how can we build healthy & active communities? james sallis, phd university of california, san...
TRANSCRIPT
![Page 1: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/1.jpg)
How Can We Build Healthy & Active Communities?
James Sallis, PhDUniversity of California, San Diego
http://sallis.ucsd.edu
For PAPH in ArubaJune 14, 2012
![Page 2: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/2.jpg)
Maintaining & Building Activity-Friendly Places in Aruba
![Page 3: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/3.jpg)
SLOTH Model of Physical Activity
• Sleep
• Leisure
• Occupation
• Transportation
• Household
![Page 4: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/4.jpg)
What is being done to improve PA?
• Minor investment in programs• Guided by theories that emphasize
psychological & social influences• Primary goals are education and
behavior change skills training targeting individuals
• Fragmented, poorly coordinated, poorly funded approaches
![Page 5: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/5.jpg)
Psychosocial Models of Health Behavior
IndividualBiologicalPsychologicalSkills
Social/Cultural
![Page 6: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/6.jpg)
Will individual interventions ever be sufficient?
Interventions based on psychosocial theories can be effective
But not sufficientReach is limitedEffects are modestMaintenance is rare
Programs are not designed to change the root causes of current behavioral patterns
![Page 7: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/7.jpg)
An Ecological Model of Health Behavior
IndividualBiologicalPsychologicalBehavioral Skills
Social/Cultural
Physical Environment
Policy Context
![Page 8: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/8.jpg)
Different environments----Different congestion
![Page 9: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/9.jpg)
Places for Physical Activity
• Leisure
• Occupation
• Transportation
• Household
• Parks, health clubs, sidewalks
• Workplace
• Streets, bike facilities
• Home
![Page 10: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/10.jpg)
Comm DesignDestinations Home
Park & Rec
School & Preschool
Elements of An Active Living Community
Transportation
![Page 11: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/11.jpg)
“Walkable”: Mixed use, connected, dense
![Page 12: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/12.jpg)
Not “walkable”
street connectivity and mixed land use
![Page 13: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/13.jpg)
The Neighborhood Quality of Life (NQLS) Study: The Link Between
Neighborhood Design and Physical Activity
James SallisBrian Saelens
Lawrence FrankAnd team
Results published March 2009 in Social Science and Medicine
![Page 14: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/14.jpg)
NQLS Neighborhood Categories
Walkability
Soc
ioec
onom
ic S
tatu
s Low High
Hig
hLo
w 4 per city
4 per city 4 per city
4 per city
![Page 15: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/15.jpg)
Accelerometer-based MVPA Min/day in Walkability-by-Income Quadrants
28.5
33.4
29.0
35.7
0
5
10
15
20
25
30
35
40
MV
PA
min
ute
s p
er d
ay(M
ea
n *
)
Low Income High Income
Low Walk
High Walk
Walkability: p =.0002
Income: p =.36
Walkability X Income: p =.57
* Adjusted for neighborhood clustering, gender, age, education, ethnicity, # motor vehicles/adult in household, site, marital status, number of people in household, and length of time at current address.
![Page 16: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/16.jpg)
Percent Overweight or Obese (BMI>25) in Walkability-by-Income Quadrants
63.156.8
60.4
48.2
0
10
20
30
40
50
60
70
% O
verw
eig
ht
or
Ob
ese
Low Income High Income
Low Walk
High Walk
Walkability: p =.007
Income: p =.081
Walkability X Income: p =.26
* Adjusted for neighborhood clustering, gender, age, education, ethnicity, # motor vehicles/adult in household, site, marital status, number of people in household, and length of time at current address.
![Page 17: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/17.jpg)
Multiple Pathways from Land Use to Health: Walkability Associations With Active Transportation,
Body Mass Index, and Air Quality.Frank et al. JAPA 2007
• 5% increase in walkability associated with:– 32% increase in walking for transport– ¼ point decrease in BMI (about 1.25 pounds)– 6.5% decrease in vehicle miles traveled– 5.6% decrease in oxides of nitrogen (NOx)
grams– 5.5% decrease in volatile organic compounds
(VOC) grams• County government is acting on results
![Page 18: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/18.jpg)
Accelerometer-based MVPA Min/day in Walkability-by-Income Quadrants
Walkability: F=13.74; p =.000
Income: F=2.59; p =.108
Walkability X Income: F=.001; p =.981
* Adjusted for gender and age
![Page 19: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/19.jpg)
Walkable neighborhoods encourage more walking in older adults
•Older women who live within walking distance of trails, parks or stores recorded significantly higher pedometer readings than women who did not. The more destinations that were close by, the more they walked.
Photo: Michael Ronkin, ODOT
King, W., Am. J. of Public Health 2003
![Page 20: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/20.jpg)
We can learn from international studies
Atlanta, USA
Ghent, Belgium
![Page 21: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/21.jpg)
Multiple Environmental Factors Are Needed to Support Physical
Activity: An 11-Country Study of Neighborhood Environments
James F. Sallis, USA
Heather Bowles, Australia
Barbara E. Ainsworth, USA
Adrian Bauman, Australia
Et al
Am J Prev Med. May 2009
![Page 22: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/22.jpg)
Associations Between Individual Environmental Characteristics and HEPA/Minimal Activity Among Respondents who Live in Cities with Population ≥ 30,000
0.6
0.8
1.0
1.2
1.4
1.6
1.8
Single FamilyHouses
Shops NearHome
T ransit StopNear Home
SidewalksP resent
Facilit ies toBicycle
Low Cost RecFacilit ies
Unsafe to Walkdue to Crime
'Agre e ' wi th Environm e ntal C haracte ristic('Disagre e ' i s re fe re nt)
Odd
s R
atio
HE
PA
/Min
imal
Act
ivit
y
![Page 23: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/23.jpg)
Dose Response between Number of Environmental Characteristics and HEPA/Minimal Activity
(Pooled City Sample)
0.60
1.00
1.40
1.80
2.20
2.60
3.00
1 2 3 4 5 6
Total Num be r of Environm e ntal C haracte ristics(Ze ro i s re fe re nt)
Odd
s R
atio
HE
PA
/Min
imal
ly A
ctiv
e
Sallis. Am J Prev Med. 06/09
![Page 24: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/24.jpg)
Built environment correlates of physical activity behaviours in a developing city:
The case of Bogota, Colombia
Olga Lucia Sarmiento and team
Universidade de los Andes
![Page 25: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/25.jpg)
photo: O.L. Sarmiento
![Page 26: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/26.jpg)
Main Results• Walking for transport (30 min/day for at least 5 days/week) was positively associated with:
– Street density (POR 1.71, 95% CI 1.19-2.46)– Street connectivity (POR 2.21, 95% CI 1.40-3.49)– Bus Rapid Transit stations in the neighborhood (POR
1.71, 95% CI 1.19-3.47)
• Leisure time physical activity (30 min/day for at least 5 days/week) was positively associated with:
– Park density (POR 2.05, 95%CI 1.13-3.72)– Bus Rapid Transit stations in the neighbohood (POR
1.27, 95% CI 1.07-1.50)
![Page 27: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/27.jpg)
People with access to parks & recreationFacilities are more likely to be active
![Page 28: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/28.jpg)
A national study of US adolescents (N=20,745)* found a greater number of physical activity facilities is directly related to physical activity and inversely related to risk of overweight
Gordon-Larsen et al, Pediatrics, 2006http://www.pediatrics.org/cgi/content/full/117/2/417
*using Add Health data
0.5
0.75
1
1.25
1.5
One Two Three Four Five Six Seven
Number of facilities per block group
Od
ds
rati
o
Odds of having 5 or more bouts of MVPA
Odds of being overweight
1.26
.68
Referent
![Page 29: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/29.jpg)
People are Most Active on Tracks and Walking Paths
0
50
100
150
200
250
300
Track
Sidew
alk
Gymnas
ium
Mul
ti-pu
rpos
e fie
ld
Playg
roun
d
Outdo
or Bas
ketb
all
Lawn
Baseb
all
Senio
r Cen
ter
Ave
rag
e N
um
ber
of
Par
k U
sers Sedentary Walking, Moderate & Vigorous
Cohen. RAND
![Page 30: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/30.jpg)
Activity-Friendly Transportation Systems
![Page 31: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/31.jpg)
Room for ImprovementPlan & Build for Pedestrians
![Page 32: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/32.jpg)
Walkability > Driving > Obesity?The more miles a person travels by vehicle, the
more likely they are to be obese
9.5
14.3
27.08
18.05
0%
5%
10%
15%
20%
25%
30%
Q1 Q2 Q3 Q4
Quartiles of vehicle miles traveled (VMT)
Lopez Zetina 2006
![Page 33: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/33.jpg)
0
5
10
15
20
25
30
Per
cen
t o
f O
bes
ity
0
10
20
30
40
50
60
Per
cen
t W
alk
, B
ike,
Tra
nsi
t
Obesity Walk, Bike, Transit
Obesity falls sharply with increased walking, cycling, and transit use!
Credit: John Pucher
![Page 34: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/34.jpg)
Daily steps are higher among adults who commute by train instead of car
7500
9500
6000
7000
8000
9000
10000
Train Car
Commuting Mode
Ave
rag
e D
aily
Ste
ps
(ped
om
eter
)
Wener & Evans, Environment and Behavior, 2007
![Page 35: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/35.jpg)
Neighborhood Walkability and Active Commuting to School
• 201 parents of children aged 4 to 17• Active commuting to school:
– 25% in hi-walkable neighborhoods– 11% in lo-walkable neighborhoods
• Parent concerns, mostly about traffic, were higher in lo-walkable neighborhoods
• Kerr, et al. MSSE, 2006
![Page 36: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/36.jpg)
Where do people bicycle? The role of infrastructure in determining bicycling behavior
Jennifer Dill, Ph.D. Center for Transportation Studies
![Page 37: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/37.jpg)
Where do people bicycle in Portland, OR? Based on GPS.
Type of road % of bicycle miles
% of road miles
Without bicycle facilities
51 92
With bicycle facilities (lane, separate path, bike boulevard
49 8
Jennifer Dill. J Public Health Policy. 2008.
![Page 38: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/38.jpg)
•The Ministry of Traffic designated Odense as Denmark’s National Cycle City 1999-2002 (186.000 citizens)
Odense – The National Cycle City of Denmark
![Page 39: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/39.jpg)
Right-hand turn lanesII - IV
![Page 40: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/40.jpg)
Awareness of cyclistsII - IV
![Page 41: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/41.jpg)
•Results •1999-2003: •> 50 sub-projects• Bicycle traffic increase by 20%•Accidents involving cyclists decrease by 20%
Odense – The National Cycle City of Denmark
www.cyclecity.dk
![Page 42: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/42.jpg)
London('03-'06)
Barcelona('05-'07)
Paris('01-'07)
Bogota('95-'07)
Minneapolis('80-'08)
Portland('90-'08)
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
1.2
0.81.0
0.81.0 1.1
1.6 1.8
2.5
3.2
4.3
6.0
Per
cen
t of
Tri
ps
Source: Pucher, Dill, and Handy, “Infrastructure, Programs, and Policies to Increase Bicycling,” Preventive Medicine, Jan 2010, Vol. 50, S.1, pp. S106-S125.
Increase in Bike Share of Trips in Cities Around the World
![Page 43: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/43.jpg)
Bogota, Colombia has invested heavily in walking, cycling, & PA events
![Page 44: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/44.jpg)
Boulder, CO
![Page 45: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/45.jpg)
Brisbane, Australia has invested in pedestrian facilities
*Beautiful pedestrian bridge*Walkways along the river*Pleasing aesthetics
![Page 46: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/46.jpg)
Amsterdam is a model for being friendly to pedestrians & cyclists
TheIncredibleBicycleParkingStructure At theTrainStation
![Page 47: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/47.jpg)
Decisions aboutClimate change andControlling chronicDisease are related
![Page 48: How Can We Build Healthy & Active Communities? James Sallis, PhD University of California, San Diego For PAPH in Aruba June 14,](https://reader037.vdocument.in/reader037/viewer/2022110320/56649ca45503460f94964be7/html5/thumbnails/48.jpg)
Resources from www.activelivingresearch.org