Chapter One documents the dangers faced by those who choose walking as a form of transportation. But while roads are not as safe for walking as they should be, walking less is not the answer. In fact, the sedentary lifestyle that has become the habit of so many Americans is proving to be dangerous to health. In this chapter, we explore how the decrease in walking may be increasing health risks for millions of Americans. We explore the danger faced by those who do not walk, often because they have been literally driven off the road by our car-oriented transportation system. The health care community has recognized the problem and is calling for an effort to design communities that invite walking and promote better physical health.

Americans are walking much less than they used to. The number of trips people take on foot has dropped by 42 percent in the last 20 years. The Nationwide Personal Transportation Survey, conducted by the U.S. Department of Transportation, documents the decline in the amount Americans walk. Walking dropped from 9.3 percent of all trips in 1977 to just 5.4 percent in 1995. Yet more than one-quarter of all trips are still one mile or less, and by one calculation at least 123 million car trips made each day in the United States were short enough to have been made on foot.(1)

The number of trips people take on foot has dropped by 42 percent in the last 20 years.

Much of the decline in walking can be attributed to the increase in neighborhoods designed so that it is not safe or convenient to travel by foot. Residential areas with no sidewalks and wide streets have been built with high-speed car travel in mind. The nearest store, school, or workplace is often far beyond the quarter- to half-mile radius that is most convenient for foot travel. Workplaces are often located in office parks accessible only by car, and isolated from any other services.

There is ample evidence from dozens of studies that compact communities that mix housing, workplaces, and shopping are places where people take more trips on foot.(2) But such "traditional" neighborhoods are often in the older part of town, and newer developments tend to be more automobile oriented. One recent study of Seattle neighborhoods found that the newer the development, the less likely it is that residents will walk, bicycle, or take transit.(3)

The decline in walking has been steep among children as well, and is also influenced by community design. In 1977, children aged five to fifteen walked or biked for 15.8 percent of all their trips. By 1995, children made only 9.9 percent of their trips by foot or bicycle, a 37 percent decline. Children now make a majority – almost 70 percent — of their trips in the back seat of a car.

The influence of community design on the decision of whether or not to walk is made clear by looking at the trend in the number of children who walk to school. Schools are increasingly isolated from the communities they serve. New schools may be placed on the edge of communities, and wide, busy thoroughfares prevent children from biking or walking to school. Even schools that back up on subdivisions are often inaccessible by foot because there is no path to them: the only link is a circuitous street network. Many communities experience traffic jams around schools as parents deliver children to the door. Increasingly, mothers (and some fathers) are becoming the bus drivers of the new millennium. Women with school-aged children now make more car trips each day than any other population group, and on average spend more than an hour a day in the car.(4)

A study in South Carolina found that students are four times more likely to walk to schools built before 1983 than to those built more recently. Hazards such as busy streets are forcing more children who live within walking distance to board a bus instead. The same study found that students are more than three times likely to get such "hazard busing" if they attend a school built after 1971.(5)

While the decline in walking has meant slightly fewer pedestrian deaths, it is contributing to a growing health threat: health problems caused by a sedentary lifestyle. The decline in walking trips has come at the same time that more Americans have become overweight (see Figure 2, pg. 15). The National Health and Nutrition Examination Surveys found that in the late 1970s (1976 to 1980) 25 percent of the population was overweight; by the early 1990s (1988 to 1994) that number had grown to almost 35 percent. Since then, the trend has apparently continued: another national health survey, the Behavioral Risk Factor Surveillance System, shows that the number of Americans defined as obese grew from twelve percent in 1991 to almost eighteen percent in 1998.(6) Today more than half of American adults are overweight or obese.

The American Medical Association (AMA) recently declared obesity an epidemic and a major public health concern. The AMA blames the epidemic on people eating more, and on the fact that "opportunities in daily life to burn energy have diminished."(7) In an editorial in its journal, the AMA noted that car trips have replaced trips that used to be made on foot or by bicycle, and says helping people get back to walking or bicycling should be a first target in combating the obesity epidemic. But it also noted, "Reliance on physical activity as an alternative to car use is less likely to occur in many cities and towns unless they are designed or retro-fitted to permit walking or bicycling."(8)

Obesity is just one of the health problems associated with a sedentary lifestyle. The Centers for Disease Control estimates that 300,000 Americans die each year from diseases associated with physical inactivity. Even modest physical activity, such as walking, can decrease the risk of coronary heart disease, high blood pressure, colon cancer, diabetes, and even depression.(9)

The health effects of not walking show up among children as well as adults. As children take fewer trips on foot, more of them are becoming overweight (see chart). Between the early 1970s (1971 to 1974) and the early 1990s (1988 to 1994), the portion of children who were overweight grew from 5.5 percent to 13.6 percent. Obesity among children is at an all-time high, and reports bemoaning the sedentary lives of children have become commonplace. About 60 percent of obese children have risk factors that will probably translate into chronic diseases as adults.(10) One study in Britain even found that children who are driven to school have an elevated risk of growing up with heart disease and brittle bones.(11)

In comparing health research to transportation data, STPP found that metro areas where people walk less tend to be places where more people are overweight. Places where people walk further each day tend to have fewer people who are at risk of health problems due to obesity. In fact, for every ten percent decrease in the amount of walking, there is an almost one percent (0.7%) increase in the percentage of people who are overweight. This relationship remained when we controlled for age, race, and income. Obviously many factors contribute to this pattern, and a more detailed, controlling study of this question is needed. But our simple comparison suggests that where you live, and whether you can walk in your neighborhood, may be related to your likelihood of suffering from obesity or the other dangers associated with a sedentary lifestyle.

Numerous national and local health organizations have begun promoting more walkable communities as a fundamental way to improve basic human health. The Centers for Disease Control is working to promote Active Community Environments: places where people can easily walk and bicycle. The California Department of Health Services has decided that better health will require a better transportation environment, stating, "Our vision is a state where doctors prescribe walking and biking to their patients, employers subsidize bike facilities and community trails, and transit services accommodate cyclists by making intermodal travel safe and seamless."

When walking to a destination is possible, a British Medical Association study shows it is well worth the extra time it may take. The study found that the extra time spent walking or cycling to a destination is more than offset by the health benefits of the cardiovascular exercise, because it extends life expectancy by more than the extra time it takes to walk or cycle.(12)

Chapter One documents the dangers faced by those who choose walking as a form of transportation. But while roads are not as safe for walking as they should be, walking less is not the answer. In fact, the sedentary lifestyle that has become the habit of so many Americans is proving to be dangerous to health. In this chapter, we explore how the decrease in walking may be increasing health risks for millions of Americans. We explore the danger faced by those who do not walk, often because they have been literally driven off the road by our car-oriented transportation system. The health care community has recognized the problem and is calling for an effort to design communities that invite walking and promote better physical health.

Americans are walking much less than they used to. The number of trips people take on foot has dropped by 42 percent in the last 20 years. The Nationwide Personal Transportation Survey, conducted by the U.S. Department of Transportation, documents the decline in the amount Americans walk. Walking dropped from 9.3 percent of all trips in 1977 to just 5.4 percent in 1995. Yet more than one-quarter of all trips are still one mile or less, and by one calculation at least 123 million car trips made each day in the United States were short enough to have been made on foot.(1)

The number of trips people take on foot has dropped by 42 percent in the last 20 years.

Much of the decline in walking can be attributed to the increase in neighborhoods designed so that it is not safe or convenient to travel by foot. Residential areas with no sidewalks and wide streets have been built with high-speed car travel in mind. The nearest store, school, or workplace is often far beyond the quarter- to half-mile radius that is most convenient for foot travel. Workplaces are often located in office parks accessible only by car, and isolated from any other services.

There is ample evidence from dozens of studies that compact communities that mix housing, workplaces, and shopping are places where people take more trips on foot.(2) But such "traditional" neighborhoods are often in the older part of town, and newer developments tend to be more automobile oriented. One recent study of Seattle neighborhoods found that the newer the development, the less likely it is that residents will walk, bicycle, or take transit.(3)

The decline in walking has been steep among children as well, and is also influenced by community design. In 1977, children aged five to fifteen walked or biked for 15.8 percent of all their trips. By 1995, children made only 9.9 percent of their trips by foot or bicycle, a 37 percent decline. Children now make a majority – almost 70 percent — of their trips in the back seat of a car.

The influence of community design on the decision of whether or not to walk is made clear by looking at the trend in the number of children who walk to school. Schools are increasingly isolated from the communities they serve. New schools may be placed on the edge of communities, and wide, busy thoroughfares prevent children from biking or walking to school. Even schools that back up on subdivisions are often inaccessible by foot because there is no path to them: the only link is a circuitous street network. Many communities experience traffic jams around schools as parents deliver children to the door. Increasingly, mothers (and some fathers) are becoming the bus drivers of the new millennium. Women with school-aged children now make more car trips each day than any other population group, and on average spend more than an hour a day in the car.(4)

A study in South Carolina found that students are four times more likely to walk to schools built before 1983 than to those built more recently. Hazards such as busy streets are forcing more children who live within walking distance to board a bus instead. The same study found that students are more than three times likely to get such "hazard busing" if they attend a school built after 1971.(5)

While the decline in walking has meant slightly fewer pedestrian deaths, it is contributing to a growing health threat: health problems caused by a sedentary lifestyle. The decline in walking trips has come at the same time that more Americans have become overweight (see Figure 2, pg. 15). The National Health and Nutrition Examination Surveys found that in the late 1970s (1976 to 1980) 25 percent of the population was overweight; by the early 1990s (1988 to 1994) that number had grown to almost 35 percent. Since then, the trend has apparently continued: another national health survey, the Behavioral Risk Factor Surveillance System, shows that the number of Americans defined as obese grew from twelve percent in 1991 to almost eighteen percent in 1998.(6) Today more than half of American adults are overweight or obese.

The American Medical Association (AMA) recently declared obesity an epidemic and a major public health concern. The AMA blames the epidemic on people eating more, and on the fact that "opportunities in daily life to burn energy have diminished."(7) In an editorial in its journal, the AMA noted that car trips have replaced trips that used to be made on foot or by bicycle, and says helping people get back to walking or bicycling should be a first target in combating the obesity epidemic. But it also noted, "Reliance on physical activity as an alternative to car use is less likely to occur in many cities and towns unless they are designed or retro-fitted to permit walking or bicycling."(8)

Obesity is just one of the health problems associated with a sedentary lifestyle. The Centers for Disease Control estimates that 300,000 Americans die each year from diseases associated with physical inactivity. Even modest physical activity, such as walking, can decrease the risk of coronary heart disease, high blood pressure, colon cancer, diabetes, and even depression.(9)

The health effects of not walking show up among children as well as adults. As children take fewer trips on foot, more of them are becoming overweight (see chart). Between the early 1970s (1971 to 1974) and the early 1990s (1988 to 1994), the portion of children who were overweight grew from 5.5 percent to 13.6 percent. Obesity among children is at an all-time high, and reports bemoaning the sedentary lives of children have become commonplace. About 60 percent of obese children have risk factors that will probably translate into chronic diseases as adults.(10) One study in Britain even found that children who are driven to school have an elevated risk of growing up with heart disease and brittle bones.(11)

In comparing health research to transportation data, STPP found that metro areas where people walk less tend to be places where more people are overweight. Places where people walk further each day tend to have fewer people who are at risk of health problems due to obesity. In fact, for every ten percent decrease in the amount of walking, there is an almost one percent (0.7%) increase in the percentage of people who are overweight. This relationship remained when we controlled for age, race, and income. Obviously many factors contribute to this pattern, and a more detailed, controlling study of this question is needed. But our simple comparison suggests that where you live, and whether you can walk in your neighborhood, may be related to your likelihood of suffering from obesity or the other dangers associated with a sedentary lifestyle.

Numerous national and local health organizations have begun promoting more walkable communities as a fundamental way to improve basic human health. The Centers for Disease Control is working to promote Active Community Environments: places where people can easily walk and bicycle. The California Department of Health Services has decided that better health will require a better transportation environment, stating, "Our vision is a state where doctors prescribe walking and biking to their patients, employers subsidize bike facilities and community trails, and transit services accommodate cyclists by making intermodal travel safe and seamless."

When walking to a destination is possible, a British Medical Association study shows it is well worth the extra time it may take. The study found that the extra time spent walking or cycling to a destination is more than offset by the health benefits of the cardiovascular exercise, because it extends life expectancy by more than the extra time it takes to walk or cycle.(12)