Building Illness
What could local zoning codes have to do with obesity and asthma? Maybe lots
An effort to save older neighborhood schools and to build the new ones smaller is gaining strength. In addition, an international program called Safe Routes to School works in communities to make walking and biking to school easier.
In many ways, focusing on the environment is returning public health to its roots. "If you go back 100 years ago, urban design and public health were integrally related--housing, sanitation, water, disease," says Allen Dearry, associate director of the National Institute of Environmental Health Sciences. But it requires researchers to take their eye off the national picture and look closely at local communities.
Mapmakers and obesity experts at the University of Pennsylvania have joined forces to plot "food opportunities" kids have on their routes to and from school. A local group is encouraging businesses on the routes to sell healthier snacks. "These solutions have got to come from the grass-roots level," says Adam Drewnowski, an epidemiologist at the University of Washington. "We're not going to solve these problems by telling people to eat larger portions of broccoli."
Even before the built environment became the hot topic, Ross Brownson knew any changes in the boot heel would have to originate there. Residents told him they might walk--if they had a place to do it. "But they didn't want more scientists to come in, do a study, and leave." So Brownson began working on a lasting change: a network of walking trails.
A grant from the Centers for Disease Control and Prevention came through in 1990, and since then Brownson has leveraged grants and donations into 30 trails covering about 15 miles. The result? Between 1998 and 2004, the number of people walking the trails has doubled. Among those who had access to the trails, nearly 40 percent reported using them, and more than half of those had increased their walking. What's more, this readily available exercise appeals to all social groups. Says Brownson, now a professor at St. Louis University: "I think walking is becoming the norm here now rather than the oddity." And the rest of the nation, including city dwellers and suburbanites, could very likely learn something by looking to Missouri's boot heel.
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