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Remember when the Great Northwest was one of the remaining corners of the nation where you could pack your granola bar, put on your hiking shoes and trek away from it all?

Millions of pristine wilderness acreage remains, but there's also a greater chance a move there will cause you to die fat, become road kill and contribute to thinning the population of salmon, gray wolves and caribou.

The third edition of Sightline Institute's "Cascadia Scorecard 2006: Focus on Sprawl and Health" -- a regional gauge of progress -- examined the connections between urban design and leading health risks such as car crashes, obesity, and physical inactivity and, thanks to sprawl and fossil fuelisness, the findings are enough to make you sick -- literally.

It's not first time sprawl and its car-driven lifestyle has been associated with an early demise. Similar findings however typically point to older metropolitan areas that have no where to go but out into the hinterlands, stretching the infrastructure thin and paving over the environment.

But even in the Great Northwest, residents of low-density, residential-only sprawling communities are more likely to die in car collisions, which kill around 2,000 Northwesterners a year; and they are also more likely to be obese, which increases the risk of many chronic, potentially fatal diseases, the report says.

But Northwesterners can look no further than to their neighbor to the north where Canada's British Columbia has the region's best record for curbing sprawl. It has a car crash fatality rate that's one-third lower than the rest of the region and an obesity rate that's nearly one half as great.

The report found:

  • Car crashes are the leading cause of death under age 45 in Cascadia, the Northwest states and British Columbia, with 1,600 of them in the U.S. Another 100,000 Cascadians are injured in car wrecks. The reason is obvious. Residents in denser communities drive less, reducing the incidents of accidents. King County, for example, is the most urban county in Washington state, also has the state's lowest car-crash fatality rate.
  • Compact, walkable neighborhoods also protect drivers and pedestrians because traffic tends to move more slowly than on suburban speedways, lessening the severity of collisions. Also, mile for mile, riding a bus and taking other public transit is more than 10 times safer than driving a car.
  • More than one in five residents of the Northwest states are obese, double the 1990 rate. Obesity-related ailments kills some 4,300 residents of the Northwest states a year (2,300 people in Washington, 1,500 in Oregon, and 540 in Idaho).
  • Neighborhood studies in greater Seattle, Atlanta, and San Diego have found that living in a compact neighborhood with good walking facilities reduced the odds of being obese, while increasing levels of physical activity, especially walking. A study in King County, Washington state found that pedestrian-friendly neighborhood design was associated with up to a one-point reduction in the body mass index, which can translate in up to 7 fewer pounds of body weight.
  • British Columbians are about half as likely to be obese as residents of the Northwest states (12 percent compared to 21 percent), one-third less likely to die in a car crash, and live an average of more than two years longer. If British Columbia was an independent nation, it would have the second longest lifespan in the world, trailing only Japan. One possible factor? Vancouver and Victoria are the region's most compact metros.
  • The study also found the total economic burden of obesity and car crashes cost the region nearly $20 billion a year; the car-based lifestyle which generates pollution further exacerbates both health conditions and the economic drain; and wildlife and the environment also pay a price -- in blood.
  • Salmon, orca whales, gray wolves, caribou, sage-grouse, grizzly bears and other creatures cling to small portions of their previous habitats.

    "The toll from car crashes and obesity-related disease is a tragedy that's largely overlooked because it unfolds slowly," said Clark Williams-Derry, research director for Sightline and lead author of the report.

    "But this tragedy is not inevitable. Simple solutions -- such as giving people the tools to drive less by encouraging more compact, walkable communities -- could make Cascadia's communities safer and healthier," he added.

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