Overweight? Blame your ZIP code

Property value beats income and education as obesity predictor

The neighborhoods around Green Lake have P-patches, destination parks, crosswalks, corner groceries and one of the densest concentrations of farmers markets in the city.

Those niceties account for some of the most sought-after real estate in Seattle and some of the city’s least obese residents.

University of Washington researchers recently found wide disparities in obesity rates among King County ZIP codes. The rates range from less than 10 percent in parts of central Seattle and Bellevue to more than 25 percent in some south county neighborhoods.

The strongest predictor of obesity rates wasn’t income or education but property values, the study found. Each additional $100,000 in median home value for a ZIP code corresponded with a drop in obesity of 2 percentage points.

It’s further evidence, experts say, that weight isn’t solely about individual behavior and that the environment you live in matters.

“If you have this mind-set that obesity has to do with the individual alone, then ZIP codes or areas really should not come into this. But they do, big-time,” said Adam Drewnowski, director of the UW Center for Obesity Research.


The study, which used data from surveys of nearly 9,000 county residents over multiple years, suggests areas where public health agencies should focus, and what kinds of programs may be unlikely to work.

“If people are concentrated in a neighborhood with no grocery store and little access to fresh fruits, this is not the place to go in and say, ‘Eat nine servings of fresh fruits and vegetables and play a bit of tennis.’ Get a grip,” Drewnowski said. “The strategies need to be targeted and sensitive.”

In less affluent areas, a lack of access to fresh produce, health insurance or nutritious groceries that are affordable likely influence obesity rates, experts said.

People often use limited money to buy cheap, calorie-dense foods rather than more nutritious fruits and vegetables, said Paul Haas, resource development director for Solid Ground, which works on hunger issues in the region.

“It’s something that’s counterintuitive to a lot of folks, how people with a greater level of food insecurity and who struggle with hunger are at a greater risk of obesity,” he said.

A coalition plans to lobby the Legislature next year for money that would allow food banks to buy more fresh food from local farmers, Haas said.

With at least three Seattle farmers markets in danger of losing their homes to redevelopment projects, some City Council members want to consider lowering street closure or park fees to help markets move to public property.

When it comes to exercise, there’s a big difference between wealthy neighborhoods with nice sidewalks and places where graffiti, broken windows, interrupted routes, crime or other deterrents make walking unappealing, said Rebecca Deehr, interim executive director of Feet First, a pedestrian advocacy group.

It’s spearheading efforts around the city to make walking less daunting — from bird-dogging developers to designing good pedestrian links to organizing “walking school buses” that connect groups of students and parents going to the same school.

In neighborhoods where cars have the run of the road, community intersection projects that paint a huge radiating sun or labyrinth on the asphalt give drivers a psychological cue that they should slow down.

“It says this community is invested and involved,” she said.

Access to healthy food

Standing a block off Aurora Avenue near Bitter Lake, two public health employees tick off the food choices within their line of sight — doughnut shop, Kentucky Fried Chicken, Ivar’s.

They’re in ZIP code 98133, where obesity rates are higher than 20 percent. Median single-family home prices last year were $140,000 less than the Green Lake ZIP code directly south.

“The No. 1 thing is that everyone should have access to fresh produce they can afford. Right now we have big gaps,” said Erin MacDougall, program manager for Public Health — Seattle & King County’s Healthy Eating and Active Living initiative.

She’d like to see cities establish standards for access to affordable healthy food, in the same way that they track proximity to open space or bus stops.

Linden Avenue itself looks different than it did at the bottom of Phinney Ridge. It lacks sidewalks on one side, crosswalks, a white center line or much of anything to separate cars from people.

One elderly woman struggles to load a personal grocery cart into a car parked on the side of the road, with traffic whizzing by her open door.

Another woman picking dust-covered blackberries nearly falls on the crumbling asphalt as brambles catch her diabetes socks.

Hannah Avessuck, who lives in a new apartment building for active seniors, points to the buckled, bumpy sidewalks on the good side of the road. Complications from diabetes make it hard for her to negotiate crummy, meandering sidewalks.

“They’re just horrible, especially for people who are on canes,” she said. “Sometimes my feet don’t clear these lumps. It definitely hinders some people from walking.”

Sidewalks and street trees may be added as properties are redeveloped, under a recent proposal by Mayor Greg Nickels that would require smaller projects to comply with those rules. But gaps will exist for a long time.

Anne Bikle, an environmental planner for Public Health, said it’s important that things such as open space, gardens and decent pedestrian connections don’t get bargained away in the development process.

People intuitively grasp that food choices affect their health. The profound influence of the built environment is less obvious, she said.

“They feel like there’s less within their power to do anything about it,” she said. “It’s become so invisible to society, and so common to not have a sidewalk or a street tree that they don’t see anything wrong with a Linden Avenue anymore in some communities.”

Teaching fellow residents

In Rainier Valley, another Seattle neighborhood with higher obesity rates, people such as Leatha Bailey are feeling more empowered these days.

She leads tours at the local Safeway store of the bread, dairy and frozen food aisles, teaching fellow residents how to read nutritional labels.

It’s part of a broad effort throughout Rainier Valley to promote nutrition and physical activity through culturally relevant programs. That includes working with local and ethnic restaurants to offer healthy menu options, senior exercise programs and community cooking classes.

“I didn’t know how to read labels. I really didn’t,” said Bailey, who never realized that the whole grain bread she bought had low fiber and sweeteners such as high fructose corn syrup.

“I thought I was buying healthy stuff because it looked good.”

A single-serving low-fat strawberry banana yogurt, for instance, can hide more calories than a mint chocolate chip ice cream sandwich or Little Debbie oatmeal cake.

Rose Motola was surprised to learn that one of her husband’s favorite cereals, Kellogg’s Raisin Bran, had more sugar, more sodium and less protein than Kellogg’s Frosted Mini Wheats.

“That’s terrible — no wonder he likes that,” she said to the group assembled in the cereal aisle, poring over boxes.

David Solet, a Public Health epidemiologist and co-author of the recent UW study, said individual choices and predispositions obviously play important roles in health issues such as obesity.

But he’s encouraged to see a growing body of research that might get communities thinking about other strategies to narrow health disparities.

“In my mind, too often this issue is sort of one of individual blame,” he said. “And I think the most effective interventions that public health can mount and have been pushing are … the social and community-level things we can do.”


For more information on the Healthy and Active Rainier Valley Coalition, visit goto.seattlepi.com/r979.

P-I reporter Aubrey Cohen contributed to this report. P-I reporter Jennifer Langston can be reached at 206-448-8130 or jenniferlangston@seattlepi.com.

Giving everyone a sidewalk is no walk in the park

By Sanjay Bhatt
Seattle Times staff reporter


Jim Portillo walks in the roadway, just a few feet from passing cars, because there are no sidewalks along his Greenwood street. Portillo, 31, is blind.

Sweeping the area ahead left to right with a white cane, he avoids the roadway’s gravel shoulder — if it exists at all — because ditches or parked cars frequently interrupt the path.

He shrugs and says he’s been dealing with the danger for five years.

“There’s not a lot of room between me and traffic,” he says. “Every now and then you wonder about some drivers.”

Forty percent of Seattle streets lack full sidewalks on both sides of the road — totaling 650 miles, the city estimates — but installing them is a staggering expense of about $2 million per mile. It’s not just the cost of the pavement: When a curb is built, it changes the flow of surface water, triggering legal requirements for drainage systems, which in turn can involve buying adjacent property. Many cities can build them only as part of a major street-paving project.

But residents are demanding sidewalks, and cities and counties are looking for ways to pay for them. Olympia turned to utility bills. Bellevue taps its capital budget. And King County spends about $1 million a year out of its roads fund. Snohomish County has committed $2 million annually to sidewalks and roads.

For the first time, Seattle has devoted money just for building new sidewalks — enough to install less than a mile a year citywide. Over the next nine years, taxpayers will foot the bill through a levy approved last year.

Next month, the city’s transportation department is holding open houses to ask residents to rank proposed sidewalks, traffic signals and other suggestions it received this summer by the hundreds.

The department will use those comments to determine which big projects to tackle out of a $1.5 million annual pot. The city’s 13 district councils get to split an additional $1.2 million a year for small projects, which frustrates neighborhood activists who want a say in how all the money gets spent.

The City Council, which has adopted pedestrian safety as its highest priority this year, is looking for ways to speed up sidewalk construction.

“It seems insurmountable, but at least we could start chipping away at it,” Council President Nick Licata said.

In addition to being a visual cue to drivers to slow down, sidewalks give residents a chance to interact with each other, says Nicole La Chasse, a real-estate agent who lives in North Beach.

“When you have a sidewalk,” she says, “you feel you can walk up to your neighbor’s door.”

Dividing line

North 85th Street is the dividing line — when it comes to sidewalks, at least — between Seattle’s haves and have-nots. It’s also the dividing line for Greenwood, a neighborhood northwest of Green Lake that is Ground Zero in the fight over sidewalk spending.

Until the mid-1950s, much of the land north of this line belonged to King County, which didn’t require developers to build sidewalks.

Seattle always required sidewalks, except for small projects. That meant only pockets of Seattle — parts of Southwest Seattle and Beacon Hill, for example — lacked sidewalks. Developers who built sidewalks to comply with the city’s land-use code passed the cost on to homebuyers.

“I have a sidewalk because I live south of 85th,” explains Kate Martin, a Greenwood community leader. “North of 85th was sort of like Hooverville.”

By the mid-1950s, people living north of the line had voted to become part of Seattle and pay its taxes — in exchange, some say, for promises from Seattle officials at the time to construct sidewalks and drainage ditches in the future.

Over the decades, the city unsuccessfully tried to organize the area’s residents to share the cost of building sidewalks.

By 1988, residents north of 85th still lacked basic amenities, especially in the area in which Portillo lives. Roughly 70 percent of the blocks in northeast Greenwood lacked storm drainage, gutters, curbs and sidewalks. Open ditches were and still are the norm, contributing to overflow into the street during heavy rain.

The community asked the city to make the residential street that Portillo now frequently walks — Fremont Avenue North from North 85th Street to North 92nd Street — a priority for street improvements.

“Walking in the street is dangerous to pedestrians and motorists,” a city official wrote in a 1988 report. “In many parts of Greenwood, pedestrians must walk in the street because the shoulder or planting strip is either used to park cars, or is covered with overgrown vegetation and/or mudholes. Residents are concerned that this is extremely dangerous for children and senior citizens.”

A few weeks ago, city staff estimated it would cost Seattle up to $4.5 billion to add sidewalks for all Seattle streets — and this doesn’t include the cost of putting in drainage systems.

The Seattle Department of Transportation plans to spend about $1 million annually on sidewalk installation, out of the Bridging the Gap levy approved by voters last year.

“The need is so great,” said Wayne Wentz, the department’s director of traffic management. “In one sense we can’t be too wrong in picking one place over another.”

Still, the transportation department created a ranking system this year to help it sort through requests from neighborhoods (see sidebar at right).

For example, its staff wants to focus sidewalk spending on routes to elementary and middle schools — but Greenwood mothers such as Martin point out that high-school students are at greater risk for being hit by cars because they’re more likely to be out walking by themselves and when it’s dark.

The city also is considering putting the onus on developers — and, in turn, prospective homebuyers — to build sidewalks in front of redeveloped lots when they tear down single-family houses and replace them. That change could especially benefit parts of Lake City, Bitter Lake and Northgate, city officials say.

Other cities are taking a more aggressive tack.

Earlier this year Bellevue’s City Council allocated $3 million to build sidewalks. The city estimates it needs $26 million to complete more than 30 critical sidewalk projects. As in Seattle, many of those sidewalk-less streets were once part of King County.

Three years ago, Olympia residents voted to raise their utility rates by 50 percent — about $60 a year — to pay for sidewalks. A little more than half of Olympia’s major streets lack them.

Like Seattle, Olympia has hired a consultant to conduct an inventory so it knows exactly how many streets do not have sidewalks.

Neighbors organized

Michael McGinn decided he wasn’t going to wait any longer for sidewalks. The Greenwood resident wanted his son to realize the health benefits of walking and bicycling.

Several years ago McGinn organized neighbors on his block and cobbled together enough money to install asphalt sidewalks near his house on North 87th Street. The sidewalks look cheap, he admits, but they’re better than nothing.

Martin would like to see the city take the responsibility for sidewalk construction away from the transportation department and delegate it to a nonprofit sidewalk authority.

“We need a lot of sidewalks to be built, and we don’t have the pieces in place to make it happen,” Martin says. The transportation department “is not going to be able to make it happen, and in the contracting world there’s only a handful of contractors qualified to do it and they’re really busy.”

Wentz, the city’s chief sidewalk planner, concedes as much. “Our ability to deliver stand-alone sidewalks is too expensive,” he says. “We have nine years of funding. We don’t think those dollars are enough to get a sidewalk on every street.”

Sanjay Bhatt: 206-464-3103 or sbhatt@seattletimes.com
Copyright © 2007 The Seattle Times Company

How the city ranks sidewalk requests

Seattle is using a new point system for selecting locations for sidewalks with the small pot of levy money it has allocated. The points shown below are the maximum possible in that category; the higher a project scores, the sooner it could get built.

Volume of pedestrians: 5 points
Within one block of hospitals, schools, playing fields or other places that draw many pedestrians, especially the elderly or disabled.

Dangerous areas: 4 points
Poor visibility, high-traffic area, a crash due to lack of a sidewalk or other safety concern.

Street category: 3 points
Along an arterial or one block away from one, or a street with apartments.

School walking route: 3 points
Adjacent to a school or within three blocks of one.

Bus stops: 3 points
Within three blocks of bus stops.

Missing link: 2 points
Existing sidewalk ends prematurely.

Cost: 2 points
Costs less than $70,000 or can piggyback on another project.

Neighborhood interest: 2 points
High priority for neighborhood residents.

Poverty: 1 point
In a federally designated low-income area.

Source: Seattle Department of Transportation
Compiled by Sanjay Bhatt

Neighborhood meetings

Seattle residents can indicate their preference for sidewalks, traffic signals or other pedestrian-safety measures at city open houses next month. The public can drop in between 5 and 8 p.m. If you require an interpreter, call 684-ROAD and press 0.

Sept. 11: Ravenna-Eckstein Community Center, 6535 Ravenna Ave. N.E.
Sept. 12: Yesler Community Center, 917 E. Yesler Way.
Sept. 13: New Holly Gathering Center, 7054 32nd Ave S.
Sept. 18: McClure Middle School, 1915 First Ave. W.
Sept. 19: Youngstown Community Center Theater, 4408 Delridge Way S.W.
Sept. 20: B.F. Day Elementary, 3921 Linden Ave N.

Source: Seattle Department of Transportation
Compiled by Sanjay Bhatt

Bitter Lake Community Celebration!

Bitter Lake Community Celebration!
Friday, August 10th 5:00- 8:00PM

Meet Council President Nick Licata at 6PM

Come down to the park, eat some great food, and enjoy some games and fun.

Please bring a can of food for the local food bank.

Fee: $2 for dinner; 25 cents for game tickets

This event is sponsored by the Bitter Lake Advisory Council and the Seattle Parks Dept.