Health and Community Design

Health and Community Design

Overweight is EpidemicRates in Adults

Overweight is EpidemicRates in Adults

2/3rds of American adults are overweight

In 1991 rates were 45% (almost 50% increase in 15 yrs)

                                                                          (

Obesity Trends* Among U.S. AdultsBRFSS, 1985

Obesity Trends* Among U.S. AdultsBRFSS, 1985

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. Adults

BRFSS, 1989

Obesity Trends* Among U.S. Adults

BRFSS, 1989

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. Adults

BRFSS, 1993

Obesity Trends* Among U.S. Adults

BRFSS, 1993

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. Adults

BRFSS, 1997

Obesity Trends* Among U.S. Adults

BRFSS, 1997

No Data <10% 10%–14% 15%–19% ≥20

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. Adults

BRFSS, 2000

Obesity Trends* Among U.S. Adults

BRFSS, 2000

No Data <10% 10%–14% 15%–19% ≥20

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

(*BMI 30, or ~ 30 lbs overweight for 5’4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. Adults BRFSS, 2002

Obesity Trends* Among U.S. Adults

BRFSS, 2004

Obesity Trends* Among U.S. Adults

BRFSS, 2004

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

OBESITY Risk Factors for the Chronic Disease

OBESITY Risk Factors for the Chronic Disease

Cardiovascular Stroke Endocrine Orthopedic Pulmonary Hepatic Psychosocial

Leading Causes of ObesityLeading Causes of Obesity

Poor Nutrition: Taking in too many calories

Inactivity: Burning off too few calories

Poor NutritionPoor Nutrition

Fast Food Five-fold increase since 1970 1/3 of US kids eat daily

Super-size me Portion sizes

Sugars and Refined Flours Soda consumption has doubled in 20 years

Processed Foods Higher in calories, fat and salt

Irregular Meal Patterns

Physical InactivityPhysical

Inactivity

25% of adults are sedentary

60% of adults not active enough

78% of kids don’t meet physical activity requirements.

Electronic Media & Kids 5 ½ hrs/day 2 hrs more if

computer/TV in room

Percentage of Trips in Urban Areas Made by Walking and Bicycling: North America and

Europe 1995

Percentage of Trips in Urban Areas Made by Walking and Bicycling: North America and

Europe 1995

The disappearing walk to school

The disappearing walk to school

Only 10% of these trips are made by walking and bicycling

1 in 4 trips made by 5-15 year olds are for the journey to and from school

Of school trips one mile or less, about 28% are walk-based and less than 1% are bike-based

Parents feel that streets aretoo dangerous

Parents drive theirchildren to school

Traffic increases

Parents feel that streets aretoo dangerous

Traffic increases

Fewer children walk andbicycle to school

The Vicious Cycle

20% to 30% of morning peak traffic is parents driving kids to school

20% to 30% of morning peak traffic is parents driving kids to school

Increasing Vehicle Travel

Increasing Vehicle Travel

Explaining the Epidemic

Explaining the Epidemic

Not genetic or biological changes

Lifestyle and environmental changes

Improving Health through

Community Design

Improving Health through

Community Design

Traffic Calming

Street Lighting

Improving Street Crossings

Compact/ Mixed Use Development

Attractive Street Design

Street Design & Connectivity

Transit-Oriented Development

Community Design/ Health Links

Community Design/ Health Links

San Diego study: 70 minutes more physical activity/week among residents in walkable neighborhood; 35% vs. 60% overweight

6 lb weight difference in sprawling vs. compact counties

King County study: 5% increase in neighborhood’s “walkability index” correlated with 32% increase in active transportation; 0.23 point reduction in BMI

Expanding our Roles and Vision

Urban planners, Transportation Engineers and Architects:

Have a critical role in public health

**************

Public Health needs to appreciate the built environment influences public health as much as vaccines or water quality.

The Public Health Impacts of the Built Environment

The Public Health Impacts of the Built Environment

Physical activity Obesity Chronic disease Access to healthy foods Pedestrian injuries/death Crime & violence Senior independence & mobility Water quality & quantity Mental health Health disparities Asthma & respiratory disease

Acute Asthma Events Among Children and Youth During the 1996 Summer Olympic

Games

Acute Asthma Events Among Children and Youth During the 1996 Summer Olympic

GamesData

SourceType of Asthma Event

Mean No. of Events Per Day

% Change

Baseline Period*

Olympic Period+

GA Medical Claims

Emergency care and

hospitalizations

4.23 2.47 -41.6

HMO Emergency care, urgent care and hospitalizations

1.36 0.76 -44.1

Emergency Department

s

Emergency care and

hospitalizations

4.77 4.24 -11.1

GA Hospital Discharges

Hospitalizations 2.04 1.65 -19.1

Best Practices Best Practices

King County, WashingtonKing County, Washington

King County pursues aggressive “smart growth: strategies:

Land Use- combating sprawl and building healthier communities.

Public transportation- getting more people onto leaner, greener busses.

Environmental management- turning waste into energy

Clean energy future- stimulating climate-friendly fuel and technology markets for a prosperous, sustainable economy.

Ron Sims, King County Executive

Health & Transportation departments collaborated

Commissioned study on health/transportation links

The first Comprehensive Plan with physical activity/health as a goal and policies in the Urban Form and Transportation Elements

Seattle, Washington

Health as a General Plan Goal in King County, WA

Health as a General Plan Goal in King County, WA

Los Angeles CountyLos Angeles County LAC Public Health and Regional Planning

Directors have agreed to have their staff work collaboratively on General Plan

Policies supporting healthy, livable communities have been incorporated into the Draft Preliminary General Plan

Review/revise zoning ordinances to ensure they are in support of new general plan

Public Health input into proposed new developments at Regional Planning’s subdivision committee meetings and EIR reviews

What Can Cities Do? What Can Cities Do?

Include health objectives in general plans

Add a health element to the general plan

Get Public Health input projects and updates

Update zoning codes to allow compact, mixed use

Update street design standards

Dedicate/Increase funds for active transportation

Integrate Health into General Plan

Integrate Health into General Plan

Health as explicit goal

Provide comprehensive definition of health

Link health and policies that support walkable, livable communities and smart growth

Models in CaliforniaModels in California

Chula Vista

Richmond

Chino

Integrate Health into Specific Plans

Integrate Health into Specific Plans

Master Plan

Redevelopment Plans

Downtown Plans

California Assembly Bill 437

California Assembly Bill 437

Authorizes the county health officer to provide assistance to cities and

counties with local land use planning and transportation planning processes

as they relate to public health.