Planners are the new public health officials
Research has linked the growing obesity epidemic to inactivity caused by poor land-use and transportation choices. Transportation and planning professionals are now joining the ranks of public health professionals to find solutions. Across the region, local officials are taking this to heart.
Obesity is a serious problem in the US. When planners shape land-use or transportation options, they're determining the potential health of the community, because these options affect whether people can choose effective transit or safe walking and bicycle routes.
When the Prince George's community hosted a screening of the four-part HBO Weight of the Nation documentary series earlier this week, the community highlighted this intersection between public health and transportation planning.
Global Solutions President and CEO Dr. Maya Rockeymore, speaking at a panel after the screening, responded to the stark numbers presented in the film. In Baltimore, residents of the Inner Harbor have a life expectancy of 62 years while residents of North Baltimore have a life expectancy of 82 years. "Context controls choice," she said. People need access to parks, transit, safe walking and bicycle routes, and full-service grocery stores to even have the choice to be healthy.
Low-income communities and communities of color have higher rates of obesity and chronic disease. The physical neighborhood of the Inner Harbor contributes to the health disparity in life expectancy. While designed as a walkable community, the neighborhood suffers from vacant houses, streets in need of maintenance and lack of destinations to meet basic needs such as a grocery store. When the physical environment deteriorates, safety becomes an additional issue in neighborhoods.
In the United States, 66% of adults are overweight or obese and nearly 20% of children are obese. Being overweight or obese increases the risk of chronic diseases such as hypertension, high cholesterol, type 2 diabetes, and asthma in both adults and children.
Pamela Creekmur, the Acting Health Officer and Director of the Prince George's County Health Department, explained that Prince George's obesity and physical inactivity rates are higher than other jurisdictions in the greater Washington region. Though Prince George's faces a bigger challenge, all the region's communities have seen a rise in obesity rates, which range between 18 to 34 percent for adults throughout the region.
Part of the cause of this obesity epidemic is physical inactivity. There has been a 300 percent increase in driving to work since 1960. As the documentary explains, in 1969 almost 50 percent of kids walked or biked to school while today only 13 percent of kids do the same.
The lack of exercise by children extends beyond just commuting to and from school. The documentary shows a mom who takes her children to a parking lot because it is the only open space they have to play. This environment isn't hospitable to the kind of physical activity a good park encourages.
Whether it's questions of commuting or questions of parks, transportation and planning professionals make decisions that affect travel and open spaces every day. These decisions need to be viewed as public health decisions.
The Centers for Disease Control and Prevention (CDC), the federal agency charged with health promotion and disease prevention, agrees. It has recognized that transportation policy, street-scale improvements, and access to places suitable for physical activity matter to our health. Among the CDC's recommendations is to participate in Safe Routes to School initiatives and adopt Complete Streets policies.
The Guide to Community Prevention Services, written by an independent group of public health and prevention professionals appointed by the CDC director, outlines several more environmental and policy approaches to provide opportunities for people to be physically active. These include the connectivity of sidewalks and streets, providing places for physical activity such as trails, and street-scale improvement such as street lighting and traffic calming. Such urban design features have been shown to improve some aspect of physical activity by 35 percent, not to mention the accompanying benefits of reduced crime and stress.
Of course, these improvements do not come overnight. After the screening, an elected official and audience members noted that such changes are not easy. After all, parks do not generate tax dollars.
But that does not mean that our environments must stagnate while our health deteriorates. Local communities can bring about change even when the federal government or state government seems stuck. Port Towns Youth Council President Erick Vargas talked about how his group took matters into their own hands by doing an audit of the streets and reporting the problems.
Prince George's County is taking action through a partnership of towns within the county. The Port Towns Community Health Partnership has a policy development team focused specifically on the built environment and nutrition policy to improve options for active living and healthy eating.
The group, which includes the towns of Bladensburg, Colmar Manor, Cottage City, and Edmonston, included a community health and wellness section in the Port Towns sector plan with the goals of providing safe places to walk and exercise and access to nutritious foods. The group is following through on sector plan recommendations to formalize a wellness opportunity zone as part of the zoning code. This would include changes in the built environment, access to healthier foods, and improved environmental stewardship.
Across the Potomac, the Fairfax County Health Department established the Partnership for a Healthier Fairfax, a group of community members and organizations concerned with public health. The Partnership created an environment and infrastructure strategic issues team as one of five teams who will make recommendations for improving health in Fairfax County. The first focus is a on local policy. The team is doing a scan of policies, including transportation and land use, that could be modified to promote a healthier and safer physical environment.
In the Washington region, better transportation and planning decisions can improve our health by increasing our access to efficient transit and space to run, bike, and play. We also create a healthier context for our environment—
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