A recent piece in the New York Times about the perils of long commutes from the exurbs made me think about a local doctor I know. This doctor, an internist, regularly sees patients with medical ailments that seem to spring from a basic lack of exercise and an unhealthy diet. We’ve all heard of these typical American complaints: high cholesterol, diabetes, weight gain.
Instead of offering surgery, a pill or further testing, however, this doctor takes a different tack. He asks his patients to start buying fresh vegetables, fruits and lean meats at their local grocery store and start cooking their meals from scratch, so they can control the amount of fat and other unhealthy ingredients. Second, this doctor asks his patients to try and walk to the grocery store to get their food, at least twice a week. In this way, they are getting regular exercise (no need to drive to a gym anymore). Last, this doctor asks them to try and find other ways to build walking into their lives: walking to pick their kids up from school, walking to and from work or walking to the bus stop.
Sadly, many of these patients think the doctor is a kook and look for another doctor who will just prescribe medication and send them on their way. Worse, however, are the many patients who want to comply but can’t. With no sidewalks and no grocery stores nearby, these patients are virtual prisoners of their cars. Fat and sick, they return to their homes and can’t even begin to follow the doctor’s advice, because walking isn’t an option.
“We’ve basically engineered physical movement out of our communities,” a public health worker told me. “Instead of encouraging people to walk or bike, we’ve made cars the only form of transportation that works.”
Much has been made in the past few years of the perils of high-fat, large-portion, sugar-laden American fast food. And undoubtedly, fatty, processed food is a huge part of the American obesity epidemic. But few people have looked at the possibility that the way we build our communities is killing us. By designing communities made for cars, we’ve made people fat.
The good doctor whose prescription for health involves fresh food and walking agrees. “In order for my patients to get healthy they need to be able to move. They can’t do that on a busy street that lacks sidewalks, on their way to a big box retail center located miles away.”