HBE 101 Impacts2

Health, the Built Environment and Smart Growth: Linkages & Solutions: 

Health, the Built Environment and Smart Growth: Linkages andamp; Solutions Safe andamp; Healthy Communities Consulting Tina Zenzola, MPH

Urban Sprawl: 

Urban Sprawl Separated land uses, low densities and leap-frog development

Asphalt Nation: 

250% increase in vehicle miles traveled (915 billion miles) (1960-1997) US average = 73 mins/day of driving 200% increase in workers commuting to another county Asphalt Nation

Low priority for other modes of transportation: 

Low priority for other modes of transportation Safety Access

Expansive “greenfield” development: 

Expansive 'greenfield' development Developing open space and agricultural land at a rate of 2.2 million acres per year

Schools on the fringe: 

Schools on the fringe Then: the social and physical center of the community. Now: on the edge of neighborhoods; too far for kids to walk.

The Public Health Impacts of the Built Environment: 

The Public Health Impacts of the Built Environment Physical activity Obesity andamp; chronic disease Pedestrian injuries Asthma andamp; respiratory disease Crime andamp; violence Social capital Child psychosocial development Elder health andamp; mobility Water quality andamp; quantity Mental health Health disparities SHCC

Smart Growth is a Public Health Strategy : 

Smart Growth is a Public Health Strategy

Slide9: 

MIX LAND USES andamp; TAKE ADVANTAGE OF COMPACT BUILDING DESIGN Smart Growth: a Public Health Strategy

The burden of physical inactivity: 

The burden of physical inactivity The Problem 25% of adults are sedentary 60% of adults not active enough The Outcome 64% overweight and 1 in 3 obese Diabetes, heart disease, cancer, depression Physical inactivity is a primary factor in over 250,000 deaths annually. Medical costs associated with physical inactivity and its consequences may exceed $76 billion annually. Data Sources: 2000 BRFSS, 1999 NHANES, Powell 1994, Pratt et. al. 2000 SHCC

Slide11: 

Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1). 1993-94

Slide12: 

Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1). 1995-96 Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS

Slide13: 

Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1). 1997-98 Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS

Slide14: 

Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1). 1999 Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS

Slide15: 

Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and other obesity-related health risk factors, 2001. JAMA 2003 Jan 1;289(1). 2001 Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS

Our “Indicator Species” is in trouble: 

Our 'Indicator Species' is in trouble The rate of overweight in kids has doubled 70% chance of being overweight/obese as adults 78% don’t get recommended activity 1 in 3 will be diabetic 1st generation of kids in the US that aren’t expected to live as long as their parents

The disappearing walk to school: 

The disappearing walk to school 1 in 4 trips made by 5-15 year olds are for the journey to and from school. Only 10% of these trips are made by walking and bicycling. 25% of the morning rush hour traffic is parents driving kids to school Photo: www.pedbikeimages.org / Dan Burden SHCC

Neighborhood environment is one of the strongest predictors of whether a person will be physically active.: 

Neighborhood environment is one of the strongest predictors of whether a person will be physically active. Brownson, et al. 2001 King, et al. 2000. SHCC

Growing body of evidence: 

Growing body of evidence San Diego study: 70 minutes more physical activity/week among residents in walkable neighborhood; 35% vs. 60% overweight (Saelens, Sallis, et. al. 2003) 6 lb weight difference in sprawling vs. compact counties King County study: 5% increase in neighborhood’s 'walkability' index correlated with 32% increase in active transportation; 0.23 point reduction in BMI (Frank, Sallis, et. al. 2006) SHCC

Community Design Policies Work! : 

Community Design Policies Work! Community-scale policies andamp; design are effective: Zoning for compact, mixed-use development Transit-oriented development Policies related to street design andamp; connectivity Street-scale policies andamp; design are effective: Traffic calming Street lighting Improving street crossings SHCC The Task Force on Community Preventive Services concluded that:

Does design make a difference for kids?: 

Does design make a difference for kids? Marin, Co SR2S evaluation: 64% increase in number of kids walking to school with safety andamp; traffic calming improvements andamp; encouragement. CA SR2S evaluation: 15% of kids walked to school more often after physical improvements (vs. 4% when no improvements). Designing to Reduce Childhood Obesity. ALR, February 2005

But, isn’t it really just aboutmaking bad choices?: 

But, isn’t it really just about making bad choices? People make decisions in a context so we have to consider the context. Individual vs. environmental-level interventions. Most major public health improvements have been due to improvements in our living/working environment. SHCC

CREATE RANGE OF HOUSING OPPORTUNITIES & CHOICES : 

CREATE RANGE OF HOUSING OPPORTUNITIES andamp; CHOICES Smart Growth: a Public Health Strategy

Housing & Health Disparities: 

Housing andamp; Health Disparities Housing is a 'Social Determinant of Health' Physical conditions – substandard housing Concentration of poverty contributes to poor health status

The “Graying of America” : 

The 'Graying of America' By 2025, one in five Americans will be 65 years or older and over 6 million will be 85+ years Source: U.S. Bureau of the Census, Projections of the Total Resident Population by 5 Year Age Groups and Sex, with Special Age Categories, Middle Series 1999- 2100 (NP-T3), www.census.gov/population/www/projections/natsum.html

Senior health and mobility“Aging in Place”: 

Senior health and mobility 'Aging in Place' Housing andamp; transportation options: Fewer falls andamp; injuries Increased mobility Maintain social networks Overall physical function improved Increase lifespan, quality of life

CREATE WALKABLE NEIGHBORHOODS : 

CREATE WALKABLE NEIGHBORHOODS Smart Growth: a Public Health Strategy

Pedestrian Injury & Death: 

Pedestrian Injury andamp; Death 6% of trips on foot, but 25% of MV deaths are pedestrians (San Diego) Per mile, walking is 23x more fatal than driving Seniors and school kids are the most vulnerable Most dangerous = wide, arterials in suburban areas (South and Western metro areas) 50% less risk of pedestrian injury for kids living near speed humps

The forgotten pedestrian: 

The forgotten pedestrian Traffic flow prioritized over pedestrian safety Only 1% Federal Hwy funds for pedestrians Engineering practices andamp; traffic laws reflect bias andamp; lack of understanding of child pedestrian behavior SHCC

Battery Hens: Cooped up for life: 

Battery Hens: Cooped up for life Kept indoors Restricted boundaries andamp; mobility Can’t stretch, flap wings Weak bones and muscles Frustration, fighting, pecking

Battery Hen Children?: 

Battery Hen Children? 'Cradle-room-house-doorstep-neighborhood' sequence interrupted Smaller 'Cognitive maps' Social isolation of teens ADHD andamp; Ritalin Future attitudes about driving, walking

FOSTER DISTINCTIVE, ATTRACTIVE COMMUNITIES WITH A STRONG SENSE OF PLACE : 

FOSTER DISTINCTIVE, ATTRACTIVE COMMUNITIES WITH A STRONG SENSE OF PLACE Smart Growth: a Public Health Strategy

Healthy environments promote social networks & social capital: 

Healthy environments promote social networks andamp; social capital Loneliness and isolation are toxic; social relationships are healthy People with strong social networks: Live longer Have fewer heart attacks and heart disease Are less depressed and use alcohol and drugs less Have fewer teen births Are healthier overall

PRESERVE OPEN SPACE, FARMLAND, NATURAL BEAUTY & CRITICAL ENVIRONMENTAL AREAS : 

PRESERVE OPEN SPACE, FARMLAND, NATURAL BEAUTY andamp; CRITICAL ENVIRONMENTAL AREAS Smart Growth: a Public Health Strategy

Trees: Nature’s Balm: 

Trees: Nature’s Balm Crime Aggression Coping ADHD Stress Social ties Living without trees Living with trees Living without trees Living with trees Kuo, et. al. University of Illinois, Urbana

Water quality & quantity: 

Water quality andamp; quantity Fewer impervious surfaces Contamination from runoff Groundwater pollution H20 shortages SHCC

PROVIDE A VARIETY OF TRANSPORTATION CHOICES& STRENGTHEN & DIRECT DEVELOPMENT TOWARDS EXISTING COMMUNITIES: 

PROVIDE A VARIETY OF TRANSPORTATION CHOICES andamp; STRENGTHEN andamp; DIRECT DEVELOPMENT TOWARDS EXISTING COMMUNITIES Smart Growth: a Public Health Strategy

Driving Ourselves Crazy Stress and mental health: 

Driving Ourselves Crazy Stress and mental health Longer commutes contribute to stress, road rage Stress: heart disease, musculosketal symptoms, traffic collisions Depression, anxiety

Cars, Kids & Asthma: 

Cars, Kids andamp; Asthma Most common chronic childhood disease; up by 160% since 1980 Cal EPA Studies: 7% more asthma among kids living in neighborhoods with high traffic pollution 2X greater risk of asthma symptoms in 5-7yr olds living 250 ft or less of major road (McConnell et. al. 2006) Almost 10% of CA’s public schools located within 500 feet of high–very high volume roads

Slide40: 

The Public Health Potential of Smart Growth Safe andamp; Healthy Communities Consulting, 2003

Slide41: 

Integrating Health into Community Design The challenge facing those with responsibility for assuring the health and quality of life of Americans is clear. We must integrate our concepts of ‘public health issues’ with ‘urban planning issues’. Urban planners, engineers, and architects must begin to see that they have a critical role in public health. Similarly, public health professionals need to appreciate that the built environment influences public health as much as vaccines or water quality. Jackson andamp; Kochtitzky, 2001 SHCC