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quinta-feira, 21 de junho de 2012

How Cities Can Help Fight Obesity



How Cities Can Help Fight Obesity
Active Living Research
Today’s post is co-authored with my colleague Marissa Ramirez, consulting project manager for sustainable communities at NRDC.
On Sundays in Ferguson, Missouri, the community encourages kids to play in the streets by closing them off to cars and turning them into temporary "parkways." Streets are closed in different neighborhoods each week as part of the city’s “Live Well” initiative for health. This is a great idea: studies show that children with regular access to parks and outdoor space have lower prevalence of obesity by 20 percent.
Ferguson’s initiative shows that there are simple things we can do at the level of our own neighborhood to improve quality of life and fitness. When we think of improving our health, we sometimes think that the entire burden is on individuals to alter lifestyles, which many people find discouraging. But, as we’ve reported before, steps taken by communities can make a big difference in making healthy lifestyles easier. 
We now have additional support for this point from a new report by the Bipartisan Policy Center and a recent article from US News & World Report, both published earlier this month. We also have a recently-revamped website that is filled with useful information on community health and active living.
First, the Bipartisan Policy Center’s new report, “Lots to Lose: How America’s Health and Obesity Crisis Threatens our Economic Future,” repeats the warning that growing obesity rates are a serious problem that extends to not only the well-being of our children but also to our economic security, because of health care costs. The core of the report provides specific prevention- and community-based recommendations based on best practices and organized into four categories: families, schools, workplaces, and communities. While the categories are interrelated, many readers of this blog will be particularly interested in the recommendations for communities:
  1. Train health care professionals in nutrition and physical activity
  2. Expand a “prevention-workforce” by providing training also to non-clinical, community health workers
  3. Provide incentives for community health services such as diabetes or weight loss education
  4. Improve menu options at large institutions, shifting food supply chains towards healthier options and better prices
  5. Promote positive nutrition and fitness examples at public institutions
  6. Use existing infrastructure assets to promote more local opportunities for physical activity
  7. Make creative use of technology, such as games, pedometers, or apps locating walking and recreation spots
  8. Incorporate physical activity and healthy transportation guidelines into construction codes and planning policies
Ferguson’s street closings for kids are a great example of how recommendation six can be implemented. Because the city used existing infrastructure, it was able to create new recreational space immediately at no additional cost.
The report and recommendations were released by former Secretaries of Agriculture Dan Glickman and Ann M. Veneman and former Secretaries of Health and Human Services Donna E. Shalala and Mike Leavitt. The leaders called attention to the country’s mounting health care spending, which is expected to reach $4.6 trillion dollars annually and consume almost 20 percent of GDP by 2020. The report urges the public and private sectors to collaborate in creating healthy families, schools, workplaces and communities, emphasizing practices that can be implemented on a large scale and help reduce obesity in the US.
While the BPC’s report does not especially focus on the effects of community design, Rachel Pomerance’s article in US News does. In particular, she features our friend Dr. Richard Jackson,author of two recent books and host of a current PBS series on the connections between design and health. Jackson particularly stresses the importance of walkable places to improving fitness and reducing risk of obesity-related disease such as diabetes.   
Pomerance’s article includes five tips for people interested in nurturing health in their communities:
  1. Start with youth, improving school lunches and periodically measuring kids’ health
  2. Rethink transportation options, considering walking when feasible
  3. For people who are moving, consider a neighborhood where you can use transit, which encourages walking at the beginning and end of trips
  4. “Complete the neighborhood,” by taking advantage of opportunities to add mixed-use amenities and local conveniences to existing places
  5. Press government agencies and homeowners’ associations for health-oriented improvements such as sidewalks and bike lanes.
Pomerance highlighted a study we also reported here, showing that users of Charlotte’s light rail service lost weight and reduced their risk of obesity by 81 percent compared to before they began using the system.   
Finally, Active Living Research, a program of the Robert Wood Johnson Foundation, has redesigned its information-laden website, which we highly recommend for those interested in community health and fitness. On the home page, for example, you will learn that kids who live near heavy traffic will have a five percent increase in Body Mass Index, on average, compared to those who don’t; that teens in poor neighborhoods are 50 percent less likely to have a nearby recreation facility; that kids who are physically active have higher grades in schools.  (Some of these facts are also succinctly summarized on the very useful website of WalkBoston, which we noted earlier.) 
Even better, if you are a practitioner in the field interested in exploring these issues in depth, the site has convenient links to resources on such subjects as the role of schools in promoting fitness, the state of observational research on physical activity in various specific contexts, and trends in walking and bicycling. There are research papers and briefs, webinars and videos, slide presentations, recommended policies, information on health impact assessments, and more, including the organization’s blog.
It’s great to see these issues gaining traction. Here’s a really fun video (with a nice blues band in the background) of a “Sunday Parkway” similar to Ferguson’s, but in Portland:
This post originally appeared on the NRDC's Switchboard blog.

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