How Our Streets Can Make Us Healthier

The very design of our street systems can have a profound impact on our health

By Matt Carmichael on August 26, 2014 at 9:39 am CDT

The study found that the grid-like street pattern was associated with lower rates of heart disease, high blood pressure and diabetes.

I was struck by this quote in a new paper by Wesley E. Marshall et al. from the University of Colorado Denver’s Department of Civil Engineering:

“It might not be common for people to explicitly contemplate health when selecting a place to live.”

At Livability, it’s one of the eight characteristics we measure for our  Top 100 Best Places to Live  list. We also know, from our exclusive Livability survey with Ipsos, that Americans at least consider access to health care to be a fundamental concern in selecting a place to live.

Sure, there is a difference between access to health care and healthy living, and, sadly, some are more concerned with curing problems than avoiding them in the first place. Increasingly, we’re seeing cities focused on helping their residents lead healthier lives. Mayors have  issued weight-loss challenges and daily walking goals  to their constituents, for example. This research suggests that the mayors might need to do more. They might just need to rebuild their communities from scratch.

Marshall et al. looked at the type of street network in a series of California cities based on a study of road safety in mid-sized cities with populations between 30,000 and 100,000. They pulled out a dozen ‘safer’ cities (several of which are on our best places to live, incidentally) and a dozen ‘less safe’ cities. Then they looked at the health outcomes as measured by the massive California Health Interview Survey. The conclusion is fairly simple to understand: “People living in more compact cities tend to have better health outcomes.” While the study points out that it’s possible that healthier people chose to live in communities where it’s easier to be healthy, it also notes that it’s important to at least have the option to replace some driving trips with walking trips. As the authors say, “Such disparities in the ability to partake in utilitarian and/or recreational transportation may be a contributing factor to health disparities.”

Areas with a fully-gridded street pattern are typically older, more compact cities. Areas with a “tree”-like street pattern are more likely to be found in today’s sprawling suburbs. The study found that the grid-like street pattern was associated with lower rates of heart disease, high blood pressure and diabetes.

While others have discussed the need to  retrofit suburbia , the authors of this study also point to the opportunity to develop for the projected U.S. population growth by building areas that at least have a chance of helping people stay healthier.  Better zoning  would certainly help that goal. So would a conscious effort to think about how the place we live shapes the way we live.

Matt Carmichael is a contributing editor and former editor-in-chief of He is a recognized authority on demographics, consumer trends, economic development and best places to live.

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