Monday, September 28, 2009

Sustainable Health Care, Part 2 - The Way We Live

This week's newspaper column - second in a two-part series on sustainable health care reform.

The way we lay out our neighborhoods directly impacts how much we, as a society, pay for health care.

Let’s take an imaginary drive through a typical American subdivision. (I say “drive” because walking is usually not an option.)

Scooting down the main drag, we see strip malls and commercial buildings lined up end to end. With rare exception, everyone we encounter along this strip drove there in an automobile.

Huge parking lots in front of each establishment accommodate workers and patrons who park as close to the front door as possible. After all, who would want to walk on hot pavement with the sun beating down when all the trees have been removed?

And you’ll notice that all of the parking lots are disconnected. To get from one place to another – even if the destination is next door – people get back in their cars and drive. Don’t bother looking for sidewalks; in strip mall land, walking is so uncool.

Something else is striking about this landscape. Where are the homes? No wonder no one is walking. You can’t get here from there. Let’s turn off on one of the side streets and see if we can find where people live.

Now we’re talking. We were looking for houses and now we have it - blocks and blocks of houses one after another without a grocery store in sight. Don’t bother looking for sidewalks here either. When all services are miles away, where would you walk to anyway?

Now let’s tour a sustainable community. I’m stopping the car; we can walk from here.

Tree-lined streets provide a cool canopy for our leisurely stroll down the sidewalk as we wave to friends and neighbors. Homes are located in close proximity to businesses here, so it’s practical and pleasant to walk to the grocery store rather than – out of necessity - drive.

We can stop in at that little coffee shop around the corner and meet Aunt Bertha. She’s not driving any more since she turned 80, but she gets around just fine. She walks to the bank, she walks to the diner, she even walks to the senior center where she and her friends have a rollicking good time. They all kid Aunt Bertha about being “spry as a kitten” because of her independence and zest for life. Aunt Bertha doesn’t spend much time at the doctor’s office.

Her younger sister, on the other hand, lives in suburbia. She also gave up driving a couple of years ago, but unlike Aunt Bertha, Aunt Bea is housebound. When she needs to go somewhere, someone must drive to her house and act as chauffer. Aunt Bea gets virtually no exercise, and is in considerably worse health than her older sister with the medical records to prove it.

Communities where walking is a normal part of daily life are inherently healthier places to live than those where driving is the only option. Think about that when you choose your next home.


Rose Marie Raccioppi said...

The "sustainable" describes the setting where I grew up. All the feelings of independence I developed as a young girl, in this setting are as you described for Aunt Bertha. When married it was the house in the suburbs - yes - just as you described. As my sons reached their early teens I saw the difference in my independence at a similar age - they had to be driven - driven - driven. I wondered at that time how was this an improved life style? I have concluded that it wasn't and look to the sustainable communities you have put forth.

Alex said...

I'm new to your blog, recently introduced by a dear friend.

This article (are you the author or is it a reprint?) really gives me pause: I don't own a car but I wish I did because getting to laundromat, grocery store, post office, etc. is so hard in my town where things are spread out and public transportation system is inadequate.

I guess I should feel confident and proud of myself--I'm walking and biking everywhere. This is the model for sustainability, right? I'm ahead of the crowd. But I have to admit, I'm almost 60 and a lot of days, I wish I had a car.

James Polk said...


In a sustainable community, services would not be so far afield. The idea is that all of your every-day destinations should be within no more than a 10 minute walking distance instead of everything being sprawled out on a "strip." The geometry of a series of nodes - or village-like neighborhoods - lends itself to comfortable, practical walking and biking transportation while the geometry of strip development does not; it's only negotiable by automobile. The latter is what you're experiencing, and though you are commuting by bike and foot, you are experiencing the downfall of American strip development.