys, like their parents, were in the park every day. Thirty-one years later our sons remain physically active-- and trim-- young men who regularly play basketball and tennis.

One son still lives in Brooklyn near the same park. Although he owns a car, he cycles to most destinations, and he and his wife push their twin sons around the neighborhood in a stroller. But our other son now lives in a suburb of Los Angeles where each adult requires a car and where children have to be driven to nearly every activity, including play dates.

Study after study has shown that suburban residents walk less, bike less and are less physically fit than city dwellers. Their cars are parked adjacent to their homes and typically driven to within a few feet of their destinations. Their neighborhoods often lack sidewalks or other paths safe for pedestrians and bicycles. Entertainment facilities, workplaces and stores are so far from residences that a car often must be used. Even public transportation, where it exists, is usually too far from home for most people to reach on foot.

Now, however, public health officials and community planners throughout the country are rethinking our vehicle-friendly communities and seeking to design developments and retrofit established communities to encourage outdoors physical activity.

This is not new. In the 1860's and 70's, Frederick Law Olmstead, who designed the park I live near, used health promotion to sell his idea for creating large parks in the heart of cities. He recognized the connection between getting people out into the fresh air and sunshine and preventing rickets and tuberculosis, then rampant in cities.

Today the goal is to engineer more physical activity into American life to reduce both spreading obesity and the chronic, often lethal health problems linked to sedentary living. Dr. William Dietz, director of the Division of Nutrition and Physical Activity for the Centers for Disease Control and Prevention in Atlanta, said most communities designed since World War II are unfriendly to pedestrians and cyclists.

"A quarter of all trips taken by Americans are under a mile, but 75 percent of those trips are done by car," he noted. "Only one-third of children who live less than a mile from school now walk to school."

In a study done for the disease control agency, Dr. Lawrence D. Frank of the Georgia Institute of Technology noted that Americans and Canadians used their feet for far fewer trips than people in other developed countries. In Italy, 54 percent of all trips and in Sweden, where it is cold and dark much of the year, 49 percent of all trips are done by walking or bicycling, whereas in the United States, the figure is only 10 percent.

People offer many excuses for their inactivity, among them a lack of time and routes that are not safe for pedestrians or cyclists. But if adults and children reduced television viewing by one hour a day, there would be ample time for physical activity. A recent study among 192 elementary school students in San Jose, Calif., showed that children who reduced the time they spent watching television and playing video games lost a significant amount of body fat in just six months.

Safety is another issue. "We can't increase activity levels for most Americans unless we change the way communities are designed," said Bob Yaro, executive director of the Regional Plan Association of New York. "We need more compact, pedestrian-oriented patterns of growth. The vast majority of Americans live in suburbs built since 1950. They don't have parks, sidewalks, retail centers they can get to on foot or by public transport, and now serious public health issues are an unanticipated byproduct of this civilization we built."

The Census Bureau forecasts extensive community development by 2050. "We need to be sure these communities are designed around pedestrian and transit friendly concepts," Mr. Yaro said. "We need more compact developments, sidewalks, accessible retail and employment centers and permanent green reserves."

Meanwhile, efforts are under way to retrofit some communities and make physical activity safe and accessible for more people. Dr. Dietz said Rhode Island is committed to developing walking trails in its 32 cities and towns. The River Trails Conservation Assistance Program of the National Park Service is helping communities throughout the country do the same. In rural southeastern Missouri, where there are few sidewalks or shopping malls or other places to walk, walking trails have been established, and 55 percent of the people who use them say they walk more as a result.

But Dr. Dietz said we don't have to wait for major reconstruction to encourage greater activity. He said that if stairways were made brighter and more attractive, more people would use them.

In a suburban shopping center, Johns Hopkins University researchers placed signs touting the benefits of stair-walking near stairs adjacent to escalators. Stair use rose from 4.8 percent to 6.9 percent among people who saw signs declaring general health benefits and to 7.2 percent among people who saw signs touting weight-control benefits.

Schools, too, must do their share. "Schools need to restore physical education programs and make existing programs more effective," Dr. Dietz said. "We need to help parents identify safe routes to school and encourage them to walk to school with their children. Schools can be opened after hours so that all members of the community can use the gym and pool."

Finally, Dr. Dietz said, employers should provide exercise facilities or underwrite memberships in health clubs. Studies have shown that such benefits improve the bottom line by preserving employee health and reducing absenteeism and turnover.