Building Healthy & Active Communities

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Building Healthy & Active Communities. Amy Stringer Hessel, MSW Missouri Foundation for Health About MFH. Created in 2000 to receive Blue Cross Blue Shield of Missouris nonprofit assets - PowerPoint PPT Presentation


Building Healthy & Active Communities

Building Healthy & Active Communities

Amy Stringer Hessel, MSWMissouri Foundation for

1About MFHCreated in 2000 to receive Blue Cross Blue Shield of Missouris nonprofit assets

Our Vision is to improve the health of the people in the communities we serve

MFH is an independent, nonprofit organization focused on grant making, health policy and capacity building

MFH is Missouris largest health care foundation and is the 3rd largest conversion foundation in the nation (California Endowment is largest). MFH was created when Nonprofit Blue Cross Blue Shield of Missouri converted to for-profit RightChoice Grant making began in 2002. MFH currently has approximately $1 billion in assets.

One area of focus: obesity prevention

12th most obese state Half of Missouri children in poor families are overweight or obese $1.6 billion adult obesityNearly 1 in 2 African American children overweight/obese1 (Obesity State, A Closer Look at Obesity in Missouri. Missouri Department of Health and Senior Services, Bureau of Health Promotion. Risk Behavior Survey 2007. Comparison Between Missouri Students and U.S. Students. Available at:

Invested over $20 million thus farWhy are we interested in transportation?4Transportation Policy IS Health PolicyPollution

Mental Health


Physical Activity

PollutionImpaired lung development and functionHeart diseaseRespiratory illnessPhysical Activity60% of US adults do not meet rec PAHour spent in a car6% increase obesity riskIncrease total minutes of physical activity(40% more)Generate two more walk/bike trips per person per weekPrevent up to 1.7 pounds of weight gain per year; 35% lower risk of obesityIncrease fruit and vegetable consumption. Black Americans' fruit and vegetable intake increased 32 % for each additional supermarket in their neighborhoodIncrease life expectancy by 4 yearsMental HealthStress-Related IllnessA convenient, reliable bus service reduces transportation-related stress a major cause of illness for people in poverty.Stress due to driving in congested conditions or being unable to complete necessary activities is directly linked to cardiovascular disease, suppressed immune function and strokes. [Wener and Evans, New Jersey Dept. of Transportation, 2000]Safety: Traffic cashes are leading cause of death and injury for Americans in prime of lifeInequitable transportation policies: neglected road maintenance, inadequate lighting; limited sidewalks; minorities have high risk for pedestrian deaths

56Achieve physicalactivity recommendations/Meet dietaryguidelinesCommunity BarriersTraditional ApproachTraditional Health PromotionOld solution: Only individual responsibility6Driving only for transportationUnsafe streets that discourage biking and walkingNo time to exercise and cant incorporate into daily routine

Another way to understand what has happened is to examine whats been our traditional approach to health promotion: focusing on the individual and on structured programs with more minutes of harder exercise as the goal and no attention given to the community environments people have around them when they try be active..

You may recognize this stick figure as Sisyphus forever condemned in Hades to roll the boulder up the hill and then have it roll back down once it reached the top. (BTW Sisyphus was more than a stick figure before he got into this boulder punishment)

The figure represents individual responsibility to achieve the recommendations (represented by the boulder) 150 minutes per week, 5 a day, etc. The hill on which we try to accomplish this daily task is our community and the grade of the incline represents the barriers to meeting those recommendations. Uff-da.

Community BarriersActiveLiving/HealthyEatingCommunity Design Approach Better solution: Individual in better environment7We want to shift to a combined community and individual focus with a more accessible and achievable goal that also tries to remove barriers in the community environment for everyone. As you can see, the theory is that we can make it easier for more people to move further along toward health.

So now that we have a flatter incline, it becomes easier to integrate the health recommendations into daily routine. Individual responsibility turns into healthy lifestyle.

Think about it, where is it easier to eat healthy in [add your state/or your town]? Where is it easier to be active in [your state/or your town]? Would you say that it is easier to be active if you lived near the chain of lakes in the Cities? How about if you live in [name some local cities, communities]

Adequate infrastructure=increased activity

Random fact:In Lincoln, Nebraska:

For every $1 investment in trails there was a $2.94 medical savings due to the physical activity levels of trail usersOne study that evaluated the relationship between access to a variety of built and natural facilities and physical activity found that the people with the greatest access were 43 percent more likely to exercise for 30 minutes on most days compared with those with poorer access.

People are significantly more active in neighborhoods with adequate sidewalks and bike lanes, particularly in low-income communities. Street networks that offer direct routes (a grid pattern where the streets interconnect easily, as opposed to having many cul-de-sacs or dead-end streets) can also increase walking, bicycling and use of public transit. Adequate, safe routes to schools increase the number of children walking to school.

Berkley Media Studies: Talking About: The Built Environment and Health.

Grantee projects9

10Strategies pulling from best practices in the field and include:

Connect roads to complementary systems of trailsSupport infrastructure improvements such as side walks and bike pathsSupport smart growth strategiesEstablish maintenance agreementsImplement complete streets for all usersWalking school buses

Vision: Through the convening of traditional and non-traditional partners, we will serve as a catalyst to empower communities to increase access to physical activity and nutrition and influence individual and societal attitudes towards maintaining healthy lifestyles.Mention AP

H&AC Goals:The Initiative has a sustained impact on healthy eating/active living for communities in Missouri by supporting promising environmental and policy change strategies. The Initiative cultivates strong local/regional and state partnerships which support the development and sustainability of healthy and active communities in Missouri. Position Missouri as a leader in building and promoting healthy and active communities.

Our request builds on past work and gets us to these goals

Promotion, EducationPolicy,InfrastructureModel Health Supported:Encouraging Healthy Behavior Through Changes in the Physical Environment

The proposed project targets public housing communities and will result in safe, accessible areas for physical activity, an increased awareness of healthy lifestyle opportunities, and citizen advocacy to leverage public dollars for infrastructure changes. Strategies include the development of Walking School Buses (WSB) at six elementary schools, community planned infrastructure improvements to decrease barriers to physical activity, establishing joint-use agreements allowing residents to utilize school gym facilities, implementing a social marketing campaign, expanding afterschool and family physical activity programming, and creating an advocacy committee focused on policy based healthy lifestyle changes.11



east broadway bridge; great pedwayDeveloping housing authority residents as advocatesFor safe walkways 14Columbians for Modern, Efficient Transit (CoMET)

GOAL: Triple Columbias Transit ServicePrint out ians piece

Connecting with park and existing trailsCity of Ozark: Pop. 18,50013 miles from Springfield, MOParnters:Health Department: promotion/community educationOzarks Transportation Organization: planningBike/Ped Advisory CommitteeFarmers Market: increase info and educate about healthy living (1/2 mile from park)

The City of Ozark proposes to enhance its pedestrian pathways and use this asset to encourage and educate the population about healthy lifestyles. Funding will support improvements to the trail and bike path system in Christian and southern Greene counties; citizen education though community maps, recreational programming on the trails, annual health event, and bike safety trainings; and, promotion of Complete Streets. They intend to provide, promote, and participate in the enhancement of a current pedestrian pathway system by implementing a new section that would encourage healthy and active lifestyles connecting the Finley River Park to the already successful completed sections of the Finley River Trail and other vital communities institutions. Strategies proposed are well integrated. Strong multi-sectoral representation. Community history and actual master plans for biking and walking is a big strength. Provides a strong qualification to carry out the project. Vendor quote not submitted- an engineer's opinion of probable contractor construction cost is submitted. Project Plan is sound. MOUs and letters of support are included.

Requested funding will primarily support major equipment ($139,625) and other direct expenses ($52,000).16Collaborative opportunities17National and Regional PartnersRegional Partnerships:California ConvergenceLiveWell ColoradoFlorida ConvergenceShaping Kentucky's FutureMaine Convergence PartnershipMassachusetts ConvergenceMissouri Convergence PartnershipNH HEAL CampaignNew Jersey ConvergenceNorthwest Convergence


Increase options for affordable transportation to parks and open spaces by discounting public transit, altering or expanding school bus routes, and incentivizing ride sharing.Incorporate physical activity into the planning and design of every physical improvement to the city from municipal buildings and new parks to streets and sidewalks.Incorporate pedestrian and bicycle lanes into street development.Enhance public safety near parks and other public spaces

Policy suggestions for mayors:

You can see who has adopted

19Federal InitiativesPatient Protection and Affordable Care ActCommunities Putting Prevention to WorkCommunity Transformation Grants

Neighborhood Revitalization InitiativeIntegrated, coordinated effort to increase the quality of a neighborhoods (1) educational and developmental, (2) commercial, (3) recreational, (4) physical, and (5) social assets

PPACA: planning zoning, promoting public transit as way to increase PA; Health Impact Assessments

White House Domestic Policy Council (DPC), White House Office of Urban Affairs (WHOUA), and the Departments of Housing and Urban Development (HUD), Education (ED), Justice (DOJ), Health and Human Services (HHS) and Treasury. 20National Prevention StrategyShift the nation from a focus on sickness and disease to one based on wellness and prevention:

Building Healthy and Safe Community Environments: Prevention of disease starts in our communities and at home; not just in the doctors office.Expanding Quality Preventive Services in Both Clinical and Community Settings: When people receive preventive care, such as immunizations and cancer screenings, they have better health and lower health care costs.Empowering People to Make Healthy Choices: When people have access to actionable and easy-to-understand information and resources, they are empowered to make healthier choices.Eliminating Health Disparities: By eliminating disparities in achieving and maintaining health, we can help improve quality of life for all Americans.

The Federal Government will Promote the development of transportation options and systems that encourage active transportation and accommodate diverse needs. Support adoption of active living principles in community design, such as mixed land use, compact design, and inclusion of safe and accessible parks and green space. Support coordinated, comprehensive, and multicomponent programs and policies to encourage physical activity and physical education,

The overarching goal of the National Prevention Strategy is to increase the number of Americans who are healthy at every stage of life. The strategy provides evidence-based recommendations that are fundamental to improving the nations health through the active engagement of all sectors of society to help achieve four broad strategic directions:

39 National Prevention Strategy by community members.231 In addition, providing opportunities for older adults to participate in physical activity (e.g., low-cost fitness classes at community centers) promotes functional health, lowers the risk of falls, and improves cognitive function.232 4 Support workplace policies and programs that increase physical activity. Effective workplace programs and policies can reduce health risks and improve the quality of life for millions of U.S. workers.233 Workplace initiatives such as flextime policies, lunchtime walking groups, and access to fitness facilities, bicycle racks, walking paths, and changing facilities with showers can increase the number of employees who are physically active during the work day.234 5 Assess physical activity levels and provide education, counseling, and referrals. Health professionals in a variety of settings can provide education, counseling, and referrals to community resources to help people lead more active lifestyles.235 Programs that are tailored to individual interests and preferences can be more effective in increasing physical activity.236 ActionsThe Federal Government will Promote the development of transportation options and systems that encourage active transportation and accommodate diverse needs. Support adoption of active living principles in community design, such as mixed land use, compact design, and inclusion of safe and accessible parks and green space. Support coordinated, comprehensive, and multicomponent programs and policies to encourage physical activity and physical education,

21What Next?Connect with groups in your regionPreventobesity.netState convergence partnershipsPrevention Institute Prevention Strategy


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