Designing Communities for Physical Activity: Evidence Base & Public Health Role

1. Designing Communities for Physical Activity:Evidence Base &Public Health Role National Center for Chronic Disease Prevention and Health Promotion Division of Nutrition, Physical Activity, and Obesity Joan Dorn, PhD. Chief, Physical Activity and Health Branch Division of Nutrition, Physical Activity, and Obesity Centers for Disease Control and Prevention The conclusions in this presentation are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. 1

2. Outline of Today’s Presentation 1.  What does it mean to design communities for physical activity? 2. Why is this strategy important? 3. How do we know this strategy works? 4. How much difference will this strategy make? 5.What is the public health role?  6. Who are key partners?

3. “We are underexercised as a nation. We look, instead of play. We ride, instead of walk. Our existence deprives us of the minimum of healthy activity essential for healthy living.” John F. Kennedy, December 5, 1961

4. Physical Activity and Health Branch: Focus on Walking • Physical activity improves health and lowers risk of many chronic diseases, yet less than half of US adults get the recommended amount • Walking is one of the most popular forms of physical activity for adults • Walking does not require a special skill or expensive equipment • Walking can be incorporated into a busy lifestyle • People who walk are more likely to meet the Aerobic Physical Activity Guideline • But people need safe, attractive and convenient places so that they can be physically active www.CDC.gov/VitalSigns

5. Design Communities for Physical Activity • Designing communities for physical activity offers safe, accessible streets that people of all ages and abilities can use and enjoy. • Such communities foster walking, bicycling and transit use which can promote healthy living and provide a wide range of benefits to their residents and can make their communities desirable places to live.1 • The CDC’s Community Preventive Services Task Force recommends: • community design components, • street scale design standards, and • other environmental changes that enhance access to places for physical activity along with information and outreach.2 Safe Routes to School National Partnership, 2014 Community Preventative Task Force, 2004 5

6. Why is this strategy important? • Health benefits of designing communities for physical activity: • Median improvement in physical activity across communities that incorporated such designs was 161%.1 • Reduces the risk of heart disease, lower blood pressure, and reduce risk of overweight and obesity through its contributions to increased physical activity.2 • Lowers health care costs.3 • Other benefits include: • Put fewer people at risk for bicyclist and pedestrian death and injury.4 • Help reduce crashes.4 • Lower transportation costs.4 • Create more jobs per million dollars spent than highway projects.5 1.Community Preventative Task Force, 2004. 2. Frank L.D., Andresen, M., and Schmid, T. (2004). Obesity Relationships with Community Design, Physical Activity, and Time Spent in Cars. American Journal of Preventive Medicine, 27(2), 87-96. 3. Maizlish, N. Woodcock, J, Co, S., Ostro, B. Fanai, A. & Fairlley, D. (2012). Health Co-Benefits and Transportation-Related Reductions in Greenhouse Gas Emissions in the Bay Area: Technical Report 4. National Complete Streets Coalition, 2014. 5. Garrett-Peltier, H. (2011). Pedestrian and Bicycle Infrastructure: A National Study of Employment Impacts. Political Economy Research Institute. 6

7. How do we know this strategy works? • A community designed for physical activity helps make it easier for people to get physical activity as part of their daily routine, lower the risk of chronic conditions associated with physical inactivity, and receive the many other benefits of physical activity. • Studies findthat communities designed for active living have people1: • More likely to meet the recommended physical activity levels. • Walking more in neighborhoods with sidewalks than those without sidewalks. • Completing 35-45 more minutes of moderate intensity physical activity per week than similar people living in low-walkable neighborhoods. 1. National Complete Streets Coalition, 2014. 7

8. How much difference will this strategy make?Benefits of Designing Communities for Physical Activity… • Contribute to health and wellness of Americans by increasing physical activity. • Lower health care associated with physical inactivity. • Improve the local economy. • Provide opportunities for all Americans to be physically active including children, older adults, and people with disabilities.

9. What is the public health role?  • Establish partnerships to: • Share health data with decision makers to inform them about the benefits of communities designed for physical activity. • Collaborate with state and local departments of transportation and metropolitan planning organizations to incorporate physical activity goals into master plans. • Work with community organizations to educate stakeholders and community members on Complete Streets policies and understand their needs for designing communities to increase physical activity. • Work with local governments to provide technical assistance on the use of zoning to change the physical environment of communities.

10. Partners • Essential partnerships include: • State and local departments of transportation and metropolitan planning organizations • Community organizations • Active transportation coalitions • Local governments

11. Time Out

12. Why the Worksite? • More than 143 million American adults go off to work • men and women across a wide range of age, race/ethnicity, education levels and health risks • Where many adults spend a significant amount of waking hours • 7.7 hours for the average worker in 2012 • Ever-increasing health care costs place many businesses at a competitive disadvantage in global markets • In 1960, US national health care expenditures were $143 per capita or 5.1% of our Gross Domestic Product (GDP). By 2010, it was more than $8,402 per capita or nearly 18% of our GDP. • Worksite can be its own community, lending itself to broad multilevel approaches • Offers physical and social infrastructure conducive to delivering health messages, screenings, clinical linkages, programs, policies and support to improve employee health

13. Worksite Walking Strategies* • Combination of strategies work best • Stairwell Enhancement (environment) • Trails with maps (environment) • Showers/locker rooms (environment) • Walking meetings (policy) • Flextime (policy) • Walking clubs • Challenges and competitions • Communications * For more information contact Dr. QaiserMukhtar at qam2@cdc.gov

14. Worksite Walking Resources • CDC Vital Signs • http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6131a4.htm?s_cid=mm6131a4_w • CDC Walking Campaign Tools • http://www.cdc.gov/nationalhealthyworksite/join/walkingtools.html • CDC StairWELL to Better Health • http://www.cdc.gov/nccdphp/dnpao/hwi/toolkits/stairwell/ • CDC Steps to Wellness Implementation Guidelines • http://www.cdc.gov/nccdphp/dnpao/hwi/downloads/Steps2Wellness _BROCH14_508_Tag508.pdf • Physical Inactivity Cost Calculator • http://www.ecu.edu/picostcalc/ • National Organizations • America Walks (http://americawalks.org/) • Arthritis Foundation Walk with Ease (http://www.arthritis.org/resources/community-programs/walk-with-ease/) • American Heart Association (http://www.startwalkingnow.org/) • EveryBody Walk Collaborative (Everybodywalk.org)

15. Questions and Discussion National Center for Chronic Disease Prevention and Health Promotion Division of Nutrition, Physical Activity, and Obesity