Fair Play: Advancing Health Equity Through Shared Use

By Heather Lewis, staff attorney at ChangeLab Solutions.

Hamilton County, Tennessee, is nestled among dramatic ridges, plateaus, and mountains. But, despite the region’s natural attractions, park space can be hard to come by. Until recently, many residents didn’t live within walking distance of a park where they could be physically active.

While standards vary, many experts recommend that a city have ten acres of park and recreation space per thousand residents. For many years, however, areas of East and South Chattanooga had less than three acres of accessible green space per thousand residents. The lack of park space in these areas disproportionately affected people of color, who make up more than two-thirds of the population in those neighborhoods, but only 35 percent of the city’s overall population. Residents of East and South Chattanooga have struggled with some of the worst health outcomes in the city:

  • Fourteen percent of adults in East and South Chattanooga zip codes have diabetes, compared with 10.5 percent of adults in the city overall.
  • Forty-three percent of adults in the same zip codes have high blood pressure, compared with 31 percent of adults in the city overall.
  • An estimated 70 percent of adults in the same zip codes are overweight or obese, compared with 61 percent of adults in the city overall.

photo credit: ChangeLab Solutions

As part of its Step ONE initiative, the Chattanooga-Hamilton County Health Department partnered with organizations and residents to address these inequities. To increase opportunities for physical activity, they turned to shared use, a low-cost strategy that makes existing recreational spaces, such as schoolyards, accessible to the community.

Public health advocates helped create two advisory councils, made up of residents from East and South Chattanooga, to lead the effort. With the councils’ input and support, the health department prepared detailed maps of areas without sufficient access to parks and playgrounds, and showed how shared use of public school facilities could increase access to recreational space in those neighborhoods. With the maps and data to back them up, the advisory councils worked with the Hamilton County Department of Education to develop and adopt an open use policy that created access to elementary school playgrounds. Residents of Hamilton County and its municipalities now have access to 210 more acres of playground and green space, and nearly 67,000 residents live within a half-mile of an accessible playground.

ChangeLab Map

Maps like these visually tell the story of a community and its health. Hamilton County used local data to create this map. To find out more about how to do this for you own community click here.

How Shared Use Can Address Health Inequities

Nationwide, low-income communities and communities of color are far less likely to have access to recreational spaces than their white, higher-income counterparts. And perhaps not surprisingly, inequities in access to recreational space often mirror inequities in health outcomes. Shared use has great potential to address this by providing recreational opportunities in the neighborhoods that need them most.

In addition to creating access to places for play and exercise, shared use can advance health equity by helping communities respond to local needs and prioritize “park poor” areas. Because it makes use of existing facilities, shared use is a particularly potent tool in cash-strapped neighborhoods, where a lack of funding prevents the development or maintenance of recreational spaces.

ChangeLab Solutions has identified three ways public health advocates and practitioners can use shared use to advance health equity:

  1. Make Use of Data: Proponents of shared use should keep an up-to-date inventory of areas that have the greatest need for recreational space, and identify spaces and facilities in those neighborhoods that may be appropriate for shared use. In Hamilton County, surveying residents and developing maps to highlight shared use opportunities were key parts of the process. Other successful data collection and inventory efforts may include interviewing school administrators and conducting telephone surveys.
  1. Engage the Community: It’s important that recreational opportunities sufficiently meet and respect local needs. Before implementing shared use, the Chattanooga-Hamilton County Health Department worked directly with residents of East and South Chattanooga to evaluate community interest. They surveyed residents living around the schools, and involved the leadership advisory councils in every phase of policy development. By engaging the community, advocates can target locations, facilities, and programming that residents want.
  1. Think Upstream: Shared use should not be considered a substitute for adequate funding to develop or upgrade recreational facilities. Rather, equity-focused shared use should be one part of a larger strategy to increase recreational access and reduce health inequities. Advocates for social and racial justice must continue to look at the root causes of health disparities, including inequities in funding for facilities and infrastructure.

photo credit: ChangeLab Solutions

The lack of safe, affordable places to play and be active contributes to the nation’s health inequities. Communities can, and should, use shared use as a tool for increasing opportunities for physical activity in areas with the fewest resources and facilities. When public health advocates leverage data and engage with residents to develop shared use sites, this strategy can have broad and lasting benefits.

For more information on using shared use as a tool to address health inequities, check out ChangeLab Solutions’ fact sheet, Fair Play: Advancing Health Equity Through Shared Use.



HeatherLewis_AuthorHeather Lewis is a staff attorney at ChangeLab Solutions, where she works primarily in the healthy planning program area. Before joining ChangeLab Solutions, Heather worked at Communities for a Better Environment, a grassroots environmental justice organization, where she provided legal support and litigated on behalf of communities working to reduce pollution and build healthy neighborhoods. While in law school, Heather worked with the Appalachian Citizens’ Law Center in Whitesburg, Kentucky, on coal mining environmental justice litigation and clerked with the U.S. EPA’s Office of Enforcement and Compliance Assurance. She was also a student advocate with the Natural Resources Defense Council in New York and the Center for Popular Democracy in Brooklyn, and she interned with New York Lawyers for the Public Interest. Heather graduated from the University of Chicago with a degree in environmental studies, and she received her law degree from the New York University School of Law, where she was Editor-in-Chief of the NYU Environmental Law Journal.


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