physical activity

Walk this Way

This originally appeared in the Workplace Wellness: Walk This Way guidebook from ChangeLab Solutions

Physical activity reduces our risk of insomnia, depression, diabetes, heart disease, some cancers, and even early death. The Centers for Disease Control and Prevention (CDC) recommend that adults participate in at least 150 minutes of moderate to vigorous aerobic exercise a week and 2 days a week of muscle strengthening exercises. Yet, 4 in 5 adults are not getting even that much physical activity.

People want to do what is best for their health and the health of their families, but our environments and the policies that shape our environments continue to make meeting basic daily physical activity recommendations nearly impossible for the majority of workers in the United States. This doesn’t just affect our health and mental health; it affects our bottom lines. Physical inactivity accounts for $90 billion in medical expenses each year.

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Given that many adults spend half their waking hours at work, the workplace can play a big role in supporting positive lifestyle changes. At the organizational level, workplace wellness policies and programs vary greatly in form and scope, but they commonly focus on disease prevention and health promotion. They often help employees participate in more physical activity.

Most workplace wellness efforts have focused on the organizational level. However, jurisdiction-wide policies (such as executive orders, resolutions, ordinances, or laws) implemented by state and local governments have also encouraged organizational wellness policies. The Walk this Way guidebook discusses state and local policies for raising awareness, creating wellness councils, establishing government wellness programs, offering paid leave for physical activity, and creating tax credits for small businesses with workplace wellness programs.

Communities have used these kinds of policies to support the following activities: Ÿ

  • raise awareness about workplace wellness and the need for physical activity Ÿ
  • create demand for organizational workplace wellness policies and programs Ÿ
  • create financial incentives for businesses to adopt workplace wellness programs

Workplace wellness, though, does not begin and end at the office. Community health and employee health are intrinsically linked. For example, adults typically spend almost an hour commuting to and from work. They run errands throughout the workday – like buying lunch or picking up the dry cleaning. Research indicates that 89% of people in the United States drive to destinations that are less than 2 miles away. For adults to incorporate physical activity into their daily routine, they need communities that are designed to make it easier to walk, bike, and use public transportation.

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Recognizing this connection between employee health and community health, organizations like the National Academy of Sciences and the Vitality Institute have called for policies that promote community health and simultaneously support employee health. Additionally, the Community Guide recently released recommendations to improve physical activity through built environment strategies, many of which are included here. Therefore, this resource includes policies that implement complete streets, update comprehensive plans, revise zoning laws, and encourage transportation demand management. Communities are using these policies to support the following actions:

  • encourage employees to live healthier, more active lives Ÿ
  • reduce health care costs for the entire community as well as for individual employers Ÿ
  • improve the health of the local pool of potential job applicants

This Walk this Way guidebook provides wellness promoters with inspiration, guidance, and an understanding of some common state and local policies that support physical activity and wellness in and around the workplace. To download the guidebook, click here. Join ChangeLab Solutions and America Walks for a free webinar on policies that support workplace wellness and physical activity, Thursday, October 5 at 2:00 p.m. Register here.

National Summit Showcases Health, Economic, and Social Justice Benefits of Walkable Communities

By Jay Walljasper

Many things leap to mind when someone mentions walking: fitness, fun, fresh air, relaxation, friends and maybe your most comfortable pair of shoes.  But a word that rarely arises is “power”.

That will begin to change after the 2017 National Walking Summit (held in St. Paul, Minnesota September 13-15), which is themed “Vital and Vibrant Communities—The Power of Walkability”.

Like earlier summits, this event brings together people of all backgrounds to strategize ways of making sure the advantages of walking can be shared by all, no matter what their income or where they live.

Walking advocates once focused primarily on physical health —spurred by mounting evidence that physical activity is key to preventing disease—but now are stepping up to promote social, economic and community health. Their ultimate goal is to transform towns and neighborhoods across America into better places for everyone to live.

“The power of walking is becoming more clear all the time,” declares Kate Kraft, executive director of America Walks. “Community connections, social equity, a sense of well-being, business opportunities, affordable housing, more choices for kids and older people, a cleaner environment—these are some of the benefits of walkable places.”

Walking Boosts Health & Happiness

Streams of medical studies now document the central role physical activity plays in fending off disease and disability. Chances of depression, dementia, colon cancer, heart disease, anxiety, diabetes and other conditions drop by at least 40 percent among people engaging in moderate exercise such as walking.

A landmark study issued last year found that sedentary habits are a bigger health threat than high blood pressure or cholesterol— about the only thing more dangerous than inactivity is smoking reported the New York Times.  This followed on the heels of a Cambridge University study showing that a lack of exercise increased your risk of death twice as much as obesity.

All the scientific data persuaded former Surgeon General Vivek H. Murthy to issue a landmark Call to Action to Promote Walking and Walkable Communities in 2015, which has been compared to the 1964 Surgeon General’s report on the dangers of smoking. “Walking helps people stay both physically and mentally healthy,” Murthy wrote, calling on us “to increase walking by working together to increase access to safe and convenient places to walk.”

Walking stands out among all other exercise because: 1) It is free; 2) It requires no special training or equipment; 3) It can be done almost anywhere at any time; and 4) It is already Americans’ #1 favorite physical activity.  The US Department Transportation reports that Americans reported walking 14 percent more in 2012 than in 2002 (latest figures available).

Walking Advances Social Justice

“The health benefits of walking are so overwhelming that to deny access to that is a violation of fundamental human rights,” declared sociologist Robert A. Bullard, founder of the environmental justice movement, at the 2015 Walking Summit. “All communities should have a right to a safe, sustainable, healthy, just, walkable community.”

Unfortunately, that’s not the case across America today. People walking in lower-income neighborhoods are twice as likely to be killed by traffic than those in more affluent areas. African-Americans on foot are 60 percent more likely to be killed by cars than whites, while Latinos are 43 percent more likely.

“If you have walkable communities, kids will do better in school…seniors will be healthier,” said Ron Simms—a neighborhood activist from the African-American community of Seattle who later became Deputy US Secretary of Housing and Urban Development, at the 2015 Summit.

Better walking conditions also help low-income families economically.  Surprising new research from the George Washington School of Business shows “the most walkable urban metros are also the most socially equitable. The reason for this is that low transportation costs and better access to employment offset the higher costs of housing.”

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This is backed up with Federal Highway Administration data finding that families living in auto dependent communities spent 57 percent of their income on housing and transportation, compared to 41 percent in walkable communities.

This refutes widespread rumors that making a street safe for walking is a luxury important only to well-off people. Actually, low-income residents benefit the most because they travel by foot the most, especially kids.  “The fact is that we have twice as many low-income children [nationally] who are walking or biking to school than those in affluent neighborhoods, even lacking the infrastructure to protect the children,” reports Keith Benjamin, Transportation Director in Charleston, South Carolina.

“A big thing we could do to help low-income families is to make it easier to live without a car,” says community consultant Gil Peñalosa.  “And it would help middle-class families to switch from two cars to one.” The American Automobile Association calculates the annual pricetag of owning one car at  $8,500 a year—which goes a long way toward easing household budgets.

Safe, convenient and comfortable places to walk are fundamental to the forgotten one-third of Americans who don’t drive— the young, the old, the disabled and those too poor to buy a car. These people live under a form of house arrest in many US communities, unable to do much of anything—buy groceries, see friends, go the doctor, engage in favorite activities—without begging someone to chauffeur them. Communities from San Francisco to Birmingham to rural Iowa are pulling together to eliminate the roadblocks that deter people of all ages, incomes and racial backgrounds from walking.

Walking Expands Economic Opportunities

People on the street mean business—literally.  Neighborhood and downtown business districts thrive on foot traffic.  West Palm Beach, Florida discovered this after making a major avenue more comfortable for pedestrians, and attracting $300 million in new business investment.  Albert Lea, Minnesota—a blue-collar rural town of 18,000—found the same thing when a walk-friendly makeover of its Main Street drew 15 new businesses in two years, with $2-5 million more in investment planned.

Even companies not dependent on local customers are eager to locate in walkable districts—especially firms in the booming tech and creative fields, who realize the young talent they depend on to stay competitive want to work within walking distance of cafes, parks and cultural attractions.  “We moved from the suburbs to downtown Minneapolis to allow our employees to take advantage of the area’s many trails and to put the office in a more convenient location for commuting by pedal or foot,” explained Christine Fruechte, CEO of large advertising firm Colle + McVoy, in a newspaper op-ed. “Our employees are healthier, happier and more productive. We are attracting some of the best talents in the industry.”

Many other companies find that walkable locations pay off in lower health insurance premiums. Thomas Schmid of the Centers for Disease Control and Prevention points to Volkswagen, which built a manufacturing plant in Chattanooga only after local officials agreed to extend a popular walking-biking trail to their door.

Walking Connects People & Strengthens Communities

Eighty five percent of Americans express the desire to live somewhere walkable, making it the #1 quality they want in  a home, according to  the National Association of Realtors’ Community & Transportation Preference Survey. This is even more true for Millennials, millions of whom will be looking to buy their first home over the next few years.

“What makes people walk is [also] what makes great places to live,” emphasizes Harriet Tregoning, until recently a director in the Office of Community Planning at the US Department of Housing and Urban Development (HUD). “Walkability is the secret sauce that improves the performance of many other things” in our communities.

Former Surgeon General Regina Benjamin emphasizes that taking a stroll “is good for the social fabric of our communities”—creating new opportunities to connect with friends and neighbors, which is not only good for your soul but also your health. That’s why Benjamin added a walking path to the grounds of the health clinic she founded in rural Alabama.

Walking Protects Our Environment

Walking more is an important step you can take to avert climate disruption, air pollution, urban sprawl and other environmental threats. More than half the suggestions in 50 Steps Toward Carbon-Free Transportation, released last year by the Frontier Group research organization, involve walking.

Walking in the Heartland

Drawing a crowd ranging from block club organizers and grassroots advocates to elected officials and medical experts, the 2017 Walking Summit features two-and-half days of workshops, major addresses, trainings, break-out discussions, success stories and on-the-ground exploration of solutions in Minnesota communities.

Among the more than seventy sessions are:  How to Build Safe Walking Networks; Walking in Rural Communities; Creating Walkable Communities Without Displacement; You Are Where You Live and Creative Walkable Interventions.

Keynote speaker Tamika Butler—director of the Los Angeles County Bicycle Coalition—will showcase how her organization broadened their mission from sustainable transportation to social justice. “We must talk about public health, gentrification, people of color, women who feel harassed on the streets, older people, black men who fear for their lives on the street, immigrants who fear deportation,” Butler says.  “Walking for many people has everything to do with living full lives and being able to get around.”

St. Paul Mayor Chris Coleman—who launched a first-of-its-kind $42 million Vitality Fund to promote walking and other community improvements—will also speak at the conference along with racial and social justice leader Glen Harris from the Center for Social Inclusion and George Halvorson of the Institute for InterGroup Understanding, who made strides in launching walking movement as CEO of the  Kaiser Permanente health care system.

Participants will find specific information and inspiration to take back home by following one or more of the Summit’s six “paths” of subject matter:

Healthy Communities: People’s zip codes are as accurate as their genetic code in predicting a healthy life. That’s why it’s essential to put in place policies, programs and resources to ensure everyone has an equal chance for a healthy life.

Safe, Well-Designed Communities: Too many communities are designed for the ease of motorists with little thought of people who get around other ways. The focus here is practical approaches to provide safe, convenient transportation and affordable housing for all.

Artistic and Innovative Communities:  Creativity flourishes in places where people regularly connect face-to-face on sidewalks and in public spaces.  Discover ideas about fostering foot-friendly settings that spark community engagement, cultural diversity and imaginative energy.

Productive and Thriving Communities: Walkability is closely linked with socially and economically successful places. Here’s where to start in creating vibrant neighborhoods, equitable development, affordable housing and strong downtowns or Main Streets.

Open and Collaborative Communities: Wide-ranging collaboration explains the difference between towns, suburbs or cities that blossom and those that wither. What’s the key in getting people together for authentic conversations and effective partnerships?

Engaged and Informed Communities: Access to information and decisionmakers are two powerful tools for transforming a community. These sessions offer a detailed look at new methods to gather data, engage communities, mobilize citizens and influence local government and businesses to catalyze walking.

This is the first Walking Summit held outside Washington, DC.  “We’re really excited to showcase some of the success we’re seeing, but also share the challenges we have in Minnesota,” says Jill Chamberlain, chair of the local host committee and a senior program manager in the Center for Prevention at Blue Cross and Blue Shield of Minnesota, a featured sponsor of the event.

The Twin Cities metropolitan area in many ways represents a microcosm of America when it comes to walking. Minneapolis and St. Paul both rank relatively high for the rate of pedestrian trips among US cities, but until recently autos were the centerpiece of all urban planning in the region. Many suburbs lack sidewalks and other basic infrastructure for pedestrians. Concentrated populations of low-income households and/or people of color are found in both suburbs and cities. But there is a growing awareness that walking is important to future prosperity and quality-of-life—and growing numbers of projects to get people back on their feet.

Mobile workshops on the first day of the conference will fan out across the  area to investigate local initiatives that illustrate the power of walking— from  a police department campaign for pedestrian safety to a residential neighborhood with a small town feel to an inner city community torn apart by a freeway, which is exploring plans to reconnect itself by building a land bridge over the road.

Jay Walljasper—author of the Great Neighborhood Book and America’s Walking Renaissance—writes, speaks and consults widely about creating healthy communities. 

4 Ways to Keep Your Heart Healthy

February is American Heart Month, which makes it the perfect time to talk about the alarming growth of heart disease in the US. Heart disease contributes to 1 in 4 deaths each year- and is the leading cause of death in both men and women. Many of the major risk factors that contribute to heart disease and mortality are modifiable with behavior change. However, some risk factors like age, gender, and family history are not modifiable and can be significant contributors to heart disease. Modifiable risk factors include:

  • High blood pressure
  • High cholesterol
  • Physical inactivity
  • Obesity and overweight
  • Smoking and tobacco use
  • Diabetes
  • Poor diet

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While heart disease cannot be cured, it can be managed with lifestyle changes. Knowing the healthy ranges for the most common risk factors (i.e. blood pressure, body mass index) is a good place to start. Behavioral changes can also decrease the risk of developing heart disease.

Below are four proven ways to keep a healthy heart.

1.Get active

The Department of Health and Human Services recommends 150 minutes of moderate to intense physical activity per week, yet roughly 1 in 3 US adults participate in no physical activity. Moderate to intense exercise can include anything from walking and swimming to household chores and gardening.


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2. Eat a heart-healthy diet

Eating a nutritious diet not only makes you feel better, it also helps keep blood pressure, sugar, and cholesterol levels in a healthy range.  Fruits, veggies, lean meats, and fish offer a rich, healthy diet. Diets with too many trans fat, salts or sugars should be avoided. Aim to consume five to 10 servings of fruits and veggies per day. This guide from the American Heart Association outlines how much constitutes a serving.


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3. Avoid smoking and tobacco products

Smoking is a major cause of heart disease. It lowers good cholesterol, raises fat in blood (triglycerides), and narrows blood vessels, among other things. Secondhand smoke can contribute to heart disease as well. According to the Centers for Disease Control, breathing secondhand smoke can increase the risk of developing heart disease by 25 to 30 percent.


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4. Manage stress

Chronic stress exposes our body to stress hormones that are harmful to our health. Stress also can contribute to high blood pressure, overeating, and physical inactivity factors that can lead to heart disease. When you’re under stress, it’s important to not engage in behaviors that add fuel to heart disease like smoking and/or eating poorly.  Of course it helps to keep a positive attitude, but exercise, meditation, and “unplugging” from the news, social media, and other stressors can help lift your mood.


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Lifestyle changes are key to preventing and managing heart disease. And while heart disease may not bean issue for you, be sure to engage those close to you about the risk of heart disease and encourage healthy habits. Million Hearts has great resources for understanding heart disease and how to talk about it with your loved ones at risk.

A New Prescription: Exercise as a Vital Sign

Movements to get more Americans up and exercising are happening all across the country. Whether it’s creating safe, walkable communities or incentivizing employee wellness programs, the importance of exercise is at the front of everyone’s minds. And for good reason. More than 9 in 10 Americans do not meet the National Physical Activity Guidelines’ recommendation of getting 150 minutes per week of moderate to intense physical activity. That’s staggering, especially since the known benefits of physical activity include not only weight loss, but also the prevention of heart disease, cancer, depression, and a host of other chronic diseases.


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Since millions of Americans are not meeting the recommendations for physical activity, health care providers are exploring ways to increasingly emphasize the importance of physical activity in their medical practices.

Kaiser Permanente in Southern California is one health provider that has been at the forefront of this movement. Through partnerships with more than 4,000 physicians at 14 hospitals and 200 medical offices, KPSC is able to provide comprehensive health care services for 3.4 million residents in Southern California.

One of the ways they have accomplished this is through promoting the health benefits of a more physically active lifestyle among patients. They are one of the first health care service providers to log patients’ physical activity levels in their electronic health records as part of the Exercise as a Vital Sign program.

When we think of vital signs, we often think of the four stats that are usually measured when we visit the doctors’ office: pulse, blood pressure, heart rate, and respiration. But since exercise is such an important factor in maintaining health and warding off chronic diseases, providers at KP have called for exercise to be included as a vital sign.

To assess exercise as a vital sign, physicians at Kaiser Permanente routinely check and record patients’ physical activity. They do this by asking patients how many days per week they engage in moderate to strenuous exercise and the average number of minutes per day they exercise at that level. Responses are recorded in patients’ electronic health records.

While the best way to assess physical activity levels is still debated, this approach at least gives physicians a way to begin the discussion with their patients’ about the importance of having a physically active lifestyle. And while more physicians are incorporating exercise as a vital sign into their practices, the significance of the program also shows promising results.

In a 2013 study, researchers found that asking patients about physical activity levels was associated with weight loss and improved glucose control in diabetic patients. Many providers see this as not only a way to get the conversation started with patients about living healthier, more physically active lives, but also an opportunity to connect them with resources that can help them manage their health.

The Great Outdoors: 5 Physical and Mental Health Benefits

Did you know 65 percent of American adults are overweight? The obesity epidemic is one that has stirred dialogue and created concern with respect to its risk factors, its consequences, and the things that can be done to prevent and/or manage it. Living an active lifestyle can make all the difference in not just managing weight, but overall mental health.

Leading an active life does not necessarily imply long hours of heavy exercise that leave your body feeling limp. It can be as simple as taking a stroll with your family. Walking to the coffee shop a few blocks down the road. Riding your bike to work. An important factor in people’s motivation be to active is the surrounding environment. It is understandable why the outdoors can make activity more appealing. Humans have an innate need to be connected with nature. In fact, spending time in nature comes with many benefits that extend beyond physical health benefits:

  1. Exercise: First and foremost, getting out and doing things will put your body to work. Although you may not consciously be exercising, you’re putting your body in motion – making it perform tasks and requiring energy that would otherwise be stored as fat if not burned. Thirty minutes of speed-walking 5 days a week is enough to reduce health risk factors. Turning these actions into habits can help reduce the risk of diseases such as hypertension, diabetes, obesity, atherosclerosis, and stroke, among many others.

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  1. Vitamin D: Although an overexposure to sunlight (a major source of Vitamin D) can result in sunburn and later the development of Melanoma and other kinds of skin cancers, moderate exposure to the sun is actually necessary. In fact, conditions like bone pain, high blood pressure and depression can develop without it. By exposing your skin to sunlight, you are allowing your body to generate Vitamin D, which is necessary for bone strengthening and development. In moderate doses, it can also help reduce symptoms of diseases like different types of cancer, multiple sclerosis, cardiovascular disease, type 1 and type 2 diabetes, and Alzheimer’s.
  1. Enhanced Concentration:  In our busy, tech-driven world, external stimuli are constantly competing for our attention. Natural environments do not require this kind of directed attention, which gives the mind a chance to restore itself. Not only does nature help us concentrate our attention, but it also promotes positive emotions, giving us a sense of accomplishment, productiveness, and contentment.

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  1. Stress Reduction:  Walking in natural settings decreases cortisol levels, cortisol being the stress hormone. People with chronic stress may develop, as a result of an overabundance of cortisol, problems with anxiety, depression, sleep and metabolic issues. It is therefore evident that if municipalities were to set up green spaces, then quality of life would generally increase due to this method of coping with stress.
    poor mental health

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  1. Mental Health: City planners and urban designers are growing in their awareness of creating green spaces in their cities. In addition to the fact that green spaces can create an atmosphere of calm and inspiration, contact with nature has also been found to decrease levels of anxiety, depression, and improve cognitive functioning in people with dementia, Alzheimer’s and attention disorders. But it doesn’t stop there, green spaces also promote more connected, engaging communities. When people have safe, inspirational places to interact, the community benefits too.

So, put yourself out there. Get your body working. Venture out into nature. It’s good for your body. It’s good for your mind.

Salud America! Launches New Report for Members

SA-logoCommunity Commons and its partner Salud America! are excited to announce the release of a new, custom tool: The Salud Report Card!

This new tool is designed to help identify and communicate what health issues are important to you and your community. The report can be downloaded, printed and shared online making it easy to provide vital information to key figures like local and state PTA, health departments, city leaders, friends, and family.

Know the Issues, Start a Change

Want to begin to address and help solve health issues facing Latinos and their children? Learn more about Salud America! by watching our recent webinar where we first announced the Salud Report Card.

The Salud America! Hub provides comprehensive content, resources, and research; which suggests lots of achievable healthy changes. You can also view some of the many posts about policy changes happening now, or follow the footsteps of the many Salud Heroes making an impact in their communities. For example, building a fitness trail!

Create a Report in Your Area

The Salud Report Card highlights key health issues in your county with data, policy solutions, research, and stories so you can start and support healthy changes for Latino kids. One of the largest hubs on the site, members of Salud America! are able to create these geo-located reports, using mapping and data tools on the provided by Community Commons.

SA! Report Highlights

Simply select your state and county and the Report Card will specifically exam the following in your county:

  • Obesity
  • Food Access
  • Physical Activity Issues
  • Health Equity
  • Vulnerable Populations

The Report Card can help you quickly get data and research in to the hands of those who need it most, and can be used to justify and advocate for grant funding and policy change. Which of the topics in the Report Card stand out in your county? Comment below and tell us what you think of this new tool.

Need Help?

Email Salud America! digital curators, Eric, Lisa, and Amanda at They can answer questions and help you access information and data/maps on many other topics.

Mapping the Impact of Rising Rents

There is a growing shortage of affordable housing in the U.S. With more middle class families turning towards renting instead of home ownership, low-income families are being squeezed out of rentals that were once affordable. But for both middle class and low-income families, renting continues to take up a growing percentage of household income.

The Shift Towards Renting

Demand for rental housing is at its highest since the 1960’s- and home ownership at a 48-year low. While home ownership is still more affordable than renting in many U.S. markets, it is not an option for individuals or families who do not qualify for loans, have incomes that are too low, or are saddled by debt like student loans. In 2008, a quarter of rental applicants were paying off student debt, by fall 2015 that number had risen to half.

With high-income earners forgoing home ownership, increasing urban populations, baby boomers downsizing, and the housing crash fresh in the minds of would-be homeowners, vacancy rates for rentals are at an all-time low. And with that comes ever increasing rent costs.

Rent Taking Up More of Americans’ Paychecks

Affordable rent is considered less than 30 percent of a household’s income, though today, most rents surpass that. According to the National Low Income Housing Coalition’s 2016 Out of Reach Report, U.S. renters need to earn an average of $20.30 per hour to afford a modest two- bedroom apartment- the average wage of a U.S. renter is $15.42.

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What about those making the federal minimum wage of $7.25? First, there is no state where a full-time worker making minimum wage could afford a fair market value, one-bedroom apartment – anywhere. Second, in order to afford a one-bedroom apartment, that worker would need to put in 90 hours per week at work or 112 hours per week for a two-bedroom apartment. For single moms or dads not only holding down full-time employment, but also part-time evening work, that is often a reality- and the only option.

 Housing Wages (By State) Needed to Afford a Modest Two-Bedroom Apartment

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But let’s take a closer look at it this way, too:

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Unaffordable rent is a critical issue millions of Americans face. These severely cost-burdened households are a critical issue for the U.S. as well. With more and more of workers income going towards rent, less and less is being spent in the market. The Out of Reach report also found that families who spend more than half their income on housing spend 50 percent less on clothing, one-third less on food, and 80 percent less on medical care compared to those with affordable rent.

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It’s interesting to note that when we look at labor force participation, it seems to be worse in many areas that have more cost-burdened households and higher rents.

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More “Low-Income” Housing is Not Always the Answer

As long as higher-income earners are willing to pay high prices, there will continue to be a shortage of affordable apartments. With federal housing funds cut in half over the last 10 years, and fewer families qualifying for rental subsidies, the shortage will remain. Though building more “low-income” housing (via tax credits to developers) often seems to be the go-to solution, that in fact has shown to be not only ineffective overall, but actually more expensive than simply increasing the purchasing power of renters.

Data Viz of the Week: Understanding Physical Activity in Schools

I recently came across some data on Community Commons regarding physical activity in schools that I didn’t quite understand. The maps showed 0-5 values, ranking each state on factors related to physical activity and nutrition in schools. What I didn’t understand from the maps was whether a score of 5 was good or bad.

Info ButtonI clicked the “INFO” button to learn more and was redirected to the data source (by the way, every data set on Community Commons has an associated “INFO” button that will lead you directly to its original source). What I learned was that this particular data comes from the Classification of Laws Associated with School Students, or CLASS. CLASS is a project of the National Institute of Health’s Division of Cancer Control and Population Sciences.

CLASS collects data on the following school related health factors:

  • School Nutrition Environment – Farm to School Requirements
  • Nutrition Education Standards
  • Reimbursable School Meals
  • Physical Education – Fitness Assessments
  • Recess Time
  • Physical Education Time Requirements

Each of these factors has a corresponding set of scored criteria that helps make up the data sets available on Community Commons. Let’s take a look at the two sets that had me stumped: Recess Time and Fitness Assessments

PE Side by Side

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In order to determine if 5 was a good score or a bad score, I explored the CLASS scoring criteria on their website. The scoring tables I found are below. Turns out, 5 is a good score and means that schools in the state have policies in place and they follow the recommended guidelines for physical activity.

Fitness assessments

Recess time

By exploring more information about the data, I was able to make an educated analysis about physical activity requirements in schools around the nation.

For example, it looks like there’s a group of states in the Midwest (Colorado, Nebraska, Kansas, Iowa, South Dakota, Montana, and Michigan) that don’t have any requirements regarding recess time or fitness assessments and there are very few (California, Texas, West Virginia, Mississippi, and Vermont) that have both types of requirements, but at widely varying degrees. Based on this information, I was able to dig deeper into those states that have requirements in place and learn more about how their policies and requirements were determined, implemented, and carried out.

Does your state have requirements for physical education? Are you working on policies related to physical education requirements? Tell us about it in the comments!

Safe Routes to School Grades States on Active Living Policies

We’ve seen the research that routinely promotes physical activity as fundamental to our health. Walking and/or biking when and where we can is one of the most cited ways to improve overall health. But to do so, we need safe, accessible areas. And that is where the role of the state comes in. States can enact laws and policies that can make or break something so basic as walking to school.

That’s why Safe Routes to School National Partnership recently released a report that grades each state on how they support walking, biking, and physical activity policies.  It’s a cool way to assess where states are, but also clearly highlights specific areas for improvement.

Grades were calculated based on four key areas:
(1) Complete streets and active transportation,
(2) Safe routes to school and active transportation funding,
(3) Active neighborhoods and schools, and
(4) State physical activity planning and support

So, is your state making strides with walking/biking policies or is it just starting to lace up?

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Click the map image to see each states report card

Some regions were stronger in key areas than others. For example, the South had higher scores in the Complete Streets/Active Transportation key area. Alternatively, those scores were a much lower for the Mountain West. Overall, states are making progress in their own way – but each with plenty of room for improvement.

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Walking and Biking to Work by State

In the U.S., 3.37 percent of the population bikes or walks to work. That number has been steadily rising for bike commuters over the past several years, according to the U.S. Census Bureau. And though 13 percent of kids (5-14 years old) walk or bike to school, that number has dropped 50 percent since 1969. There are many factors at-play in that decrease like distance to school, traffic concerns, weather, crime, and even opposing school policies. So it’s encouraging to see the Safe Routes to School and Complete Streets/Active Transportation/Active key areas score the highest in almost all the regions – another sign that communities (and schools) are shifting attitudes about the importance of livable and complete streets to residents’ health.

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Beyond the health-related reasons for active transportation policies, there’s sometimes a perception on what kinds of people bike and walk to work. People often think that those with higher education and higher incomes walk and bike to work more than others. Maybe they are thought of as being more health conscious. But that’s not necessarily true. As the U.S. Census Bureau reported, while those with more education do use more forms of active transportation, those with the lowest income are actually more likely to bike or walk to work. So it’s important to remember that for many people, walking or biking to work is not always a choice, it’s a necessity.

For kids, safe routes to school opens doors to much needed physical activity. Research shows kids who bike or walk to school not only have lower body mass index, but also improved overall physical and mental health. But for kids and adults to take advantage of the health and economic benefits of walking or biking to work, they need safe, active transportation routes. That’s why states and communities need to not only understand the implications of active transportation policies, but also have a clear vision of who they are building for and how they can build in a way that fosters strong, accessible communities for everyone.

Ready, Set, Gold! Inspires Kids to Train Like Olympians

It’s one thing to watch an Olympian on TV, but to actually train with one, that’s often just a dream of both kids and adults! But that dream has come true for students in the Los Angeles Unified School District (LAUSD).

Serving over 640,000 students, the LAUSD is the second largest school district in the nation, and like many school districts, administrators and activists were concerned with rising rates of childhood obesity. In LAUSD, 25.83% of elementary students are obese (high risk).

LAUSD Obesity

This data is available for California only. Additional obesity data can be found under the Maps and Data tab.

To help address the problem, LAUSD forged a creative partnership with the Southern California Committee for the Olympic Games (SCCOG) and worldwide Olympic sponsor Samsung in 2006. Together they introduced Ready, Set, Gold!, a mentoring program that uses Olympians and Paralympians to inspire and educate students about health and fitness. SCCOG promoted the program to help Los Angeles secure the 2016 Olympic bid. Although Rio de Janeiro ultimately won the bid, leaders knew that the unique partnerships they forged could be used for the ongoing benefit of students.

“It’s the first and only program of its kind in the country. You can have programs with athletes, but we have Olympians and Paralympians,” said Ready, Set, Gold! Executive Director Bernadine Bednarz.

For Olympians, RSG! is the perfect opportunity to share the strategies that have helped them excel on the world stage, and also promote the values that got them there. “We promote fitness. We promote health. And that’s what we have to promote to our kids here in America today because obesity is a problem,” said track and field U.S. Olympian Rosalyn Clark.

The program brings more than 50 Olympians and Paralympians (including 22 Olympic medalists) to 60 schools in LAUSD to train with 5th, 7th, and 9th graders throughout the school year. “We focus on students in those grades because we have a state -mandated test in California Ready, Set, Gold! Picture 1called FitnessGram which measures students’ level of fitness. They [the students] are taught by a PE teacher in between the times an Olympian is there. The Olympian emphasizes that test when he or she is there and they meld it with how they train themselves,” said Bednarz.

Athletes serve as mentors, motivators, and coaches and help students train like an Olympian. “We took nutrition classes to learn all the things we should be doing throughout life…The best part is probably seeing everyone get off the couch and see everyone play, have fun, and laugh,” said Ready, Set, Gold! student Miranda.

Over the course of a school year, the Olympians and Paralympians visit 5-6 times to exercise and talk with the students about healthy living habits. From doing a gymnast inspired handstand on chairs to cycling and running relays, these accomplished mentors gives youth hands-on opportunities to learn new and exciting exercises and sports, as well as how to make all around healthy living decisions.

“[I’m proud that] we have kept going, schools want us back, and people call us and want the program when they hear about it from colleagues. Teachers who transfer [to other schools] call me and say they want an Olympian or Paralympian in their school,” Bednarz said.

Ready, Set, Gold! Picture 3What’s more, RSG! has made a measureable difference. Data shows that students who participate in RSG! score higher on the FitnessGram physical exams than their peers in other Los Angeles schools without the program. However, most importantly, kids are walking away with confidence that they can control their health, have the knowledge and tools to do so, and can dream even bigger.

Says RSG! student Rogerlio, “I learn so much and I have so much fun. One day I hope that I can be an Olympian too.”

For more information on the program contact Ready, Set, Gold! director Bernadine Bednarz at or 213-482-6346.

MDs Now Prescribe Walking as a Boost to Health

The following was originally published at and written by Jay Walljasper. 

A compelling reason to keep your New Year’s resolution to be more active.

Everyone knows walking is good for you.

It’s plain common sense, backed by a wealth of recent medical research. In fact, a major new study found that lack of physical activity is twice as deadly for us as obesity.   

Health data shows that as little as 30 minutes of walking a day cuts the incidence of Alzheimer’s Disease in half, lowers the likelihood of diabetes by 60 percent, limits colon cancer by 31 percent for women and reduces risk of dementia, heart disease, depression, osteoporosis, glaucoma and catching a cold.  

This kind of evidence prompted US Surgeon General Vivek Murthy to issue a call for Americans to walk more . “Physical activity – such as brisk walking – can significantly reduce the risk of heart disease and diabetes,” Murthy explains. “Even a small first effort can make a big difference in improving the personal health of an individual and the public health of the nation.”

“Walking is the most common form of physical activity across incomes and ages and education levels,” adds Thomas Schmid of the federal Centers for Disease Control and Prevention (CDC). That’s because it’s free, easy, relaxing, available right out your front door and easily incorporated into daily schedules.  Plus it’s fun. The CDC’s most recent research shows the number of Americans who take a walk at least once a week rose six percent in the last decade.

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Click on the interactive map to see what this data looks like for your own community or visit our Map Room to create your own maps.

Still less than half of all adults meet the minimum recommended guidelines for walking, rolling in a wheelchair or other physical activity  (30 minutes a day five days a week), according to the federal Centers for Disease Control and Prevention.  Even worse, only a quarter of high school students today reach the mark (an hour a day seven days a week), according to the Surgeon General’s report.

What can be done to ensure the health of our country?  The Surgeon General encourages everyone to walk and work to make their hometowns more safe and inviting for people on foot.  He lauds the new walking movement that’s emerged over the past few years for getting Americans moving again.

Health care professionals are on the frontlines of this effort, and many are bringing the message back to their clinics by including physical activity as one of the vital signs—like blood pressure and tobacco use—they check on with patients. Some MDs even write prescriptions for walking. Several health care systems track physical activity in their health care records, including Greenville Health in South Carolina, Intermountain Healthcare in Utah and Idaho, and Kaiser Permanente, an integrated health care delivery system, in California and seven other states.

If Walking Were A New Drug, it Would Make Headlines

“What if there was a pill you took one day that lowered your blood pressure, prevented diabetes, improved your mood and protected against depression, increased bone density and prevented fractures, helped you remain independent as an older adult, enhanced your ability to think, and gave you more energy?” ask Dr. Robert Sallis and Dr. Karen J. Coleman in Sports Medicine Bulletin.

“Would you be asking your doctor to prescribe it for you?”

Such a drug already exists, Sallis notes, it’s called walking. “If walking was a pill or surgical procedure, it would be on 60 Minutes.”

Sallis, a family practitioner at a Kaiser Permanente clinic in Fontana, California, keeps special walking RX prescription pads in his exam rooms, which he fills out for some patients saying, “This is what I want you to do to treat your high blood pressure or depression or diabetes etc.  If it’s not enough, then we will consider using a medication.”

What are patients’ reactions?  “They respond very well to this message,” Sallis says. “This approach really frames for them how important exercise is to their health and treating their disease.”  

Sallis first spoke up about walking and other physical activity being recognized as a vital sign in 2007, when serving as president of the American College of Sports Medicine and helping launch the Exercise is Medicine initiative with the American Medical Association.  The aim of that project is to highlight the mounting research proving that physical activity should be seen as essential to health and the treatment of disease.  It’s obvious that doctors, nurses and other clinicians should raise the idea of walking during medical exams, when people are paying particularly close attention to their health and how to maintain it.

Putting the Plan Into Action

In 2009, physical activity was designated as a vital sign for Kaiser Permanente facilities in Southern California and the idea was quickly adopted throughout the rest of the non-profit organization—the nation’s largest integrated care health system with 10.2 million members, seventeen thousand physicians, fifty thousand nurses, 620 clinics and 38 medical centers on the West Coast, the Mid-Atlantic region, Colorado, Hawaii, and Georgia.

Patients are asked how many days a week on average they engage in moderate or strenuous physical exercise, like a brisk walk, and for how many minutes? These two simple questions frequently spark conversation about the value of walking (or yoga, Zumba classes, bicycling, gardening and other physical activity) in treating and preventing disease.

A follow-up study published in the journal Medicine and Science in Sports and Exercise found that 18 months after Kaiser Permanente adopted physical activity as a vital sign in Southern California, 86 percent of all adult patients had a record of their activity levels included in electronic medical records. In 2013, Kaiser Permanente’s Exercise as a Vital Sign program was honored with an Innovation Award by the National Business Coalition on Health.  

“Asking an individual about their daily physical activity helps our providers learn what matters to our patients and prompts our patients to think about healthier habits,” explains Lisa Schilling, vice president for Healthcare Performance Improvement with Kaiser Permanente’s Care Management Institute.  “It also allows us to connect the individual to resources and habits that promote better health.”

Even health care professionals sometimes need encouragement to live more healthy. Zendi Solano, a research assistant for Kaiser Permanente in Pasadena, California, admits that she knew the importance of exercise but “really didn’t take it seriously” until her doctor asked about it during a check up.  Diabetes runs in Solano’s family, and she was obese with elevated blood sugar. Right then and there, she decided to take up running. At her next physical, Solano had lost 30 pounds and her blood sugar levels were normal. Being asked about exercise as a vital sign, she says, “is a great reminder.”

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Click on the interactive map to see what this data looks like for your own community or visit our Map Room to create your own maps.

About 2/3 of Sallis’s patients fall below the minimum federal guidelines for exercise, and half of those report no moderate physical activity at all during an average week, he says.  “Talking about physical activity can have an impact on everyone,” he says, especially high risk patients with diabetes, lung disease, heart disease, hypertension, arthritis or other chronic diseases.

“Anyone who is at risk for chronic disease should consider exercise an essential vaccine to greatly lower risk of illness and…extend life,” he wrote in a guest editorial for The British Journal of Sports Medicine.  

The power of exercise to heal really hit home for Sallis after meeting Valerie, a 68-year-old patient with Parkinson’s Disease who hobbled into his office with a walker.  She was desperate and depressed because her medication was no longer working. He recommended she visit a fitness professional to walk on a treadmill at one mile-per-hour speed along with some resistance training and stretches.  

“In a month-and-a half, she came back to my office without the walker, and telling me she had more energy and a more positive outlook,” he remembers. This convinced him, “if something so simple and inexpensive as exercise can have such a profound effect, shouldn’t we try to prescribe this powerful medicine to all of our patients?”

Something You Can Say ‘Yes’ to For Better Health

For Liz Joy, Medical Director for Community Health at Intermountain Healthcare based in Utah, the “a-ha” moment about physical activity as a vital sign came in 2008 at a meeting focused on preventing obesity among youth.  “It was a roomful of physicians, health care directors, scientists and coaches,” she remembers, “and one speaker got up and asked: ‘What is health care doing about this crisis?’  That’s when it came to me that physical activity needs to become a vital sign.”

Intermountain adopted the idea in 2013 in its electronic health record for use by clinicians in Utah and Idaho. “It’s a way to bring discussion of physical activity into the exam room,” Joy explains.  “Even if it’s just a brief conversation about how important it is to your overall health. I can let patients know it’s as important as blood pressure, and more important than obesity and cholesterol to your overall health.”

“I generally start by talking about walking, because it’s free and everyone knows how to walk,” she adds. “I’ll tell them just start with 10 minutes at a time—and no one has ever said they can’t do that.  Do that three times a day, and you have your 30 minute daily minimum.”

Joy notes that doctors have been charting people’s weight for generations, telling them to lose weight while watching the national obesity rate continue to rise.  “Talking about physical activity is a positive conversation–something people can do to improve their health. And when they take that first step, sometimes their eating habits begin to change too. You’ve helped enhance their self-efficacy.”

Some of her patients don’t consider walking real exercise, so the conversation can offer new motivation to get back on their feet.  “I saw a patient and was surprised his records showed that his physical activity was zero. I knew he had a dog, and I asked if he walked the dog? Yes, he said 30-60 minutes a day. But he didn’t think of it as exercise.”

“The physical activity vital sign is a great prompt to have a conversation with patients about activity and exercise— to them things like gardening and dog walking count,” she adds.  

Joy points out that health care systems have a strong incentive for adding physical activity to their lists of vital signs.  “Physical activity is stressed in Medicare reimbursements as one of the HEDIS (Healthcare Effectiveness Data and Information Set) measures, which Medicare and others use to assess the quality of health care delivery to determine level of payments.  It’s a huge financial driver.”

Spreading the Message into Exam Rooms Everywhere

The American College of Sports Medicine (ACSM) has joined with other groups in the walking movement to alert health care professionals about the promise of adding physical activity to their list of vital signs.  

“One strategy is to get influential medical organizations to formally adopt physical activity as a vital sign, and then activate their individual members,” says ACSM CEO Jim Whitehead.  They’re already working toward that goal with 10 medical societies, including the American Medical Association, the American Hospital Association, American Academy of Pediatrics, American College of Cardiology and the Preventive Cardiovascular Nurses Association.

“This is for all health care providers, not just physicians.  Nurses can often make a greater impact because they typically spend more time with you, ” notes Brenda Chamness, ACSM Strategic Health Program’s Senior Director.

Working with Kaiser Permanente and the Every Body Walk! Collaborative— a coalition of organizations ranging from the CDC to AARP to NAACP to the PTA—ACSM hosted a two-day scientific roundtable on the subject last April, which detailed recent research and presented best practices used by working physicians, including Robert Sallis and Liz Joy.  In October, several hundred health professionals around the country took part in a webinar on “Making Physical Activity a Vital Sign.”

“All this can have a major impact by showing people that they all don’t have to go to the gym to be healthy,” says Adrian Hutber, Vice President of Exercise is Medicine at ACSM. “They can just go out and take a walk.”
Jay Walljasper writes regularly about public health and healthy communities.  The former editor of Utne Reader, he is author of The Great Neighborhood Book. His website is

Salud America! Receives Funding, Releases New Research in 2016

Salud America! is a nonprofit network launched in 2007 that develops multimedia communications to educate and motivate its national online network—more than 50,000 kids, parents, teachers, academics, healthcare providers, and community leaders—to take action to reduce Latino childhood obesity and build a culture of health. Community Commons is proud to partner with Salud America! in the effort to provide data and research to affect communities across the country.

New Research Material

Throughout 2016, Salud America! will release research packages with specific recommendations for Latinos based on RWJF’s Five Big Bets:

  • Ensure that all children enter kindergarten at a healthy weight.
  • Make a healthy school environment the norm and not the exception across the United States.
  • Make physical activity a part of the everyday experience for children and youth.
  • Make healthy foods and beverages the affordable, available, and desired choice in all neighborhoods and communities.
  • Eliminate the consumption of sugar-sweetened beverages among 0-5 year olds.

Check out the research already available in the Salud America! Hub on Community Commons!

Active Spaces

“Latino kids don’t get enough exercise, so it’s critical to make parks, school playgrounds, and other recreational sites safer and more accessible to help Latino kids be active and fight obesity,” said Dr. Amelie G. Ramirez, director of Salud America! and the Institute for Health Promotion Research at the UT Health Science Center at San Antonio.

Salud America!’s Active Spaces and Latino Kids research package includes an in-depth review of the latest science on the U.S. physical activity environment and policy recommendations for Latinos. Research shows that 81% of Latino neighborhoods do not have a recreational facility, compared with 38% of white neighborhoods. Fear of crime and poor neighborhood conditions also prohibit Latino kids from being active.

Healthy Weight Entering Kindergarten

Maternal obesity, less exclusive breastfeeding, and workplace and childcare are issues that affect nutrition and physical activity levels, according to a new package of research: Healthy Weight by Kindergarten for Latino KidsObese Latina moms gave birth to kids who were 1.8 times more likely to be obese than their peers.

Healthy School Environment

Research shows that Latino-majority schools tend to have weaker policies on school snacks and drinks than white-majority schools, may be less likely to implement nutritional guidelines, and offer few programs or access to facilities for physical activity. Salud America!’s Healthier Schools and Latino Kids research tackles the latest science on the Latino school environment and offers policy recommendations.

Join the Hub and Become a Leader!

To stay up to date on topics related to Latino childhood obesity and health, consider joining Community Commons and become a member of the Salud America! Hub. Members can even sign up to become a Salud Leader to receive a free jump rope, a customized health report for your area, and be featured on our national map of Leaders. You can also follow Salud America! (@SaludToday) on social media on Twitter, Facebook, and YouTube.

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.

Data is Key for This School Nurse

This feature was previously published on the Healthy Schools Campaign blog.

When school nurse Kelly Grenham first started at Mapleton Public Schools outside of Denver, a serendipitous event put her office next to the tech department. “Tech people love teaching people about tech stuff,” she said. She started with a simple spreadsheet full of student health data, but that sheet morphed into a complex thing with lots of data and info, she says.

Kelly is a district school nurse consultant at Mapleton, which is contracted through the Children’s Hospital School Health Program. It’s through this program that she’s able to access research and resources and apply this information to benefit her students and their families.

And it’s data that Kelly used to spearhead some of her most successful interventions. She led an effort over four years to ensure that more students with asthma in her suburban district were able to receive the care they needed—and reduced their rate of absence at the same time. By working with the Regional Nurse Specialist Program through the Department of Education on a statewide level, Kelly made changes in her schools and across the state.

In her role as a Regional Nurse Specialist, she helped revise the standardized state asthma health care plan, which she presented to nurses in the metro area and in Northern Colorado. In the Mapleton district, she sent home an intake sheet and asthma care plan to all students with asthma. Prior to developing care plans, the school was only allowed to give two puffs of albuterol every three to four hours. The new plan allowed for up to eight puffs in an hour.
Asthma Map

The number of care plans for children with asthma increased from a handful to several hundred over a period of four years. By collecting data, Kelly found that the absentee rate of children with asthma was statistically down. Parents who may have kept their children home when they had concerns about asthma were more confident their child could be at school, and fewer children were sent home because their asthma was treated appropriately.

Kelly also used evidence and best practice research to change the district’s policy on head lice, another common reason children are absent from school. The district had a policy that involved sending the child home if there was evidence of nits, the eggs of head lice. Using information supplied by the Children’s Hospital of Colorado (School Health Program), National Association of School Nurses, American Academy of Pediatrics, the Colorado Department of Health and supported by Children’s Hospital, Kelly made the case that a child found to have head lice did not have to be excluded until the end of the school day and that child could return to school after treatment, even with evidence of nits. Kelly also helped change the previous practice of checking every child in the involved class for head lice, which has not been shown to be an effective practice.

In York International IB School, there is a Life Skills Program for students with developmental delays and Kelly is working on implementing a “Healthy Living” program for the students with special needs. Kelly is working with staff members at the school to identify programs that would educate students about making better lifestyle choices including food and physical activity. “We’re helping the kids to figure out how they can put their heights and weights into a CDC BMI calculator,” she says. “Then we show them the graph and say, ‘Here you are.’ We then tell them what that is saying and how it relates to their health.”

Youth Disability map

Click the map to zoom to your community.

The program is in the early stages, Kelly says, but the hope is that there will not only be a decrease in BMI but that the education will positively affect these students’ lives and how they think about their health.

Kelly has been instrumental in Mapleton Public Schools’ collaboration with the University of Colorado and Children’s Hospital to implement in January 2016 a 12-session course on “The Healthy Living Program” for families to improve their physical activity and nutrition.

Last May, HSC proudly announced the winners of our second annual School Nurse Leadership Award. It’s an award that acknowledges the tireless commitments that school nurses make, and is supported by School Health Corporation and MAICO Diagnostics. The five winners and five honorable mentions selected from across the country represent school nurses who are reimagining the role they play in school health and wellness, students’ academic success and the health of the larger community. Congrats to Kelly for being selected as a 2015 School Nurse Leadership Award winner! Thank you for the work you’ve done—and continue to do—to improve the health and wellness of your students and community. Read more 2015 School Nurse Leadership Award winner profiles.

feature photo credit: Neil Turner