The suburbs are not alright

Kevin Lam is a third-year medical student at McMaster University

Lawrence Loh is Associate Medical Officer of Health at Peel Region, Ontario, and Adjunct Professor at the University of Toronto Dalla Lana School of Public Health


Suburbs, and later exurbs, became central to the Canadian lifestyle during the automobile boom in the 1960s and 1970s. Cars were sold as the future and urban planners created suburban neighbourhoods that quickly became the primary venue where people lived and learned. Suburbs were touted to be cleaner and safer spaces, far away from “derelict” urban cores, where people went only to go to work. From this idyllic image, suburban built environments have since developed various distinct characteristics, typically defined by "commercial strips, low density, separated land uses, automobile dominance, and a minimum of public open space."

Having reshaped many cities in North America, the suburban model has gone global. Around the world, the suburban forms of major cities such as Mississauga (Toronto), Surrey (Vancouver), Limert Park (Los Angeles), Footscray (Melbourne), and Prospect Park South (New York) share these similar characteristics. But it’s becoming clear that suburban living doesn’t necessarily promote wellbeing. In fact, urban sprawl is not healthy.

Recently, Active Design Guidelines were created as a collaboration between city planners and public health professionals, when they realised that physical and mental wellbeing are essential to healthy communities. Deployment of such guidelines is intended to improve wellbeing by increasing physical activity, promoting greater social cohesion, and improving environmental health.

However, most Active Design Guidelines are from dense urban environments like New York, Toronto and Melbourne, and often were not created specifically for suburban or exurban settings and often the urban ones do not all apply to suburban areas. Recommendations for small block sizes, curb extensions for congested sidewalks, and maps and signage for calories burned to next transit stop, are not useful, for example. Urban guidelines are less applicable to the majority of Canadians who live in suburbs today.

The need for suburb-specific Active Design Guidelines is clear: time and time again, it has been shown that typical suburbs are not the promised lands they were sold as.  And the key characteristics that challenge health in the suburbs are also what makes them different from urban areas: automobile dependent infrastructure, single-use zoning, and relatively low density housing.

The need to travel by car is one of the defining characteristics of suburbs in North America. Zoning restrictions that that limit large expanses of  land for building housing  and the low density form that drives sprawl creates long distances between the places people want to go and it’s almost impossible for suburb-dwellers to reach places to shop and work by anything except for motorized transport – typically in private automobiles. Dependence on cars is a main driver for sedentary behaviour and poorer self-reported health as well as associated conditions such as obesity, diabetes and hypertension, leading to poor health, worsened quality of life and increased spending on healthcare.

Evidence is also accumulating that suburban developments cost governments a lot more money than the taxes they generate in the long term, resulting in significant diversion of resources towards upkeep away from health and community services. Researchers in the United States have found that denser neighbourhoods cost less overall: for every 10% increase in compactness, there is a 3.5% decrease in transportation costs even after adjusting for income. Similarly, a study in Spain showed that sprawl has increased infrastructure costs by 7 per cent and housing and local police costs by 2 per cent.

The absence of Active Design Guidelines specific to suburban settings is especially pressing in a time when rising living costs in city centres is pushing lower socioeconomic families out of city centres and promoting greater population growth in suburban settings. The absence of Active Design Guidelines for suburbs thus presents the potential for exacerbation of differential health status between those who can afford to live in dense urban cores and those who must choose to live in the surrounding suburbs.

Creating suburban guidelines will help public health professionals and urban planners communicate better. This will help them in making existing suburbs better and support the creation of new suburban developments that plan to put health first.

In speaking with experts, we identified some specific ideas. For example, large malls might be a focal point for re-engineering the suburban built environment rather than moving to amend zoning laws to permit mixed-uses of land. Furthermore, simple solutions may not be the best answer, such as the belief that open spaces in large-scale developments might function well. One expert we spoke to mentioned that “the [use of open spaces] depends on the design and programming; [I have seen] open space in [city] suburbs that are big but empty” - pointing to the low population density in suburban settings that would likely limit the possibility of reaching optimal use and capacity in oversized open spaces.

Experts also noted that deployment of suburb-specific Active Design Guidelines would require substantial political will - particularly to address conflicts such as the construction and use of cycle lanes, which would effectively increase travel times and decrease driving speeds for motorists. Some even suggested that the development of dedicated infrastructure for cycling would only be useful in the suburbs if they are entirely separated from motorized traffic - which is very different from thinking in urban guidelines.

What’s clear is that the cost of simply allowing suburban growth to go unchecked without considering that the long-term health impacts are simply too great. Urban planners and public health officials need to work together to address these problems. But let’s remember that the challenges facing dense urban areas are not the same as those facing the suburbs.

2 thoughts on “The suburbs are not alright

  1. Gordon Friesen

    Dear Kevin and Lawrence,

    This is indeed a most important subject.

    As I see it, people want to have it all. They want to be able to walk, within a couple of hundred meters, to a restaurant or other mini-business, and within perhaps one km to a nice little park with a wading pool for the kids

    They then wish to be able to get in the car and enjoy the full range of services and employment opportunities in a 7500 sq. km. area (circle from home of 50 km radius).

    Each mode has its rules : People can not comfortably stroll down to the mall, nor should they expect to park in the "village" center (although integrated offsite parking within short walking distance is a fine thing). In a certain protected zone, people should be able to walk and skateboard and bicycle to their heart's content without danger. But they should also enjoy immediate access to more than adequate fast roads and highways where none of these distractions are an issue.

    In the end, the calculation is one of building lot size vs population density. The basic parameters are : sufficient people within a given radius to support (very) small-business and parks within easy walking distance AND required parking capacity of one vehicle for every inhabitant. This means either apartment/condo structures with integrated parking OR housing lots (single, duplex, triplex) with the required land space to accommodate the vehicles required.

    Obviously, such developments are wonderful places to live, especially when combined with natural features such as waterfront access. They will therefore, depending on details, be somewhat expensive. But nothing in comparison with downtown apartments for the privileged few for whom "transportation" means calling a driver to go to the airport.

    Then there are the captive poor, inhabiting the same cities with the rich, but restricted, for work and leisure, to those destinations they can reasonably access by public transport. These are the true victims of planning as it is done now. They have no way to move up to the automobile owning class (beyond parking in the street). And the neighborhoods are abandoned to perpetual poverty because inhabitants, to live better, when and if they can, must leave.

    And finally, there are those, looking for more space, or looking for lower taxes, who will locate at driving distance only, from any destination at all. These people should not be artificially hindered in achieving their goals. They are rationally choosing what is best for themselves and their families, in an imperfect world.

    Calculations for each person will depend on preference and income.

    But public planning has an crucial role to play in the allocation of infrastructure. Guiding principles should be : respect of choice, and budgetary reality. We must admit, finally, belatedly -- once and for all -- that the vast majority of people, who are able to own an automobile (but not rich enough to dispense with one), will in fact do so. One car per person. Because no one wants to wait for somebody else to "take" them somewhere. Not if they don't have to.

    Therefore, it seems to me that building roads robust enough to take that traffic, and designed to interface with the sort of idyllic village life described above, would go a long way towards solving the problem. People could choose to build developments that have these characteristics, without being penalized by insufficient access.

    As to urban planning. New construction should always include the car spaces that would enable residents, even the relatively poor, to take part in modern life and transportation opportunities, without emigrating from the city. And of course, policies based on efficient automobile infrastructure to take people rapidly through and beyond cities. No more ideological war on the automobile class (the majority of citizens). This would encourage increasingly prosperous residents to remain in place, and thus stop the forced conversion of certain neighborhoods into permanent poverty traps.

    And then, as the ultimate "planner"(1) once said : Let a hundred flowers blossom.

    Feel the Love


    (1) Mao Zedong

  2. Albert Schumacher

    These are great thoughts, but cannot be pursued in isolation without challenging some basics.
    After all, we are still taxing bicycles, bicycle helmets and solar panels.


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