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Current research show troubling trends in physical activity and health: children are becoming more sedentary, and the general population is becoming increasingly obese. Today, many of our communities are much less pedestrian and bicycle-friendly than they were 50 years ago, and fewer people have the option of walking out their front door and being physically active in their community. Fortunately, better community design can go a long way to encouraging physical activity and improving public health in your community.
A Public Health Crisis
The Benefits of Daily Physical Activity
Active Communities: Making the Planning and Public Health Connection
A Public Health Crisis
Americans are gaining weight. Between 1987 and 1999, the U.S. population grew dramatically more overweight and obese, according to the Centers for Disease Control (CDC). Today, more than 60% of adults are either overweight or obese, and the percentage of young people who are overweight has more than doubled in the last 30 years - between 10% and 15% of Americans aged 6-17 years are overweight.
Lack of physical activity is one of the primary causes of America's collective weight gain, and is thought to be a primary factor in more than 300,000 deaths per year in the United States, a total equivalent to 25% of all chronic disease deaths and 10% of all deaths. People who are overweight or obese increase their risk for heart disease, diabetes, high blood pressure, arthritis-related disabilities, and some cancers. Furthermore, not getting an adequate amount of exercise is associated with needing more medication, visiting a physician more often, and being hospitalized more often.
Specifically, overweight and obese people are at increased risk for physical ailments such as:
- High blood pressure, hypertension
- High blood cholesterol, dyslipidemia
- Type 2 (non-insulin dependent) diabetes
- Insulin resistance, glucose intolerance
- Hyperinsulinemia
- Coronary heart disease
- Angina pectoris
- Congestive heart failure
- Stroke
- Gallstones
- Cholescystitis and cholelithiasis
- Gout
- Osteoarthritis
- Obstructive sleep apnea and respiratory problems
- Some types of cancer (such as endometrial, breast, prostate, and colon)
- Complications of pregnancy
- Poor female reproductive health (such as menstrual irregularities, infertility, irregular ovulation)
- Bladder control problems (such as stress incontinence)
- Uric acid nephrolithiasis
- Psychological disorders (such as depression, eating disorders, distorted body image, and low self esteem).
- The direct medical costs associated with physical inactivity were $29 billion in 1987 and nearly $76.6 billion in 2000.
- The annual cost of obesity in the United States is about $100 billion.
- After controlling for physical limitations and socioeconomic status, researchers found that more than 12% of the annual medical costs of inactive people with arthritis is associated with their inactivity.
- Despite the proven benefits of being physically active, more than 28% of adults report no leisure-time physical activity.
- In 2000, women were 20% more likely than men to report no leisure-time physical activity.
- Blacks were 36% and Hispanics 63% more likely than whites to report no physical activity in 2000.
- The percentage of adults reporting no leisure-time physical activity in 2000 ranged from 16% in Utah to 41% in Kentucky.
The Benefits of Daily Physical Activity
Modest, regular physical activity substantially improves health. Such physical activity does not need to be excessively strenuous - walking, gardening, or taking a leisurely bike ride can help improve health in a number of ways:
- Reduces the risk of dying prematurely.
- Reduces the risk of dying from heart disease.
- Reduces the risk of developing diabetes.
- Reduces the risk of developing high blood pressure.
- Helps reduce blood pressure in people who already have high blood pressure.
- Reduces the risk of developing colon cancer.
- Reduces feelings of depression and anxiety.
- Helps control weight.
- Helps build and maintain healthy bones, muscles, and joints.
- Helps older adults become stronger and better able to move about without falling.
- Promotes psychological well-being.
Almost anybody can walk for exercise, no matter who they are, and the research shows that walking can be excellent for one's health. The CDC cites a study that reports that men who walked at moderate intensity for at least 30 minutes a day reduced their risk of coronary heart disease. Another study of non-smoking men showed that those who walked less than 1.6 kilometer each day had a mortality rate nearly twice that of those who walked more than 3.2 kilometers per day.
Bicycling is another cheap and easy form of physical activity and transportation, and significant health benefits are possible if even a small percentage of short automobile trips are made instead by bicycle trips. However, Americans aren't using their bicycles to their fullest potential: according to the League of American Bicyclists, more than 42 million Americans have bicycles, but less than 1% of all trips are made by bicycle.
Other easy-to-do activities, such as golfing, gardening, walking the dog, playing frisbee in the park, and rollerblading can dramatically improve one's health if done on a regular basis. 30 minutes a day is all it takes to achieve some benefits.
Active Communities: Making the Planning and Public Health Connection
The public health and planning professions share common goals and similar histories. Both disciplines seek to improve peoples' lives by preventing, identifying, investigating, and eliminating problems that may pose threats to residents' health and welfare.
As mentioned above, physical inactivity exacts an enormous public health toll. For the U.S. population, in which 29% of adults are sedentary and more than 50% are overweight, becoming moderately active can provide a multitude of health benefits. The negative effects of physical inactivity have once again encouraged the collaboration between the public health and city planning professions.
One of the primary ways in which we can improve public health is to use planning techniques that integrate walking and bicycling into daily routines and try to substitute these activities for part of the time we spend driving every day.
Data from the Nationwide Personal Transportation Survey (NTPS), conducted by the U.S. Department of Transportation, has shown that private vehicle-based travel dominates transportation in the United States. In the 1995 survey, travel by motorized vehicle accounts for 86% of all person-trips and 91% of all person-miles. Walking accounted for only 5% of trips and less than 1% of miles. Furthermore, private vehicles have been steadily increasing their share of personal transportation over time, and walking and bicycling trips are mostly for recreational travel. According to the NPTS survey, only 7% of all walking trips and 8% of all bicycling trips were to work. This is, at least in part, because many of our communities are not designed to encourage walking and bicycling - in fact, in some neighborhoods, walking and bicycling is downright dangerous, with no sidewalks, shoulders, crosswalks, or bike lanes, and only high-speed roadways. Often, even when bicycling and walking might not be dangerous, it's simply unappealing: who wants to walk around a place with no trees, shop windows to look into, no attractive sidewalks, no park benches?