New reports from the Trust for America’s Health grabbed headlines today. The headline in the Chicago Sun-Times read “South Will Rise Again — If It Can Get Off Couch.” It wasn’t a fun day to be from Tennessee, which ranked fifth on the list of “fattest states.”

Why are we fat? Another report today noted the proximity of McDonald’s to schools. And, indeed, we eat too much, too often of the wrong foods.

But the way in which we design our cities also plays a significant role. We have engineered physical exertion out of our lives. If every trip depends on a car, and the only way to get moving is to “exercise,” we are a huge disadvantage if our goal is healthy living. Unfortunately, except for those who are very poor or ultra committed, every trip in Memphis does, indeed, begin and end in the automobile. And there is no sign, no hint that this will change in the foreseeable future, despite the fact that other Southern and Western cities are making serious commitments to transit.

If obesity were simply an individual problem of individual making with individual consequences, we might hope for better behavior and be done with it. But it is not.

A 1993 report by the former director of the Centers for Disease Control traced the underlying factors leading to the diseases listed on death certificates. He found that “diet/physical inactivity” ranked second only to smoking in their impact. An unhealthy diet and sedentary lifestyle actually caused 17 percent of deaths, while smoking caused 18 percent of deaths.

Health care costs are skyrocketing in America. It is the fastest growing item in most state budgets. Where will the money come from? A report earlier this summer from the National Governors Association said there are only two places to get it: K-12 education or higher education. Governors are afraid to cut funds for K-12 since schools everywhere are underperforming. What’s left? Higher education where the constituencies for spending are far narrower and precedent for private funding is much stronger.

Now, consider that research from CEOs for Cities points out that cities don’t have to grow larger to grow richer but they do have to grow smarter. Their economic success depends on their number of college graduates.

Americans get fatter, Americans get sicker, states spend more on health care, states spend less on higher education, the economies of cities suffer, we all suffer.

Could we please re-think how we develop and design our city? Could we please get serious about public transportation and quit fooling with toy trolleys on routes to nowhere? Could we please support active lifestyles as part of daily living?

Is this too much to imagine for Memphis? I don’t believe it.