Hoofing It
By Erin Middlewood, The Columbian Staff Writer
Sunday, May 8, 2005
One of Vancouver 's biggest advocates of walking and exercise, Florence Wager, finds it difficult to take a stroll in her own neighborhood.
She lives in the 1960s-era Heights neighborhood, one of many swaths in greater Vancouver without sidewalks.
"There's a huge period in our history when the whole goal was to move automobiles," Wager said. "But without sidewalks you can't keep people healthy. You can't expect them to walk to the store or to school."
Sidewalks are missing on almost half of all roads in Vancouver and unincorporated Clark County . This lack of pedestrian pathways, along with development patterns that make it difficult to get around by foot, may be contributing to record obesity in Clark County .
Sixty-three percent of Clark County residents are overweight or obese. Compare that to 52 percent in the more densely developed and walkable Multnomah County , where Portland is located.
Research suggests that differences in the ways the two counties have developed may account for some of the disparity in obesity rates. It's not merely the absence of sidewalks that can discourage walking, experts say, but also what might be described as a suburban style of development with widely spaced streets and zoning that discourages mixing homes with stores, restaurants and offices that provide pedestrian destinations.
Although the link between urban planning and public health has gained currency in recent years, critics say other factors personal decisions to watch TV and eat fast food, for example play a bigger role.
"Nobody will ever convince me it's the county's fault that people are obese because of land-use planning," Clark County Commissioner Betty Sue Morris said. "You just can't blame government for everything."
But Clark County 's public health advisory council recently ranked "healthy community growth" as a priority.
Community Choices 2010 won a five-year federal grant that provided $555,000 in funding this year to tackle obesity.
The effort has identified the so-called "built environment" as a factor contributing to people's growing waistlines.
"There's a still a mind-set that it's an individual problem and not a community problem. I will hear, 'People should just change their behavior,' " said Barbe West, executive director of Community Choices 2010. "We have created communities where we've made it easy to use cars. We've made it hard to walk or find healthy food. . Now we've now got a huge obesity problem."
Studies show link
Heart disease, stroke and diabetes, which have all been linked to obesity, accounted for 40 percent of Clark County deaths in 2001, according to county health department statistics.
Federal officials have estimated that treating obesity-related illnesses costs about $93 billion a year nationwide. Obesity was the source of about a quarter of the phenomenal increase in health care costs over the past 15 years, according a study by Emory University researchers published in the journal Health Affairs last year.
That provides plenty of incentive to find and eradicate the causes. More and more research points to the layout of our communities as a culprit.
"American adults living in more sprawling counties walk less in their leisure time, weigh more and have higher blood pressure after accounting for their education, race, sex and age, and to a degree, their diet," concluded Reid Ewing, an associate professor at the University of Maryland, in a 2003 study.
He compared 448 counties across the nation and found that the average adult living in sprawling Geauga County outside Cleveland , Ohio , weighs six pounds more than the average adult living in New York City .
"We attributed that six-pound difference to the amount of physical activity in their daily lives," Ewing said.
People in more sprawling communities may set aside time for walking or exercise, yet they miss out on the incidental physical activity of walking to lunch, the store, public transit stops or work.
Geauga County rated 63.12 on the sprawl index Ewing developed, compared to New York 's 352.07. The index comprises measures of population density and block size, which are good indicators of walkability, he said.
Multnomah County 's score was 131.41, about 27 percent better than Clark County 's 103.44.
"We are not sprawling in this county," Morris insists.
She points out that, according to state growth management laws, four houses per acre is acceptable for urban areas. Clark County has averaged about six housing units per acre in urban areas, although the density in the Vancouver urban area is about seven units per acre, according to a 2002 report, which contains the most recent figures available.
That's less compact than the eight units per acre one researcher linked with greater fitness. Lawrence Frank of the University of British Columbia surveyed 12,000 people in the Atlanta area and found that fewer men and women were overweight or obese in neighborhoods with eight units per acre than in ones with one house per acre.
Commute time increasing
Published in the American Journal of Preventive Medicine in 2004, Frank's study found that each additional hour spent in a car per day was associated with a 6 percent increase in the likelihood of obesity, while each additional kilometer walked per day reduced the likelihood of obesity by 4.8 percent.
Evidence shows Clark County residents are spending more time in their cars. About a third of the work force commutes across the Columbia River to work. The average Clark County resident's commute time increased by 19 percent, from 21 minutes to 25 minutes, between 1990 to 2000, according to U.S. Census figures.
Of course, much of our driving is not to work, but to run errands.
National statistics show that a quarter of all driving trips are less than a mile, a distance easily walked.
A lot stands in the way of walking instead of driving for those errands. People are pressed for time. And if you live in a neighborhood without sidewalks, or that has long blocks with winding roads that don't connect, it can be difficult to walk from point A to point B.
Grid blocks and sidewalks
Wager, 77, remembers walking all the time when she grew up in Vancouver 's Arnada neighborhood, built in the early 20th century with grid blocks and sidewalks.
Walking has declined over the years. In 1977, children walked or biked for about 16 percent of all their trips. By 1995, children made only 9.9 percent of their trips that way, a 37 percent decline, according to a white paper by the Centers for Disease Control and Prevention.
Wager, a community activist working on the local anti-obesity effort, calls the lack of sidewalks "a huge problem."
On that, Commissioner Morris agrees. She has called gaps in the sidewalk system "a crisis."
Vancouver has had at least some provision requiring sidewalks since 1965. Much of what has since been annexed by the city originally developed under Clark County 's jurisdiction. The county established loose requirements for sidewalks in 1973 that were tightened in 1980.
About 45 percent of the streets in both Vancouver and the county's urban unincorporated area are lined by sidewalks. If you count roads with sidewalks on one side, that adds another 10 percent, according to data provided by the city of Vancouver and Clark County .
An estimated 60 percent of Portland 's streets virtually all of the central city are served by sidewalks, said Stuart Gwin, a planner in the city's Office of Transportation. Small blocks and a dense urban center make Portland it one of the top 10 walker-friendly cities, as ranked by the American Podiatric Medical Association earlier this year.
$100 million to retrofit
Filling in the blanks to complete Vancouver 's sidewalk network is an expensive proposition.
It would cost upward of $100 million to retrofit Vancouver neighborhoods, estimates Jennifer Campos, a Vancouver transportation planner. Not to mention the cost of building sidewalks in the surrounding unincorporated areas under the county's jurisdiction.
Vancouver expects to spend $325,000 in Community Development Block Grant funding and $500,000 from a real estate excise tax on pedestrian, bike and traffic-calming projects in 2006, Campos said.
The county will spend about $400,000 a year, plus whatever it can win in grant money, to build sidewalks, said Bill Wright, the county's traffic engineering manager.
"We recognize we have a ways to go to get the sidewalks and walkways built in the county," Wright said. "We have a list and we're starting at the top and working our way down."
For its part, the Choices 2010 anti-obesity effort will identify where sidewalk projects could create better connectivity, said Dave Miletich, who serves on the group's committee on the built environment.
The group also plans to develop maps of trails and sidewalks so people can find places in their neighborhood to walk.
Portland has had luck with this tactic. The city received $100,000 from the U.S. Environmental Protection Agency to create the Ten Toe Express walking campaign. The campaign targeted north Portland in 2004 to coincide with the opening of the Interstate light-rail line.
With sponsorship from Kaiser Permanente, Portland 's transportation options division gave away 4,000 kits, including pedometers, walking logs, a north Portland walking map, and a schedule for escorted walks. More than half of respondents to a follow-up survey reported taking more than one new trip per week by walking instead of driving. Cameras recorded a 320 percent increase in pedestrian traffic.
The neighborhood had an edge because it's served by sidewalks and businesses that provide a destination, said Rich Cassidy of Portland 's transportation department. "You've got to start with making those improvements to the infrastructure."
Erin Middlewood covers transportation. Reach her at 360-759-8031, or by e-mail at erin.middlewood@ columbian.com.
The debate
Does Clark County 's approach to suburban planning make us fat?
On one side:
Yes. Several studies have connected low-density, suburban-style development with an increase in weight.
On another side:
No. Personal choices to avoid exercise and eat fatty foods cause obesity.
How to get involved:
Those interested in helping Clark County 's anti-obesity effort can contact Community Choices 2010 at 360-567-1087. Visit www.stepstoahealthierclarkco.org for more information.
Health office focuses on growth issues
The Clark County Health Department, following an emerging national trend in public health, for the first time has a division that will address growth issues.
Director John Wiesman, who started the job in July, reorganized the department so the environmental health division will tackle the issue more broadly, to not only ensure drinking water is safe, but also have a hand in making sure people have safe places to walk.
"In the last five years, public health as a discipline has become more aware of how the built environment affects health," Wiesman said. "It's a logical extension of what public health has been doing for some time."
Public health increasingly addresses growth and development. For example, the Centers for Disease Control and Prevention's environmental health division has a section on "designing and building healthy places." And the Clark County Public Health Advisory Council recently named "healthy community growth" a top issue.
How the health department will tackle the issue still is taking shape, but already Wiesman has served on a Vancouver-Clark Parks and Recreation committee in the early stages of developing a new trail and bikeway system plan for the county.