Building Health. Design. through Community. A sign of hope in Brunswick... Mark Fenton Tufts University Bar Harbor ME Oct
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1 Building Health through Community Design Mark Fenton Tufts University Bar Harbor ME Oct A sign of hope in Brunswick...
2 Personal perspective. The physical activity challenge. Call to action: Speak up lead the discussion. Act up target policy change. Step up actually try stuff! > Weslaco TX
3 Youthful recollections
4 Changes in Walking & Cycling to School, 1969 to 2001 Ham et.al., Jour. of Physical Activity & Health, 2008, 5, % of students age Car Bus W/B W/B = Walk/Bike
5 Trends in Childhood Obesity & Overweight CDC, National Center for Health Statistics. National Health Examination Surveys (NHANES)
6 The real risk Nov-2009 Lenore Skenazy
7 My admittedly unique perspective...
8
9 We should be physically active.
10 Surgeon General s Report 1996 Physical Activity Guidelines min/week; more better. Any is better than none. Can be broken up. 300 min/week for youth. Reduced risk for CVD, diabetes, osteoporosis, obesity, dementia, clinical depression, cancers... These counts!
11 But mostly we are not.
12 Physical Activity in the US Measured by Accelerometer Troiano et.al., Med Sci Sports & Ex, 40(1), 2008.
13 Simply encouraging & educating does not work.
14 Exercise Participation Effect of Short Bouts, Home Treadmills Jakicic et.al., J. Amer. Med. Assoc., 282, Exercise (min/week) ? LB SB SBT months
15 Exercise Participation Effect of Short Bouts, Home Treadmills Jakicic et.al., J. Amer. Med. Assoc., 282, Exercise (min/week) LB SB SBT months
16 Body Mass (kg) Weight Loss with Wearable Technology Jakicic et.al., J. Amer. Med. Assoc., 316(11), Sep Weight Loss Standard Enhanced Months
17 But Social Ecology does! Individual Group Sallis & Owen, Physical Activity & Behavioral Medicine. Institutional Community Public Policy
18 Healthy design yields a Triple Bottom Line! Prosperity Healthy Economy Planet Healthy People Healthy Environment People
19 Four Elements of Healthy Design: Ped, bike, & transit network Mix of land uses Safety & access Site design
20 i. Land use. Live, work, shop, play, learn, pray. Compact neighborhoods, open space. Jr. High School Housing above, retail below. King et al., Relationship between convenience of destinations & walking levels... Am J Health Promotion 2003;18:74-82.
21 ii. Network of facilities: Bar Harbor Sidewalks, bike lanes. Multi-use trails; links between cul-de-sacs. Access to quality transit. Besser, Walking to Public Transit: Steps to Help Meet Physical Activity Recommendations. Am J Prev Med 2005;29:
22 iii. Site Design: Portland Which setting is more inviting for travel on foot and by bicycle?
23 Frank et al., Linking objectively measured physical activity & urban form... Am J Prev Med 2005;28: Portland OR Portland, Mankato OR Buildings near the sidewalk, not set back; parking on street or behind. Trees, benches, lighting, awnings, human scale. Details: bike parking, open space, plants, art, materials.
24 E.g. rural settings.... Middleburgh Delhi NY Liberty NY
25 iv. Safety & access. Median islands Engineering can markedly improve safety. Increasing pedestrian and bike trips decreases overall accident & fatality rates. Roundabouts Curb extensions Jacobsen, Safety in Numbers: More walkers & bicyclists, safer walking & bicycling. Injury Prevention, 2003; 9:205-9.
26 Complete Streets Accommodate all users: pedestrians, bikes, transit, & motor vehicles. E.g. lane reductions (road diets, right sizing). Better for all modes. Urbana, IL; before & after.
27 Potential Cyclists (conceptual) Portion of potential users No way, no how Interested, but concerned Likelihood of Bicycling Strong & confident
28 Potential Cyclists (actual) Portion of potential users ~33% ~60% ~7% No way, no how Interested, but concerned Likelihood of Bicycling Strong & confident
29 Bicycle network tools: Sharrow On-street Multi-use Trail Protected bike lane Bike lane
30 surgeongeneral.gov/stepitup ^ Walkable, Livable Communities. Safe Routes to School (Parks, etc.). Age-Friendly Commun. (AARP, WHO) Sustainability, Smart Growth. Transportation Demand Management. Transit Oriented Development. New Urbanism (CNU). health.gov/paguidelines >
31 What is your role? Speak up: To patients, clients, family, friends, colleagues, students, media, & especially community leaders. Act up: Help improve the built environment for routine physical activity, walking, cycling, & transit. Step up: Be a role model build more activity into your days!
32 Speak up: Counseling physical activity... Used to ask: Enjoy sports? Group or solitary? Competitive or not? Instructor or selfmotivated? Morning person? Measure aerobic fitness, estimate Max HR.
33 Counseling physical activity... Now also ask: Where do you live, work, shop, do daily tasks...? Closest park, trail, playground, garden? Commute habits, travel time? Own a bike, safe to park it? Transit pass?
34 A health coalition? ACS Employers YMCA AHA ADA Hospital Insurer Rec. Health Transit Housing Planning Transport DPW Parks Trails Electeds Neighborhoods Bike/Ped Advocates Developers Schools PTOs
35 The stealth chart: Transport Planning Elected Parks Trails Rec. Bike/Ped Advocate Enviro. Neighborhoods Employers Hospital Insurer DPW Transit Chamber Health ADA Vision Job Reach ACS Found. Schools AHA Housing Developer Churches PTOs Service Orgs. Banks Chamber NAR NAHB
36 Sell the economic benefits of healthy design: 1. Market demand 2. Market performance epa.gov/smartgrowth 3. Developer interest 4. Quantifiable health benefits!
37 Nat l Assoc. of Homebuilders realtor.org
38 peopleforbikes.org epa.gov/ smartgrowth
39 Build consensus: Active Community Design Workshops 1. Learn 2. Walk audit 3. Work & solve 4. Plan for action
40 School for the blind ^ Senior center v Active input: Listening, focus groups Surveys Photo-voice Walk audits Charrettes Church lay ministry ^ YMCA
41 Act up: Support national movements changing the physical activity landscape. (Fenton, Community Design & Policies for Free Range Children, Childhood Obesity 8(1), Feb 2012) 1. Healthy planning & zoning. 2. Complete Streets. 3. Transportation trail networks. 4. Transit- & bicycle-friendly policies. 5. Safe Routes to School initiatives.
42 Show up at a planning or school board meeting. Testify in behalf of: Bar Harbor HS Keeping schools close to where kids live! Neighborhood corner stores (w/ healthy choices) & pocket parks. No more big box & strip malls build villages! Terre Haute SW Harbor
43 E.g. Best practices in new subdivisions More like this? Less of this... Narrower streets, sidewalks both sides, links to trail system (existing & planned). Compact design, shared open space. Mix housing types, sizes (& incomes).
44 Trials, pilots & specials events. E.g. temporary protected bike lane. Whitefish MT
45 Livingston MT walk audit suggested a mini-circle.
46 Goshen CT - inexpensive demo mini-circle.
47 TRY STUFF: Design for bikes & peds. Scituate MA E.g. vocational school designed & built bike racks. North Adams, MA
48 Improve streetscapes Street furnishings (Tinley Park) Parklets Buy a bench
49 Wayfinding WalkYourCity.org
50 Lower cost options... Paint & flexible bollards Curb stops & planters
51 Billings MT
52 Formally adopt updated guidance... nacto.org fhwa.gov Adopt Nat l Association of City Transportation Officials guidelines; compiled evidence base & best practices.
53 Step up: Be an active role model. Leave the car behind at least one trip per week; walk, bike, or take transit instead.
54 Weslaco HS Student safety initiative
55 Weslaco HS S. Texas College
56
57
58
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60 Olshansky et.al., A Potential Decline in Life Expectancy... New Eng. J. of Med., March 17, 2005
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