The pace of life: most cities where people walk, talk and work the fastest also have the highest rates of heart disease – includes related articles

Robert Levine


Most cities where people walk, talk and work the fastest also have the highest rates of heart disease. But what do the exceptions tell us? “`Will you walk a little faster?’ said a whiting to a snail. `There’s a porpoise close behind us, and he’s treading on my tail.'” If you live in a city where people keep treading on you, are you more likely to have heart trouble? Our research says yes, generally speaking — though other factors of culture and personality play a big part in determining individual susceptibility to life in the fast lane.

Our research team — graduate students Karen Lynch, Kuni Miyake, Marty Lucia and six other volunteers — recently measured the tempo of life in 36 American cities of various sizes in all parts of the country to answer two questions: 1) How does the overall pace compare from one city and region to another? 2) Is there any relation between an area’s pace of life and its residents’ physical condition — specifically the prevalence of coronary heart disease (CHD)?

What makes these questions especially interesting right now is the continuing controversy between researchers who think that a strong sense of time urgency — the classic Type A struggle to make every second count — is an important element in CHD, and those who believe a combination of anger and hostility is the only Type A characteristic that really causes heart disease.

We studied three large (more than 1.8 million people), three medium-sized (850,000-1.5 million) and three smaller (350,000-550,000) cities in each of the four census-defined areas of the United States — Northeast, Midwest, South and West. In each, we looked at how fast people walked, talked and worked.

The Speedy Northeast

As the chart on page 45 indicates, the three fastest cities and seven of the fastest nine are in the Northeast. Northeasterners generally walk faster, give change faster, talk faster and are more likely to wear watches than people in other areas.

Boston edges out Buffalo for first place, trailed by New York City, everyone’s prestudy favorite. Perhaps New Yorkers lose a couple of steps stopping to watch the local festivities. Walter Murphy, who collected the walking-speed data there, reported an improvised music concert, an attempted purse snatching, and an unsuccessful mugging during the hour and a half he clocked pedestrians on one corner.

The West has the slowest pace overall, due mostly to particularly slow walkers and bank tellers. Least hurried of all is America’s symbol of sun, fun and laid-back living. Los Angelenos are 24th in walking speed, next to last in rapid speech and far, far behind people in every other city we studied in money-counting speed. Their only concession to the clock is to wear one — the city is 13th highest in watches worn.

The stopwatches we used weren’t all that told us the West lives time differently from the East. We often learned as much from the process of data collection as from the data. To get the exact time of day in No. 1-ranked Boston, for example, we dialed “N-E-R-V-O-U-S.” In my home town of Fresno (31st in time urgency), the number is “P-O-P-C-O-R-N.”

Walking and Talking

There usually isn’t much difference between one rank and the next. But at the extremes, people march to very different drummers. In walking speed, for example, the fastest pedestrians — in Springfield, MA — cover 60 feet in an average of 11.1 seconds, 3.6 seconds faster than they do in Fresno, the slowest town. If they were walking a football field, the Massachusetts team would move the full 100 yards and cross the goal line at about the same time their California opponents were still about 25 yards short.

Differences in talking speed are even greater. The fastest-talking postal clerks — in Columbus, OH — rattle out nearly 40% more syllables per second than their colleagues in Los Angeles (3.9 compared to 2.8). If they were reading the 6 o’clock news, it would take the California workers until nearly 7:25 to report what the Ohio clerks finish at 7.

With these pace figures in hand, we compared them with rates of death from CHD in each city to see if there is any association between the two. Since age is a major factor in heart disease, we statistically adjusted the CHD figures for the median age of each city’s population.

The Pace of Death

Pace of life and CHD were highly related, as a whole, for both cities and regions. In fact, this statistical relationship was even stronger than the correlation researchers usually find between heart disease and Type A personality measures such as hostility, aggression and competitiveness. The speed of a person’s environment seems to predict the likelihood of heart disease as well as Type A personality test scores do. This turned out to be true no matter how we corrected for age, or whether we took it into account at all.

Why are people in Type A (fast-paced) environments more likely to get heart disease? Largely, we suspect, it’s because these environments attract Type A people — who then do their best to keep the pace fast. Social psychologist Timothy Smith of the University of Utah and his colleagues have shown that Type As both seek and create time-urgent surroundings. Thus the fastest cities in our study may represent both their dearest dreams and their creations.

Smith found that time pressure also initiates, maintains and exacerbates Type A-like behavior in Type Bs. They act more like As, while As strive to push the beat even faster — all in an environment already filled with coronary-prone personalities.

Stress and Smoking

On the physiological side, University of Oklahoma psychologist Logan Wright and other researchers have found that stress leads to an increase in the blood levels of adrenaline, noradrenaline and other hormones that can damage the lining of arteries. This ties in with new research from Duke University Medical Center showing that personality affects how individuals with high cholesterol react to stressful tasks. Under stress, the Duke researchers found, levels of cortisol, adrenaline and noradrenaline shot up rapidly in Type As. In Type Bs, the same hormones went down or stayed the same.

For Type As with high cholesterol, then, this response to stress may make an unhealthy situation worse. While cholesterol is at work clogging arteries, the stress chemicals are damaging their inner linings. Research has also shown that adrenaline may prevent cells from clearing harmful cholesterol out of the blood. Instead, it collects on artery walls.

In Type Bs, by contrast, the body seems to lower its chemical response to stress, reducing the harm high cholesterol can do, and the likelihood that Type Bs will develop CHD.

Recent statistics from the U.S. Department of Health and Human Services (HHS) points to another possible tie between a fast pace and CHD — cigarette smoking, which has been identified as the single most important preventable cause of heart disease. The HHS figures show that smoking rates follow the same regional patterns as our figures for coronary heart disease and the pace of life: Smoking and CHD rates are highest where the pace is fastest, in the Northeast, followed by the Midwest, the South and the West.

Support for this link comes from a city that deviates sharply from the usual relationship between pace and CHD. Salt Lake City, with its predominately Mormon population, is the 4th highest American city in pace of life but 31st (6th from the lowest) in CHD. The Mormon religion strongly encourages hard work but strictly prohibits smoking — an example of a cultural norm that buffers between fast pace and heart disease (see “Pace of Life Around the World” for another).

Finding the Right Pace

On the whole, then, we found that people living in fast-paced, Type A cities are more prone to CHD than those in slower cities — logical enough, since Type A cities attract Type A individuals, who research shows are more likely to have heart attacks. But time pressure isn’t always stressful and damaging. Researchers like Jonathan Freedman and Donald Edwards of the University of Toronto have demonstrated that it also can be challenging and energizing. How much pressure is stressful depends on the person.

So, for individuals, the relationship between pace of life, personality and CHD isn’t a simple one. Just as Type A settings may be stressful to Type Bs, Type As may experience distress when their surroundings are too relaxed for their tastes. The key is knowing one’s limits and preferences. A good fit between our inner and outer worlds is a better predictor of health than any mailing address.

“Time,” writes Joyce Carol Oates in her novel Marya: A Life, “is the element in which we exist …. We are either borne along by it or drowned in it.” Synchronizing rhythms to your surroundings, be they your city, your neighborhood, your job, your friends or your lover, is integral to your well-being.

Robert Levine, Ph.D., is a professor of psychology at California State University, Fresno.

COPYRIGHT 1989 Sussex Publishers, Inc.

COPYRIGHT 2004 Gale Group

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