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Urban planning influences physical activity, public health

NEWS RELEASES SAINT LOUIS UNIVERSITY HEALTH BEHAVIOR NEWS SERVICE ************************* New Saint Louis University research paints portrait of how active communities look ST.
WalkingStroller

NEWS RELEASES

SAINT LOUIS UNIVERSITY

HEALTH BEHAVIOR NEWS SERVICE

************************* New Saint Louis University research paints portrait of how active communities look

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."

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.

************************* Neighborhood fear factors may contribute to obesity

Older adults living in disadvantaged urban neighborhoods have an increased risk of obesity, a new study has found, possibly due to fear caused by living in areas characterized by crime, disorder and neglect.

"There is almost a twofold higher chance that you're going to be obese if you live in the worst neighborhoods," said epidemiologist and lead author Thomas Glass, Ph.D., of Johns Hopkins Bloomberg School of Public Health. "Moreover, the risk is not something that can be explained away by personal variables such as dietary intake, tobacco use and household wealth."

The study appears in the current issue of the American Journal of Preventive Medicine.

Previous studies of environmental risk factors for obesity have focused primarily on measures of food availability, such as the concentration of fast food restaurants or barriers to physical activity, such as the absence of sidewalks, parks and recreational facilities.

To explore the link between stressors in the environment and excess weight, Glass and colleagues looked at the prevalence of obesity among 1,140 adults, age 50 to 70, residing in one of 65 Baltimore neighborhoods.

The neighborhoods had varying levels of environmental stress as measured by a scale of features that appeared to promote heightened vigilance, fear or alarm.

Fear-inducing factors included visible signs of disorder such as vacant houses and liquor stores, indicators of social disorganization and poverty such as single-parent families and unemployment and public safety measures such as violent crimes and 911 calls.

While the overall obesity rate in this population was 38 percent, it ranged from a low of 27 percent in the least hazardous neighborhoods to a high of 53 percent in the most hazardous neighborhoods.

The explanation for higher obesity rates in the disadvantaged neighborhoods couldn't be accounted for by simple economics, Glass said, because after accounting for differences in diet and exercise and other individual risk factors, obesity rates were not different between impoverished and more affluent neighborhoods.

According to Kathy Sykes, senior advisor for the Aging Initiative at the Environmental Protection Agency, this study adds to a growing body of research that links the places people live with health outcomes, particularly among older adults.

"While healthy communities are important for people of all ages, we know that this is especially needed for older adults," Sykes said. "It may be that there are major things going on in our communities that play a bigger role in the obesity problem than simply the fact that people are not eating right and exercising."

Glass said that the increasing prevalence of obesity in the United States is unlikely to be reversed by individual-level treatment approaches.

"This is an environmental epidemic and it's going to require environmental solutions," he said. "Restoring the health of neighborhoods and communities in cities that have gone into disrepair is something that we're going to have to take more seriously."

Glass TA, et al. Neighborhoods and obesity in older adults: The Baltimore Memory Study. Am J Prev Med 31(6), 2006.

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David Helwig

About the Author: David Helwig

David Helwig's journalism career spans seven decades beginning in the 1960s. His work has been recognized with national and international awards.
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