Marion County Health Department Alliance for Health Promotion City of Indianapolis Department of Metropolitan Development and Parks Department Indiana Departments of Transportation, Health, and Natural Resources American Heart Association AARP Indianapolis Neighborhood Resource Center IU Department of Public Health, School of Public and Env. Affairs, Center for Aging Research Central Indiana Soil and Water Conservation District Hendricks County Health Department Department of Planning, City of Carmel 100Year Metropolitan Indianapolis Board of Realtors Builders Association of Greater Indianapolis IU Center for Urban Policy and the Environment Hoosier Rails to Trails Council And more…
Since World War II, physical activity has been engineered out of many parts of American life. From elevators and drive-thru restaurants to cul-de-sac suburbs and strip malls, we have become increasingly car-dependent and sedentary.
Quality of Life Overall Health Status Economic Vitality Intellectual Capital Sustainability
Given the continuing burden of cancer and cancer disparities in Indiana and throughout the U.S., state cancer control programs are in a unique position to implement policy, systems, and environmental change initiatives and evoke sustainable, far-reaching impact on the burden of cancer. The Indiana Comprehensive Cancer Control Program (ICCCP) was one of 13 recipients of a grant from the CDC to specifically implement policy change to address these needs. Policy strategies such as comprehensive statewide smokefree air policy and tobacco tax increases have been demonstrated to effectively and sustainably impact both active smoking and exposure to secondhand smoke while improving the burden of cancer. Physical activity can be promoted through environmental changes such as Complete Streets and opportunities for school-based physical activity in order to impact disparities and be of benefit to whole communities. These initiatives through their effects across age groups, genders, and race/ethnicities are particularly important in addressing populations of need. Using the grant funds, the ICCCP is implementing the policy agenda along with several internal and community partners and stakeholder organizations.
State Street, Santa Barbara
IMPROVED COMMUNITY HEALTH
This illustrates why there is an immediate need for change! We know that BMI is underreported, so the problem is even worse than it appears! Improving the built environment and giving people more active transportation options means that physical activity can begin to be integrated into people’s everyday routines… instead of being an inconvenience, or just one more thing on a to-do list. * 07/16/96 * ##
THE DEMAND IS THERE, so why aren’t people walking and biking more? … (next slide)
Media coverage 3/28/12 – findings from the Annual Report to the Nation on the Status of Cancer, 1975–2008 The report highlights the effects of excess weight and lack of physical activity on cancer risk. Esophageal adenocarcinoma, cancers of the colon and rectum, kidney cancer, pancreatic cancer, endometrial cancer, and breast cancer among postmenopausal women are associated with being overweight or obese. Several of these cancers also are associated with not being sufficiently physically active. “ This report demonstrates the value of cancer registry data in identifying the links among physical inactivity, obesity, and cancer,” said CDC Director Thomas R. Frieden, M.D. “It also provides an update of how we are progressing in the fight against cancer by identifying populations with unhealthy behaviors and high cancer rates that can benefit from targeted, lifesaving strategies, and interventions to improve lifestyle behaviors and support healthy environments.” For more than 30 years, excess weight, insufficient physical activity, and an unhealthy diet have been second only to tobacco as preventable causes of disease and death in the United States. However, since the 1960s, tobacco use has declined by a third while obesity rates have doubled, significantly impacting the relative contributions of these factors to the disease burden. Excess weight and lack of sufficient physical activity have been linked to increased risk of cardiovascular disease, hypertension, diabetes, and arthritis, as well as many cancers. “ In the United States, 2 in 3 adults are overweight or obese and fewer than half get enough physical activity,” said John R. Seffrin, Ph.D., chief executive officer of the American Cancer Society. “Between children and youth, 1 in 3 is overweight or obese, and fewer than 1 in 4 high school students get recommended levels of physical activity. Obesity and physical inactivity are critical problems facing all states. For people who do not smoke, excess weight and lack of sufficient physical activity may be among the most important risk factors for cancer.” * 07/16/96 * ##
Incomplete streets favor automobiles over walking & biking. * 07/16/96 * ##
A new survey on the nation’s walking habits Top reason for not walking was “involved in OTHER physical activities and don’t feel the need to walk more” Walking is not seen as a means to get from point A to point B. * 07/16/96 * ##
A CS policy or ordinance ensures that the entire right of way is routinely designed and operated to enable safe access for all users. Having some form of policy in place will gradually create a complete streets network of roads that serve ALL USERS. Policy will shift transportation investments so they are creating better streets now .
Decades of research have demonstrated how we can intervene. On this slide is a 5-tier pyramid that describes the level of impact of different types of public health interventions and provides a framework to think about how to improve health. This pyramid comes from a recent article by Dr. Frieden the Director of CDC. In that article, he points that all of these levels can have a health benefit but if we want the largest impact for the population, we need to focus on the bottom levels of the pyramid. For this initiative, we are focusing towards the bottom of the pyramid on “Changing the Context” that focuses on strategies designed to “make individual default decisions healthy” or making the healthy choice the easy choice.
* 07/16/96 * ##
What’s wrong with this picture? Busy intersection with no crosswalks, sidewalks, or bike lanes. Recognize it? This is 56 th and Binford in Indianapolis! * 07/16/96 * ##
Pictures taken in Clairmont * 07/16/96 * ##
* 07/16/96 * ##
Indiana Complete Streets
Promoting Complete Streets for Healthy Communities Kim Irwin, MPH Executive Director Alliance for Health Promotion April 27, 2012 Annual Meeting Indiana Cancer Consortium
The Health by Design CoalitionMore than 500 members representing 200+ orgs Non-profits academia private industries and businesses environmental groups Planners, designers, architects, and builders transportation officials public health and environmental professionals recreation and safety personnel concerned citizens YOU?
Our focus: How the built environment (neighborhoods, communities, transportation systems, buildings, regions, parks, and open spaces) impacts public health.
Active Living A way of life that integrates physical activity into daily routines “When communities organize themselves around the automobile as the primary mode of transportation, they effectively engineer physical activity right out of the equation.” Neil Caudle
What do these reports all recommend? White House Task Force on Childhood Obesity Report and Action Plan (2010) APHA’s The Hidden Health Costs of Transportation (2010) CDC’s Transportation Recommendations (2010) National Physical Activity Plan (2010) Institutes of Medicine’s Local Government Actions to Prevent Childhood Obesity (2009)
Complete Streets for Healthy LivingComplete Streets are designed and operated so that they are safe, comfortable, and convenient for all users- pedestrians, bicyclists, transit riders, and motorists of all ages and abilities.Complete Streets Policies Create a new vision Institutionalize Planning and Decision-making Result in a safer, healthier built environment
Indiana Cancer Control Plan 2010-2014 The Plan includes strategies – like Complete Streets – that support active living communities for adults and children
Comprehensive Cancer Control PolicyTechnical Assistance Agenda Increase the percentage of Indiana residents who work in a smoke-free workplace Increase the Indiana cigarette excise tax Increase the number of Complete Streets policies at the local level Amend legislation to require elementary schools to incorporate 30 of the recommended 60 minutes of daily physical activity
Indiana’s Comprehensive Nutrition andPhysical Activity Plan, 2010-2020 The IHWI and ISDH released the State Obesity Plan in January 2011. The Plan outlines a plan of action for different settings to address obesity in Indiana, including Complete Streets.
Why do we need completestreets? Obesity is lower in places where people use bikes, public transit, and their feet (Pucher, 2009). States with the lowest levels of walking and biking have on avg. the highest levels of obesity, diabetes, and high blood pressure. The CDC recently named the adoption of CS policies as a recommended strategy to prevent obesity (2009).
Why do we need completestreets? Americans WANT to walk and bicycle more . Recent opinion polls found that 52% of Americans want to bicycle more, and 55% would prefer to drive less and walk more.
Streets Are Inadequate TOO NARROW TO SHARE WITH BIKES
Streets Are Inadequate INACCESSIBLE FOR WHEELCHAIR USERS
Negative Health Impact ofINCOMPLETE Streets One study found that, on a daily basis, each additional hour spent driving is associated with a 6% increase in the likelihood of obesity. Each additional kilometer walked is associated with a 5% reduction in this likelihood.
Streets Are Inadequate NO ROOM FOR BIKES OR PEDESTRIANS
Key MessageNational Walking Survey - 2011 The second most cited reason for not walking was neighborhood-related barriers, such as not enough sidewalks or being wary of speeding traffic. Neighborhoods that are more walkable are home to a greater number of frequent walkers.
Incomplete Streets Are UnsafeAlliance for Biking & Walking 2010 Benchmarking Report
Complete Streets Policies 330+ jurisdictions nationally have a stated commitment to complete streets Policy Types – Public: legislation, ordinances, resolutions, executive orders – Internal: policies, plans, manuals Policy Levels – Local, MPO, State, Federal
Who has Complete Street Policiesin Indiana? Northwest Indiana MPO Bloomington MPO Madison County MPO Columbus, Indiana Evansville MPOComplete Streets policiesnow cover 20% of Indiana’spopulation.
The Best Complete Streets Policies Apply to all phases of all projects Feature direct use of the latest and best design standards Allow flexibility in balancing user needs Specify any exceptions and require high-level approval of them
Design Elements All users must be able to safely move along and across a complete street. Each complete street is unique. Complete streets are appropriate in all communities, regardless of size or setting.
Why Policy Change is important: Changing policy so that our transportation system routinely includes the needs of people on foot, wheelchairs, public transportation, and bicycles means that walking, riding bikes, and riding buses and trains will be safer and easier. People of all ages and abilities will have more options when traveling to work, to school, to the grocery store, and to visit family.
SmallestImpact One-on-one & Small group education, health fairs Counseling & Education Provider Brief intervention Clinical Interventions PHS Guidelines Long-lasting Protective InterventionsLargest Changing the Context POLICYImpact to make individuals’ default decisions healthy Poverty, housing, Socioeconomic Factors education
Complete Streets =Livable Communities Complete streets make fiscal & economic sense Complete streets improve safety Complete streets encourage physical activity Complete streets ease transportation woes Complete streets benefit children Complete streets are good for air quality
So What Can You Do? Learn and get involved in the process Participate in an advocacy group Examine the environment and policies in your community Invite others to get involved Take action!
Media Advocacy: Shape the Story Translate the individual problem to a community issue Assign primary responsibility Present a solution
SHAPE the StoryFind the authentic voices:The elderly, bikers, walkers, school-aged children, those without cars,visually impaired, pedestrians/bikersinjured in car crashes, etc…
Questions and Next Steps What are your next Who can be your steps to help partners? promote Complete What assistance do Streets in your you need? community?
Contact information: Health by Design 401 W. Michigan Street Indianapolis, IN 46202-3233 317.352.3844 email@example.com www.healthbydesignonline.org an Alliance for Health Promotion initiative