The latest data from the Centers for Disease Control and Prevention affirms an alarming trend: we’re fat and not getting any slimmer. An estimated 35 percent of U.S. adults are obese, and another third still maintain weights exceeding those deemed healthy. This doesn’t bode well for governments and individuals paying insurance premiums, especially with the country’s aging population.

But there are antidotes to the problem, and among the best could be sidewalks and bike lanes. Such infrastructure not only facilitates outdoor recreation and an alternative to congested roadways, but data shows it delivers slimmer waistlines in some of the nation’s largest metropolitan regions.

A Governing review of census and CDC data finds communities where more residents walk or bike to work boast significantly healthier weights. The analysis of 2010 statistics for 126 metropolitan areas finds these communities are strongly correlated with higher numbers of residents who are neither obese nor overweight.

Historically, studies have linked trails, sidewalks and bike lanes with an increase in walking or cycling. As medical costs continue to rise and evidence mounts that such infrastructure also improves well-being, more officials might look to give health consideration greater standing in transportation planning.

“The more access that people have to these kinds of places, the more likely they are to be healthy,” said Susan Polan, associate executive director for public affairs and advocacy with the American Public Health Association.

Metropolitan regions with the healthiest weights are home to high counts of walkers and bike commuters.

Approximately half of Fort Collins-Loveland, Colo., metro area residents are neither overweight nor obese. That might not sound like a lot, but it’s the highest percentage of healthy residents of all metro areas surveyed in the CDC’s 2010 Behavioral Risk Factor Surveillance System, an annual telephone survey measuring a range of health issues. Accordingly, census figures indicate 5.3 percent of Fort Collins-Loveland area commuters walk or bike as their primary form of transportation to work, one of the highest rates in the country.

Five of the top 10 healthiest metro areas in terms of weight were among the 10 regions with highest percentages of residents walking or biking to work in the Governing analysis. Although tallies of walkers and bikers are small compared to all commuters, many who walk or bike to public transit stations aren’t counted in the Census Bureau’s American Community Survey data, and significantly more exercise outdoors outside of their daily commutes.

The CDC considers those with sizable weights for their height (body mass index of 30 or greater) to be obese, and others who are not quite obese, but exceeding healthy weights, to be “overweight.”

While only a fraction of workers in an area may opt to bike or walk to work, having the necessary infrastructure in place compels others to use it more regularly.

Spending hours a day in a car or living a sedentary lifestyle makes it difficult to shed pounds. Exercising helps, and eating habits, medical conditions and other factors understandably drive obesity rates as well.

Along with commuting habits, other measures showed statistically significant relationships with healthy weights in the analysis. Healthier metro areas were most closely correlated with the portion of a region’s population holding at least a bachelor’s degree. The Bridgeport-Stamford-Norwalk, Conn. metro area, a wealthy region ranking near the top in education attainment, recorded the lowest obesity rate in the CDC's 2010 survey.

Still, the correlation between commuting and residents not considered obese nor overweight was strong--16 percent greater than the relationship with median household income.  An area’s average commute time was slightly correlated with weight, but was not statistically significant.
 

Scatter plot of metro areas' walkers/bike commuters correlated with healthy weights:

The CDC recommends a range of infrastructure for communities to rein in obesity. Bike lanes, shared-use paths and bike racks promote cycling. Urban design with adequate sidewalks, lighting, street crossings and similar features supports walking and other physical activity. The agency also suggests localities work to cut miles driven on roadways. American Public Health Association's Polan cited public transit projects and converting old rail lines into trails as two of the more popular initiatives localities pursue. It’s particularly important, she said, to encourage kids to walk to school and educate them about pedestrian safety at a young age. Last year, Los Angeles County, Calif., earmarked nearly $16 million in funding for an initiative aimed at curbing obesity, part of which included expanding bike networks and promoting open spaces. “There are a lot of smaller initiatives that can engage and energize people and make them realize what a difference they can make at the local level,” Polan said. When cutting expenses, health costs are an easy target. A recent study by two Lehigh University researchers reported obesity-related costs accounted for $190 billion annually in U.S. health expenditures, nearly 21 percent of the country’s total bill. Advocates often push for related projects in transportation planning, but the amount of weight officials actually give to health concerns varies. While it may be a major consideration in some communities, others focus strictly on economic concerns, Polan said. John Norquist, president of the Congress for the New Urbanism, said many American cities have taken steps in recent years to promote walking and biking.

To improve walkability, connected street grids – with slower speed limits and no more than two lanes in each direction – are a key component, he said.

Those looking to move can use the popular walkscore.com website to measure how accessible an apartment or home’s various neighborhood amenities are on foot. Norquist, whose group advocates mixed-use and transit-oriented development, cited New York City, San Francisco, Denver and Albuquerque, N.M., as cities making strides in developing walkable communities.

Biking has also accelerated, Norquist said, particularly in Seattle and other older urban environments. “The old downtowns are in great shape for biking,” he said.

Young people’s attitudes toward biking and public transit have shifted, with more seeking alternatives to long car rides, Norquist said. Bicycle manufacturers have joined in the push to remake communities, hiring lobbyists to pressure Washington and support more bike-friendly transportation planning policies.

The emphasis on healthy lifestyles in urban design isn’t new, though. Richard Jackson, a former head of the CDC’s National Center for Environmental Health who has since become one the movement’s most vocal proponents, published an article linking built environments to adverse health effects back in 2001.

Norquist said that the benefits of walking and biking have now become one of the central themes of urbanists’ arguments for urban revival as recreation represents an increasingly key aspect of living downtown.

“It’s really going to be a big factor, because people want to be healthier,” he said. "It's a very personal thing."

View a summary of the methodology and results
 

Data

The CDC’s Behavioral Risk Factor Surveillance System measures obesity and other health factors. The table below shows 2010 estimates for each geographic region surveyed, most of which are metro areas. Click here for a complete list of communities included in the 2010 survey, along with specific counties comprising each area.

The following definitions describe the data:

-- Healthy weight: Neither overweight nor obese
-- Overweight: Body mass index of 25-29.9
-- Obese: Body mass index of 30-99.8
-- No physical activity: Respondents reporting doing no physical activity or exercise in the past 30 days

 

         
Area Healthy Weight Overweight Obese No Physical Activity
Atlantic City-NJ Metro Area 30.7% 42.5% 26.8% 27.8%
Austin-Round Rock-TX Metro Area 35.9% 37.1% 27.0% 19.3%
Bethesda-Gaithersburg-Frederick-MD Metro Division 42.8% 37.3% 19.9% 17.3%
Buffalo-Cheektowaga-Tonawanda-NY Metro Area 37.9% 37.5% 24.7% 23.9%
Charleston-North Charleston-SC Metro Area 34.7% 36.4% 29.0% 25.4%
Charlotte-Gastonia-Concord-NC-SC Metro Area 37.0% 35.0% 28.0% 22.6%
Chicago-Naperville-Joliet-IL-IN-WI Metro Area 38.8% 34.2% 27.0% 23.3%
Coeur d´Alene-ID Metro Area 35.5% 39.8% 24.7% 18.8%
Denver-Aurora-CO Metro Area 43.0% 37.4% 19.6% 16.2%
Durham-NC Metro Area 41.1% 32.4% 26.6% 22.0%
Edison-NJ Metro Division 38.5% 37.4% 24.2% 26.0%
Greenville-SC Metro Area 32.1% 33.9% 34.0% 26.5%
Hickory-Morganton-Lenoir-NC Metro Area 33.4% 41.7% 25.0% 30.2%
Kennewick-Richland-Pasco-WA Metro Area 33.4% 35.1% 31.5% 24.2%
Key West-Marathon-FL Micropolitan Area 46.0% 37.1% 16.9% 16.9%
Kingsport-Bristol-TN-VA Metro Area 29.9% 33.4% 36.7% 37.6%
Little Rock-North Little Rock-AR Metro Area 29.3% 36.0% 34.6% 23.8%
Louisville-KY-IN Metro Area 33.7% 35.1% 31.2% 25.2%
Miami-Fort Lauderdale-Miami Beach-FL Metro Area 34.2% 37.5% 28.3% 24.1%
Myrtle Beach-Conway-North Myrtle Beach-SC Metro Area 32.2% 41.2% 26.6% 22.7%
Nashville-Davidson--Murfreesboro-TN Metro Area 37.8% 37.4% 24.7% 26.7%
New Haven-Milford-CT Metro Area 38.8% 34.9% 26.2% 22.1%
New Orleans-Metairie-Kenner-LA Metro Area 30.1% 37.2% 32.6% 26.9%
New York-White Plains-Wayne-NY-NJ Metro Division 40.5% 37.6% 21.9% 24.6%
Newark-Union-NJ-PA Metro Division 38.2% 37.9% 23.9% 26.1%
Orlando-Kissimmee-FL Metro Area 34.3% 37.4% 28.3% 25.3%
Panama City-Lynn Haven-FL Metro Area 34.1% 37.9% 28.0% 23.9%
Peabody-MA 41.0% 36.7% 22.3% 19.6%
Phoenix-Mesa-Scottsdale-AZ Metro Area 36.0% 41.1% 22.8% 18.5%
Port St. Lucie-Fort Pierce-FL Metro Area 35.5% 36.5% 28.0% 22.1%
Portland-South Portland-Biddeford-ME Metro Area 37.6% 38.6% 23.9% 17.9%
Portland-Vancouver-Beaverton-OR-WA Metro Area 40.3% 33.7% 26.0% 15.8%
Sacramento—Arden-Arcade—Roseville-CA Metro Area 40.9% 35.1% 24.0% 15.3%
Salt Lake City-UT Metro Area 41.8% 34.6% 23.6% 18.3%
San Antonio-TX Metro Area 36.7% 33.5% 29.8% 26.5%
San Diego-Carlsbad-San Marcos-CA Metro Area 41.2% 32.8% 26.1% 19.0%
San Francisco-Oakland-Fremont-CA Metro Area 44.8% 36.9% 18.2% 17.4%
San Jose-Sunnyvale-Santa Clara-CA Metro Area 39.7% 39.1% 21.2% 17.0%
Santa Ana-Anaheim-Irvine-CA Metro Division 43.1% 36.3% 20.7% 21.1%
Santa Fe-NM Metro Area 46.3% 32.9% 20.8% 17.9%
Scottsbluff-NE Micropolitan Area 27.9% 39.1% 33.0% 27.5%
Scranton--Wilkes-Barre-PA Metro Area 35.9% 35.7% 28.4% 32.8%
Seaford-DE Micropolitan Area 30.5% 37.7% 31.8% 25.8%
Seattle-Bellevue-Everett-WA Metro Division 42.3% 34.9% 22.8% 16.6%
Sebring-FL Micropolitan Area 35.5% 35.0% 29.4% 28.9%
Shreveport-Bossier City-LA Metro Area 33.2% 36.3% 30.4% 34.1%
Sioux City-IA-NE-SD Metro Area 32.6% 35.7% 31.7% 28.2%
Sioux Falls-SD Metro Area 33.3% 39.9% 26.8% 21.4%
Spokane-WA Metro Area 35.9% 39.7% 24.5% 18.3%
Springfield-MA Metro Area 41.2% 35.0% 23.8% 20.5%
St. Louis-MO-IL Metro Area 36.2% 33.9% 29.8% 25.5%
Wichita Falls-TX Metro Area 32.9% 39.2% 27.9% 28.6%
Wichita-KS Metro Area 38.5% 34.4% 27.1% 22.6%
Akron-OH Metro Area 38.2% 32.5% 29.3% 22.6%
Albuquerque-NM Metro Area 43.3% 34.9% 21.7% 18.0%
Allentown-Bethlehem-Easton-PA-NJ Metro Area 37.5% 33.5% 29.0% 26.1%
Amarillo-TX Metro Area 35.0% 36.3% 28.7% 24.1%
Arcadia-FL Micropolitan Area 32.2% 33.7% 34.1% 35.1%
Asheville-NC Metro Area 37.3% 35.2% 27.5% 22.2%
Atlanta-Sandy Springs-Marietta-GA Metro Area 37.4% 33.9% 28.7% 22.1%
Augusta-Richmond County-GA-SC Metro Area 31.1% 36.8% 32.1% 25.9%
Augusta-Waterville-ME Micropolitan Area 37.1% 33.4% 29.4% 22.3%
Baltimore-Towson-MD Metro Area 33.5% 38.4% 28.0% 24.0%
Bangor-ME Metro Area 31.1% 35.4% 33.5% 24.1%
Barre-VT Micropolitan Area 41.2% 36.9% 21.8% 16.1%
Baton Rouge-LA Metro Area 35.4% 32.2% 32.5% 25.7%
Billings-MT Metro Area 35.4% 37.4% 27.2% 24.0%
Birmingham-Hoover-AL Metro Area 33.7% 37.0% 29.3% 29.2%
Bismarck-ND Metro Area 39.4% 36.1% 24.5% 19.4%
Boise City-Nampa-ID Metro Area 38.0% 36.6% 25.3% 16.6%
Boston-Quincy-MA Metro Division 43.2% 34.8% 22.0% 21.5%
Bremerton-Silverdale-WA Metro Area 34.9% 36.3% 28.8% 15.3%
Bridgeport-Stamford-Norwalk-CT Metro Area 45.6% 37.8% 16.6% 18.8%
Burlington-South Burlington-VT Metro Area 42.3% 36.0% 21.7% 13.6%
Cambridge-Newton-Framingham-MA Metro Division 44.2% 35.2% 20.7% 17.3%
Camden-NJ Metro Division 34.7% 35.8% 29.5% 27.2%
Canton-Massillon-OH Metro Area 35.4% 36.3% 28.3% 26.6%
Cape Coral-Fort Myers-FL Metro Area 40.0% 34.2% 25.8% 27.9%
Casper-WY Metro Area 34.7% 37.7% 27.6% 23.2%
Cedar Rapids-IA Metro Area 41.1% 33.5% 25.4% 25.5%
Charleston-WV Metro Area 30.5% 37.3% 32.3% 31.4%
Chattanooga-TN-GA Metro Area 30.9% 38.6% 30.4% 32.2%
Cheyenne-WY Metro Area 33.8% 39.2% 27.0% 23.1%
Cincinnati-Middletown-OH-KY-IN Metro Area 38.1% 34.4% 27.4% 25.4%
Cleveland-Elyria-Mentor-OH Metro Area 34.4% 40.9% 24.7% 22.7%
Colorado Springs-CO Metro Area 38.6% 37.8% 23.6% 19.1%
Columbia-SC Metro Area 32.9% 36.1% 31.0% 27.7%
Columbus-OH Metro Area 34.5% 35.0% 30.5% 26.3%
Concord-NH Micropolitan Area 36.5% 40.9% 22.6% 16.9%
Dallas-Plano-Irving-TX Metro Division 36.4% 29.8% 33.8% 26.4%
Dayton-OH Metro Area 35.0% 35.3% 29.7% 25.2%
Del Rio-TX Micropolitan Area 25.8%   32.9%  
Deltona-Daytona Beach-Ormond Beach-FL Metro Area 34.8% 38.0% 27.2% 23.7%
Des Moines-West Des Moines-IA Metro Area 35.1% 38.9% 26.0% 22.3%
Detroit-Livonia-Dearborn-MI Metro Division 32.9% 34.0% 33.1% 28.3%
Dover-DE Metro Area 29.4% 38.8% 31.9% 30.4%
El Paso-TX Metro Area 30.2% 41.1% 28.6% 28.5%
Eugene-Springfield-OR Metro Area 39.9% 30.1% 30.0% 18.2%
Evansville-IN-KY Metro Area 37.0% 33.7% 29.3% 27.7%
Fargo-ND-MN Metro Area 37.8% 36.8% 25.4% 26.6%
Farmington-NM Metro Area 35.0% 31.4% 33.7% 22.9%
Fayetteville-Springdale-Rogers-AR-MO Metro Area 38.5% 37.1% 24.4% 26.2%
Fort Collins-Loveland-CO Metro Area 50.2% 28.5% 21.3% 13.1%
Fort Wayne-IN Metro Area 30.9% 36.0% 33.2% 23.4%
Fort Worth-Arlington-TX Metro Division 30.3% 34.4% 35.3% 24.0%
Gainesville-FL Metro Area 43.8% 36.0% 20.1% 19.1%
Grand Island-NE Micropolitan Area 31.2% 39.9% 29.0% 26.2%
Grand Rapids-Wyoming-MI Metro Area 34.8% 38.7% 26.6% 19.3%
Greensboro-High Point-NC Metro Area 32.7% 38.6% 28.7% 23.4%
Hagerstown-Martinsburg-MD-WV Metro Area 34.3% 33.6% 32.1% 27.7%
Hartford-West Hartford-East Hartford-CT Metro Area 38.0% 37.9% 24.2% 19.5%
Hastings-NE Micropolitan Area 33.4% 35.8% 30.8% 26.0%
Helena-MT Micropolitan Area 39.3% 39.6% 21.1% 18.4%
Hilo-HI Micropolitan Area 39.4% 33.9% 26.8% 19.2%
Hilton Head Island-Beaufort-SC Micropolitan Area 40.2% 37.5% 22.4% 19.0%
Homosassa Springs-FL Micropolitan Area 38.3% 38.0% 23.7% 22.7%
Honolulu-HI Metro Area 43.9% 34.2% 21.9% 19.7%
Houston-Sugar Land-Baytown-TX Metro Area 36.9% 34.0% 29.1% 23.6%
Huntington-Ashland-WV-KY-OH Metro Area 30.6% 35.8% 33.5% 30.2%
Idaho Falls-ID Metro Area 35.9% 35.8% 28.3% 19.4%
Indianapolis-Carmel-IN Metro Area 36.2% 35.7% 28.2% 23.5%
Jackson-MS Metro Area 33.3% 33.5% 33.3% 31.5%
Jacksonville-FL Metro Area 38.6% 35.4% 26.0% 27.9%
Kahului-Wailuku-HI Micropolitan Area 37.1% 35.9% 27.0% 16.4%
Kalispell-MT Micropolitan Area 40.5% 41.2% 18.3% 20.4%
Kansas City-MO-KS Metro Area 34.5% 36.0% 29.5% 23.0%
Kapaa-HI Micropolitan Area 44.5% 31.8% 23.7% 16.5%
Knoxville-TN Metro Area 35.4% 34.1% 30.5% 29.1%
Lake City-FL Micropolitan Area 29.7% 39.1% 31.2% 28.0%
Lakeland-Winter Haven-FL Metro Area 29.0% 33.0% 37.9% 26.0%
Laredo-TX Metro Area 29.1% 37.6% 33.3% 34.2%
Las Cruces-NM Metro Area 32.0% 37.2% 30.8% 24.5%
Las Vegas-Paradise-NV Metro Area 39.6% 37.3% 23.1% 23.7%
Lebanon-NH-VT Micropolitan Area 40.2% 34.6% 25.2% 19.6%
Lewiston-ID-WA Metro Area 35.0% 38.3% 26.7% 22.3%
Lewiston-Auburn-ME Metro Area 38.2% 34.9% 26.9% 24.3%
Lincoln-NE Metro Area 37.4% 32.5% 30.1% 18.2%
Los Angeles-Long Beach-Glendale-CA Metro Division 37.5% 38.2% 24.3% 20.8%
Lubbock-TX Metro Area 35.3% 32.5% 32.2% 30.7%
Manchester-Nashua-NH Metro Area 39.7% 35.8% 24.5% 18.7%
McAllen-Edinburg-Mission-TX Metro Area 30.8% 35.8% 33.3% 36.0%
Memphis-TN-MS-AR Metro Area 28.9% 35.3% 35.8% 26.1%
Midland-TX Metro Area 38.5% 37.6% 23.9% 33.3%
Milwaukee-Waukesha-West Allis-WI Metro Area 39.1% 35.0% 26.0% 24.4%
Minneapolis-St. Paul-Bloomington-MN-WI Metro Area 38.4% 36.7% 24.9% 17.1%
Minot-ND Micropolitan Area 30.8% 40.4% 28.9% 26.5%
Mobile-AL Metro Area 32.8% 33.6% 33.6% 30.3%
Naples-Marco Island-FL Metro Area 40.8% 36.4% 22.9% 13.6%
Nassau-Suffolk-NY Metro Division 41.3% 36.8% 21.9% 22.7%
Norfolk-NE Micropolitan Area 29.0% 38.4% 32.5% 28.3%
North Platte-NE Micropolitan Area 33.2% 34.6% 32.2% 28.8%
North Port-Bradenton-Sarasota-FL Metro Area 41.9% 36.4% 21.6% 21.6%
Ocala-FL Metro Area 32.5% 33.7% 33.8% 28.8%
Ocean City-NJ Metro Area 37.0% 37.6% 25.4% 24.9%
Ogden-Clearfield-UT Metro Area 39.6% 34.2% 26.2% 16.5%
Oklahoma City-OK Metro Area 35.1% 34.8% 30.1% 28.5%
Olympia-WA Metro Area 41.5% 33.7% 24.8% 15.2%
Omaha-Council Bluffs-NE-IA Metro Area 37.0% 37.2% 25.8% 23.7%
Palm Bay-Melbourne-Titusville-FL Metro Area 31.4% 37.4% 31.3% 26.4%
Pensacola-Ferry Pass-Brent-FL Metro Area 35.5% 35.0% 29.6% 25.5%
Philadelphia-PA Metro Division 39.9% 35.7% 24.4% 24.2%
Pittsburgh-PA Metro Area 35.0% 35.7% 29.3% 23.6%
Providence-New Bedford-Fall River-RI-MA Metro Area 35.7% 37.9% 26.4% 24.3%
Provo-Orem-UT Metro Area 44.3% 33.9% 21.8% 16.2%
Raleigh-Cary-NC Metro Area 37.1% 36.0% 27.0% 20.4%
Rapid City-SD Metro Area 32.3% 42.2% 25.5% 24.4%
Reno-Sparks-NV Metro Area 42.5% 36.8% 20.7% 19.1%
Richmond-VA Metro Area 32.8% 41.1% 26.1% 26.2%
Riverside-San Bernardino-Ontario-CA Metro Area 35.1% 36.4% 28.5% 23.6%
Rochester-NY Metro Area 37.4% 34.5% 28.1% 19.0%
Rockingham County-Strafford County-NH Metro Division 37.1% 36.1% 26.8% 19.5%
Rutland-VT Micropolitan Area 36.2% 33.3% 30.5% 22.6%
Tacoma-WA Metro Division 32.3% 36.5% 31.2% 19.6%
Tallahassee-FL Metro Area 33.6% 39.9% 26.5% 22.1%
Tampa-St. Petersburg-Clearwater-FL Metro Area 35.5% 38.2% 26.3% 22.1%
Toledo-OH Metro Area 31.1% 38.6% 30.3% 24.7%
Topeka-KS Metro Area 28.9% 35.0% 36.1% 22.3%
Trenton-Ewing-NJ Metro Area 43.3% 33.6% 23.1% 24.8%
Tucson-AZ Metro Area 41.6% 31.8% 26.6% 20.3%
Tulsa-OK Metro Area 33.6% 36.3% 30.1% 29.2%
Tuscaloosa-AL Metro Area 30.8% 38.0% 31.2% 31.0%
Twin Falls-ID Micropolitan Area 35.7% 33.2% 31.1% 25.4%
Tyler-TX Metro Area 39.5% 35.2% 25.3% 26.0%
Virginia Beach-Norfolk-Newport News-VA-NC Metro Area 37.8% 32.0% 30.3% 22.8%
Warren-Troy-Farmington Hills-MI Metro Division 34.4% 35.2% 30.4% 19.4%
Washington-Arlington-Alexandria-DC-VA-MD-WV Metro 37.8% 37.0% 25.2% 19.3%
Wauchula-FL Micropolitan Area 17.6% 40.6% 41.8% 27.2%
West Palm Beach-Boca Raton-Boynton Beach Metro Division 39.9% 40.1% 20.0% 22.6%
Wilmington-DE-MD-NJ Metro Division 35.5% 34.2% 30.4% 23.5%
Worcester-MA Metro Area 39.1% 35.8% 25.2% 19.0%
Yakima-WA Metro Area 31.6% 37.0% 31.4% 25.1%
Youngstown-Warren-Boardman-OH-PA Metro Area 29.7% 35.5% 34.8% 26.4%

Alternative Means of Transportation Map

Governing compiled 2010 American Community Survey estimates for means of transportation to work for metropolitan statistical areas for the data analysis. Separate data for more than 400 U.S. cities, towns and other census-designated places is shown on the map. Larger icons represent higher total percentages of workers who either walk, bike, use public transportation or another alternate means of commuting to work. (Click to open interactive map in a new window).