[HealthyTribes] It's official: built environment interventions increase physical activity

Fri May 5 16:05:46 PDT 2017

Dear Partners -

This week you may have seen or heard the important news shared by public health organizations about new evidence proving that intervening in the built environment to address issues like walkability is a proven way to get the population more physically active and prevent chronic disease.

Below I've pulled together some excerpts from announcements that have been circulating, for your use in your work and with your community partners. Enjoy! Please reach out if you have any questions.

Heather Gramp, MPH

Policy Specialist

The Community Preventive Services Task Force* released a new recommendation for combined built environment approaches to increase physical activity<https://urldefense.proofpoint.com/v2/url?u=http-3A__links.govdelivery.com-3A80_track-3Ftype-3Dclick-26enid-3DZWFzPTEmbWFpbGluZ2lkPTIwMTcwNTA0LjczMDMwOTkxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDUwNC43MzAzMDk5MSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3MTM2MjY0JmVtYWlsaWQ9a2FyZW4uZS5naXJhcmRAc3RhdGUub3IudXMmdXNlcmlkPWthcmVuLmUuZ2lyYXJkQHN0YXRlLm9yLnVzJmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY-3D-26-26-26103-26-26-26https-3A__www.thecommunityguide.org_findings_physical-2Dactivity-2Dbuilt-2Denvironment-2Dapproaches&d=DwMFAA&c=7gilq_oJKU2hnacFUWFTuYqjMQ111TRstgx6WoATdXo&r=qbhJt-cbOoeMXp7vToGxzCmPpSlTf9ij_dQpPqwET4-UJ_JSGMH9SzUYK7t6TWoi&m=1Gr2tdtoeL3gsXRreZXsH_llE9Kp6aVOfFn8uSG5M_4&s=jdUY3LVKe7Al7W7GiWBddkiwCbNqBM1XHL9dxKxQKA8&e=>. These approaches combine new or enhanced transportation systems (e.g., walking and biking paths) with new or enhanced land use design (e.g., proximity to a store or other destinations, access to a public park) to facilitate greater levels of physical activity among residents.

What are "Built Environment Intervention Approaches?"  Built environment intervention approaches to increase physical activity create or modify environmental characteristics in a community to make physical activity easier or more accessible.

Transportation system interventions include one or more policies or projects designed to increase or improve the following:

  *   Street connectivity
  *   Sidewalk and trail infrastructure
  *   Bicycle infrastructure
  *   Public transit infrastructure and access

Land use and environmental design interventions include one or more policies, designs, or projects to create or enhance the following:

  *   Mixed land use environments that increase the diversity and proximity of local destinations where people live, work, and spend their recreation and leisure time
  *   Access to parks, and other public or private recreational facilities

What does the evidence show? Physical activity increases among individuals in communities with new or improved projects or policies combining transportation (e.g. pedestrian or cycling paths) with land use and design components (e.g. mixed land uses or access to public parks).

  *   Combinations of activity-supportive built environment characteristics are associated with higher levels of transportation-related physical activity, recreational physical activity, and total walking among exposed individuals.
The Centers for Disease Control, the American Planning Association, the U.S. Department of Transportation and other agencies have touted the connection between transportation options and health for many years. But this announcement is important because of the rigor of evidence. The Task Force recommendation is based on evidence from a systematic review<https://www.thecommunityguide.org/about/our-methodology> of 90 studies. These studies used diverse designs, assessed and compared different combinations of interventions or existing built environment characteristics, and evaluated longitudinal changes or cross-sectional differences for a wide range of physical activity outcomes.

This recommendation increases recognition of and support for public health and medical communities to actively engage with the transportation, land use, and community design sectors to address critical health challenges. The National Academy of Medicine<https://www.nap.edu/catalog/21802/physical-activity-moving-toward-obesity-solutions-workshop-summary> and the Transportation Research Board<http://onlinepubs.trb.org/onlinepubs/sr/sr282.pdf>, many professional associations (including AAFP<http://www.aafp.org/about/policies/all/obesity.html>, AAP<http://pediatrics.aappublications.org/content/123/6/1591>, ACSM<http://www.acsm.org/public-information/position-stands>, AMA<https://searchpf.ama-assn.org/SearchML/searchDetails.action?uri=%2FAMADoc%2FHOD.xml-0-3875.xml>, APHA<https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2014/07/31/08/21/improving-health-through-transportation-and-land-use-policies>, ASTHO<http://www.astho.org/Policy-and-Position-Statements/Position-Statement-on-Obesity-Prevention-and-Reduction/>, NACCHO<http://www.naccho.org/uploads/downloadable-resources/03-02-Healthy-Community-Design.pdf>, and NEHA<http://neha.org/eh-topics/built-environment>), and the U.S. Surgeon General<https://www.surgeongeneral.gov/stepitup> supported the Task Force's decision to review this evidence.

Why is this important? Physical inactivity accounts for about 11% of premature deaths in the United States, and $117 billion (in 2012 dollars; 11% of aggregate health care expenditures) annually were associated with inadequate levels of physical activity. Despite the health benefits, only one-half of U.S. adults reported levels of physical activity consistent with the guideline for aerobic physical activity in 2013 (Surgeon General's Call to Action<http://www.surgeongeneral.gov/stepitup>).
Regular physical activity is one of the most important things people can do for their health to:

  *   Control weight
  *   Reduce risk of cardiovascular disease
  *   Reduce risk for type 2 diabetes and metabolic syndrome
  *   Reduce risk of some cancers
  *   Strengthen bones and muscles
  *   Improve mental health and mood

For More Information

The Benefits of Physical Activity<https://urldefense.proofpoint.com/v2/url?u=http-3A__links.govdelivery.com-3A80_track-3Ftype-3Dclick-26enid-3DZWFzPTEmbWFpbGluZ2lkPTIwMTcwNTA0LjczMDMwOTkxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDUwNC43MzAzMDk5MSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3MTM2MjY0JmVtYWlsaWQ9a2FyZW4uZS5naXJhcmRAc3RhdGUub3IudXMmdXNlcmlkPWthcmVuLmUuZ2lyYXJkQHN0YXRlLm9yLnVzJmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY-3D-26-26-26104-26-26-26https-3A__www.cdc.gov_physicalactivity_basics_pa-2Dhealth_index.htm&d=DwMFAA&c=7gilq_oJKU2hnacFUWFTuYqjMQ111TRstgx6WoATdXo&r=qbhJt-cbOoeMXp7vToGxzCmPpSlTf9ij_dQpPqwET4-UJ_JSGMH9SzUYK7t6TWoi&m=1Gr2tdtoeL3gsXRreZXsH_llE9Kp6aVOfFn8uSG5M_4&s=VVds3gQbIagg9zMAvoat6FlIzfzbakLBcz8ebdh2IHw&e=>

The Community Guide<https://urldefense.proofpoint.com/v2/url?u=http-3A__links.govdelivery.com-3A80_track-3Ftype-3Dclick-26enid-3DZWFzPTEmbWFpbGluZ2lkPTIwMTcwNTA0LjczMDMwOTkxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDUwNC43MzAzMDk5MSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3MTM2MjY0JmVtYWlsaWQ9a2FyZW4uZS5naXJhcmRAc3RhdGUub3IudXMmdXNlcmlkPWthcmVuLmUuZ2lyYXJkQHN0YXRlLm9yLnVzJmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY-3D-26-26-26105-26-26-26https-3A__www.thecommunityguide.org_&d=DwMFAA&c=7gilq_oJKU2hnacFUWFTuYqjMQ111TRstgx6WoATdXo&r=qbhJt-cbOoeMXp7vToGxzCmPpSlTf9ij_dQpPqwET4-UJ_JSGMH9SzUYK7t6TWoi&m=1Gr2tdtoeL3gsXRreZXsH_llE9Kp6aVOfFn8uSG5M_4&s=F9nZqu-DX23rtlouVd-xuqebMxNW7PqD6Q6N-JKUrY4&e=>

Increasing Physical Activity: Built Environment Approaches Combining Transportation System Interventions with Land Use and Environmental Design<https://urldefense.proofpoint.com/v2/url?u=http-3A__links.govdelivery.com-3A80_track-3Ftype-3Dclick-26enid-3DZWFzPTEmbWFpbGluZ2lkPTIwMTcwNTA0LjczMDMwOTkxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDUwNC43MzAzMDk5MSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3MTM2MjY0JmVtYWlsaWQ9a2FyZW4uZS5naXJhcmRAc3RhdGUub3IudXMmdXNlcmlkPWthcmVuLmUuZ2lyYXJkQHN0YXRlLm9yLnVzJmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY-3D-26-26-26106-26-26-26https-3A__www.thecommunityguide.org_findings_physical-2Dactivity-2Dbuilt-2Denvironment-2Dapproaches&d=DwMFAA&c=7gilq_oJKU2hnacFUWFTuYqjMQ111TRstgx6WoATdXo&r=qbhJt-cbOoeMXp7vToGxzCmPpSlTf9ij_dQpPqwET4-UJ_JSGMH9SzUYK7t6TWoi&m=1Gr2tdtoeL3gsXRreZXsH_llE9Kp6aVOfFn8uSG5M_4&s=f2gjcQxG21M8ucWBc6QCVNYMV6M6XUx9k3VelYU6OrE&e=>

One Pager: Built Environment Approaches to Increase Physical Activity<https://urldefense.proofpoint.com/v2/url?u=http-3A__links.govdelivery.com-3A80_track-3Ftype-3Dclick-26enid-3DZWFzPTEmbWFpbGluZ2lkPTIwMTcwNTA0LjczMDMwOTkxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDUwNC43MzAzMDk5MSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3MTM2MjY0JmVtYWlsaWQ9a2FyZW4uZS5naXJhcmRAc3RhdGUub3IudXMmdXNlcmlkPWthcmVuLmUuZ2lyYXJkQHN0YXRlLm9yLnVzJmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY-3D-26-26-26107-26-26-26https-3A__www.thecommunityguide.org_sites_default_files_assets_OnePager-2DPhysical-2DActivity-2Dbuilt-2Denvironments.pdf&d=DwMFAA&c=7gilq_oJKU2hnacFUWFTuYqjMQ111TRstgx6WoATdXo&r=qbhJt-cbOoeMXp7vToGxzCmPpSlTf9ij_dQpPqwET4-UJ_JSGMH9SzUYK7t6TWoi&m=1Gr2tdtoeL3gsXRreZXsH_llE9Kp6aVOfFn8uSG5M_4&s=MtPuqkaX_FXQQkCxJnJdD0gzKjk05IKeWO4nD84pRsk&e=>

Physical Activity: Creating or Improving Places for Physical Activity<https://urldefense.proofpoint.com/v2/url?u=http-3A__links.govdelivery.com-3A80_track-3Ftype-3Dclick-26enid-3DZWFzPTEmbWFpbGluZ2lkPTIwMTcwNTA0LjczMDMwOTkxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDUwNC43MzAzMDk5MSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3MTM2MjY0JmVtYWlsaWQ9a2FyZW4uZS5naXJhcmRAc3RhdGUub3IudXMmdXNlcmlkPWthcmVuLmUuZ2lyYXJkQHN0YXRlLm9yLnVzJmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY-3D-26-26-26108-26-26-26https-3A__www.thecommunityguide.org_findings_physical-2Dactivity-2Dcreating-2Dor-2Dimproving-2Dplaces-2Dphysical-2Dactivity&d=DwMFAA&c=7gilq_oJKU2hnacFUWFTuYqjMQ111TRstgx6WoATdXo&r=qbhJt-cbOoeMXp7vToGxzCmPpSlTf9ij_dQpPqwET4-UJ_JSGMH9SzUYK7t6TWoi&m=1Gr2tdtoeL3gsXRreZXsH_llE9Kp6aVOfFn8uSG5M_4&s=623ro0bsn2-2aR9QxASkRoi5dHIZnT5ONpKjqhVGpaE&e=>

Physical Activity: Point-of-Decision Prompts to Encourage Use of Stairs<https://urldefense.proofpoint.com/v2/url?u=http-3A__links.govdelivery.com-3A80_track-3Ftype-3Dclick-26enid-3DZWFzPTEmbWFpbGluZ2lkPTIwMTcwNTA0LjczMDMwOTkxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDUwNC43MzAzMDk5MSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3MTM2MjY0JmVtYWlsaWQ9a2FyZW4uZS5naXJhcmRAc3RhdGUub3IudXMmdXNlcmlkPWthcmVuLmUuZ2lyYXJkQHN0YXRlLm9yLnVzJmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY-3D-26-26-26109-26-26-26https-3A__www.thecommunityguide.org_findings_physical-2Dactivity-2Dpoint-2Ddecision-2Dprompts-2Dencourage-2Duse-2Dstairs&d=DwMFAA&c=7gilq_oJKU2hnacFUWFTuYqjMQ111TRstgx6WoATdXo&r=qbhJt-cbOoeMXp7vToGxzCmPpSlTf9ij_dQpPqwET4-UJ_JSGMH9SzUYK7t6TWoi&m=1Gr2tdtoeL3gsXRreZXsH_llE9Kp6aVOfFn8uSG5M_4&s=pq7IbBzHTn3ILWj7rrAgiJlM8hFVWh2ItPvhZ-BM8c4&e=>

Program Resources
Oregon Department of Transportation and Oregon Health Authority collaboration http://staging.apps.oregon.gov/ODOT/Programs/Pages/ODOT-OHA.aspx
CDC's Physical Activity and Health Program: https://www.cdc.gov/physicalactivity/
Surgeon General's Call to Action to Promote Walking and Walkable Communities: http://www.surgeongeneral.gov/stepitup
CDC's Healthy Places: https://www.cdc.gov/healthyplaces/

Share the news! Following are links to more information and promotional materials we hope you will share with your colleagues and any others who may be interested.

  *   Intervention Summary<https://www.thecommunityguide.org/findings/physical-activity-built-environment-approaches>-read a summary of the evidence review and Task Force finding
  *   Combined Built Environment Features Help Communities Get Active<https://www.thecommunityguide.org/content/combined-built-environment-features-help-communities-get-active>-include this story in your newsletter, or share the link with colleagues
  *   Built Environment One-Pager<file:///C:\Users\jge5\AppData\Local\Microsoft\Windows\Temporary%20Internet%20Files\Content.Outlook\E1732XHU\*%09https:\www.thecommunityguide.org\sites\default\files\assets\OnePager-Physical-Activity-built-environments.pdf>-use this one-pager as a quick reference
  *   Twitter<https://twitter.com/CPSTF>(r)-retweet @CPSTF <https://twitter.com/CPSTF> messages about the new recommendation or tweet one of the   following examples:
     *   Evidence supports combined built environment approaches to increase  physical activity: http://bit.ly/2oYW1UT   #TheCommunityGuide
     *   See #TheCommunityGuide for new findings from @CPSTF about creating better environments for physical activity: http://bit.ly/2oYW1UT

*What are the Task Force and Community Guide?
*         The Community Preventive Services Task Force (Task Force)<https://www.thecommunityguide.org/task-force/community-preventive-services-task-force-members> is an independent, nonfederal, voluntary panel of public health and prevention experts. The Task Force works to improve the health of all Americans by providing evidence-based recommendations about community preventive programs and services to improve health. Its members represent a broad range of research, practice, and policy expertise in community prevention services, public health, health promotion, and disease prevention.
*         The Guide to Community Preventive Services<http://www.thecommunityguide.org> (The Community Guide) is a collection of all the evidence-based findings and recommendations of the Community Preventive Services Task Force and is available online at www.thecommunityguide.org<http://www.thecommunityguide.org>.
Visit The Community Guide website at www.thecommunityguide.org<http://www.thecommunityguide.org>. You'll find other recommendations, as well as supporting resources such as Community Guide in Action stories that feature decision-makers who have used The Community Guide to make their communities safer and healthier. We have also added three websites below to use as additional resources.

Heather Gramp, MPH
Physical Activity and Nutrition Policy Specialist
OREGON HEALTH AUTHORITY
Public Health Division
Health Promotion and Chronic Disease Prevention
Office: 971-673-0630
Cell: 503-358-0337
http://www.oregon.gov/OHA

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