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Fat Cities
How modern life encourages obesity—and what we can do about it.
by Helen Cordes

Sidebar: The Chemical Connection
Sidebar: Pedestrian Politics

It's a gorgeous early August day in Denver, perfect for a hike in the nearby Rockies, or just a bike ride down the street to catch the cool breezes that temper the intense mile-high sun. But in this rundown apartment building in a south-central neighborhood, the Esparza family is penned in as if surrounded by an invisible wall.

In the cramped courtyard, a lone girl wheels her bike awkwardly around the corners of the fenced rectangle where a tiny playground area was razed years ago and covered in concrete. She is obese, as are many of the children and adults who drift back and forth from couches in front of flickering TVs to cool off on the narrow walkway in front of their apartment doors.

Two pictures on Maria Esparza's living room wall explain the reluctance to venture outside. One shows a smiling son who was murdered in gang violence; the other, a daughter who drowned along with a carful of drunken friends in a nearby river. That daughter's children, who now live with Esparza, understand that their boundaries are the building's dull brick walls.

With one exception. "I would let these kids go anywhere with Dan," says Esparza, beaming at Dan Ridgeway, a carpenter and outdoor enthusiast who has taken her grandchildren and other neighborhood kids skiing, swimming, hiking, and rafting with the Sierra Club's Inner City Outings program. Slender ten-year-old Maria happily describes how she learned to ski, something her grandmother "never dreamed would happen." And Samuel, five, "isn't scared of water anymore" after getting the swim lessons Ridgeway arranged for dozens of local children.

Ridgeway is particularly proud of the free swimming program he'd been able to offer after convincing a local private pool to provide access. "So many of these kids never learn how to swim," says Ridgeway. "They're stuck inside; they're eating and watching TV; and now lots of them are getting diabetes. I see it over and over—when we get them outdoors, they learn that it's fun and they want to keep doing it. These are the kids who are not getting fat."

Ridgeway is not alone in seeing outdoor recreation as an antidote to obesity. With two-thirds of American adults now classed as overweight or obese, policymakers, health providers, urban planners, and environmental activists are teaming up to get people moving outside.

This motivational effort is not restricted to low-income neighborhoods like Esparza's, where parks are scarce and crime is high. In the suburbs, fat stats often surpass those of the inner city: According to a 2003 nationwide survey of over 200,000 people, suburbanites weigh more and have higher blood pressure than city dwellers. One culprit is an automobile-centric suburban design that encourages driving instead of walking, a factor that boosts obesity rates by 6 percent for every additional daily hour spent in a car. Even with safe streets and nearby parks, couch-potato habits and fast-food diets make obesity an equal-opportunity threat.

Coaxing all Americans to get off the sofa and out the door requires a range of creative initiatives. Walking programs lure new folks with friendly competitions; park and recreation departments tout hip sports like kayaking; and "active design" projects remove the structural obstacles to healthy lifestyles by, for example, creating hike-and-bike trails that knit neighborhoods with exercise corridors. A happy bonus is that as folks head outdoors to fight the fat, many learn to cherish and protect their natural environment.

One of the difficulties in dealing with obesity is its gradual onset. If you woke up one morning weighing 50 or 100 pounds more than the night before, you'd be strongly motivated to change your habits. But the 64.5 percent of U.S. adults who are overweight didn't get that way overnight, and often aren't inclined to do anything about it until the problem is acute. Once obese, however, it's harder to take even a short hike. As the pounds pile on, so do the rates of diabetes, heart disease, stroke, arthritis, and asthma, as well as liver and bone problems. An estimated 300,000 Americans die prematurely each year because of obesity-related disorders.

Exercise is an obvious solution to this public-health emergency. Yet at the same time that U.S. Department of Health and Human Services chief Tommy Thompson was ballyhooing obesity as a top health menace that costs taxpayers $39 billion annually to treat, federal dollars for key outdoor programs were being slashed. Funding was eliminated for the Urban Park and Recreation Recovery program, which over the past 25 years created 38,000 places to play, from spruced-up neighborhood parks to soccer fields. The Land and Water Conservation Fund, which helped communities acquire parkland and greenways and develop campgrounds, playgrounds, and hiking trails, was cut by two-thirds. Even hours of operation and services in the national parks are being reduced. "Everyone is telling people to be more active," says Kathy Spangler, partnerships director of the National Recreation and Park Association, "but often they don't have an accessible way to do it."

Despite such obstacles, outdoor recreation has the advantage of simplicity. The best programs, Spangler says, encourage three things: easy participation by all ages, learning lifelong skills, and having fun. "If it's not fun," she says, "people aren't going to do it." But it is, and they are, even in belly-bulging Texas.

By nearly any measure, Texas is a heavyweight state. Nearly half of its fourth graders are overweight, and for three years running, Houston held the title of America's Fattest City. (In 2004 it was edged out by Detroit, and followed by Dallas and San Antonio, with Fort Worth in sixth place.) Not coincidentally, Men's Fitness magazine also gave Texas failing marks for exercise.

But Texans aren't taking the insult sitting down. In 2003 11,600 walkers in 59 counties logged 600,000 miles in "Walk Across Texas," a program created by Texas Cooperative Extension. "We form walking teams, and compete for the most miles," says Alicia McLean, a vivacious information technology specialist, as we trek around White Rock Lake, an urban jewel minutes from downtown Dallas. "People get really embarrassed if they let down the team, so they'll walk even when they don't feel like it." In addition to peer pressure, there's also peer bonding: "It's so simple, because all you need is a reliable pair of shoes and some friends," says Carol Rice, a Texas A&M health sciences professor who helped found the program. Weight loss is a natural result; the walkers in Dallas collectively shed over 450 pounds.

A similar program sponsored by the state health department, "Walk Texas," aims to reduce diabetes rates by getting overweight Texans ambulating in local parks and neighborhoods. (More than 80 percent of people with type 2 diabetes are overweight.) Minerva Garcia fills the bill: All of her siblings suffer from diabetes. She's led a Walk Texas team for four years now, favoring spots like the Lady Bird Johnson Wildflower Center. "I still need to lose more weight," she says, "but at least I don't have diabetes."

Hispanic children suffer some of the highest obesity rates in the nation, and a Latino kid born in 2000 or after stands a 50 percent chance of getting diabetes. Health educators acknowledge that the proven preventatives for obesity and diabetes—healthier food and more exercise—are often hard sells for kids who haven't yet experienced major symptoms.

Yet the kids who crowd the Grandma Camacho Recreation Center in Austin, Texas, defy the statistics. When it's time to register for classes at Camacho, reports supervisor Don Goerner, "we've got folks lined up at four in the morning, and our whole summer or after-school program will be filled up by ten." Meanwhile, a traditional park and rec center blocks away "that does the usual indoor basketball stuff" is often deserted.

What makes Camacho a hot property, says Goerner, is its wide range of nontraditional classes, including mountain biking, kayaking, and rock climbing. Kids unused to outdoor activity are won over by rec leaders who start out slow and incorporate breaks for nature education. "We may end up hiking five miles, but the kids don't notice because we stop to look at interesting rocks and birds and the river," says Goerner. Since most kids can't afford outdoor gear, Goerner and others worked hard to find city and private funding for a trove of equipment, including the roomful of mountain bikes that a Camacho team has ridden to victory in state competitions.

Recreation is only part of an active lifestyle. Some communities have concluded that their automobile-centric infrastructure is making them fat, and are incorporating "active design" basics into city plans and private developments. The mantra is "mixed use": By keeping services, jobs, and entertainment close to residential housing and making streets and walkways safe, people will naturally use their feet, bikes, and public transportation just as they have in cities in Europe and elsewhere for centuries.

Denver's former Stapleton airport, for example, is being remade into a model village. "Our goal is to have everything—shopping, services, schools, entertainment, recreation—within a ten-minute walk," says spokesperson Tom Gleason. Move-in rates are brisk for the more than 11,000 homes and apartments with big porches and lush (yet water-efficient) landscaping surrounding roomy common play areas. Thirteen miles of trails provide shortcuts to most destinations, and 1,100 acres of parks and open space are within easy reach.

The activity levels and health of Stapleton's expected 30,000 residents will be documented by the Active Living Partnership, and spurred by groups like "Colorado on the Move," which distributes pedometers and advocates at least 2,000 steps a day. Meanwhile the local branch of "Safe Routes to School" is encouraging parents to let their children walk or bike to school, a practice that has declined in recent years.

Existing communities also find that simple measures to inspire walking, biking, and outdoor recreation can produce wide ripple effects. In Visalia, California, city council member Jesus Gamboa used to look out his office window and see moms tugging young children and older people struggling to walk along a busy highway with no sidewalks, headed toward the supermarket and health clinic. Gamboa pushed through a number of measures that made walking safer and easier, such as well-lit sidewalks and signal lights along the busy highway and in other crucial corridors; pedestrian passages through highway barriers and culs-de-sac; and tiny "pocket parks" in several neighborhoods. Health organizations helped publicize the new activity opportunities, urging residents to use exercise as a free fix for obesity, heart disease, and diabetes. These relatively low-cost measures "make a big difference toward making a community more healthy, user-friendly, and united," says Gamboa.

If a cash-strapped city like Visalia can manage such fat-fighting improvements, any community can. And the payoff doesn't stop with healthier, happier residents. "Once we get people to see the link between health and outdoor activities, then we start to see more ‘green bonding,'" says Mary Margaret Sloan, president of the American Hiking Society. "It's only when people get to know a natural area or park that they're motivated to protect it." Rather than an end in itself, shedding fat can be just a happy consequence of a new relationship with the natural world.


Helen Cordes is writing about childhood obesity as a 2004 Journalism Fellow in Child and Family Policy through the University of Maryland.

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