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Reprinted with permission from the May 16 National League of Cities Nation's Cities Weekly.
By Charles Royer
To get a sense of what your city can do to combat childhood obesity, take a walk around. Can you walk around your city? Would you want to? Is there anywhere to go? How we construct and renovate our cities can go a long way toward stemming what is now regarded as an epidemic of childhood obesity. The childhood obesity rate has more than doubled for children aged 2-5 years and 12-19 years over the past three decades, according to the Institute of Medicine's "Preventing Child-hood Obesity: Health in the Balance." It has more than tripled for children aged 6-11 years, and 9 million children over 6 years of age are considered obese.
Local government interests Local governments have strong incentives to combat obesity. Reducing obesity fits easily within the mission of health departments to organize community efforts to prevent disease and eliminate health disparities among groups. Plus, obesity rates-and the dramatic increases in chronic disease that go along with them-portend yet another explosion in health care costs, including lost productivity. There is also a strong economic development incentive to combat obesity. Businesses-when considering where to locate-often consider quality of life factors. This calculation increasingly includes whether a locality promotes-through its built-in environment-a sedentary or active lifestyle. Walkable streets and neighborhoods are, by definition, lively and beautiful, definitely the kinds of places Richard Florida envisioned in his book, "The Rise of the Creative Class." A city's health, parks and recreation, transportation and planning departments all have roles to play in developing priorities and instilling values that promote healthy lifestyles. The inclusion of a public health perspective in local planning decisions in transportation, community development, zoning and building codes would make it much more likely that community development and maintenance decisions would support physical activity. There are several considerations that local governments can apply to their decision-making about physical activity in their communities. Density-Not surprisingly, the more spread out and less dense a community, the more people drive. And, increased driving is correlated with less physical activity and weight gain. People living in one study's most sprawling county-Geauga County, Ohio-weighed, on average, six pounds more and walked 79 minutes less each month than Manhattanites. While it is unlikely that suburbanization trends are going to be reversed any time soon, there are many things that suburban, urban and rural communities can do to facilitate physical activity, particularly among children. Structures-Sidewalks, bike trails (or bike lanes along roads), parks and other recreation facilities spur physical activities. Having good "connectivity" among these amenities is vital. For example, too many dead-end cul-de-sacs, wide intersections and locations of busy parking lot entries and exits can affect the walk- and bike-ability of sidewalks and bike lanes. Safety-Research indicates that the lack of structures and facilities such as sidewalks and parks is only one reason for not exercising. Another is fear. Parents worry about letting their kids walk or bike because of traffic-related dangers as well as crime and "stranger anxiety" concerns (real and perceived). Local governments should address these concerns in addition to providing the structures. A growing "safe routes to school" effort-most notably one in Marin County, Calif.-promotes walking and biking to school by addressing the safety concerns of parents, encouraging greater enforcement of traffic laws, educating the public and exploring other ways to create safer streets. Land Use-Zoning that promotes mixed uses is an important factor. People need destinations to walk to. With houses, offices, shops, parks, public transit stations and schools located within walking distance, people are much less likely to drive. Only 10 percent of public school students walk to school today. A generation ago, most did. The change is partly due to the location of schools, now often built at the edge of communities, too far from home to walk to. Another land use issue involves the location of grocery stores. Low-income neighborhoods generally have fewer grocery stores with fresh produce and other healthy foods and more convenience stores that generally have few healthy food selections. State and local governments can provide incentives to stimulate the development of nearby grocery stores or even farmers' markets and community gardens. For example, Pennsylvania Governor Ed Rendell created a statewide Supermarket Initiative to support development of supermarkets and other fresh-food retailers in underserved, disadvantaged urban and rural communities throughout Pennsylvania that lack adequate access to supermarkets. The community design and land use decisions we make in our cities can re-engineer physical activity back into our daily lives, which would be a big step toward curbing childhood obesity as well as creating lively, attractive places in which to live. For more information contact Keshia Crosby at 202-626-3074 or fellow@nlc.org, or visit www.nlc.org/iyef and click on the program areas section. Charles Royer is director of the Robert Wood Johnson Foundation's Urban Health Initiative, and a member of the Institute of Medicine's Panel on Prevention of Obesity in Children and Youth. He was mayor of Seattle from 1979-1991 and was NLC President in 1983.
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