Health and Land Use


Health and Land Use

In brief

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. According to 2017 National Household Transportation Survey, 87% of daily trips take place in personal vehicles. In 2021 The Maryland Transportation Institute found that 52% of all trips in the US were for distances of less than three miles, 28% of trips were for less than one mile, and just 2% were for greater than 50 miles. 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.

The issue

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 $1,861 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.

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.

Did you know?

Vermont was the healthiest state in 2022:

  • first for daily fruits and vegetables,
  • first for exercise,
  • third for health status,
  • seventh for obesity, and
  • fourth for air pollution. (America’s Health Ratings)

However, 60 percent of adult Vermonters are overweight or obese and 24 percent are obese (National Center for Chronic Disease Prevention and Health Promotion). Each year, obesity-related medical expenditures for Vermont adults cost $202 million (Obesity and Cancer in Vermont, 2016)

According to The Yale School of the Environment, a quarter of all asthma cases in the US are caused by traffic pollution. (E360 Digest April, 2019)

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

Mobilizing Action Toward Community Health: County Health Rankings

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