Community Design, Physical Activity, Eating, and Obesity: Evidence for Policy and Practice

Medical science is generally concerned causes of health and disease within the individual, but public health takes a broader view that emphasizes environmental and policy factors.  Health outcomes vary dramatically by neighborhood, and much of this has been attributed to socioeconomic status, but the mechanisms of these effects were unclear.  Recent research has greatly increased understanding of specific neighborhood characteristics that are related to physical activity, diet, and obesity, which are leading causes of ill health and increases in health care costs.  For example, the ability to walk to destinations near homes is related to physical activity for transportation and to weight status.  Proximity of parks and other recreation facilities is related to leisure time physical activity.  Access to stores that sell healthy foods is related to dietary quality.  There are disparities in all of these neighborhood resources in low-income and mostly-minority neighborhoods.  Each of these environmental factors can be influenced by policies, but those policies are not in the health domain; they are the province of city planning, transportation, parks and recreation agencies, and the business community.  Thus, policy-relevant research on policies and environments needs to be conducted with a wide range of non-traditional partners in health research.  This presentation will summarize key findings in these areas, highlight efforts to build research capacity in this new field, and discuss strategies for using the research to inform policy and practice.