Physical Activity and the Built Environment

Nefertiti Durant, MD MPHAssistant Professor

Division of General Pediatrics and Adolescent MedicineDivision of Preventive Medicine

University of Alabama at Birmingham School of Medicine

Trends in Overweight

Figure 2. Prevalence of overweight among children and adolescents ages 6-19 years

18.816.3

17.416.7

0

5

10

15

20

2001-2002 2003-2004

Per

cen

t

6-11

12-19

Decline in Physical Activity

Why focus on physical activity? Healthy People 2010

HP2010, objective 22.6– “Increase the proportion of adolescents who engage

in moderate physical activity for at least 30 minutes per day on 5 or more days of the previous 7 days

Physical Activity Recommendations

• Current Recommendations: – Adults: 30 minutes/day of moderately intense physical activity– Youth: 60 minutes/day of moderately intense physical activity

(Physical activity and health: A report of the U.S. Surgeon General, 1996)

• This does NOT have to be done all at one time• Short five or ten minute spurts of fun physical activities are just

as good!

• How do our youth measure up?– 28% of adolescent girls and 44% of adolescent boys met the

recommendation of 60 minutes of physical activity per day– (2005 YRBS Survey)

• Built environment factors recently linked to physical activity in youth

What is the Built Environment?

• Parks• Recreation Centers• Walking Trails, Sidewalks, Bike Paths • Population Density• Traffic and Safety• Aesthetics• Suburban Sprawl• Neighborhood Walkability• Proximity to grocery stores, open space, amenities• Transportation access• Relationship to surrounding streets

Built Environment and Physical Activity: The Evidence

• Environmental mediators consistently linked with physical activity – Access to facilities (e.g. parks and recreation) and

physical activity equipment linked with increased physical activity for children and adolescents

– Adolescents in census block groups with seven or more physical activity facilities are 32% less likely to be overweight and 26% more likely to be highly active

– Greater proportion of park area is associated with increased physical activity in children ages 4-7

Built Environment: Safety and Physical Activity

• Chicago Neighborhood Study: – Unsafe neighborhoods and social disorder

linked to lower physical activity in 11-16 year olds

• Gomez et. al.• Neighborhood safety correlated with physical

activity in girls

How do we translate this research into practice?

• Health Departments

• School Based

• National Campaigns– NIEHS– CDC

• Web Based

Public Health Department Approaches: Washington State

Benton Franklin County Health Departmentwww.bfhd.wa.gov/ph/pahep.php

Dakota County Minnesota

• “Do the parks" is a joint effort of Dakota County Public Health and local and county park and recreation agencies– Purpose of the campaign is to make citizens

aware of the many city and county parks, trails, and  recreational facilities

Dakota County Minnesota

Simple Steps

• Simple Steps in Dakota County!

• Provides tips to help people get started walking and keep them motivated

• Indoor walking options

• Maps of interesting places to walk in the county maps of interesting places to walk

• www.co.dakota.mn.us/.../HealthyLiving/Fitness/

Boston Steps

• Boston Steps – Community mobilization effort to address

obesity, diabetes and asthma in eight neighborhoods

– Target area:• 58% of Boston’s total population • 70% of the city’s under-18 residents

– http://www.bphc.org/programs/program.asp?b=2&d=&p=190

Boston Health Commission: NeighborWalk

• NeighborWalk – The Boston Public Health Commission has funded 54

community-based organizations to join NeighborWalk to promote walking as a way to good health

• NeighborWalk Walking Groups– Organizes residents to walk in their neighborhoods at least once

a week for 30 to 60 minutes– Walks promote physical activity and are an opportunity for

residents to meet new people and show community spirit

• http://www.bphc.org/programs/program.asp?b=2&d=&p=190

Active Transport: CDC Campaign

KidsWalk-to-School Materials

• Step-by-Step GuideWalkable Routes to School

Survey

• Brochure• Web site

www.cdc.gov/nccdphp/dnpa/kidswalk

For copies:www.cdc.gov/nccdphp/kidswalkCcdinfo@cdc.gov

1-888-CDC-4NRG

Active Transport: CDC Campaign

National Institute ofEnvironmental Health Sciences NIEHS

• Kid and Parent Friendly– Dancing or playing music games, like the Hokey Pokey,

Bunny Hop, Ring Around the Rosies, Skip to My Loo, Head, Shoulders, Knees and Toes, or The Walking Song

– Team sports, like soccer, basketball, hockey, volleyball, and softball or baseball

– Choosing the stairs instead of escalators or elevators – Taking physical education (PE) classes at school, or

lessons such as swimming, tennis, or gymnastics

• Source: NIEHS Website, Kids Pages, http://kids.niehs.nih.gov/weight.htm

School Based Approaches: Fitness for Life

Fitness for Life Goals:•Improve fitness and health among

teens• Prepare youth to be physically

active and healthy throughout their adult lives

• First personal fitness textbook for teens

•Updated Fifth Edition, and the new textbook for middle school

students, available in early March 2007

•Should be integrated with other physical education activities

•Material available for students and teachers

www.fitnessforlife.org/student/4/4/

School Based: Fitness for Life Program

•ACTIVITYGRAM

•Uses the physical activity pyramid guidelines for youth as the

basis for feedback and instruction

•Computer software program

•Students to record and monitor their physical activity levels and patterns

•Self monitoring s levels of fitness levels

• The ACTIVITYGRAM software provides constructive feedback about physical activity based

reported levels of physical activity and the current physical activity guidelines

www.fitnessforlife.org/student/4/4/

Resources

• School Based- Fitness for Life www.fitnessforlife.org/student/4/4• NIEHS Kid’s Pages• President’s Challenge:

– http://www.presidentschallenge.org/the_challenge/active_lifestyle.aspx

• California Project Lean– www.caprojectlean.org/.../default.asp

– School and Community nutrition and physical activity policies that youth can engage in with the help of a teacher/advisor

– Activities and success stories of California teens making nutrition and physical activity policy changes in their communities.

Resources

• Active Living Research Foundationhttp://www.activelivingresearch.org/

• http://www.cdc.gov/nccdphp/dnpa/kidswalk/resources.htm#presentation

• CDC VERB campaign:– http://www.cdc.gov/youthcampaign/

Thanks!