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Opinion: Why doctors are supporting the drive toward sustainable communities

If doctors and other health experts designed our cities, they would look quite different than the sprawling, car-centered communities of today. But why would health experts care about city planning and laws like the Sustainable Communities and Climate Protection Act (SB 375 passed in 2008)? The answer is simple: our communities significantly impact chronic illness and overall public health.

Most California cities were designed to make it easy to drive and park cars. Homes were separated from stoares, workplaces and other commercial activities. The unwitting result was sprawling cities that maximize the amount of miles we drive and the time we sit idling in traffic and that minimize healthier options like walking, biking or public transit. California’s severe air pollution problems are, in large part, the result of this dependence on car travel. California remains home to some of the worst air pollution in America, and transportation emissions account for the majority of smog-forming emissions statewide and nearly 40 percent of the state’s global warming pollution. Significant increases in asthma attacks, chronic lung illness, heart attacks, strokes and premature deaths are all driven by high pollution levels.

This auto-centered lifestyle also has led people to become more sedentary, putting themselves at higher risk for a string of chronic illnesses. Obesity, diabetes, heart and lung diseases and depression are some of the major conditions that doctors deal with every day that could be significantly reduced by simply getting people out of their cars. Sadly, our children are falling into the grip of these preventable diseases at earlier ages and will face life-long challenges as a result.

The American Lung Association in California has developed new data on the health benefits of smart growth scenarios for California. The results show that by 2035, more compact development patterns could result in 45,000 – 104,000 fewer asthma attacks and other respiratory symptoms and 61 – 141 fewer premature deaths each year from reduced vehicle emissions. These health benefits add up to $700 million – $1.7 billion annually in avoided public health costs. These numbers are conservative and would be higher if they included the additional major benefits of increased physical activity.

Children’s health is especially impacted by our dependence on car travel. The Southern California Children’s Health Study found that children living in communities with higher levels of traffic related air pollution have a 30 percent higher risk of new asthma cases. Clearly, we need to ask for a second opinion on community design.

How would doctors change our cities if they were in charge of planning?  Doctors would embrace solutions like SB 375 (Steinberg) that call for regional cooperation in reversing course and planning for sustainable communities. They would recognize that beating a chronic, unhealthy condition will take time and commitment, but that we need to start today. They would recommend planners use strategies like transit-oriented development and increased jobs-housing balance to reduce the miles we need to drive. They would stress greater investment in walking and biking infrastructure, better mixes of residential, commercial and retail zoning, better access to transit and more parks for kids and families. And they would ensure that these opportunities were spread across communities of all income levels.

The good news is that some cities already are embracing these healthier principles.  The Sacramento region put itself at the forefront of envisioning sustainable growth through the adoption of the Sacramento Area Council of Governments’ (SACOG) Blueprint plan which focuses on compact and mixed use development. In addition to improving public health, local governments also benefit because compact development uses less energy and water, requires less city expenses on road maintenance than sprawling neighborhoods and generates more city revenue. In fact, by 2050 SACOG’s compact development vision is estimated to save the region $16 billion in avoided infrastructure costs and cut household vehicle miles traveled by about one quarter. Families save on transportation costs and vehicle maintenance and spend more time together than delayed in traffic.

The California Air Resources Board will make a critical decision next week to adopt regional greenhouse gas reduction targets to implement SB 375 and kick off the process at the local and regional levels of developing “sustainable communities plans” to shift development and transportation patterns to reduce vehicle trips and emissions. Health and medical organizations and physicians strongly support the adoption of ambitious targets by the CARB Board to spur decisive action at the local level.

It is unlikely that we will see doctors take over our urban planning decisions anytime soon, but policymakers can take steps to incorporate healthier land use and transportation options into community design. The California Air Board’s pending adoption of SB 375 targets is the first step toward a prescription for better health for our communities.


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