 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Roland Sturm, PhD, RAND, 1700 Main Street, Santa Monica, CA 90401, 310 393-0411 X6164, roland_sturm@rand.org and Deborah A. Cohen, MD, MPH, Health, RAND Corporation, 1700 Main Street, Santa Monica, CA 90405.
Objective: Study the association between objective measures of urban sprawl and chronic medical conditions and mental health disorders. Design:Data are from 1998-2001 Health Care for Communities, a national household survey. Dependent variables are 16 medical conditions, 4 mental health disorders assessed by clinical screeners, and health-related quality of life. Main explanatory variables are four dimensions of sprawl (residential density; neighborhood mix of housing, schools, shops, and jobs; strength of a center; street design) and a combined overall index. Other individual sociodemographic and site characteristics are included in regression models. Results:The overall sprawl index is a significant predictor of chronic medical conditions (p<0.01) and physical health-related quality of life (p<0.05), but not of mental health. A 50 point change from more to less sprawling (one standard deviation below to one standard deviation above the average) implies 96 fewer chronic medical problems per 1000 residents (95 % confidence interval: [22, 223]. Comparing the effect sizes of sprawl on physical health-related quality of life to aging, a 50 point change from less to more sprawl corresponds to a decline of 0.34 point in health-related quality of life, which is similar to 3 years of premature aging (95% confidence interval: .24, 65). Conclusions: Urban sprawl is a hotly debated environmental factor for which no empirical evidence exists beyond traffic accidents and air pollution. Urban sprawl appears to have adverse physical health effects and those effects are most pronounced for conditions with a plausible causal pathway. In contrast to prominent hypotheses, however, we find no effects of adverse effects on mental health.
Learning Objectives:
Keywords: Epidemiology, Environmental Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.