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Are We There Yet? Health Advocates Enter The Fray

Editor's Note: The nexus of transportation and health and the growing importance of the built environment and the availability of fresh produce in the battle against our national obesity epidemic are the subject of this week's Are We There Yet? excerpt.

The emerging understanding about the relationships between physical activity, health and the built environment has pushed public health advocates into the arena of transportation and land-use planning, where they’ve gotten consistent and impressive results. For example, in Nashville, Tennessee, the regional planning agency has incorporated public health objectives into its transportation plan, which now includes a bike and transit network, and has provided immediate funding for a “complete streets” policy requiring 70 percent of roads — up from 2 percent — to include sidewalks and bike lanes.

In Tennessee, where one in three residents are obese, Governor William Haslam has created a statewide Health and Wellness Task Force to enable everyone to make healthy lifestyle choices. Last year the League of American Bicyclists recognized Tennessee for its progress, its emphasis on bike safety and on creating Safe Routes to School for children. “As a bicyclist myself, I realize the importance of safety in offering this healthy option as we encourage Tennesseans to take responsibility for their personal health,” Haslam says.

Top 10 regions with park rich opportunity areasGovernment agencies in Baltimore, the Twin Cities, Denver, Atlanta, Los Angeles and many other places have started using “health impact assessments” (HIAs) to encourage the input of health experts and medical professionals on land-use planning and investment decisions. Nashville’s HIA found strong links between chronic disease and a lack of physical activity. San Francisco’s HIA revealed major disparities between higher- and lower-income areas: life expectancy was 28 years lower for men and 25 years lower for women in low-income neighborhoods. These measures bring the best of medical science into the planning profession – and make for some compelling new ways to measure whether communities are moving in an undisputed positive direction.

 In Louisville, Kentucky — the home of Colonel Sanders’ Kentucky Fried Chicken and the “Hot Brown,” a turkey and bacon sandwich smothered in a rich Mornay sauce — six of 10 residents are considered obese. This fact alarmed former Mayor Jerry Abramson so much that he worried it was scaring away business. “[A] healthy work force is more productive and less costly, so this became a competitiveness issue,” he says in a 2011 New York Times article. “Every city was offering tax incentives and real estate deals but not every city had the weight problem we do.”

Louisville responded by providing grants to help stock corner stores with fresh produce, helping to pay for refrigerators, dry goods tables, marketing, community outreach, technical assistance and even the first order of produce, and also by encouraging community gardens, and building bike lanes, wider sidewalks, and more parks. KFC is even offering a non-fried menu.

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