Promoting Healthy and Promoting Healthy and Active Communities: Active Communities: Medical Students and Medical Students and the Built Environmentthe Built Environment

Jan K Carney MD MPHJan K Carney MD MPH

Lynn Zanardi Blevins MD MPHLynn Zanardi Blevins MD MPH

Kelly HuynhKelly Huynh

Background:Background:

Vermont Integrated Vermont Integrated Curriculum (VIC) Curriculum (VIC)

Implemented at the UVM College of Implemented at the UVM College of Medicine in fall 2003Medicine in fall 2003

Integrates sciences and clinical Integrates sciences and clinical medicinemedicine

Develops skills for life-long Develops skills for life-long learninglearning

Public health competencies Public health competencies

Project backgroundProject background

One of 13 public health projects 2004One of 13 public health projects 2004 Group of seven students (second Group of seven students (second

year)year) Faculty mentorFaculty mentor 2-3 hours/week; 16 weeks2-3 hours/week; 16 weeks Partnership between university and Partnership between university and

community community Timely area of public healthTimely area of public health

Public Health Projects:Public Health Projects:Educational GoalsEducational Goals

Understand the breadth and scope Understand the breadth and scope of public healthof public health

Understand current and emerging Understand current and emerging public health issuespublic health issues

Understand how public health Understand how public health interfaces with clinical medicineinterfaces with clinical medicine

Understand and apply public Understand and apply public health research methodshealth research methods

Public Health ProjectsPublic Health ProjectsEducational GoalsEducational Goals

Understand the role of the Understand the role of the community in improving community in improving individuals’ healthindividuals’ health

Learn practical ways to improve Learn practical ways to improve the health of both individuals and the health of both individuals and populationspopulations

Be creative and have fun!Be creative and have fun!

For each Public Health For each Public Health Project:Project:

1. must address a public health 1. must address a public health issueissue

2. must ask and answer a 2. must ask and answer a scientific scientific questionquestion

3. must show a public health 3. must show a public health benefitbenefit

Public Health Public Health FrameworkFramework

Healthy People 2010Healthy People 2010Overarching goalsOverarching goals

1. increase quality and years of 1. increase quality and years of healthy lifehealthy life

2. eliminate health disparities2. eliminate health disparities

Healthy People 2010Healthy People 2010Focus AreasFocus Areas Access to quality health Access to quality health

servicesservices ArthritisArthritis CancerCancer Chronic Kidney DiseaseChronic Kidney Disease DiabetesDiabetes Disability Disability Educational programsEducational programs Environmental healthEnvironmental health Family planningFamily planning Food SafetyFood Safety Health CommunicationHealth Communication Heart Disease and StrokeHeart Disease and Stroke HIVHIV Immunization and Infectious Immunization and Infectious

DiseasesDiseases

Injury and violence preventionInjury and violence prevention Maternal, infant and child Maternal, infant and child

health health Medical Product SafetyMedical Product Safety Mental healthMental health Nutrition and overweightNutrition and overweight Occupational healthOccupational health Oral healthOral health Physical activityPhysical activity Public Health InfrastructurePublic Health Infrastructure Respiratory DiseasesRespiratory Diseases Substance abuseSubstance abuse TobaccoTobacco Vision and HearingVision and Hearing

2004 Public Health 2004 Public Health Projects : HP 2010 Projects : HP 2010 areas areas Access to Quality Health ServicesAccess to Quality Health Services Health CommunicationHealth Communication Environmental HealthEnvironmental Health DiabetesDiabetes Immunizations and infectious Immunizations and infectious

diseasedisease Nutrition/Physical ActivityNutrition/Physical Activity Mental HealthMental Health

Promoting Healthy and Promoting Healthy and Active Communities: Active Communities: goalsgoals Educate medical students about Educate medical students about

the environment and healththe environment and health Engage community plannersEngage community planners Share and promote best practices Share and promote best practices

to promote healthy and active to promote healthy and active Vermont communitiesVermont communities

Chittenden County, VT: Chittenden County, VT: Project Communities Project Communities

BurlingtonBurlington WillistonWilliston WinooskiWinooski

Burlington, VermontBurlington, Vermont

Williston, VermontWilliston, Vermont

Project methods:Project methods:

Literature reviewLiterature review CDC, NIEHSCDC, NIEHS Development of questionnaireDevelopment of questionnaire Recruitment of local communitiesRecruitment of local communities ““promote the positive” strategy promote the positive” strategy

to engage community plannersto engage community planners

Project methods Project methods (cont’)(cont’) 3 towns in VT’s largest county3 towns in VT’s largest county Various development stagesVarious development stages Interview of town plannersInterview of town planners Pre-interview questionnairePre-interview questionnaire QuestionnaireQuestionnaire Identify and share “best Identify and share “best

practices”practices”

Pre-interview Pre-interview Questionnaire:Questionnaire: PopulationPopulation % residents with stores and % residents with stores and

recreation within ½ mile radius of recreation within ½ mile radius of homeshomes

% land for mixed use neighborhoods% land for mixed use neighborhoods Public spaces for physical activity (% Public spaces for physical activity (%

or acres)or acres) % budget for parks and recreation% budget for parks and recreation

Pre-interview Pre-interview questionnaire (cont’-2) questionnaire (cont’-2) % streets with sidewalks % streets with sidewalks

(residential)(residential) % streets with sidewalks % streets with sidewalks

(commercial and mixed use)(commercial and mixed use) Estimate of miles of bike pathEstimate of miles of bike path Documents or references used in Documents or references used in

planning to promote physical planning to promote physical activityactivity

Questionnaire Questionnaire

Introduction, summary, what Introduction, summary, what town will receive from project, town will receive from project, timelinetimeline

Definition of “built environment’Definition of “built environment’ Current infrastructureCurrent infrastructure Future developmentFuture development Goal to identify “best practices”Goal to identify “best practices”

Questionnaire (cont’-Questionnaire (cont’-2)2) Collaboration with health Collaboration with health

professionals in town planning? professionals in town planning? Town provides information to Town provides information to

residents on public spaces for residents on public spaces for physical activity?physical activity?

Recreation classes and programs?Recreation classes and programs? Accessible?Accessible?

Questionnaire (cont-3)Questionnaire (cont-3)

Guidelines for aesthetically Guidelines for aesthetically pleasing elements to encourage pleasing elements to encourage activity?activity?

Does town plan identify natural Does town plan identify natural resources? resources?

Requirement for sidewalks in new Requirement for sidewalks in new residential areas?residential areas?

Traffic calming measures in public Traffic calming measures in public recreation areas?recreation areas?

Questionnaire (cont’-Questionnaire (cont’-4)4) Traffic signals pedestrian-Traffic signals pedestrian-

controlled?controlled? Bypass of dangerous Bypass of dangerous

roads/intersections?roads/intersections? Bicycle parking?Bicycle parking? School crossing guards?School crossing guards? Practices to increase safety in Practices to increase safety in

public recreation areas?public recreation areas?

Questionnaire (cont’-Questionnaire (cont’-5)5) Education – signs to promote Education – signs to promote

stairs? stairs? Community outreach to promote Community outreach to promote

physical activity?physical activity? Planning new recreation areas?Planning new recreation areas? 3 top practices to promote 3 top practices to promote

physical activity? physical activity?

Questionnaire (cont’-Questionnaire (cont’-6)6) Town “Observations” Town “Observations”

– Student visits to best town assetsStudent visits to best town assets– PhotosPhotos– DescriptionsDescriptions

Promoting Healthy and Promoting Healthy and Active VT Active VT Communities:Communities: Progress to dateProgress to date Preliminary findingsPreliminary findings Timeline and format for sharing Timeline and format for sharing

“best practices”“best practices” Summary paperSummary paper Poster presentationPoster presentation Future directionsFuture directions

Questions ?Questions ?

Comments? Comments? Suggestions?Suggestions?

Jan K Carney, MD MPH,Jan K Carney, MD MPH,Associate Dean for Public Associate Dean for Public Health, Health, University of Vermont University of Vermont College of MedicineCollege of Medicine

371 Pearl St, Burlington VT 371 Pearl St, Burlington VT 0540105401

(802) 847-8268(802) 847-8268

Jan.Carney@uvm.eduJan.Carney@uvm.edu