The Effects of Urban Sprawl on Rising Obesity Rates in the U.S.

by Neil Desai on March 27, 2014

In the last four decades in the U.S. obesity prevalence has increased substantially from 13.44% to 32.2%, for example, between the early 1960s and 2004 (Zhao & Kaestner, 2010). Obesity, or being severely overweight, is caused by overconsumption of calories while not expending enough through physical activity. Onset of the disease is influenced by lifestyle choices, exercise habits, diet, genetic disposition, socioeconomic status, race and gender. Physical inactivity resulting from obesity is the fourth leading cause of death globally, accounting for nearly 3.2 million deaths annually (Ewing, Meakins, Hamidi, & Nelson, 2014). Obesity is linked to numerous health outcomes, such as type 2 diabetes, sleep apnea, hypercholesterolemia, hypertension, edema, respiratory problems, which are risk factors for fatal acute and chronic illnesses like heart attack, stroke, and coronary heart disease (CHD). As a result, such obesity-related illnesses have contributed largely to the annual increase in U.S. health care costs (Zhao & Kaestner, 2010).


Among American youth, obesity rates have doubled for children between two and five years old, and tripled in adolescents between ages twelve and nineteen years old. Retrospective research indicates that obese children are more likely to remain overweight into and throughout adulthood (Ewing, Brownson, & Berrigan, 2006). In addition, the past several decades has seen a decline in physical activity trends for men, women and youth in parallel with rising obesity rates. 43% of adults, for example, did not meet physical activity guidelines set by the CDC in 2009 (Ewing et al., 2014). Attributed factors include advancements in technologies that reduce the need to move around as frequently, such as individualized auto and public transportation, television and the internet. Using such technologies has led to trends of increased sedentary lifestyle, which ultimately contributes to growing obesity rates (Ewing et al., 2014).

Between 1950 and 2000, the percentage the of U.S population living in cities increased from 50% to 80%. The majority of growth in such regions has been a result of urban sprawl. While city populations have broadly increased, central city populations have declined as surrounding city suburb numbers have risen (Zhao & Kaestner, 2010). Trends also indicate that the decline in population size in central city regions matches the surge in obesity rates. All of the examined publications utilize the Body Mass Index scale (BMI), which provides a measurement for individualized body fat to height ratio, to determine how BMI change relates to population changes. BMI scores greater than or equal to 30 indicate that an individual is obese. As the literature suggests, the rise in BMI scores correlates with population migration out of central city regions and into suburban regions overtime (Zhao & Kaestner, 2010).

Zhao and Kaestner (2010) largely attribute the development and expansion of the Interstate Highway System in 1947 as a reason for the decline in population, which people favored because they could easily commute to work and live in a more private area. As they found, however, living in secluded regions generally leads to worse health outcomes. Their findings indicate, for example, that if such populations did not leave metropolitan areas, obesity rates today would have been reduced by 13% (Zhao & Kaestner, 2010). This estimate, however, does not account for people who may live directly on the border of city centers and suburbs, who can access resources in both regions.




Cars on a Highway (mid 1950s)

Plantiga and Bernell (2007) suggest that the layout of low-density suburban areas where sprawl has occurred explains why obesity growth can be linked to sprawl. As they suggest, inhabitants of low-density and expanding regions are less well off in terms of access to community resources, such as grocery stores or hospitals, in comparison to connected city center inhabitants. In turn, this forces people to use individualized auto or public transportation to travel between locations (Plantinga & Bernell, 2007). Such inhabitants cannot easily walk or bike to resources, unlike central city inhabitants who may live within walking distance from a necessary resource. In addition, living in suburban regions may increase commute times to and from work, which leads to traffic congestion and a subsequent loss in available time to exercise (Griffin et al., 2013). The researchers also suggest that many suburban developments lack parks, bike trails and recreation centers that promote exercise (Plantinga & Bernell, 2007). As a result, such people exercise less, and thus gain weight.




Dunton, G. F., Kaplan, J., Wolch, J., Jerrett, M., & Reynolds, K. D. (2009). Physical environmental correlates of childhood obesity: a systematic review. Obesity Reviews: An Official Journal of the International Association for the Study of Obesity, 10(4), 393–402. doi:10.1111/j.1467-789X.2009.00572.x


Ewing, R., Brownson, R. C., & Berrigan, D. (2006). Relationship Between Urban Sprawl and Weight of United States Youth. American Journal of Preventive Medicine, 31(6),  464-474. doi:10.1016/j.amepre.2006.08.020

Ewing, R., Meakins, G., Hamidi, S., & Nelson, A. C. (2014). Relationship between urban sprawl and physical activity, obesity, and morbidity – Update and refinement. Health & Place, 26, 118–126. doi:10.1016/j.healthplace.2013.12.008

Griffin, B. A., Eibner, C., Bird, C. E., Jewell, A., Margolis, K., Shih, R., … Escarce, J. J. (2013). The relationship between urban sprawl and coronary heart disease in women. Health & Place, 20, 51–61. doi:10.1016/j.healthplace.2012.11.003


Plantinga, A. J., & Bernell, S. (2007). The Association Between Urban Sprawl and Obesity: Is It a Two-Way Street? Journal of Regional Science, 47(5), 857–879. doi:10.1111/j.1467-9787.2007.00533.x


Zhao, Z., & Kaestner, R. (2010). Effects of urban sprawl on obesity. Journal of Health Economics, 29(6), 779–787. doi:10.1016/j.jhealeco.2010.07.006z

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