Transportation for Healthy Communities


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Transportatoin decisions have an impact on the health of our population, and ultimately the bottom line.

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  • Notion that obesity is caused by irresponsibility and weakness – govt intervention intrudes on personal freedomOur bodies try very hard to help us regulate our weight…………however…….Default – sitting to work, how get to work, school. Fast food…take the stairs, parking place, movies = popcorn and soda, etc.
  • Tooter
  • Inactive: 2 = Louisiana, 3 = Mississippi, 4 = Kentucky, 5 = Alabama, 6 = N Carolina, 7 = Arkansas, 8 = W VA, 9 = Nevada, 10 = Oklahoma
  • Is it better for more people to get less exercise, or fewer people to get more exercise?
  • The calculation uses an average of data from 76 million records from seven state studies conducted in the United States. The results are meant to provide an estimated cost of your physically inactive population to help you make better resource allocations. Since the scientific evidence base varies across the cost realms, a total estimate is provided as well as individual costs for medical care, workers’ compensation, and workers' lost productivity.
  • But one cost that is too rarely understood and factored into decisions at the state, city and organizational level is the mounting expense associated with a physically inactive population or workforce. A new tool helps leaders understand, estimate and address this cost.
  • a collection of 50 reports that reflect the overall health of counties in every state
  • Counties can improve health outcomes by addressing all health factors with effective, evidence-based programs and policies.
  • The weights for the factors (shown in parentheses in the figure) are based upon a review of the literature and expert input.
  • Walkable neighborhoods have a center, whether it's a main street or a public space. People: Enough people for businesses to flourish and for public transit to run frequently. Mixed income, mixed use: Affordable housing located near businesses. Parks and public space: Plenty of public places to gather and play. Pedestrian design: Buildings are close to the street, parking lots are relegated to the back. Schools and workplaces: Close enough that most residents can walk from their homes. Complete streets: Streets designed for bicyclists, pedestrians, and transit.
  • Walkable neighborhoods result from smart policy decisions that allocate our tax dollars and set the rules for development. The Walk Score algorithm looks at destinations in 13 categories and awards points for each destination that is between one-quarter mile and one mile of the subject residential property: · grocery store · restaurant · coffee shop · bar · movie theater · school · park · library · bookstore · fitness · drug store · hardware store · clothing and music store
  • More time in the car means more money at the pump, less exercise, and more pollution. Communities: Studies show that for every 10 minutes a person spends in a daily car commute, time spent in community activities falls by 10%.3
  • My address has a score of 18
  • Walkability raises home values. The property value premium for walkability seems to be higher in more populous urban areas and those with extensive transit, suggesting that the value gains associated with walkability are greatest when people have real alternatives to living without an automobile. The nation’s urban leaders should pay close attention to walkability as a key measure of urban vitality and as impetus for public policy that will increase overall property values –
  • Increased car trips have contributed to the rise of obesity. By taking even a percentage of short distance trips in an active transportation mode, such as walking or biking, the increase in physical activity can greatly affect obesity rates. Because 50% of urban area trips are 3 miles or less and 40% are 2 miles or less, great opportunity exists to transfer these trips to active modes of transportation.
  • Countries with the highest levels of walking and cycling have much lower rates of obesity, diabetes, and hypertension than the United States. The Netherlands, Denmark, and Sweden, for example, have obesity rates only a third of the American rate. Public transit use is linked with higher levels of physical activity and lower rates of obesity. Transit users in the US average 19 minutes/day of walking as part of their journey using transit.As shown on this slide, obesity rates tend to be inversely related to rates of active transportation (walking and biking), suggesting that transport policy affects public fitness and health.
  • What’s going on in Tennessee?
  • CDC funds 25 states (including Tennessee), 5-years to:
  • CSH priority is childhood obesity
  • Save the Children
  • In all sectors: where we live, where we play, where we learn, where we heal, where we work, vulnerable pops
  • Safe Pathways to Schools Legislation
  • Transportation for Healthy Communities

    1. 1. Transportation <br />& Health<br />Presented by: <br />Joan Randall, MPHAdministrative Director, Vanderbilt Institute for Obesity and Metabolism<br />Executive Director, Tennessee Obesity Taskforce<br />
    2. 2. Obesity – why be concerned?<br />Excess weight and obesity – often the result of physical inactivity and unhealthy eating – have tremendous consequences on Tennessee’s health and economy.<br />Both are linked to a number of chronic diseases (heart disease, stroke, diabetes, certain cancers, hypertension, osteoarthritis and asthma).<br />Annual cost of obesity-related diseases in Tennessee estimated at $2.7 billion; 3 times the annual TDOT budget (approximately $900 million).<br />
    3. 3. Military<br />Childhood obesity has become so serious in this country that military leaders view it as a potential threat to our national security. <br />Obesity the number 1 reason why applicants between the ages of 17 and 24 fail to qualify for military service.<br />
    4. 4. In Public Health…..<br />We like to PREVENT diseases rather than treat them.<br />Obesity is very difficult to treat, so Public Health has a major role in this arena.<br />My focus is on policies, interventions and environmental strategies to prevent and control obesity.<br />
    5. 5. Blend of Personal Responsibility and Collective Responsibility<br />Humans have a very sophisticated regulatory system. However, we are highly responsive to environmental cues.<br />Default conditions now contribute to obesity.<br />Create conditions that are conducive to making healthier choices and support personal responsibility.<br />
    6. 6. What separates the “doers” from the “watchers”?<br />Some people have a natural propensity to exercise.<br />Genes influence whether or not we exercise.<br />Genes influence how our bodies respond to exercise.<br />Genes influence adherence to exercise.<br />We need to intensify efforts for certain individuals.<br />Molly Bray, University of Alabama – Genes and Exercise Adherence<br />
    7. 7. Tennessee Grades<br />1st – adult inactivity<br />2nd highest overweight<br />3rd highest obese (32.8% of adults)<br />4th highest extreme obesity<br />5th highest – overweight or obese children ages 10-17 (36.5%)<br />
    8. 8. Rate of increase in TN is 1.4% each year.<br />
    9. 9. You have a role in reducing obesity<br />A large body of research shows that people’s physical environments—for instance, access to and quality of housing, transportation, stores, playgrounds and parks—either promote or present obstacles to healthy behaviors. <br />
    10. 10. Culture of active transportation<br />
    11. 11. Many Americans live and work in circumstances that make healthy living nearly impossible, even when they are informed and motivated. Many have limited or no access to active transportation, grocery stores that sell nutritious food; many live in communities that are unsafe or in disrepair, making it difficult or risky to exercise.<br />Goal: Create culture of active transportation<br />
    12. 12. 5 Elements of a Healthier Community:<br />Compact, varied village centers & neighborhoods.<br />Good connections for walking, bicycling, & transit.<br />Inviting designs & destinations.<br />Safety & access for all.<br />Healthy food widely available, affordable & accessible.<br />Bristol, TN<br /><br />
    13. 13. Healthy Community<br />The health of a community depends on many different factors, including quality of health care, individual behavior, education and jobs, and the environment. <br />For example, people who live in communities with ample park and recreation space are more likely to exercise, which reduces heart disease risk. <br />The problem is that there are big differences in health across communities, with some places being much healthier than others. <br />
    14. 14. Physical Activity Guidelines<br />The U.S. Department of Health and Human Services (HHS) issues the Physical Activity Guidelines for Americans. <br />Being physically active is one of the most important steps that Americans of all ages can take to improve their health. <br />Adults should do at least 150 minutes (2.5 hours) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. <br />
    15. 15. Two Rivers Disc Golf Course, Nashville<br />Pros: - Very, very hilly<br />Cons: - Very, very hilly<br />Start with small steps<br />
    16. 16. Quantifying the Cost of Physical Inactivity<br />Nearly 80 % of obese adults have diabetes, high<br />blood cholesterol levels, high blood pressure, coronary<br />artery disease or other ailments.<br />43 % of people with safe places to walk<br />within ten minutes of home meet recommended<br />activity levels. Only 27 % of those<br />without safe places to walk are active enough.<br />
    17. 17.<br />
    18. 18.
    19. 19.
    20. 20.
    21. 21. County Health Rankings<br />2010 <br />Tennessee <br />
    22. 22. In this model, health outcomes are measures that describe the current health status of a county. These health outcomes are influenced by a set of health factors. These health factors and their outcomes may also be affected by community-based programs and policies designed to alter their distribution in the community. <br />
    23. 23. Health <br />Factors<br />
    24. 24. 2010 County Health Factor Rankings<br />
    25. 25. Walkable Neighborhoods<br />Walkable neighborhoods offer surprising benefits to the environment, our health, our finances, and our communities.<br />The average resident of a walkable neighborhood weighs 7 pounds less than someone who lives in a sprawling neighborhood.<br />
    26. 26. Walkability<br />Cities in Tennessee<br />Walk Score is a number between 0 and 100 that measures the walkability of any address.<br />The 42 largest cities in Tennessee have an average Walk Score of 34. The most walkablecities in Tennessee are Cookeville, Knoxville, and Memphis. The least walkablecities are Brentwood, Soddy-Daisy and La Vergne.<br />
    27. 27. Walk Score Description<br />90–100 Walker's Paradise — Daily errands do not require a car. <br />70–89 Very Walkable — Most errands can be accomplished on foot. <br />50–69 Somewhat Walkable — Some amenities within walking distance. <br />25–49 Car-Dependent — A few amenities within walking distance. <br />0–24 Car-Dependent — Almost all errands require a car.<br />
    28. 28. Walkability Scores<br />
    29. 29. Walking the Walk: How Walkability Raises Housing Values in U.S. Cities<br />CEOs for Cities report* <br /><ul><li>Based on 94,000 transactions in 15 markets.
    30. 30. Compared sale prices & WalkScores (1-100 based on number of nearby destinations . . .)
    31. 31. Higher WalkScore correlated to higher home values.</li></ul>Average to above average walkscore =<br /> $4,000 to $34,000 increase in home value<br />*<br />
    32. 32. Transportation and Obesity<br />Sources: Centers for Disease Control – National Health and Nutrition Examination Survey/ <br />U.S. DOT – Federal Highway Administration, Annual Vehicle Distance Traveled in Miles and Related Data<br /> <br />
    33. 33. Public Transportation<br />Residents of transit oriented communities tend to walk more and have lower rates of obesity and hypertension than residents in sprawled areas.<br />As a result, policies and planning practices that support public transportation tend to increase public fitness and health.<br />
    34. 34.
    35. 35. Mission: <br /> to strengthen partnerships and enhance collaboration in order to reduce the burden of obesity in Tennessee using systematic, multidisciplinary, and evidence-based strategies.<br />
    36. 36. CDC Obesity Funded States<br />Develop & maintain infrastructure for coordinated statewide nutrition, physical activity and obesity strategies;<br />Convene and lead a process to develop and implement a state plan for nutrition, physical activity and obesity– focus on policy and environment.<br />
    37. 37. Building Statewide Momentum<br />State – Depts Health/Ed/Min Hlth/Ag/Trans/Gov ofc<br />Coordinated School Health<br />American Heart Association<br />American Diabetes & Juvenile Diabetes Research Fndn<br />Healthy Memphis Common Table<br />Community Food Advocates<br />Knoxville Childhood Obesity Coalition<br />Chattanooga Partnership for Healthy Living Network<br />Tennessee Dietetic Association<br />YMCA Pioneering Healthier Communities<br />
    38. 38. Partners, cont’d<br /><ul><li>Tennessee Extension
    39. 39. ECO – Every Child Outdoors
    40. 40. Alignment Nashville/Nashville Collaborative/CPPW
    41. 41. Tennessee SCORE (Statewide Collaborative on Reforming Ed)
    42. 42. HEAL – Healthy Eating Active Living Appalachia
    43. 43. Metropolitan & Rural Planning Organizations
    44. 44. Centers for Disease Control & Prevention
    45. 45. Alliance for a Healthier Generation
    46. 46. Robert Wood Johnson Foundation
    47. 47. Save the Children Campaign for Healthy Kids
    48. 48. Let’s Move
    49. 49. The Food Trust
    50. 50. The Rudd Center
    51. 51. Center for Science in the Public Interest</li></li></ul><li>Plan launched at Tennessee Public Health Association (TPHA) meeting in Cool Springs on September 17, 2010<br />
    52. 52. Eat Well Play More addresses 6 target areas (mandated by CDC):<br />1. Increased physical activity;<br />2. Increased consumption of fruits and vegetables;<br />3. Decreased consumption of sugar-sweetened beverages;<br />4. Increased breastfeeding initiation and duration;<br />5. Reduced consumption of high-energy dense foods;<br />6. Decreased television viewing.<br />
    53. 53.
    54. 54.
    55. 55. Built Environment Action Team: Health in All Policies<br />Built environment policies/resources<br />Complete Streets policies<br />School Siting<br />Joint Use Agreements<br />Safe Routes to School Network<br />
    56. 56. Early Wins<br />Complete Streets Policies<br />NashVitality – Healthy, Active and Green City<br />Bike Share – Chattanooga and Nashville<br />Nashville Regional Transportation Plan, Health Impact Assessments<br />The Rutherford County Wellness Council - Active Living Neighborhood Award of Excellence to encourage developers to consider adding amenities to their developments that will encourage future residents to lead active lifestyles. <br />
    57. 57. Conclusions <br />Walkable/Bikeable communities increase physical activity, decrease obesity.<br />Transportation planning decisions impact public health. <br />Communities where people drive less are healthier places to live and work.<br />Transportation policy and planning reform can help achieve public health and social equity objectives by creating more diverse and efficient transportation systems.<br />Takes “political courage” to do the right thing; continuing education is a large component. (Mayor Graves – raising revenue for transit)<br />
    58. 58. Convergence Opportunities<br />As the CDC says, "When state and city officials, health professionals, nonprofit organizations, urban planners, parks and recreation representatives, school staff, transportation officials, and community members work together, their efforts can increase the number of Americans who live healthier lives, by creating communities that support and encourage physical activity."<br />
    59. 59. Reversing the obesity epidemic is a shared responsibility. Social and environmental changes are influenced by the efforts of many…<br />