Suburban sprawl has long been blamed for many environmental and social evils. Now, it's being blamed for public health problems as well.

A growing number of environmentalists and a handful of public health officials are blaming America's suburbs for an increase in respiratory diseases, obesity, diabetes — even depression and road rage.

Calling it a "matter of life and death," the Sierra Club's Pat DeZern said recently that, "sprawl hurts us all."

While anti-sprawl activists for years have been harping about out-of-control growth in the suburbs (they even turned it into a campaign issue in the 2000 election), the connection between public health and sprawl is new and raising eyebrows among critics of the anti-sprawl movement.

The trend can be traced to a study conducted by two Centers for Disease Control and Prevention public health researchers and published by Sprawlwatch, an anti-sprawl group, and the Sierra Club. The study blamed sprawl for, among other things:

— Increased commuting, resulting in more air pollution and respiratory disease, as well as car wrecks and threats to pedestrians.
 
— Less walking and physical activity, resulting in increased cardiovascular problems and obesity.

— Increased dangers to the elderly and disabled.

Hardly new, so-called urban sprawl can be traced to the late 1950s when middle-class families began a decades-long exodus out of the cities.

The areas they settled are today characterized by strip malls, chain restaurants, apartment complexes, and single-family developments, none of which are within walking distance of each other. So residents are forced to drive rather than walk to get anywhere.

Anti-sprawl activists say typical suburban developments are not friendly enough to pedestrians and lack the "town center" that once bound communities. Long commutes from such areas, they contend, not only encourage road rage, but leave families with less time together. So depression can also be blamed on urban sprawl, the activists insist.

"It allows for less social time, but more time on the road, and a loss to the extent that a sense of place can be restorative and healing," said Howard Frumkin, a professor at Emory University's School of Public Health and a key player in the movement.

But JunkScience.com publisher and Cato Institute scholar Steven J. Milloy calls the study and subsequent movement "a bunch of nonsense" perpetuated by anti-growth advocates who want to tell the rest of America where and how to live.

"They have no data to support these things," he said. "The public isn't buying into the anti-sprawl thing, so they're making it a health issue."

He said that despite an increase in the number of cars on the road, air pollution has actually decreased during the last 30 years. There is really no data, he says, comparing the heart and respiratory problems and obesity of urbanites and suburbanites.

"I don't think being able to walk to the local 7-Eleven is a good indicator of overall health," Milloy insists.

The claims of the anti-sprawl movement also have drawn the ire of the National Home Builders Association.

"The authors seem to have forgotten that people often prefer living in the suburbs," said Bruce Smith, president of the association. "Considering that this country is counting on the CDC for its expertise in addressing tough questions regarding bio-terrorism threats right now, it's strange to see such an ill-considered report come from this important health agency."

The CDC said the authors of the study were not available for comment and that the report was not an official CDC one. "It is an issue that the CDC is certainly aware of, and we are paying attention to it, but to say it was a CDC study is incorrect," said a CDC spokesman.

Brian Miller, the town planner in Berlin, Conn., a suburban community outside of Hartford, said aesthetic and social concerns about sprawl are real, and that municipal planners and developers recognize as much in their building goals today.

But he said pursuing the issue along health lines might be counterproductive.

"I think if you overstate an argument you detract from the main point. It may have some validity to it, but the ties might be a little strained," he said. "The questions are, do we want to converge and associate with our neighbors? Do we like driving four miles to get a quart of milk? But public health issue is just a tough tie to make."