Land Use and Transportation Planning to Promote Physical Activity in North Carolina

With national and state agencies as well as leading public health foundations providing impetus, efforts to improve the understanding of policy and environmental attributes that may support active lifestyles have become a promising area for collaboration between planning and public health professionals. This article highlights the results of work performed at the University of North Carolina at Chapel Hill examining the relationship between planning policies and physical activity and the prevalence of land use policies and implementation tools that might support the viability of non-motorized modes. With the hope of bridging research and practice, it discusses fi ndings most relevant to planners interested in the broader health-related applications of their work

Associations of suicidal ideation with opioid/prescription drug use, violence, food insecurity, and community factors among New Hampshire high school students

Purpose: Suicide is the second leading cause of death for New Hampshire (NH) youth. Evidence-based public health emphasizes the use of data for translating research into practice/policy. We utilized data from the Youth Risk Behavior Survey (YRBS) to support community-academic partnerships and inform suicide prevention interventions. Methods: Data from the 2011 NH YRBS, a cross-sectional survey of 9th-12th grade students, were analyzed. Gender-stratified, adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using logistic regression models (SAS 9.4, ProcSuveylogistic) to evaluate associations between suicidal ideation (seriously considering attempting suicide within the past 12 months), violence (e.g., physical bullying, cyber-bullying, forced sexual activity), opioid/prescription drug use, food insecurity, and perceptions of being valued by one’s community. Results: Overall, the prevalence of suicidal ideation was 14.3% (females 16.8%; males 12.2%). For both genders, higher prevalence of suicidal ideation was observed among students in grades 9 (15.6%) and 10 (17.8%) compared to grades 11 (11.6%) and 12 (11.3%). In adjusted models, among girls, suicidal ideation was positively associated with the use of opioid/prescription drugs (aOR: 1.38; CI: 1.13-1.67)), violence (being forced to have sex (aOR 2.32 (CI 1.12-4.81)); being bullied on school property (aOR 2.28 (CI 1.31-3.97)), and food insecurity ((aOR 1.36 (CI 1.02-1.81)). Among boys, suicidal ideation was positively associated with opioid/drug use (aOR 1.25 (CI 1.04-1.49)), cyberbullying (aOR 2.69(CI 1.17-6.18)), and food insecurity ((aOR 1.44 (CI 1.14-1.83). Youth who perceived that they did not matter to their community were more likely to report suicidal ideation (Girls: aOR: 1.62; CI: 1.27-2.08; Boys: aOR: 1.37; (CI: 1.10-1.71)), compared to those who felt that they mattered to their community. Conclusions: Drug use, violence, and food insecurity emerged as significant risk factors for suicidal ideation among NH youth. Interventions that make youth feel that they matter to their communities may protect against suicidal ideation

An Assessment of the Impact of Climate Change on Human Health in New Hampshire

Climate change threatens human health in many ways. The negative impacts of climate change on human health are likely to increase in both magnitude and frequency as the climate continues to change in response to ever increasing global emissions of heat-trapping gases released from a variety of human activities.The Centers for Disease Control and Prevention (CDC) Building Resilience Against Climate Effects (BRACE) framework provides guidance to states and cities to develop strategies and programs to confront the health implications of climate change. This report serves to address Steps 1 and 2 of the BRACE framework via an assessment of past and future climate change across New Hampshire combined with an assessment of the impact of climate change on human health. A key component of the BRACE framework is building resilience. In public health, resilience is a measure of a community’s ability to utilize available resources to respond to, withstand, and recover from adverse situations. More generally, people think of resilience as the ability to recover, persist, or thrive amid change. The New Hampshire Climate and Health Workgroup has tentatively developed the following definition: Resilience is the ability and capacity to anticipate, prepare for, respond to, and recover from significant threats with minimum damage to human health and well-being, the economy, and the environment. The importance of the way we plan our built environment—including land use, transportation, and water management decisions, as well as how we interact with our natural environment and preserve its life-supporting functions—must be emphasized as pivotal points of intersection as we develop climate adaptation strategies. Notably, a resilience-based approach to climate change adaptation should align with New Hampshire’s transformative State Health Improvement Plan. That plan underscores the importance of cross-sector collaboration and coordinated strategies to address the social and environmental determinants of health. These strategies not only support healthy communities for all New Hampshire residents, but they are also critically important for reducing health care costs and reducing the burden of disease

Involvement of Park and Recreation Professionals in Pedestrian Plans

Professionals from many different disciplines are finding innovative ways to work together to increase physical activity to help create healthier communities. One process that can provide a focal point for promoting physical activity by park and recreation professionals, land use and transportation planners, public health practitioners, and other stakeholders is the development and implementation of pedestrian plans. A pedestrian plan is a public document that lays out a community’s vision for future pedestrian activity, identifies the actions required to realize that vision, ties actions to funding sources, and describes implementation and use. The purpose of this study was to explore whether park and recreation professionals were involved in creating pedestrian plans and how park and recreation elements were represented in these plans. To answer this, we identified, collected, and conducted a content analysis of all pedestrian plans in North Carolina. Among the 41 regional, county, and municipal pedestrian plans, park and recreation professionals were mentioned in the plan 56% of the time. Seventy-one percent (n=29) had a vision statement; however, among those only five vision statements mentioned parks or recreation. In all five cases, when a plan contained a vision statement that mentioned parks or recreation, there was a park and recreation member involved in the development of the plan. A higher percent of plans with a park and recreation professional involved were more likely to list parks in their land use analysis (74% vs. 67%). Park master plans were mentioned in the pedestrian plans 29% of the time; however, a lower percent of plans with a park and recreational professional involved mentioned a park master plan (26% vs. 33%). Given the potential importance of pedestrian plans in creating connections for pedestrians, park and recreation professionals are encouraged to become involved in the pedestrian planning process if they are not already. Parks can offer opportunities for residents of diverse ages and cultures to come together to socialize and engage in health-promoting activities. Integrating a park and recreation perspective into a more comprehensive planning process can enhance access to parks, inform programs, support multiple community goals, facilitate efficient use of resources, and promote partnerships for greater sustainabilit

Planning for Pedestrians and Bicyclists in North Carolina.

Over the past decade, as obesity has continued to rise among both youth and adults, interest has grown in developing policies to promote community environments that support healthy lifestyles.1 A broad range of local, regional, state, and federal policies under the rubrics of active living, smart growth, and sustainable development share the underlying assumption that they can help people make healthier choices. From a transportation planning perspective, the benefits of pedestrian and bicycle plans resulting from the building of infrastructure to support pedestrian and bicycle travel include improved health (for example, through increased levels of physical activity and reduced obesity), a better environment (for example, through lower carbon emissions), and a stronger economy (for example, through lower fuel bills). However, until more recently, the health benefits have not been specifically explored

Urban Containment Policies and Physical Activity A Time–Series Analysis of Metropolitan Areas, 1990–2002

Background: Urban containment policies attempt to manage the location, character, and timing of growth to support a variety of goals such as compact development, preservation of greenspace, and efficient use of infrastructure. Despite prior research evaluating the effects of urban containment policies on land use, housing, and transportation outcomes, the public health implications of these policies remain unexplored. This ecologic study examines relationships among urban containment policies, state adoption of growthmanagement legislation, and population levels of leisure and transportation-related physical activity in 63 large metropolitan statistical areas from 1990 to 2002. Methods: Multiple data sources were combined, including surveys of urban containment policies, the Behavioral Risk Factor Surveillance System, the U.S. Census of Population, the National Resources Inventory, and the Texas Transportation Institute Urban Mobility Study. Mixed models were used to examine whether urban containment policies and state adoption of growth-management legislation were associated with population levels of leisure-time physical activity (LTPA) and walking/bicycling to work over time. Results: Strong urban containment policies were associated with higher population levels of LTPA and walking/bicycling to work during the study period. Additionally, residents of states with legislation mandating urban growth boundaries reported significantly more minutes of LTPA/week compared to residents of states without such policies. Weak urban containment policies showed inconsistent relationships with physical activity. Conclusions: This study provides preliminary evidence that strong urban containment policies are associated with higher population levels of LTPA and active commuting. Future research should examine potential synergies among state, metropolitan, and local policy processes that may strengthen these relationship

Land Use and Transportation Planning to Promote Physical Activity in North Carolina

With national and state agencies as well as leading public health foundations providing impetus, efforts to improve the understanding of policy and environmental attributes that may support active lifestyles have become a promising area for collaboration between planning and public health professionals. This article highlights the results of work performed at the University of North Carolina at Chapel Hill examining the relationship between planning policies and physical activity and the prevalence of land use policies and implementation tools that might support the viability of non-motorized modes. With the hope of bridging research and practice, it discusses findings most relevant to planners interested in the broader health-related applications of their work

Relation of modifiable neighborhood attributes to walking

Abstract Background There is a paucity of research examining associations between walking and environmental attributes that are more modifiable in the short term, such as car parking availability, access to transit, neighborhood traffic, walkways and trails, and sidewalks. Methods Adults were recruited between April 2004 and September 2006 in the Minneapolis-St Paul metropolitan area and in Montgomery County, Maryland using similar research designs in the two locations. Self-reported and objective environmental measures were calculated for participants\u27 neighborhoods. Self-reported physical activity was collected through the long form of the International Physical Activity Questionnaire (IPAQ-LF). Generalized estimating equations were used to examine adjusted associations between environmental measures and transport and overall walking. Results Participants (n = 887) averaged 47 years of age (SD = 13.65) and reported 67 min/week (SD = 121.21) of transport walking and 159 min/week (SD = 187.85) of non-occupational walking. Perceived car parking difficulty was positively related to higher levels of transport walking (OR 1.41, 95%CI: 1.18, 1.69) and overall walking (OR 1.18, 95%CI: 1.02, 1.37). Self-reported ease of walking to a transit stop was negatively associated with transport walking (OR 0.86, 95%CI: 0.76, 0.97), but this relationship was moderated by perceived access to destinations. Walking to transit also was related to non-occupational walking (OR 0.85, 95%CI: 0.73, 0.99). Conclusions Parking difficulty and perceived ease of access to transit are modifiable neighborhood characteristics associated with self-reported walking

The Importance of the “Local” in Walkability

Transportation infrastructure and transportation behaviors consume significant natural resources and are costly to municipalities, states, and the federal government. Small cities, in particular, may find themselves with high costs. Although transportation has been extensively investigated, methods that may enable small cities to act are still lacking. To investigate the influence that neighborhood-level built environment characteristics have on adult personal transportation decisions within small cities, this study combined community-based research, a multi-level analysis of residents, and a case study approach in two (North-Eastern United States) New Hampshire cities, Portsmouth and Manchester. Neighborhood-level physical characteristics were determined using Geographic Information Systems and visual surveys. Resident-level characteristics and behaviors were determined by survey of adult residents. Data were supplemented with input from and collaboration with city representatives. The results showed significant relationships between self-reported destination walking and built environment characteristics in the neighborhoods studied. Furthermore, the results showed variability between neighborhoods, underscoring the importance of local factors and behaviors. The results suggested that small cities and their regional planning organizations can make changes to specific existing neighborhoods to remove barriers to walking and allow more residents to choose walking as a transportation mode, but the changes that are most effective vary by neighborhood