Health and Land Use


Land use patterns in the US have shifted since the invention of the automobile. Communities were once designed around downtown centers with homes, workplaces, businesses and schools nearby. Now they are more commonly spread out, often without sidewalks or access to public transit, leaving them heavily auto-dependent. A 1996 study showed that automobile use for all trips in Sweden amounted to 36 percent whereas in the United States, personal cars were used for 84 percent of all trips. As we spend more time in our cars, we have less time for healthy activities and increase auto emissions, which have a serious negative impact not only on our environment, but also on our health.

In communities designed so that people can easily incorporate physical activity and healthy eating into their daily lives, activity levels increase. When land use patterns make it difficult for people to walk, bike, or use public transit, they rely on cars, limiting their daily physical activity. Communities with downtown centers, high street connectivity and a preserved natural countryside foster active lifestyles that not only increase activity, but can save money and increase quality of life. The impacts of land use and the built environment on overall health include:
  • Obesity: Defined as a body mass index (BMI) of over 30, obesity is best countered by physical activity and healthy eating, both of which are increasingly difficult to maintain in our over-developed landscape.
  • Chronic disease: Obesity increases the incidence of chronic diseases such as cardiovascular disease, diabetes, high blood pressure, and high cholesterol. The annual health cost of someone who is obese is $1,429 more than someone of average weight, according to the National Center for Chronic Disease Prevention and Health Promotion.
  • Air and water quality: As we drive more, we increase air and water pollution. Runoff from roadways and parking lots pollutes our water. Vehicles idling in traffic increase air pollution. Auto emissions increase respiratory illness and can contribute to certain forms of cancer and other health complications.
  • Mental health: Towns where we can greet each other as we walk down the street can increase our “sense of community” and give us a sense of belonging. Long commutes, heavy traffic and lack of space for personal solitude increase stress.
  • Safety and injury: Safer streets and crime prevention can increase our personal safety and decrease the rate of injuries caused by traffic accidents. Streets designed solely for vehicles do not make people feel safe walking and bicycling, adding more barriers to physical activity.
Vermont was the healthiest state in 2009:

  • first for daily fruits and vegetables,
  • fifth for physical activity,
  • fifth for health status,
  • seventh for obesity, and
  • eleventh for air pollution. (America’s Health Ratings)

However, 58 percent of Vermonters are overweight or obese and 23 percent are obese. By 2018, obesity is expected to rise to 38 percent. Each year, obesity-related medical expenditures for Vermont adults cost $183 million (Rudd Center for Food Policy and Obesity).

Senior citizens, children, low-income households and people with disabilities have limited options in choosing their living environments. To support the well-being of everyone in our community, we need to design compact, mixed-use communities that integrate safe routes to schools, parks and access to nutritious food. When compact development and accessible transportation options exist in communities, healthy lifestyle choices are easier to make.

A study from the 1996 Summer Olympics in Atlanta, Georgia found that when officials restricted driving in the city for the games, ozone in the air reduced drastically. A 23 percent decrease in driving during that period led to a 42 percent fall in asthma-related hospitalizations of children. In comparison, hospitalization rates for other reasons did not change. (Source: E&E News)

Related Issues

Related Tools


Vermont Department of Health Fit and Healthy Vermonters Community Assessment Toolkit
How healthy is your town? VT Department of Health Town Health Resources Inventory
Active Living Research
Convergence Partnership Healthy People Healthy Places
Healthy Eating, Active Communities Tips and Tools
Mobilizing Action Toward Community Health: County Health Rankings