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Gaining Weight

Michigan sprawl increases waistlines, health care costs

March 31, 2003 | By Arlin Wasserman
Great Lakes Bulletin News Service

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While a diet rich in fats and high in calories is what’s been putting on the pounds, the sprawling lifestyle’s inherent lack of physical activity makes sure they stay on.

Sprawl not only saddles Michigan’s taxpayers with soaring infrastructure, commuting, and pollution costs, it also burdens many of them with a heavy personal price: Obesity. That’s the message that can be gleaned from two recent reports by the American Farmland Trust and the Centers for Disease Control. The AFT report found that Michigan has one of the nation’s highest sprawl rates; the CDC report said that the state has the highest combined incidence of overweight and obese people in the nation.

The two reports come as the Michigan Land Use Leadership Council begins a careful evaluation of the consequences to sprawling patterns of development in Michigan and the solutions. The 26 prominent state public policy leaders, appointed to the bipartisan panel by Governor Jennifer Granholm, began their work on March 24 with a consensus that conserving farmland and open space and rebuilding Michigan’s cities were the top priorities.

The AFT and CDC reports provide clear evidence that reducing sprawl’s unhealthy consequences also merits the council’s careful consideration. Lifestyles that are almost completely dependent on motors and wheels touch many Michiganians in a direct way, greatly reducing the opportunity and inclination for people to do something as simple and healthy as walking. Sprawl, many of its critics say, discourages walking to school, to the corner store, to a neighbor’s home, to work, and to play, and strongly encourages walking only to and from the front door and the car. While a diet rich in fats and high in calories is what’s been putting on the pounds, the sprawling lifestyle’s inherent lack of physical activity makes sure they stay on Michigan thighs and stomachs.

Richard Killingsworth, the national public health and land use expert who directs the Active Living by Design program at the Robert Wood Johnson Foundation in New Jersey, said community design is the chief culprit. 

“The poor land use, minimal transportation choices, and engineering innovations that minimize physical activity have contributed to an enormous national public-health burden and epidemic,” he observed. He said that a sedentary lifestyle is a primary factor in more than 200,000 deaths per year, 10 percent of all deaths in the United States annually.

How Heavy Are We?
That statistic is particularly ominous for Michigan. Last year, the CDC concluded that in 2000, 59 percent of Michiganders were either overweight or obese — a rate that’s tied with Alabama for first in the nation. It is also 10 percent higher than the national average. Six out of every ten Michigan residents are at least 20 pounds heavier than they should be.

The implications for Michigan’s own public health costs are immense, and not just because weight problems, which are strongly exacerbated by poor diets and inactivity, are so strongly linked to a variety of serious illnesses, including diabetes, vascular disease, and hypertension. It is also because the state’s collective weight problem is worsening at an alarming rate, according to Karen Petersmarck, a public health consultant with the Michigan Department of Community Health’s Cardiovascular Health, Nutrition, and Physical Activity Section.

“The percentage of people who are considered overweight in 1987 was 32 percent,” said Ms. Petersmarck, who also collects statewide data for the CDC. “In 2000, it was closer to 39 percent. Obesity increased even more, from about 11 percent in 1987 to over 20 percent by 2000.”

Like Mr. Killingsworth, Ms. Petersmarck believes Michigan’s drastic weight gain is linked to the state’s sprawling patterns of development. “Unless we can incorporate our feet, bikes, and such things for transportation it becomes very difficult to get enough physical activity for good health,” she said, adding that “when we allow our communities to evolve into places where we must use the automobile to get around, then we are setting a trap for obesity.”

A 2002 Michigan Department of Community Health study suggests that this is exactly what is happening. In its most recent survey of state residents, the department found that 23 percent of people had done no exercise in their leisure time in the past three days. Ms. Petersmark offered a simple explanation: “If people only do physical activity after work, there isn’t enough time. If you’re only active during your free time, there isn’t enough free time.”

Design Flaw
If these two health experts are correct, Michigan’s overweight epidemic will continue to worsen until the state accomplishes effective land use reform. Reversing Michigan’s sprawl rate presents a particularly urgent challenge because, according to the 2002 report by the American Farmland Trust, that rate is accelerating.

Between 1987 and 1992, the state on average lost approximately 14,000 acres of farmland a year to suburban development. In the following five-year period, 1993 to 1997, the rate jumped 67 percent, to approximately 24,000 acres a year, even though Michigan has one of the nation’s lower population growth rates.

Sprawl’s Other Big Price Tag
Land use reform advocates have long argued that sprawling development is unhealthy for people precisely because it is so harmful to their environment. For example, in Michigan nearly one out of three people live in one county and work in another, commuting endless miles between home and job. The human cost: more stress from road rage, more polluted air from vehicle emissions, and more death and injuries from traffic accidents

Advocates also say sprawl is costing Michigan taxpayers billions of dollars for the roads, sewers, and other infrastructure needed to support new subdivisions, shopping malls, schools, and office complexes. But while many state leaders now realize that unwise development patterns come with hefty public works price tags, they haven’t publicly made the connection between sprawl and soaring health care costs.

The Henry J. Kaiser Family Foundation recently estimated that Michigan’s collective medical bill was approximately $36 billion in 1998, which is 13 percent of the state’s overall economic activity. That same year, the state treasury alone spent about $9 billion on health care costs, or more than $885 per resident. By comparison, the original price tag for the Build Michigan III road expansion program, announced by former Governor Engler and now scaled back by Gov. Granholm, was approximately $1 billion.

Time to Move
Given Michigan’s obesity and sprawl, public health experts are becoming skeptical that Michigan’s weight problem can be solved simply through public education efforts.

“Education isn’t triggering more exercise,” Ms. Petersmarck said. “So we need to change the environment. The only way this is going to change is if we stop and think about the way our communities are evolving. In public health, we’re hoping to help communities make inexpensive decisions to help people become more active.”

The state health department is staging a conference, Designing Healthy, Livable Communities, to help address the problem. The conference, sponsored by the Michigan Land Use Institute and a host of other public interest groups and government agencies, is aimed directly at the people who plan, develop, and administer townships and municipalities. The May 22 gathering in Lansing will provide practical advice about designing communities that help, rather than hinder, the incorporation of physical activity into people’s everyday lives. The department is also providing these planners and administrators with an Internet-based system that evaluates their efforts to promote active lifestyles.

Arlin Wasserman is the Michigan Land Use Institute’s policy advisor. Reach him at arlin@mlui.org.

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