The Public’s Health and the Built Environment

Health & Community Design Accessibility Accessibility Children’s Health Children’s Health Elders’ Health Elders’ Health Gentrification Gentrification Health Impact Assessment Health Impact Assessment Injury Injury Mental Health Mental Health Physical Activity Physical Activity Respiratory Health & Air Pollution Respiratory Health & Air Pollution Social Capital Social Capital Water Quality Water Quality

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PHYSICAL INACTIVITY!!!

Sedentary Lifestyle Increases the risk of: Overall mortality (2 to 3-fold) Overall mortality (2 to 3-fold) Cardiovascular disease (3 to 5-fold) Cardiovascular disease (3 to 5-fold) Some types of cancer, including colon and breast cancer Some types of cancer, including colon and breast cancer Sources: Wei et al., JAMA 1999; Blair et al., JAMA 1996

The effect of low physical fitness is comparable to that of hypertension, high cholesterol, diabetes, and even smoking. Sources: Wei et al., JAMA 1999; Blair et al., JAMA 1996

Adults w/ No Leisure Activity Escambia % Escambia % Okaloosa % Okaloosa % Santa Rosa % Santa Rosa % Walton % Walton %

Adults w NO regular moderate activity Escambia % Escambia % Okaloosa % Okaloosa % Santa Rosa % Santa Rosa % Walton % Walton %

Lack of physical activity = Increased risk of being overweight or obese

No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) Obesity Trends* Among U.S. Adults BRFSS, 1992

No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) Obesity Trends* Among U.S. Adults BRFSS, 1995

No Data <10% 10%–14% 15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) Obesity Trends* Among U.S. Adults BRFSS, 1998

No Data <10% 10%–14% 15%–19% 20%–24% ≥25% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) Obesity Trends* Among U.S. Adults BRFSS, 2001

No Data <10% 10%–14% 15%–19% 20%–24% ≥25% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) Obesity Trends* Among U.S. Adults BRFSS, 2004

Percentage of Adults who are obese (Body Mass Index (BMI) >= 30) Legend State Avg 22.3 Escambia25% Okaloosa21.1% Santa Rosa21% Walton23.4%

Percentage of Adults who are overweight (Body Mass Index (BMI) >= 25 to < 30) 2002 Legend State Avg Escambia32.6% Okaloosa38.1% Santa Rosa35.2% Walton36.4%

How fat are we in the REGION? Escambia % Escambia % Okaloosa % Okaloosa % Santa Rosa - 56% Santa Rosa - 56% Walton % Walton %

 risk of overall mortality (up to 2.5-fold in the age group)  risk of cardiovascular mortality (up to 4-fold in the age group)  risk of diabetes (up to 5-fold)  risk of hypertension  risk of gall bladder disease Overweight Sources: Willett et al, NEJM, 1999; JAMA, Vol. 282, 1523.

ENGINEER Physical Activity into our Communities

Deaths and Injuries to Motor Vehicle Occupants and Pedestrians Leading cause of deaths among persons 1-34 years old Leading cause of deaths among persons 1-34 years old Annual U.S. toll from motor vehicle crashes: Annual U.S. toll from motor vehicle crashes: 42,000 deaths 42,000 deaths 3 million nonfatal injuries 3 million nonfatal injuries $230 billion in costs $230 billion in costs Sources: CDC, 2000 and NHTSA, 2002

The Story of 4 4,000 pedestrians killed each year 4,000 pedestrians killed each year 40,000 people killed in vehicle crashes 40,000 people killed in vehicle crashes 400,000 people die due to sedentary lifestyle and poor nutrition 400,000 people die due to sedentary lifestyle and poor nutrition $40,000,000,000 annual national cost for both Medicaid and Medicare due to inactivity and poor nutrition $40,000,000,000 annual national cost for both Medicaid and Medicare due to inactivity and poor nutrition

ENGINEER ROAD/PEDESTRIAN SAFETY into our COMMUNITIES

Water Quality Increased numbers of roads and parking lots Increased non-point source water pollution and contamination of water supplies Increased numbers of roads and parking lots Increased non-point source water pollution and contamination of water supplies Increased erosion and Increased erosion and stream siltation causes stream siltation causes environmental damage environmental damage - may impact water - may impact water treatment plants treatment plants

Community Design and Health Physical Inactivity Epidemic Physical Inactivity Epidemic Obesity, CVD, DM, HTN Obesity, CVD, DM, HTN Non-point run-off Non-point run-off  Auto crashes/injuries/deaths  Auto crashes/injuries/deaths  Pedestrian injuries/deaths  Pedestrian injuries/deaths  Mental health impact  Mental health impact  Social capital  Social capital Related to land use Related to automobile dependency Related to social processes

Underutilized Urban Buildings

Durham, NC

Smart Growth is Likely to Feature: Higher density, more contiguous development Higher density, more contiguous development Preserved green spaces Preserved green spaces Mixed land uses with walkable neighborhoods Mixed land uses with walkable neighborhoods Limited road construction, balanced by transportation alternatives Limited road construction, balanced by transportation alternatives Architectural heterogeneity Architectural heterogeneity Economic and racial heterogeneity Economic and racial heterogeneity Development and capital investment balanced between central city and periphery Development and capital investment balanced between central city and periphery Effective, coordinated regional planning Effective, coordinated regional planning

Development Patterns

“Complete Streets” Definition: a safe, comfortable and convenient route designed for travel via automobile, foot, bicycle, and transit. Definition: a safe, comfortable and convenient route designed for travel via automobile, foot, bicycle, and transit. Oregon state law: “Footpaths and bicycle trails… shall be provided wherever a highway, road or street is being constructed, reconstructed, or relocated.” Oregon state law: “Footpaths and bicycle trails… shall be provided wherever a highway, road or street is being constructed, reconstructed, or relocated.” Source:

Source: Smart Growth and Neighborhood Conservation, Maryland Brownfield Redevelopment: Disease Prevention AND Health Promotion

Boulder, Colorado

Major Messages Regional / Community design and land use choices do have an impact on the health of the public Regional / Community design and land use choices do have an impact on the health of the public As regional leaders, you can influence the health of our residents with your growth management decisions As regional leaders, you can influence the health of our residents with your growth management decisions

Community design and land use choices can either promote or harm human health It’s UP TO YOU!

Other Web Sites activelivingleadership.org activelivingleadership.org activelivingbydesign.org activelivingbydesign.org activeliving.org activeliving.org planning.org planning.org healthytransportation.net healthytransportation.net cdc.gov/healthyplaces.gov cdc.gov/healthyplaces.gov