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ST. LOUIS -- A new comprehensive study by Saint Louis University researchers that flags the top 10 features of activity-friendly communities is a blueprint for improving public health, the author of the research says.

"We wrote the book on identifying the range of different influences that gets people engaging in physical activity not just for recreation but as part of their everyday life activities," says Laura Brennan Ramirez, Ph.D., adjunct assistant professor of community health at Saint Louis University School of Public Health.

"We outlined what needs to happen and what is most feasible. It's going to require a commitment toward health and social wellbeing."

While regular moderate physical activity can prevent many diseases and prolong life, most Americans don't move around enough to stay healthy, earlier studies have shown.

The Saint Louis University research builds on a growing body of evidence that shows a link between how our cities are designed and built and how much activity we get.

Many of the study's recommendations focused on wrestling us away from our cars, says Brennan Ramirez, who also directs Transtria, a public health research and consulting company.

"The number of hours we spend in our car everyday detracts from our physical, social and mental health," she says. "People are increasingly becoming aware of it. Our dependence on the car is overwhelming."

Brennan Ramirez and her colleagues sifted through academic literature, reports and websites to cull a list of 230 indicators of communities that encourage activity. Then they convened two panels of experts to boil that list down to the top 10 factors that influence our activity levels. Their findings were published in the December issue of the American Journal of Preventive Medicine. The research was funded by The Robert Wood Johnson Foundation and the Centers for Disease Control and Prevention.

Among the significant factors:

* Land use: A mix of commercial and residential development in a community increases a person's desire to be more active. Hiking and biking trails and crosswalks do work to promote walking and bike use.

* Transportation: Sidewalks and mass transit support physical activity because they get people out of cars and encourage a more active lifestyle.

* Aesthetics: Monuments and historic attractions also encourage people to move about. In addition people are more inclined to walk in communities that are well maintained and have pleasant things to see.

* Institutional and organizational policies: Encouraging physical education programs at schools, flextime on the job, and having showers and gyms in the workplace promote an active lifestyle.

* Promotions: Campaigns and media messages build awareness of the importance of seizing opportunities for activity, which increases movement.

* Public policies: Appropriating highway funds to create bike lanes and city funds to improve parks and recreation facilities give the necessary financial muscle to build an activity-friendly infrastructure.

* Travel patterns: People are more likely to bike or take mass transit to work when they see other people doing the same thing.

Brennan Ramirez says the findings that highlight the best way to design an activity-friendly community are particularly important for the very old and very young.

"We haven't really designed our communities well for older adults, particularly once they get to the point that they can't drive," she says. "In addition, given concerns about the soaring childhood obesity rates, not having schools located within the neighborhood is a major problem."


[From a second press release.]

Researchers identify key indicators for activity-friendly communities

Factors that contribute to regular physical activity

There is no doubt that people can benefit from regular physical activity. There is also no doubt that Americans do not get enough exercise. While there is a long list of policies and methods that might increase participation, advocates, community leaders, and researchers lack the tools needed to assess local barriers to and opportunities for more active, healthy lifestyles. In a study published in the December 2006 issue of the American Journal of Preventive Medicine, researchers used a systematic review process to identify key indicators of activity-friendly communities that can be used to assess and improve opportunities for regular physical activity.

By searching peer-reviewed journals, reports and websites, the authors identified 230 potential factors that might be used to assess activity-friendly communities. Then, using a consensus-building approach among experts drawn from a wide range of institutions, government agencies, and not-for-profits, they identified ten key indicators that could serve as the foundation of efforts to design activity-friendly communities.

Example indicators include land use policies that favor closer distances between home and shopping. Interesting things to look at while walking was important, as was a clean and safe environment.

Writing in the article, Laura Brennan Ramirez, PhD, MPH, states, "These findings represent an important first step in the identification of practical and empirical indicators that can be used to assess and improve the degree to which communities support routine physical activity. This initial set of indicators can serve as the basis for further study of physical activity indicators in different populations (e.g., older adults, children, women, racial and ethnic minorities) and settings (e.g., urban, rural, schools, worksites, healthcare facilities, faith-based organizations)."

The article is "Indicators of Activity-Friendly Communities: An Evidence-Based Consensus Process" by Laura K. Brennan Ramirez, PhD, MPH, Christine M. Hoehner, PhD, MSPH, Ross C. Brownson, PhD, Rebeka Cook, MPH, C. Tracy Orleans, PhD, Marla Hollander, MPH, Dianne C. Barker, MHS, Philip Bors, MPH, Reid Ewing, PhD, Richard Killingsworth, MPH, Karen Petersmarck, PhD, Thomas Schmid, PhD, and William Wilkinson, AICP.

It appears in the American Journal of Preventive Medicine, Volume 31, Issue 6 (December 2006) published by Elsevier.


Saint Louis University School of Public Health is one of only 37 fully accredited schools of public health in the United States and the nation's only School of Public Health sponsored by a Jesuit university. It offers masters degrees (MPH, MHA and MS) and doctoral programs (Ph.D.) in six public health disciplines and joint degrees with the Doisy College of Health Sciences and Schools of Business, Law, Medicine and Social Service. It is home to seven nationally recognized research centers and laboratories with funding sources that include the National Institutes of Health, the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the American Cancer Society, the Robert Wood Johnson Foundation and the World Health Organization.

Editorial Notes: The scientific article will appear in the December 2006 issue American Journal of Preventive Medicine (viewable by subscribers only). This is the most recent of a spate of article detailing the public health implications of cities that are designed for cars rather than people. Related articles: Our Ailing Communities Urban Sprawl and Public Health: Designing, Planning, and Building for Healthy Communities -BA

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