Is Sprawl Unhealthy?

Abstract
This article addresses the contention that urban sprawl influences general health through physical activity, obesity, and the presence of chronic disease. Data on individual health is obtained from the National Health and Nutrition Examination Survey III study in 29 primary metropolitan statistical areas, and data on sprawl are from Ewing et al. Using hierarchical modeling, the results indicate that even with strong controls for individual variables, residents of areas with more highly accessible and gridded street networks have higher health ratings. At the same time, residents of more densely populated urban areas have lower rated health, net of individual-level measures. Measures of sprawl have no significant relationship to frequency of walking, body mass index, or diagnosis of various chronic diseases. However, among those with chronic conditions, including hypertension, diabetes, and lung disease, those who live in areas with more highly connected street networks have higher rated health.