We got big butts and we cannot lie

Studies say sprawl is the reason why

For a state whose official motto calls for "Wisdom, Justice, and Moderation," it seems some Georgians — especially those in the Atlanta 'burbs — are quick to ignore that third one.

Almost 60 percent of adults in Georgia are overweight or obese, and Georgia is the sixth most obese state in the nation, according to the Centers for Disease Control and Prevention. Between 1984 and 2002, the prevalence of overweight and obese adults increased in the state by 60 percent.

Researchers are honing in on some of the causes of obesity, at least as far as Atlanta is concerned. Several studies now suggest that the culprit is sprawl. With the suburbs spreading at alarming rates — roughly 50 acres are gobbled up daily — so are suburban waistlines. What's more, the repercussions of the obesity problem may jolt the entire health care system, experts say. An Emory University report released in October describes obesity as being responsible for a 27 percent hike in health care costs over the past 15 years.

Two years ago, the CDC and Georgia Tech scientists found a link between the amount of time Atlantans spend in their cars and their weight. Given that metro Atlanta has the highest average commute time in the nation, it's no surprise the study also showed that the further from the city's core that people live, the more they weighed.

An updated version of the study even pinpointed the average difference in weight between people who live in an urban environment and those who live in an area where they rely solely on their cars for mobility. The difference, on average, is six pounds.

But it's not just about the disproportionate weight of the suburbanites, according to Rich Killingsworth, who helped launch the CDC's first obesity-sprawl studies in 1997.

"People [in dense urban areas] have lower blood pressure, and lower instances of diabetes versus places that are sprawling like Atlanta and most of the Southeast," says Killingsworth, now the director of Active Living by Design, a program administered by the University of North Carolina's School of Public Health.

The opposite is true of the suburbs, where there is a "higher incidence of obesity, diabetes, hypertension and lower levels of physical activity," Killingsworth says.

Obesity, commonly diagnosed when someone is 30 pounds overweight, is a full-blown epidemic. And behavioral scientists around the country expect it to get worse, posing an enormous strain on the nation's already overburdened health care system.

It's not like the suburbs themselves are actually causing Atlantans to balloon. Rather, it's the conditions accompanying sprawl that are contributing to the ballooning of the 'burbs: spending too much time behind the wheel and living in neighborhoods that aren't walking distance from schools and shops.

Tom Schmid, a behavioral scientist with the CDC's physical activity and health branch, says that the findings "hold true for a whole city but not for individuals. But even when we take affluence and other economic factors into account, we still get these kinds of patterns."

Schmid expects further research to shed more light on those patterns. In all, about three-dozen studies of sprawl's impact on physical health are underway, with funding from the Robert Wood Johnson Foundation, the National Academy of Sciences, the National Institutes of Health and the CDC. At the beginning of the year, the American Journal of Preventive Medicine will devote an entire issue to the subject.

"In the pubic health community, this research has definitely caught fire," says Barbara McCann, a transportation consultant who's helped research and author several sprawl-obesity studies. "If we can improve where people live and therefore improve health, then you've met a great goal. That's what public health is all about."