Saturday, October 22, 2011

MTO, Health, and New Urbanism

It's great to see so much press coverage around the publication of "Neighborhoods, Obesity, and Diabetes — A Randomized Social Experiment," an article in the New England Journal of Medicine about the health gains made by women who moved to low-poverty communities under the Moving To Opportunity Program. Here's a summary from CNN: "between 2008 and 2010, Ludwig and his colleagues followed up with 3,186 women who participated in the [MTO] program. . . . Of the women who stayed in their original neighborhoods, 20% had blood-sugar levels consistent with diabetes and 18% had a BMI of at least 40 (the unofficial cutoff point for morbid obesity). These rates were not measurably different among the women who received unrestricted vouchers. By contrast, just 16% of the women who moved to low-poverty areas had diabetes and just 14% were morbidly obese."

However, one thing that no article we have seen has mentioned is how this data flies in the face of so much New Urbanist propaganda about how living in the suburbs makes people fat. In the MTO program, moves from high-poverty communities to low-poverty ones typically (though not always) meant moves from denser, more urban neighborhoods to less dense, less walkable, more suburban ones. So what is it about the new environments that accounts for the health benefits? Jens Ludwig, lead author of the study is quoted in CNN saying that the move "changed a bunch of things at one time for these families, so it's hard to tease out exactly what made a big difference for them," but that greater access to healthy foods, a safer environment more conducive to outdoor exercise, and lower levels of psychological stress all "seem like plausible explanations."

1 comment:

  1. Is it possible that their urban high-poverty areas weren't walkable? Living in Baltimore, I know that urban does not imply walkable, as many low-income areas struggle to support the kind of business that residents crave. One element that makes a place walkable is access to a variety of amenities, including a full-service grocery and health care. Areas that are considered to be walkable are typically highly sought after, meaning they are more expensive and therefore, not high-poverty areas. Ludwig is right to speculate that too many factors are at play here.