The issue of obesity is oft discussed in the media and by healthy living figureheads like Michelle Obama as the cause for many of our country’s ills. Mrs. Obama fights to introduce healthy, affordable produce into our food deserts (discussed eloquently in this recent blog post), and champions increased physical activity for children. For adults, much of the obesity debate seems to center around changing individual attitudes towards fast food and television. This approach incorrectly focuses on the choices themselves when it should focus on the environment in which those choices are made. Obesity is not simply the result of an individual’s choice, but the effect of many government policies —transportation, public safety, economic development, etc. — on that individual’s environment that enable him to make one choice over another.
To be clear, this is not a call for government to coerce people into gyms or mandate treadmill desks for all offices within jurisdictional boundaries. This is an entreaty to help residents choose the healthiest options for themselves. This is done by removing barriers to healthy choices, like eliminating graffiti from walkable corridors to make them safe and inviting, allowing food stamps at farmer’s markets and limiting downtown parking to encourage walking. And it is done by increasing the quantity and quality of healthy options, like strategically locating transit stops, sidewalks and bike lanes for ease of use, creating incentives for healthy corner stores, and installing bicycle lanes and playgrounds. In an interview about Shape Up Somerville, the Tufts University-led ‘environmental change intervention’ in his city, Mayor Joseph Curtatone explained to his constituents, “We’re not telling you how to live your life, we want to make sure that we’re giving you the best options.” In this way, government can implement policies that help their constituents make healthy choices.
To look at it another way, let us start from the beginning with some fundamental questions about obesity:
What is obesity and how widespread is it?
Overweight and Obesity are labels for weight ranges that are greater than what is generally considered healthy for a given height. Obesity is the heaviest designation, defined as a Body Mass Index of 30 or more, and has been shown to increase the likelihood of certain diseases and other health problems, including coronary heart disease and cancer.
The Centers for Disease Control and Prevention tracks data on obesity and has documented the trends by state since 1985 in an animated map. The map shows, in terrifying detail, how more than thirty percent of adults across the nation came to be obese. (And this data is self-reported, which suggests under-reporting.) Our proportions are now epidemic.
And it is not just adults: one in six children aged 2-19 are obese. In a country with a legacy of remarkable medical, technological and governmental achievements, many experts are concerned that this generation of American children will not outlive their parents.
Considering the myriad other threats to cities, why should this be a policy priority?
A recent New York Times article puts the obesity epidemic in perspective: “You’re sitting in a freshly drywalled house, drinking coffee from a plastic foam cup and talking on a cellphone. Which of these is most likely to be a cancer risk? It might be the sitting, especially if you do that a lot.” Physical inactivity is harmful to our bottoms.
And it is harmful to our bottom lines. The economic consequences for our society entail an increase in medical and transportation costs, a less productive workforce, a higher prevalence of disabilities and premature deaths, and a possible link to reduced educational attainment. A healthy workforce is essential for national and local competitiveness.
How can behavior be changed?
Behavior change is possible through good design. Active Living is a health-focused policy that integrates physical activity into daily life through strategic design of our built environment. Several innovative design models come from experiments conducted by Volkswagen, all caught on video, to see if people would choose a healthy behavior – taking the stairs, recycling plastic bottles, throwing away trash, obeying the speed limit – if it were made more fun. The experiments worked.
How can city leaders incorporate active living policies in their communities?
While the federal government does not have active design standards or guidelines, local governments are successfully employing both traditional and innovative strategies across all sectors. They are repurposing existing land, expanding recreation facilities, adding pedestrian medians to streets, implementing new transit options like bike-sharing programs and creating targeted community education campaigns. The Cities of Kirkland, Wash.; Columbus, Ohio; and Bloomington, Ind., have developed citizen-engaged task forces to promote and help guide active living initiatives. The City of Decatur, Ga., has created an active living agency. Others are conducting Health Impact Assessments of current conditions to determine vulnerable neighborhoods and populations. In Oklahoma City, Okla., Mayor Mick Cornett is leading by example; he put his city on a diet, starting with himself. He lost forty-two pounds and started a website, www.ThisCityIsGoingOnADiet.com, which has enrolled 45,000 residents who have collectively lost more than 800,000 pounds.
To assist city leaders as they implement active living policies, NLC published a new municipal action guide, Healthy People, Healthy Places – Building Sustainable Communities Through Active Living. Improving public health is one of several benefits of active communities addressed by the guide, along with stimulating the local economy, increasing public safety, and supporting the environment. In addition, the guide provides resources for cities like toolkits and additional city practices.