State of Practice in Designing for Healthy Communities
Previous research has identified numerous environment and policy changes likely to be effective in promoting active living and healthy eating. Our article “Designing for Healthy Communities: Active Living and Comprehensive Community Development” in this issue outlines the benefits and opportunities of such an approach. But achieving these changes will be challenging.
Table 1 lists some of the relevant research programs. Parallel to the growing body of knowledge is a rapid development of practice in the past few decades that uses environmental and policy interventions to promote active living, healthy eating and social benefits. These practices incorporate multi-level approaches (changing the person, social environment, physical environment and policies) and involve multiple stakeholders. Table 2 summarizes some important examples in these areas.
Table 1. Sources of environment and policy research
Active Living Research, www.activelivingresearch.org
Healthy Eating Research, www.healthyeatingresearch.org
National Collaborative for Childhood Obesity Research, www.nccor.org/
National Physical Activity Plan, www.physicalactivityplan.org/
Salud America! The Robert Woods Johnson Foundation Research Network to Prevent Obesity among Latino Children, www.salud-america.org/index.html
Youth, Education and Society Project, www.yesresearch.org/index.html
Table 2. Examples of multi-disciplinary initiatives intervening on multiple levels to promote active living and healthy eating
Walkable Communities to Promote Active Transportation and Recreation
Active Living by Design
Established by the Robert Wood Johnson Foundation, this community grant program helps 25 communities create activity-friendly environments using a community action model and 5P strategies—preparation, promotion, programs, policy and physical projects.1 www.activelivingbydesign.org/
New York City Active Design Guidelines
Developed by a partnership of several New York City departments working with architects and academic partners, this document provides a manual for creating healthier buildings, streets and urban spaces, based on the latest academic research and best practices in the field.
The California Endowment’s programs
The Central California Regional Obesity Prevention Program2 and Healthy Eating Active Communities program3 are changing food and physical activity environments for the better by teaming up with local schools and communities.
Kaiser Permanente Community Health Initiative
This comprehensive initiative promotes obesity-prevention policy and environmental changes in communities served by Kaiser Permanente. It is designed to produce a sustained effort by engaging a broad range of community stakeholders.
Comprehensive plans addressing active living
Local governments use comprehensive plans to establish a long-term vision to guide local policy decisions. A new trend is for plans to address public health. Active living is the 7th most cited (44 percent) public health topic in comprehensive plans and the 5th most cited (59 percent) public health topic in sustainability plans.4
Health impact assessment
A health impact assessment is a combination of procedures, methods and tools that estimates the health impacts of proposed policies, plans and projects using quantitative, qualitative and participatory techniques. It helps decision-makers make choices about alternatives and improvements to prevent disease/injury and promote health.
Sustainable development initiatives promoting walkability
LEED-ND (Leadership in Energy and Environmental Design-Neighborhood Development): a rating system for sustainable neighborhood development that integrates the principles of smart growth, urbanism and green building. It promotes improved walkability in communities, consistent with promoting active transportation.
A planning movement promoting diverse, walkable, compact, vibrant and mixed-use communities. Currently, there are more than 4,000 New Urbanist projects planned or under construction in the U.S. alone.
Streets that Promote Active Transportation and Recreation
Complete streets is a nation-wide movement in the U.S. to build street networks that are safer and welcoming to all users (bicyclists, public transportation vehicles and riders, and pedestrians) of all ages and abilities. States, cities and towns are instituting complete streets policies.
Streets giving higher or equal priority to pedestrians and/or bicyclists
Woonerf: A street where pedestrians and cyclists have legal priority over motorists. It uses techniques such as shared spaces, traffic calming, and low speed limits to improve pedestrian, bicycle and automobile safety.
An urban design concept that encourages traffic engineers and urban planners to consult with users of public space when planning streets and squares. It replaces the conventional road priority management systems with an integrated, people-oriented understanding of public space.
Use of streets for physical and/or social activity
Some cities and communities are converting streets to places for physical and/or social activity, by temporarily blocking vehicle traffic. Examples include Ciclovias, play streets (e.g., summer streets in New York) and farmers’ markets.
Parks and Other Recreational Facilities to Promote Active Recreation
Easy-to-use outdoor gyms developed by the Trust for Public Land to promote health and introduce new healthy activities to the park, creating a supportive, accessible and social environment for getting fit. The equipment is installed in existing parks and designed to be durable and appropriate for people of all ages and fitness levels.
A nonprofit organization that creates a nationwide network of trails from former rail lines and connects corridors to provide healthier places for healthier people.
Schools to Promote Active Transportation and Recreation
Active school transportation
Federal Safe Routes to School program: A program of the U.S. Department of Transportation’s Federal Highway Administration. It was created by Section 1404 of the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users Act (SAFETEA-LU). A total of $612 million was made available over five years (FY 2005-2009) to improve the ability of primary and middle school students to walk and bicycle to school safely.
Walking School Bus
A program that organizes a group of children to walk to school with one or more adults. The adult supervision helps to overcome the safety barrier frequently reported by parents. A variation of this program is the bicycle train, in which adults supervise children riding their bikes to school.
Initiatives promoting neighborhood schools
The National Trust for Historic Preservation developed a report on policy recommendations for removing barriers to community-centered schools.
Joint use agreement
A formal agreement between two separate government entities–often a school and a city parks department–that sets forth the terms and conditions for shared use of public property or facilities.
Food Environment in Schools
Healthy school food program
Federal programs: The Healthy, Hunger-Free Kids Act of 2010 focuses on improving child nutrition. It authorizes funding for multiple school programs that help provide nutritious food at school. The Summer Food Service Program provides free, nutritious meals and snacks for low-income children during the summer months.
In 2006, three soft-drink companies controlling more than 90 percent of school beverage sales announced voluntary guidelines to limit portion sizes and reduce the number of calories available to school children during the school day.5
School garden movement
A program that helps children learn where food comes from while providing modest amounts of fresh produce.
School wellness policy
The Child Nutrition and WIC Reauthorization Act of 2004 established a new requirement for all school districts with a federally-funded school meals program to develop and implement wellness policies that address nutrition and physical activity by the start of the 2006-2007 school year.
1 P. Bors, M. Dessauer, R. Bell, R. Wilkerson, J. Lee, S. L. Strunk, “The Active Living by Design national program: community initiatives and lessons learned,” American Journal of Preventive Medicine (2009).
2 L. Schwarte, S. E. Samuels, J. Capitman, M. Ruwe, M. Boyle, G. Flores, “The Central California Regional Obesity Prevention Program: changing nutrition and physical activity environments in California’s heartland,” American Journal of Public Health (2010).
3 S. E. Samuels, L. Craypo, M. Boyle, P. B. Crawford, A. Yancey, G. Flores, “The California Endowment’s Healthy Eating, Active Communities program: a midpoint review,” American Journal of Public Health (2010).
4 “Comprehensive planning for public health: results of the Planning and Community Health Research Center Survey,” Planning & Community Health Research Center, American Planning Association (2011).
5 School Beverage Guidelines, American Beverage Association, Washington, DC (2006).
Posted in Journal Volume 2, Number 2 -- December, 2011, Healthy Residents