Urban design could be significantly associated with some forms of physical activity and some health outcomes. Although the magnitude of the effects observed in this study are small, they do provide added support for the hypothesis that urban form affects health and health-related behaviors. Furthermore, even a change can have important public health implications.
After controlling for demographic and behavioral covariates, the county sprawl index had small but significant associations with minutes walked ( p = .004), obesity ( p < .001), BMI ( p = .005), and hypertension ( p = .018).
Residents of sprawling counties were likely to walk less during leisure time, weigh more, and have greater prevalence of hypertension than residents of compact counties.
At the metropolitan level, sprawl was similarly associated with minutes walked ( p = .04) but not with the other variables.
This ecologic study reveals that urban form could be significantly associated with some forms of physical activity and some health outcomes. More research is needed to refine measures of urban form, improve measures of physical activity, and control for other individual and environmental influences on physical activity, obesity, and related health outcomes. (Am J Health Promot 2003;18:47–57.)