Does the Built Environment Influence Physical Activity? Examining the Evidence -- Special Report 282 (2005) / Chapter Skim
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7 Future Directions
7 Future Directions
Pages 219-232
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From page 219... ...
A growing body of empirical evidence, primarily from cross-sectional studies reviewed in Chapter 6, suggests an association between the built environment and physical activity levels. The science, however, is not sufficiently advanced to support causal connections or iden tify with certainty those characteristics of the built environment most closely associated with physical activity behavior.
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From page 220... ...
Finally, the committee wishes to emphasize that, as noted in Chapter 6, modifications to the built environment alone are un likely to solve the public health problem of insufficient physical activity. Increasing populationwide levels of physical activity will require a range of approaches.
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For ex ample, the steady dispersion of both population and employment to low-density suburban locations has increased reliance on the private vehicle as the dominant and most convenient travel mode. Rebuilding physical activity into the daily routine is a public health priority, but the specific contribution that the built environment could make is not well understood.
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From page 222... ...
In general, the role of time has not been well accounted for in examining the relation ship between the built environment and physical activity. The available empirical evidence shows an association between the built environment and physical activity.
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From page 223... ...
For example, none of the national public health surveys on physical activity report its location or include such activity within build ings, although physical activity often takes place in workplaces, homes, and schools. Travel surveys are typically focused on pur poseful travel and ignore physical activity for exercise or recreation.3 Another issue is the appropriate scale of the built environment to which physical activity data should be linked and the relevant environmental characteristics that should be included at each 3 The distinction between physical activity for exercise and for transportation, however, is not al ways clear.
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From page 224... ...
CONCLUSIONS Regular physical activity is important for health, and in adequate physical activity is a major, largely preventable public health problem. The committee concurs with the strong and well-established scientific evidence linking physical activity to health outcomes and supporting reversal of the decline in overall physical activity levels as a public health priority.
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From page 225... ...
Moreover, the built environment is constantly being renovated and rebuilt and new developments are being constructed; these changes provide opportunities to incorporate more activity conducive environments. In the committee's judgment, such changes would be desirable even in the absence of the goal of in creasing physical activity because of their positive social effects on neighborhood safety, sense of community, and quality of life.
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Trend data from national public health surveys sug gest that in fact leisure-time physical activity has increased slightly over the past decade, and the literature reveals that many charac teristics of the built environment at the neighborhood level are sig nificantly correlated with leisure-time physical activity and exercise. Of course, individuals can also obtain their daily physical activity by exercising at home.
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From page 227... ...
Priorities for this research include the following: · Interdisciplinary approaches and international collaboration bring ing together the expertise of the public health, physical activ ity, urban planning, and transportation research communities, among others, both in the United States and abroad. · More complete conceptual models that provide the basis for for mulating testable hypotheses, suggesting the variables and rela tionships for analysis, and interpreting the results.
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Geocoding the data on physical activity and health collected in large surveys, such as the Behavioral Risk Factor Surveillance Sys tem, the National Health and Nutrition Examination Survey, and the National Health Interview Survey, could help link these rich data sets with information on the built environment and the spe cific locations where physical activity is occurring. Similarly, travel surveys, such as the National Household Travel Survey, as well as regional travel surveys, should be geocoded to provide more fine grained geographic detail so researchers can link these surveys and diary data with characteristics of the built environment.
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When changes are made to the built environment -- whether retrofitting existing environments or constructing new de velopments or communities -- researchersshouldviewsuch naturalexperimentsas"demonstration"projectsandanalyze their impacts on physical activity. Numerous such opportunities exist, ranging from the construc tion of new, neotraditional developments to projects of the Active Living by Design Program of the Robert Wood Johnson Founda tion.4 To take advantage of these natural experiments, baseline data must be collected.
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The new National Institutes of Health initiative on obesity and the built environment is one possible funding source.5 The committee encourages the study of a combined strat egy of social marketing and changes to the built environ ment as interventions to increase physical activity.6 The research should be designed to study these approaches both separately and in combination so that the influence of individual factors can be evaluated. To be effective, social marketing campaigns should be tailored to different population subgroups with relatively homogeneous characteristics and linked with other interventions involving the built environment for evaluation.
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At a minimum, existing programs in public health, transporta tion, and urban planning should be expanded to provide courses related to physical activity, the built environment, and public health. Similarly, practitioners in the field -- local public health workers, physical activity specialists, traffic engineers, and local urban planners -- could benefit from supplemental training in these areas.
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64436_TRB_239_252 4/25/05 10:21 AM Page 232 232 Does the Built Environment Influence Physical Activity? Examining the Evidence Even though causal connections between the built environment and physical activity levels have not been demonstrated in the literature to date, the available evidence suggests that the built environment can play a facilitating role by providing places and inducements for people to be physically active.
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