Active TransportationPhysical Activity (PA), the Built Environment
and Active Transportation (AT)
Glyn Bissix, PhD. School of Recreation Management and
Kinesiology
and
August 2010
• PhD. LSE Natural Resources & Environmental Management
• City of Eugene, Oregon • NS Culture, Recreation and
Fitness (now HPP) • Acadia University.
The Trend!
• To engineer physical activity out of all aspects of our lives –
home, mobility, work and play.
• In western society advances in medical care have paralleled
declines in population health (at least the potential for real
decline).
Planning and Public Health: the Historic Connections
• Physician Reformers in the 19th
Century. – Dr John Snow, London, 1854
• Health and Morality Movement: Housing Reform, 1900-1914 – New
York Tenement Buildings - Twenty
Teens
• Zoning for Health, Safety and Welfare – 1907-1926
• Health and the Garden City, 1898- 1930.
Is there a New (Increased) Role for Medical Officers of
Health
and Public Health Officials in Urban and Regional Planning?
• Can population health be improved by a combination of appropriate
planning and education?
• Is this worth your time and effort to make this a priority?
• Can you be an effective and positive change agent?
Is there a relationship between
your choice of mobility mode and
BMI?
BMI?
The Unequivocal Evidence?
• Taking as a given that increased BMI (health) and physical
activity are highly correlated I’d like to tell you that the
evidence is unequivocal that retrofitting the built environment to
encourage physical activity will have substantial health
benefits.
• I can’t do that but there is increasing evidence that a positive
(but not overly strong) relationship exists between the way we
build and retrofit our villages, towns and cities, and rural areas
for physical activity and population health.
• Let’s look at the evidence.
A Review of Methodology
• Ross C. Brownson, PhD, Christine M. Hoehner, PhD, MSPH, Kristen
Day, PhD, Ann Forsyth, PhD, and James F. Sallis, PhD. Measuring the
Built Environment for Physical Activity: State of the Science. Am J
Prev Med. 2009 April ; 36(4 Suppl): S99–123.e12.
doi:10.1016/j.amepre.2009.01.005.
• Three categories of built environment data are being used:
– (1) perceived measures obtained by telephone interview or
self-administered questionnaires; (19 questionnaires
reviewed)
– (2) observational measures obtained using systematic
observational methods (audits); (20 audit instruments) and
– (3) archival data sets that are often layered and analyzed with
GIS (50+ studies).
• This study is the first comprehensive examination of
built-environment measures
• demonstrates considerable progress over the past decade,
• showing diverse environmental variables available that use
multiple modes of assessment.
• Most can be considered first-generation measures, so further
development is needed.
• In particular, further research is needed to improve the
technical quality of measures, understand the relevance to various
population groups, and understand the utility of measures for
science and public health.
Evidence from Canadian Research
• Physical Activity.
• Conclusion: This study suggests that PA promotion strategies
should be tailored to enhance – people's confidence to engage in
PA, motivate people to be more
active, – educate people on PA's health benefits – and reduce
barriers, – as well as target different factors for men and women –
and for differing socio-economic and demographic groups
[seniors,
children, minority groups] .
• Sai Yi Pan*1, Christine Cameron2, Marie DesMeules1, Howard
Morrison3, Cora Lynn Craig2,4 and XiaoHong Jiang1. Individual,
social, environmental, and physical environmental correlates with
physical activity among Canadians: a cross-sectional study. BMC
Public Health 2009, 9:21 doi:10.1186/1471-2458-9-21.
Policy Barriers for Local Government Investments in PA
Infrastructure for Youth –
Atlantic Canada • Participants consistently identified four
categories
of barriers.
– Financial barriers
– Legacy issues
– Governance barriers
• Conclusion:
Participants indicated that health issues have increasing profile
within local government, making this an opportune time to discuss
strategies for optimizing investments in the built environment. The
focus group method can foster mutual learning among professionals
within government in ways that could advance health
promotion.
• Jill L. Grant, PhD,1 Kathryn C. MacKay, MPlan,2 Patricia M.
Manuel, PhD,3 Tara- Leigh F. McHugh, PhD4. Barriers to Optimizing
Investments in the Built Environment to Reduce Youth Obesity:
Policy-maker Perspectives. CANADIAN JOURNAL OF PUBLIC HEALTH •
MAY/JUNE 2010.
34th Conference of New England Governors and Eastern Canadian
Premiers in Massachusetts July 11 to 13, 2010.
Find the full text at: http://tinyurl.com/2cwlhb3
• 1. INTRODUCTION.
• 4. PHYSICAL FITNESS.
• 5. SOCIAL CAPITAL.
• 6. MENTAL HEALTH.
• 7. SPECIAL POPULATIONS.
• 8. SUMMARY CONCLUSIONS.
Understanding the Relationship between Public health and the Built
Environment: a Report prepared for the LEED-ND Core Committee.
Design, Community & Environment: Dr. Reid Ewing, Lawrence Frank
and Company, Inc; Dr. Richard Kreutzer. May 2006.
Air Quality
Conclusions
• The chain connecting the built environment, driving, vehicle
emissions, air quality & public health is somewhat
complex.
• Researchers still conclude that community design is one important
factor in improving health.
• Despite critiques, federal & state agencies including the EPA
conclude that evidence justifies building more compact, mixed use
development around transit to reduce air pollution.
Fatal and Non-Fatal Injuries
Conclusions:
• Traffic accidents with fatal and non-fatal injuries closely
related to Vehicle Miles Traveled (VMT), auto speed & traffic
volumes. Characteristics linked to design, street networking &
land use distribution especially those that increase VMT, speed and
traffic volume.
Physical Fitness Physical Activity & the Built
Environment
• Extensive literature linking health & physical activity
(PA).
• Last 15 years a literature linking PA & the Built Environment
has emerged.
• From a PA & health perspective, mean difference between high
& low walkability neighborhoods is roughly equivalent to
meeting one day dosage of PA guidelines.
• 1996 US Surgeon General Physical Activity & Health – PA
reduced risk of several chronic diseases. Moderate activity works -
brisk walks for 30 mins (even in 10 min blocks).
• 25 % of our trips are easily walkable - 63% Bikable <5
miles
• Land-use mix, residential density, & intersection density
walked more than low walkability neighborhoods.
• There is the problem of inconsistent measures, insufficient data,
determining causality, and substitution.
• General consensus that changes in the built environment can make
walking and biking more attractive.
Social Capital • Robert Putman “Bowling Alone”.
• 10% decrease in social capital since the sixties attributed to
suburbanization, sprawl and commuting. – Prolonged life,
– Better health overall,
– Other Benefits
Mental Health
• Sprawl predicts physical health and quality of life but no
relationship with mental health (Strum & Cohen, 2004 – large
geographical area which may have washed out incidence in some
neighborhoods).
• Stress and driving – road rage.
• Conclusion – little is known about the direct relationship
between urban form and mental health.
Special Populations
• Conventional development patterns that rely on driving present
more health risks for some than for others. Women, children, older
[citizens], people with limited incomes and disabled [people] all
are disproportionately affected in various ways by the current
urban environment. – Women – Children – The Elderly – Low Income
Communities – People with Disabilities
• Conclusions – plan for 6 - 86
Literature Update
• Bibliography Provided
• Scanning of recent studies shows more of the same (as per the
LEED-ND Study, 2006)
My Own Research Efforts
• Comparing Youth Activity in Glace Bay and Kings County.
• Glace Bay Neighborhood Study (Unpublished GIS Study)
• Wolfville Postal Code Study (In Progress)
• Wolfville Interactive Mapping Calorie and GHG Counter (In
Progress).
GIS and Physical Activity Literature Review (NSHPP)
• 43 Papers reviewed (1977-2005) in 2 categories– physical
environment (PE) on physical activity (PA) (n=34) & GIS
Facility Distribution: equity and Impact
– Overall - revealed various degrees of positive associations
between proximity to facilities and/or supportive physical
environments (PEs) and levels of physical activity (PA).
– Accessible facilities were found to be insufficient alone for
individuals to achieve recommended exercise levels, they were
nevertheless necessary (Giles-Corti & Donavon, 2002)
– Giles-Corti and Donovan (2003) looked at environmental supports
for walking behaviour and noted the odds for reaching recommended
levels of walking were 2.13 times higher for people who lived in
the most highly rated physical environments.
• GIS in relation to social policy and understanding facility
distribution and/or accessibility within the context of health
and/or recreation that promoted physical activity.
– Social Networks more important than proximity. – Safety is a
major issue (for urban populations) – using pathways and parks, and
getting to PA facilities. – Little attention given to private
facilities.
Robert Pitter, PhD; Glyn Bissix, PhD; Jennifer Ezard; and Lindsay
Fenton, BKIN (2005). USING GIS TO STUDY PHYSICAL ENVIRONMENTS THAT
PROMOTE HEALTH THROUGH SPORT AND PHYSICAL ACTIVITY: a Literature
Review . Centre of Lifestyle Studies, Acadia University prepared
for the Nova Scotia Department of Health Promotion.
Comparing Youth Activity in Glace Bay and Kings County, NS.
• Used Evans and Stoddart’s [Ecological Health] framework.
• Two distinct communities provide insights into the role of place
on health and well- being - largely urban (Glace Bay) vs largely
rural (Kings) & lower SES vs. higher SES.
• No difference in the communities in youths’ physical activity at
work or school, but Kings County youth more active in sport and
active recreation, walking or riding a bicycle to work or school,
and doing errands than their Glace Bay peers.
• Found no substantive relationship between PA and self reported
health
• There is clearly something else at work in determining the
relationship between self- reported health and physical activity in
these two communities.
Bissix, Glyn; Darren Kruisselbrink, Liesel Carlsson, Peter
MacIntyre and Tracey Hatcher, (2005). Active Lifestyle, Physical
Recreation and Health Outcomes of Youth in Two Contrasting Nova
Scotian Communities. In Sport for Young People. Editors: Peter
Bramham, Anne Flintoff, Jonathan Long, Jayne Caudwell, John Spink,
and Kevin Hylton. London: LSA. Publication No. 88. pp.
141-155.
The Determinants of Health--Evans and Stoddart Framework
Social Environment Physical Environment Genetic Endowment
Individual Response
Mental Health, Physical Activity and Neighbourhood
Safety, Physical Activity and Neighbourhood
Robert Pitter, Glyn Bissix; Acadia University; Konrad Dramowicz,
Nova Scotia Community College, Centre of Geographic Science; and
Peter MacIntyre, Cape Breton University. Neighbourhood as a
determinant of leisure, physical activity and health: the Glace Bay
experience.
Wolfville Postal Code Study (In Progress)
• Glyn Bissix (2009) Active Lifestyles, Active Transportation and
Neighborhood Influences in Wolfville.
Wolfville Interactive Mapping Project
• Will information on ecological footprint & Active
Transportation Calorie Counter motivate more Physical
Activity?
The Role of Education • Is it a case of build it and they
will
come?
• Who do we educate and who does it?
• Who has most influence about health issues?
• Do MOHs have to have absolutely bomb proof evidence before
acting?
• If no harm in investing in AT infrastructure but possible
population benefits, is that good enough?
• The CFLRI seems to think so:
http://www.cflri.ca/eng/active_transpo rtation/index.php