Superbia!

We hear and read a lot about the hidden costs of sprawl, for example that the average American now spends 443 hours behind the wheel every year, the equivalent of 55 nine-hour days. And we hear about new kinds of subdivisions and building projects such as "new urbanism" and "pedestrian pockets" that may help reduce both sprawl and unwanted driving. But we don't hear much about what can we do to enhance the health of existing suburbs. The fact is, we've already sprawled, doubling the size of metro areas like Kansas City, Atlanta and Las Vegas in just the past few years.

Starting with what's already in place, how can we tune our neighborhoods up so they're healthier and more efficient? Rather than getting in the car five or ten times a day for shopping, kid shuttling, recreation and work, with a little teamwork we can find ways to meet more of our needs right in our own neighborhoods.

For the last six years, I've experimented with this idea in my personal life. Because I work at home, walk to stores for exercise, and have friends and recreation ( in the form of a large garden) right in my neighborhood, I've had to borrow my neighbor's battery charger several times recently, because I'm not driving enough to recharge my car's battery. A few basic changes in my daily routine have saved me a lot of money on gas, parking, food, medical bills, insurance premiums, and other expenses, not to mention a lot of stress on the highways.

While many of the impacts of suburban design focus on water pollution, habitat loss and other symptoms "out there," recent findings by the Centers for Disease Control connect these impacts directly with our personal health. Says CDC Director Richard Jackson, "The diseases of the 21st century will be chronic diseases like diabetes, obesity, asthma, and depression, that steal vitality and productivity, and consume time and money. These diseases can be moderated by how we design, build, and maintain our human environment."

Dr. Jackson points to the connection between urban sprawl -- which makes fewer sidewalks and bike paths available -- and the recent surge in adult-onset diabetes. "Obesity increases the risk of this type of diabetes as much as 34-fold," he says, "which in turn increases the incidence of amputations, blindness, kidney failure, and heart disease." Since 1975, childhood obesity doubled and adult obesity shot from 47 percent to 61 percent of the population.

The good news is that weight loss and physical activity are more effective -- and cheaper -- in controlling diabetes than medication. The same is true for other sprawl-related diseases. For example, physical activity is as effective as prescription drugs for treatment of relatively mild cases of anxiety and depression, according to Jackson.

However, if our neighborhoods aren't interesting or even safe to walk in, and if there are no stores, parks and other destinations that give walking a sense of purpose, we won't walk. To become more active, many resolute Americans climb in their cars and drive to the gym, which creates other health risks. Says Jackson, "Respiratory disease, especially asthma, is increasing yearly in the U.S., and poor quality air makes it worse. In 1997, smog pollution was responsible for more than 6 million asthma attacks and 160,000 emergency room visits."

Other health impacts related to the design of suburban neighborhoods include heart disease and stroke, high blood pressure, colon cancer, bicycle and pedestrian accidents, and less mobility for the elderly and disabled.

One way to make suburban neighborhoods healthier is to make them more like villages, so we'll want to spend more time there. Wouldn't the steady addition of shops, home businesses, pocket parks, trails, community gardens, neighborhood recycling systems, and vanpools make suburbia more lively and invigorating? These elements and many more like them can be added to neighborhoods across the country if suburban residents begin to work together, pooling energy, time and skills.