I wouldn't call it pragmatic, but alienating is definitely the right word.
There are few (affordable) places in America right now that you can live without complete car dependence. The poor, elderly, young, and disabled are in fact alienated.
It's easy to understand why this pattern of settlement began when you consider the novelty, freedom, individuality (which can not be understated as something Americans valued), and convenience that came with the availability of automobiles.
Somehow though, we've moved forward through almost a century of such development, placing the car above all else. I'm reminded of Raquel Nelson, charged with (but thankfully not convicted) manslaughter because a hit an run driver killed her child while she was allegedly jaywalking .
Re: the elderly, I think it's also exacerbating the already problematic question of how to care for the increasing number of elderly. There are a lot of elderly who don't really need to be in a nursing home or staffed assisted-living facility, but can't easily live on their own in suburbia because they can't drive. If they were in more urban areas, we might be able to decrease the proportion of the elderly population who need active care, or at least reduce the intensity of care needed.
My mom volunteers for Meals on Wheels (http://en.wikipedia.org/wiki/Meals_on_Wheels), and a lot of the people they deliver to are in decent enough health, but just sort of trapped in suburban apartment complexes. They end up surviving through a mixture of charities like that one, and relatives who drive them around and bring them things. But many end up moving to assisted-living facilities after a bit, even though they don't truly need to live in a staffed facility, because the logistics of living in suburbia without a car are just unworkable, and they either don't know about or can't afford a more walkable area to move to.
Also, because Medicare covers nursing homes for people who can't take care of themselves (considered a medical expense) but not the lower-key assisted-living facilities (considered a residential expense, and more likely to be abused), people who run out of money when living in an assisted-living facility may be forced to move prematurely to a nursing home, if they aren't able to go back to living on their own. That ends up both worse for them and more expensive for the public.
I am not sure whether suburbia is really to blame. People who are not able to drive are likely also unable to climb stairs or to walk a mile to the nearest supermarket and carry the groceries back home.
Also, I would expect that for people in a wheelchair living in areas that do not have a lot of space can be quite difficult.
In terms of accessibility, planned suburban towns are far ahead of older cities that have never been designed with accessibility in mind. Where I live, I can't remember the last time I saw someone in a wheelchair in a supermarket. I guess she wouldn't even be able to get through the aisles because they are too narrow.
Most of the elderly I know who don't have good enough eyesight to pass a driving exam can still walk around ok. My grandmother in Greece was able to do her own errands up until her 80s, for example, even though her eyesight was not good enough to drive. It wasn't a mile to the nearest supermarket, though; that might've been more difficult. In many cities you'll typically find a supermarket within a few blocks, if you live in the city. Here in Copenhagen, I would guess there's a supermarket every 1/4 mile on average.
I don't see many people out in wheelchairs either, and I agree accessibility for them could (and should) be improved. I do see quite a few people with walkers, though.
I live in Denver and while my wife and I have a car (one) we use it solely as a means to tour the mountains.
Denver is blessed with amazing central neighborhoods. I live in a house with a yard and the whole bit. Yet I'm 11 minutes by bus to Downtown. I generally ride my bike to work (we have an amazing intra-city bike path system) or take the bus. Because Denver is so incredibly compact getting around without a car is easy.
Our neighborhood has lots and lots of restaurants, coffee shops, dry cleaners, etc... so we almost always walk when we go out.
Boston, Philadelphia, and DC all have substantial car-free populations.
They are small in proportion to the overall populations of the respective cities' urban areas, but that's almost entirely because public transportation has lagged the construction of suburbs and sprawl. Boston's T, or Philly's SEPTA were mostly constructed in the early 20th century so it's only those older areas that are feasible for car-free living. (The DC Metro is an interesting exception in that it's a much newer system, but it too fell out of step with development.)
In fact, I'd say that there's a sort of "car free radius" that's basically the edge of residential areas just before World War II. The suburbs that got built after that are hugely car-centric, ones built before typically aren't.
I lived without a car in Chicago for three years with absolutely no problems.
Also, there is a spectrum from being totally car-dependent to not owning a car. My parents live in the D.C. suburbs and they have more cars in their garage than people who live there. Because you can't even go to the drug store without driving several miles (and this isn't a far-flung exurb, they're only 17 miles from downtown) my brother and I each got a car as soon as we could drive. Meanwhile, I now live in Westchester (a suburb of NYC), and while I own a car I only drive it a couple of times a month (Costco trips mostly). The same is true for Chicago. Unlike in Manhattan, most people do own cars, but a large number of people don't use them that heavily because the suburbs are easily accessible by train.
Portland, OR. One of the most bike-friendly cities in the country, also highly walkable, and with a great light rail and bus system. And on the occasions when you need a car, or a truck, Zipcar has vehicles all over Portland.
I agree, but the caveat for any city/town where you can get by without a car is "affordable".
full disclosure: I've lived in NYC without a car for 10 years, but grew up in Ohio completely car-dependent.
Edit: There are in fact many places that do meet the requirements of affordable and walkable, but a new concern in an age of urbanization is keeping them affordable. The desire for such neighborhoods is growing, but the supply is too low as of 2013.
Try Philadelphia. Our current mayor has built more bike lanes than ever and Philly's compact size makes reaching distant neighborhoods by bike a breeze. Anectdotedly myself and several friends do not own cars, some don't even have licenses.
Ya I'm living in Hollywood right now w/o a car by choice. It's totally functional for me since I live next to a subway stop and my work is also off a major stop. And the neighborhood is incredibly walkable--everything I need or want. Taxis readliy available should I need one.
Although being a single guy here, I think women see it as a red flag (at least from what I see on okcupid). Interested in moving to NYC unless I find somewhere cheaper and still interesting.
It feels alienating to many of us Americans, too. Having visited a few foreign countries, I've seen beautiful public spaces, and its disappointing to come home and see how ugly our cities look now that I've seen better.
I desperately want to live in a cosmopolitan urban center that is practical, something I have yet to find here.
You know, there's something comforting about going just about anywhere and having, at least, a vague idea of how the layout might be, what things look like, and where to find things.
On the other hand though, I agree with you. That same comfort makes it dissatisfying to travel at times. I live in an area of California surrounded by lots of historical smaller cities, but it's nearly pointless to travel to any of them because, aside from a few key features, they all look like the same place overall.
Don't even get me started about housing developments. Once you're lost in one of those, your best hope is to start leaving breadcrumbs.
I'm not sure it's the uniformity. Making a neighborhood or city similar to another neighborhood or city has been common throughout history. It's more the vast disconnectedness of everything in the USA that is alienating.