The Public’s Health The Public’s Health andand

the Built Environmentthe Built Environment

Health & Community Health & Community DesignDesign

AccessibilityAccessibility Children’s HealthChildren’s Health Elders’ HealthElders’ Health GentrificationGentrification Health Impact Health Impact

AssessmentAssessment InjuryInjury

Mental HealthMental Health Physical ActivityPhysical Activity Respiratory Health Respiratory Health

& Air Pollution& Air Pollution Social CapitalSocial Capital Water QualityWater Quality

www.cdc.gov/healthyplaceswww.cdc.gov/healthyplaces

for more informationfor more information

The The EPIDEMICEPIDEMIC that is that is killing us right now!killing us right now!

PHYSICAL INACTIVITY!!!PHYSICAL INACTIVITY!!!

Sedentary LifestyleSedentary Lifestyle

Increases the risk of: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 Some types of cancer, including

colon and breast cancercolon and breast cancer

Sources: Wei et al., JAMA 1999; Blair et al., JAMA 1996

The effect of low physical The effect of low physical fitness is comparable to that fitness is comparable to that

of hypertension, high of hypertension, high cholesterol, diabetes, and cholesterol, diabetes, and

even smoking.even smoking.

Sources: Wei et al., JAMA 1999; Blair et al., JAMA 1996

Adults w/ Adults w/ No No Leisure Leisure ActivityActivity

Escambia - 24.8%Escambia - 24.8%

Okaloosa - 20.8%Okaloosa - 20.8%

Santa Rosa - 25.4%Santa Rosa - 25.4%

Walton - 32.5%Walton - 32.5%

Adults w Adults w NONO regular moderate regular moderate activityactivity

Escambia - 52.2%Escambia - 52.2%

Okaloosa - 49.6%Okaloosa - 49.6%

Santa Rosa - 55.3%Santa Rosa - 55.3%

Walton - 55.1%Walton - 55.1%

Lack of physical activityLack of physical activity==

Increased risk of being Increased risk of being overweight or obeseoverweight or obese

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. Obesity Trends* Among U.S. AdultsAdults

BRFSS, 1992BRFSS, 1992

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. Obesity Trends* Among U.S. AdultsAdults

BRFSS, 1995BRFSS, 1995

No Data <10% 10%–14% 15%–19% ≥20

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. Obesity Trends* Among U.S. AdultsAdults

BRFSS, 1998BRFSS, 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. Obesity Trends* Among U.S. AdultsAdults

BRFSS, 2001BRFSS, 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. Obesity Trends* Among U.S. AdultsAdults

BRFSS, 2004BRFSS, 2004

Percentage of Adults who are obese (Body Mass Index (BMI) >= 30)2002

15.2 - 21.8 

21.8 - 25.5

25.6 - 30.2 

30.3 - 38.9 

Legend

State Avg 22.3

Escambia 25%Okaloosa 21.1%Santa Rosa 21%Walton 23.4%

Percentage of Adults who are overweight(Body Mass Index (BMI) >= 25 to < 30)

2002

Legend21.3 - 31.8 

31.9 - 34.1 

34.2 - 36.5

36.6 - 43.8

State Avg. 35.1

Escambia 32.6%Okaloosa 38.1%Santa Rosa 35.2%Walton 36.4%

How fat are we in the How fat are we in the REGION?REGION?

Escambia - 57.6%Escambia - 57.6%

Okaloosa - 59.2%Okaloosa - 59.2%

Santa Rosa - 56%Santa Rosa - 56%

Walton - 59.8%Walton - 59.8%

risk of overall mortality (up to 2.5-fold in the 30-44 age group)

risk of cardiovascular mortality (up to 4-fold in the 30-44 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 ENGINEER

Physical ActivityPhysical Activityinto into our our

CommunitiesCommunities

Deaths and Injuries to Motor Deaths and Injuries to Motor Vehicle Occupants and Vehicle Occupants and

PedestriansPedestrians• Leading cause of deaths among persons 1-34 Leading cause of deaths among persons 1-34

years oldyears old• Annual U.S. toll from motor vehicle crashes: Annual U.S. toll from motor vehicle crashes:

• 42,000 deaths42,000 deaths• 3 million nonfatal injuries3 million nonfatal injuries• $230 billion in costs$230 billion in costs

Sources: CDC, 2000 and NHTSA, 2002

The Story of 4The Story of 4

4,000 pedestrians killed each year4,000 pedestrians killed each year 40,000 people killed in vehicle 40,000 people killed in vehicle

crashescrashes 400,000 people die due to sedentary 400,000 people die due to sedentary

lifestyle and poor nutritionlifestyle and poor nutrition $40,000,000,000 annual national cost $40,000,000,000 annual national cost

for both Medicaid and Medicare due to for both Medicaid and Medicare due to inactivity and poor nutritioninactivity and poor nutrition

ENGINEERENGINEER

ROAD/PEDESTRIAN SAFETYROAD/PEDESTRIAN SAFETYintointoourour

COMMUNITIESCOMMUNITIES

Water QualityWater Quality• Increased numbers of roads and Increased numbers of roads and

parking lots Increased non-parking lots Increased non-point source water pollution and point source water pollution and contamination of water suppliescontamination of water supplies

• Increased erosion and Increased erosion and stream siltation causesstream siltation causes environmental damageenvironmental damage - may impact water- may impact water treatment plantstreatment plants

Community Design and Community Design and HealthHealth• Physical Inactivity EpidemicPhysical Inactivity Epidemic• Obesity, CVD, DM, HTNObesity, CVD, DM, HTN• Non-point run-offNon-point run-off

Auto Auto crashes/injuries/deathscrashes/injuries/deaths

Pedestrian injuries/deathsPedestrian injuries/deaths

Mental health impactMental health impact Social capitalSocial capital

Related to land use

Related to automobile dependency

Related to social

processes

Underutilized Urban Buildings

Durham, NC

Smart Growth is Likely to Smart Growth is Likely to Feature:Feature:

• Higher density, more contiguous Higher density, more contiguous developmentdevelopment

• Preserved green spacesPreserved green spaces• Mixed land uses with walkable neighborhoodsMixed land uses with walkable neighborhoods• Limited road construction, balanced by Limited road construction, balanced by

transportation alternativestransportation alternatives• Architectural heterogeneityArchitectural heterogeneity• Economic and racial heterogeneityEconomic and racial heterogeneity• Development and capital investment Development and capital investment

balanced between central city and peripherybalanced between central city and periphery• Effective, coordinated regional planningEffective, coordinated regional planning

Development PatternsDevelopment Patterns

http://www.smartgrowthamerica.org/smartgrowthintro.htm

““Complete Streets”Complete Streets”

• DefinitionDefinition: a safe, comfortable : a safe, comfortable and convenient route designed and convenient route designed for travel via automobile, foot, for travel via automobile, foot, bicycle, and transit. bicycle, and transit.

• Oregon state law: “Footpaths Oregon state law: “Footpaths and bicycle trails… shall be and bicycle trails… shall be provided wherever a highway, provided wherever a highway, road or street is being road or street is being constructed, reconstructed, or constructed, reconstructed, or relocated.” relocated.”

Source: www.AmericaBikes.org

Source: Smart Growth and Neighborhood Conservation, Maryland

Brownfield Redevelopment:

Disease Prevention AND

Health Promotion

Boulder, Colorado

Major MessagesMajor Messages

• Regional / Community design and Regional / Community design and land use choices do have an impact land use choices do have an impact on the health of the publicon the health of the public

• As regional leaders, you can As regional leaders, you can influence the health of our residents influence the health of our residents with your growth management with your growth management decisionsdecisions

Community design Community design andand

land use choices can land use choices can either promote or either promote or

harm human healthharm human health

It’s UP TO YOU!It’s UP TO YOU!

Other Web SitesOther Web Sites

activelivingleadership.orgactivelivingleadership.org activelivingbydesign.orgactivelivingbydesign.org activeliving.orgactiveliving.org planning.orgplanning.org healthytransportation.nethealthytransportation.net cdc.gov/healthyplaces.govcdc.gov/healthyplaces.gov