Some of the Biggest Problems Sometimes Have the Simplest Solutions

Some of the Biggest Problems Sometimes Have the Simplest Solutions

In environmental public health, we often get caught up in looking for complex answers to complex problems. Sometimes we get lucky, though, and a simple solution will serve. The U.S. Surgeon General’s Call to Action to Promote Walking and Walkable Communities proves this point.

The simplicity of this response to the growing public health threats of obesity, chronic disease, etc. was so surprising that Jimmy Fallon remarked on it in his Tonight Show monologue. But simple doesn’t necessarily equate to easy. Throughout the speeches made during the launch itself, the importance of the built environment and community engagement to support walkability was highlighted.

Importance of Solutions at the Neighborhood Level

First, the Assistant Secretary for Health, Dr. DeSalvo, highlighted the importance of neighborhood-level solutions and talked about her own experience with a Complete Streets policy and installing traffic calming interventions. Then, the U.S. DOT Assistant Secretary of Transportation for Policy, Carlos Monje, highlighted the current partnership between DOT and CDC (led by NCEH’s Healthy Community Design Initiative) to create a Transportation and Health Tool. The tool, due to be launched in October, will

• allow transportation decision-makers to better understand the issues at the intersection of transportation and public health,
• allow decision-makers to understand how their community or state compares to their peers in key health and transportation indicators, and
• strengthen collaborations between the transportation and public health sectors.

Increasing Acting Living Opportunities for All

One of the most powerful examples of the importance of the built environment to increasing active living, particularly for potentially vulnerable populations, came from the individual experience described by the Deputy Director of Special Projects and Partnerships at the U.S. Department of Education, Juliette Rizzo.

Juliette, a person who uses a wheelchair, described the impact built environment barriers have had on her life and health in the past. She spoke of feeling isolated as a child when she could not participate in games and sports with classmates because the environmental supports that she needed didn’t exist. Today, though, she is known as the “Mayor” of her community because its environment has allowed her to become significantly active in community activities.

When asked to define “disabled,” Juliette responds that it stands for Deserving Individuals Seeking A Better Life, Exercise, and a Date. She emphasized the importance to persons with a disability of both the Call to Action and its companion campaign This is How I Walk—an effort led by CDC’s partner the National Center for Health, Physical Activity, and Disability to rebrand the word walking by challenging individual and societal perspectives.

Positive Change through Collaborations – Across Communities and Disciplines

The Surgeon General also focused on the importance of the built environment as he challenged city planners, community designers, and transportation professionals to pick up the mantle of public health champion and address the ongoing threat of sedentary lifestyles. In his remarks, he only mentioned one community by name, holding up West Wabasso, Florida, as an example of just how much positive change was possible even in a mostly initially “unempowered” place. He described how citizens in Wabasso, a small, lower income, lower education, minority community in Florida worked with the local health department to identify the highest priority health challenges and describe the changes needed to fix them.

Using the PACE-EH tool developed by NCEH’s Environmental Health Services Program, in partnership with NACCHO, the residents identified the need for streetlights, sidewalks, and outdoor recreational spaces as some of their highest priorities. Over several years, working in partnership with other local government agencies such as public works and transportation and nonprofit groups involved in housing development, the health department was able to leverage an initial $30,000 public health investment into more than $3 million of non-public health investments to address Wabasso’s public health priorities. Even more amazing were the documented health outcomes: after 2 years, 87% of residents indicated that they felt safer than before, 81% reported that they spent more time active outdoors, and 86% reported an improvement in their physical and mental health.

Building a Culture of Health

The Surgeon General reminded us that we must build a culture of health where communities ensure that everyone has a fair shot at active and engaged lives—rebuilding a culture of physical activity and health.

Rebuilding active community environments and reclaiming a culture of active living will not be easy. It has taken us more than 50 years to design and build communities designed to make the sedentary choices the easy choices. Only through dedication and multisector collaborations will we be able rediscover in less than 50 years the safe and healthy community environments for all residents that we once had – while at the same time improving the opportunities for active engaged lives for potentially vulnerable populations.