By Andrew Starc

21 April 2010 – A new report by Curtin University of Technology and Parsons Brinckerhoff highlights evidence that the potential for the Federal Government to enforce deregulation of urban zoning and planning across Australia could  have detrimental effects on both the health and productivity of urban populations.

In the report, The Cost of Urban Sprawl: Physical activity links to healthcare costs and productivity, authors Roman Trubka, Peter Newman and Darren Bilsborough identify a redevelopment path known as “active-travel neighbourhoods,” a scenario that presents the polar opposite of what urban centres might resemble if deregulation does go ahead.

According to the report, an active-travel neigbourhood is one that is defined by “redevelopment in walkable, transit-oriented developments…conducive to both cycling and walking, which in daily life activities could lead to most able bodied people engaging in at least 30 minutes of active travel per day.”

The report highlights the health and productivity of an active-travel neighbourhood, while conversely highlighting the detrimental implications of the potential scenario if deregulation takes place, that is, an urban sprawl.

Some of the key points outlined in the report include:

  • A growing body of evidence suggests that neighbourhoods characterised by low density, poor connectivity, and poor access to shops and services, are associated with low levels of walking. Moreover, sprawling areas of low walkability have been linked to obesity and numerous other chronic illnesses (Giles-Corti 2006; Sturm & Cohen 2004).
  • Although not all obesity is attributable to urban form, one study has documented in its research that each additional hour spent in a car per day was associated with a 6per cent per cent increase in the odds of being obese, while each additional kilometre walked per day was associated with a 4.8 per cent reduction in the odds of being obese (Frank et al. 2006).
  • Another study has shown that individuals in the least walkable environments drive the most per day (74 kilometres, while those in the most walkable environments drive the least (43 k) (frank et al. 2007a).
  • All this implies that a step towards designing our cities around active transport instead of the automobile can have some profound effects on physical health and possibly mental health. As a result, an increase in discretional and non-discretional active transport could identifiably benefit social capital and public health while saving the healthcare system considerable money.
  • Research by Active Living Research in the US has shown that residents of more walkable areas spend about 30 minutes more per week (20per cent of the recommended amount) on walking trips than residents in sprawling areas (active living research 2005). Another study conducted by findings from SMARTRAQ in the US found that 19per cent more people (the difference between 37per cent and 18per cent) are likely to meet or exceed the recommended minimum activity quota of 2.5 hours a week (or 130 hours a year) in highly walkable areas than people in the most sprawling neighbourhoods (frank et al 2005). Total potential health-related savings were then calculated using the logic that if 19per cent more of the total resident population meets the npa’s minimum recommended level of moderate activity a week in active travel neighbourhoods, then a 19per cent discount could be expected in inactivity-related health costs.
  • In 2007, Medibank Private contracted Econtech to produce a report on the direct inactivity costs of Australian adults. This value was estimated at $1.5 billion and included the following seven illnesses: falls, coronary heart disease, type two diabetes, depression, stroke, colon cancer, and breast cancer (Econtech 2007). An adult was defined as anyone of the age 18 and over and the value represented the potential savings that could be achieved if more adults became sufficiently active. Their report quoted the 2000 National Physical Activity Survey in stating that 54.2 per cent of Australia’s adult population is not getting enough physical activity to remain healthy. Using this figure and assuming that the $1.5 billion estimate can be applied to the inactive portion of the adult population, an overall value of $2.8 billion was estimated for the physical-activity related component of health for all Australian adults. Indirect costs are more difficult to calculate because of the complexity of the assumptions required. Health Canada’s Economic Burden of Illness (1993) assigns an overall ratio to its economic health assessments. That approximates indirect costs at 54.3 per cent of the total cost of illness. This approach takes into account productivity losses due to mortality and short-and long-term disability. Using this ratio would estimate Australia’s indirect cost of inactivity at $1.78 billion, the total cost of inactivity at $3.82 billion, and the total value of all Australian adults meeting recommended activity levels at $6.1 billion. Australia’s National Public Health Partnership (ANPHP) estimates that indirect costs would more than double direct costs but provides no numerical value (Bauman et al. 2002). To be conservative and simply say that indirect costs would amount to double the value of direct costs would produce an estimate of $3 billion. Using this estimate would translate into a total cost of $4.5 billion due to inactivity and a total value for all Australian adults of $8.3 billion. For the purpose of this calculation, the figure of $6.1 billion for the total health value of activity among Australian adults is used in determining the estimate for the healthcare savings of active travel neighbourhoods as the ANPHP ’s indirect-cost estimate lacks specificity and rigor for our purposes.

With regard to the employment productivity benefits to be garnered from active-travel neighbourhoods, the report states:

As of yet, we are unaware of any studies that directly tie urban form characteristics to employment productivity via the physical activity link, but it does not require a stretch of the imagination to see that such a link exists.

The report goes on to further highlight evidence of this link, with some of the main points including:

  • The majority of empirical studies relating exercise to workplace productivity have been focused on workplace fitness and wellness programs. The rationale behind their introduction by firms is that if their employees are healthier, this may result in fewer sick days being taken, better productivity on the job (presenteeism), and better employee relationships (Pronk et al. 2004).
  • The choice for firms to invest in workplace fitness programs and facilities may be one justified (or partially justified) on imprecise calculations, but for many smaller firms the whole concept is simply financially unrealistic. If similar health benefits can be accomplished through urban design efforts, ones particularly geared towards increasing incidental travel by way of walking or cycling, it is logical to see how planning policy can thus influence the economic productivity of cities (inclusive of companies of all sizes). In this way, health policy and community-scale urban planning may currently be missing opportunities to effectively improve health and productivity simultaneously and across multiple sectors (Yancey et al 2007).
  • Keeping with some of the assumptions made in the calculation of the activity-related health care benefits and sourcing some empirically estimated productivity benefits from existing studies, we can make some rough estimates of how active-travel has an economic impact on employee productivity through urban form. For the sake of simplicity, we will focus on benefits as they relate to absenteeism and on-the-job productivity — the two most common empirically studied effects. Mills et al. (2007) found that after a 12-month intervention-control study on a multinational corporation, the intervention group benefited from 4.3 fewer absentee days and an on-the-job productivity increase of 10.4per cent. similarly, Lechner et al. (1997) in their longitudinal pre-test – post-test study found that fitness program participants experienced a decline of 4.8 sick days with a sample consisting of employees in the police force, the chemical industry, and in banking. Furthermore, Sheppard (1992) provides a critical analysis of worksite fitness programs and generates a table summarising the results from a number of reviewed studies.