Title: Book Review: Urban Sprawl and Public Health
Author:
Section/SPIG: Community Health Planning and Policy Development
Issue Date:
Urban Sprawl and Public Health: Designing, Planning, and Building for Healthy Communities
by Howard Frumkin, Lawrence Frank, & Richard Jackson
What is sprawl? And what does it have to do with health? The two physicians (Jackson and Frumkin, both APHA members) and landscape architect/transportation planner (Frank) who teamed up to write this book present case after case of the impact our planned, built environment has on health, and argue persuasively that it’s time for a closer look at our communities through a much different lens. It is accepted both as a belief based on common sense and policy based on evidence that the places we live, work and play have a great deal to do with how we feel, emotionally and physically.
The word sprawl invokes a host of negative associations when applied to describing where we live and work. Quickly, cheaply built large subdivisions of homogenously designed homes in an otherwise largely rural area with no basic services – schools, groceries, library, stores — anywhere near enough to get to without a car. A decade ago, James Kunstler wrote in The Geography of Nowhere: The Rise and Decline of America’s Man-made Landscape that sprawl is “depressing, brutal, ugly, unhealthy and spiritually degrading.” Sprawl is credited with the demise of American cities as the heavily tax subsidized highway system allowed families to live in ever greater numbers in the burgeoning suburbs while the main wage-earner commuted ever-longer distances daily to a job in the city. The majority of the book provides chapter-by-chapter details of the health effects of sprawl, everything from reduced physical activity as peoples’ auto-dependence consumes several hours each day in driving, to how this compromises mental health, increases the pollutants people breath, and even reduces ‘social capital,’ defined as peoples’ sense of connection with one another and their willingness to voluntarily reciprocate in the life and needs of community. The authors present a cogent and heartrending picture of the increasing isolation of people who travel mostly in their single occupancy vehicle, leaving their homes each day from garages with electric doors, rarely knowing let alone socializing with neighbors or depending on or helping them in times of need. All of this, they say, is brought about by the ways in which our built environment obstructs our social interactions with one another. Instead, they argue, imagine communities that provide places that nurture and promote interactions both socially and with nature.
The book is meant to appeal to a wide audience of designers, urban planners, architects, health care providers, public health professionals, public officials and anyone who understands the power of both place and sense of community in the health of individuals and the communities in which they live.
Eight years into my own career in public health, I stumbled –reluctantly initially — into the role of city planning commissioner at the suggestion of the mayor of my small city. A non-public health friend whose advice I valued insisted that my misgivings about “knowing nothing about planning” were far less important than my credentials as a public health professional, a perspective he knew to be absent and yet completely necessary for a more rational approach to urban and community design. Graduating to City Council four years later, I had to marvel at my friend’s accurate instinct: public health became a major source of information and the compass that guides and informs my votes about zoning, land use, annexations, parks and trails, capital facilities projects –the host of decisions and planning that are local government officials’ daily fare. Though my community has a way to go yet to achieve the density, walkability, bikeability, transit-centered, civically oriented and socially cohesive place I envision with most of the services we need close by provided by locally owned businesses, it’s much closer than when I started.
In a recent interview with Northwest Public Health (spring 2005), Howard Frumkin heralded the traditional convening function of public health as a way to get community dialogue going about improving a community’s safety, attractiveness, sustainability and health. Local governments also try to do this! We begged for citizen input throughout the four-year planning process for our town center. I believe our eventual plan was significantly improved by what we heard from people in our community. It seems to me public health in particular could be of great help as city councils consider questions of community development, sustainability, safety and what creates the strong ‘sense of place’ that inspires civic pride, engagement and attachment to community.
Significantly, Urban Sprawl and Public Health was published by Island Press, a 20-year-old non-profit whose principal purpose is the publication of books on environmental issues and natural resource management. As a growing number of public health professionals recognize the interdependence between our work and that of others in fields with which we haven’t traditionally worked, the audience for this expanding literature on the impacts of the built environment can only expand as well, which is a very good thing for all of us.
By Karen Valenzuela, a member of APHA’s Executive Board who is serving her sixth year as a member of the Tumwater City Council in Washington state. She works for the Washington WIC Program.