Category Archives: Physical activity
International Making Cities Livable Conference: UCLA’s Richard Jackson on Shaping Healthy Suburban Communities
"We have medicalized what is in fact an environmental-driven set of diseases," said Richard Jackson, MD, MPH, professor and chair of environmental health science at the UCLA School of Public Health, in a keynote presentation that energized and galvanized discussion among the diverse audience of city planners, architects and public officials at this week’s International Making Cities Livable Conference. This year’s conference focuses on bringing together a vision— across sectors—of how to shape healthy suburban communities.
Jackson, a prominent pediatrician and host of the “Designing Healthy Communities” series that aired on PBS, told an all-too-familiar story of a child who comes into a doctor’s office overweight and with alarming cholesterol and blood pressure results even at a young age. So the doctor prescribes behavior change: No soft drinks in the house. No screens in the bedroom. Exercise, do more, and come back in two months. In two months, what’s changed? Nothing. The food at school is still unhealthy, the neighborhood is still unsafe to play in and the family still uses the car to get absolutely everywhere because there is no other choice. The likely outcome for that child and so many others, said Jackson, is to end up on costly cholesterol medication just two months later when the child’s vital statistics continue to spiral out of control.
"It’s a 20th century idea that our minds are separated from our bodies, and our communities are separated from ourselves,” he Jackson, who reminded the crowd that the most critical health advancements in the last century took place because of changes in infrastructure, not medicine—primarily new sanitary standards to curb out-of-control infectious disease.
Now, said Jackson, “We’ve built America around the car” and we need a whole new set of infrastructure changes to re-build communities that offer better opportunities for health as part of everyday life. “The built environment is social policy in concrete.”
Jane Brody is the Personal Health columnist for The New York Times. She joined the newspaper in 1965 as a specialist in medicine and biology after receiving degrees in biochemistry and writing for multiple college newspapers, as well as for the Minneapolis Tribune. With her column she has seen and reported on almost 50 years in the evolution of personal and community health.
NewPublicHealth recently spoke with Brody about her take on the state of community health—and what we can all do to improve it.
NewPublicHealth: Over the years, what efforts have you seen that you think have been most effective at improving community health?
Jane Brody: Well, I think one of the most exciting things that’s happened in New York City, and possibly in other cities as well, is getting better food to people who live in food deserts. For example, collecting food that would otherwise be wasted and bringing it to communities where people get free food that is healthy, fresh, and they even have demonstrations of recipes. In fact, I got one of my favorite recipes—it’s a green bean frittata—from one of their demonstrations that I attended just to see how it all worked out.
We’ve also, as you’ve no doubt heard, been putting in all of these bike lanes and we now have introduced the Bike Share Program, which is not inexpensive, but it does at least give more people an opportunity to get off their butts and get out of their cars and maybe even not even use public transportation in some cases, but to get some exercise to and from work, which is wonderful. I remember during one of the transit strikes that we had in New York City, I rode my bicycle from Brooklyn to Times Square where I work, over the bridges and stuff, and it was just wonderful because I got my exercise in at the same time as I got to work and I didn’t have to spend an extra hour exercising. There have been improvements. We have, of course, public pools that are only open in the summer, but in summer is better than no public pools and nobody has to pay anything for a public pool, which is really great.
A community needs assessment of a Chinese-American community in New York City several years ago found multiple barriers to physical activity for children and teens including parents unable to supervise kids at play because of long work hours, unsafe neighborhoods, limited knowledge or access to existing programs, financial hardship, inadequate support for physical activity in schools, limited time due to competing priorities such as academics, and too much time in front of video games, computer screens and television. To increase exercise time and options and help to reduce obesity rates among Chinese-American youth, public health professionals from the Charles B. Wang Community Health Center sought out funding from the New York State Department of Health and Mental Hygiene to create the Chinatown JUMP (Joining Urban Partners for More Physical Activity) program.
>>Read more on New York's Health Improvement Plan, which sets out a plan for similar community health assessments and cross-sectoral collaborations in response to these findings.
Chinatown JUMP currently works with eight afterschool programs to incorporate daily physical activity into the curriculum of these academic programs, blending activity with learning. Program goals include:
- Promote healthier and fit children by educating them and their families about the correlation between exercise and staying healthy.
- Increase staff capacity to support students’ healthier lifestyle through training and technical assistance.
- Establish an afterschool culture that supports physical activity as well as academic achievement.
The program works hard to incorporate parents’ support and involvement as well. Participating students in iMove receive a community resource guide with information about free and low-cost recreational centers and public spaces in the neighborhood to share with their parents. Parents are also invited to workshops on the importance of physical activity and healthy eating habits.
NewPublicHealth recently spoke with Susan Yee, Associate Director of Programs at the Charles B. Wang Community Health Center, about Chinatown JUMP.
NewPublicHealth: What is the Chinatown JUMP program and what do you think sets it apart from other programs with similar goals?
Susan Yee: Chinatown JUMP’s goal is to try to improve opportunities for more physical activity in the Manhattan Chinatown area in order to create sustainable changes within the community.
Howard County has been the healthiest in Maryland since the Country Health Rankings launched in 2010. NewPublicHealth recently spoke with the county’s executive, Ken Ulman, about how the Rankings have helped drive further progress in improving the health of Howard County. Health initiatives introduced by Howard County have included a program that certifies schools as “Healthy Schools,” if they meet criteria in several areas including nutrition and physical activity, and a smoking ban in all county parks.
NewPublicHealth: Howard County has been consistently been ranked the healthiest county in Maryland. What key factors do you credit for that?
Ken Ulman: We start with some advantages. We have the blessings of a highly educated population that cares deeply about their community and have good jobs, and many, though not all, have [adequate financial] resources and access to care. We also have the advantage of having a nonprofit, the Horizon Foundation, based in Howard County that is dedicated to improving the health and wellbeing of people living and working in our county.
So it’s a combination of policy initiatives coupled with a public that really wants to make progress in these areas.
NPH: Have the County Health Rankings helped drive any of your public health and prevention initiatives?
Municipal mixed-use zoning is a public health strategy to create more walkable neighborhoods by creating integrated, un-siloed access to daily activities—such as going grocery shopping and traveling to school and work. A recent study in a special issue of the Journal of Health, Politics, Policy and Law funded by Public Health Law Research, a program of the Robert Wood Johnson Foundation, evaluated municipal zoning ordinances in 22 California cities to see whether the ordinances improved walkability in those communities. NewPublicHealth spoke with the study’s two authors, Sue Thomas, PhD, senior research scientist at the Pacific Institute for Research and Evaluation-Santa Cruz (PIRE) and Carol Cannon, PhD, formerly with PIRE and current associate research scientist at the CDM Group, Inc, a consulting firm in Bethesda, Md.
>>Read the full study.
NewPublicHealth: What was the scope of your study?
Carol Cannon: We looked at ordinances that create municipal mixed use zoning, and whether these laws seem to have an impact on the potential for walking to destinations.
NPH: In what ways were the study and findings innovative?
CDC: Only 20 Percent of U.S. Adults Meet Aerobic, Muscle-strengthening Requirements
Only about one in five U.S. adults meet the aerobic and muscle strengthening components of the federal government's Physical Activity Guidelines for Americans, according to a new report in the U.S. Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report. The guidelines call for a minimum of 2.5 hours of moderate-intensity aerobic activity each week, or 1.25 hours of vigorous-intensity aerobic activity, as well as at least two days of muscle-strengthening activities. About half of adults meet the aerobic minimums and 30 percent meet the muscle-strengthening requirements, which Carmen D. Harris, MPH, epidemiologist in CDC's physical activity and health branch, called “encouraging.” "This is a great foundation to build upon, but there is still much work to do,” she said. “Improving access to safe and convenient places where people can be physically active can help make the active choice the easy choice." Read more on physical activity.
Hospital Programs Find Success in Cutting Antibiotic Prescriptions, Drug-resistant Bacteria
Hospital programs designed to decrease the number of prescriptions for antibiotics also successfully cut the number of drug-resistant bacteria, according to a new study in the Cochrane Library. Such bacteria, as well as the possibility of secondary infections, can leave patients especially at risk. "Antibiotic resistance is recognized worldwide as a public health problem that's just getting worse. Really around the world people are worried that we'll end up with bacteria that are resistant to the antibiotics we've got," said Peter Davey, MD, of the University of Dundee in Scotland. Researchers found that while persuasion/education programs were effective, actually restricting prescriptions saw more improved outcomes early on, which persuasion/education’s effectiveness catching up later. "We got good evidence that restrictive interventions work faster in terms of changing prescribing and microbial outcomes," he said. Read more on preventing antibiotic resistance.
Suicide Rate Up Significantly for Middle-aged Americans
Attempts to explain the dramatic increase in suicides by middle-aged Americans over the past decade have left many public health experts “dumfounded,” according to Lanny Berman, executive director of the American Association of Suicidology. "The best we can come up with is maybe this is the group most likely to be affected by the recession and unemployment and [home] foreclosure," he said. "It affected suicide rates both nationally and internationally." A new report from the U.S. Centers for Disease Control and Prevention reveals that suicides for people aged 35-64 rose by 28 percent from 1999 to 2010. For comparison’s sake, more Americans died by suicide in 2010 (38,364) than in car crashes (33,687). According to an agency news release: "Suicide is a tragedy that is far too common. The stories we hear of those who are impacted by suicide are very difficult. This report highlights the need to expand our knowledge of risk factors so we can build on prevention programs that prevent suicide,” said CDC Director Tom Frieden, MD. Read more on mental health.
Study: Better Fitness Equals Better Grades for Kids
Getting kids more exercise may also make them more likely to get better grades, according to a new study in the Journal of Pediatrics. The study found that physically fit elementary and middle school students were 2.4 times more likely to pass math tests and about 2 times more likely to pass reading tests . The findings are especially significant at a time when schools across the country are cutting physical education programs. "Schools sacrificing physical education and physical activity time in search of more seat time for math and reading instruction could potentially be pursuing a counterproductive approach," said lead researcher Robert Rauner, MD, of Creighton University and Lincoln Public Schools in Lincoln, Neb. Read more on physical activity.
Personalized Risk Assessments Lead to Smarter Patient Decisions
Providing patients with personalized risk assessments instead of generalized assessments makes them more likely to make educated decisions about screening tests, according to a new review of 41 studies published in the Cochrane Library. The personalized evaluations include factors such as age, race, gender, weight, lifestyle and family history. "Knowing your individual risk for a particular health problem may help you make an informed choice about what screening services you might be interested in," said Michael LeFevre, MD, MSPH, co-vice chair of the government-backed U.S. Preventive Services Task Force. "Over time, what would be ideal is that we're able to make more specific, individualized recommendations and fewer population recommendations.” Read more on access to health care.
Study: ADHD, Autism, Depression May Share Genetic Link
Autism, attention-deficit/hyperactivity disorder (ADHD), major depression and other mental disorders may share genetic risk factors, according to a new study in The Lancet. Bipolar disorder and schizophrenia were also linked. Researchers do not yet understand the link between the gene variants and the disorders, but the knowledge may help improve prevention and treatment methods. "This is the first clue that specific genes and pathways may cause a broader susceptibility to a number of disorders,” said lead researcher Jordan Smoller, MD, a professor of psychiatry at Harvard Medical School in Boston. “Now the important work will be to figure out how this actually happens.” Read more on mental health.
Restaurant Chains Serving More Lower-Calorie Choices Do Better Financially
Restaurant chains that serve more lower-calorie foods and beverages have better business performance, according to a study released today by the Hudson Institute. Over five years, chains that increased the amount of lower-calorie options they served had better sales growth, larger increases in customer traffic, and stronger gains in total food and beverage servings than chains whose offerings of lower-calorie options declined.
The report, Lower-Calorie Foods: It’s Just Good Business, analyzed 21 of the nation’s largest restaurant chains, including quick-service chains such as McDonald’s, Wendy’s, Burger King, and Taco Bell, and sit-down chains such as Applebee’s, Olive Garden, Chili’s, and Outback Steakhouse.
“Consumers are hungry for restaurant meals that won’t expand their waist lines, and the chains that recognize this are doing better than those that don’t,” said Hank Cardello, lead author of the report, senior fellow at the Hudson Institute, and director of the Institute’s Obesity Solutions Initiative.
Read more on obesity.
New AMA Report Outlines Physician Responsibilities for Newly Discharged Hospital Patients
The American Medical Association (AMA) has released a new report, “There And Home Again, Safely” that outlines a list of five responsibilities for outpatient physicians to consider when caring for patients who have recently left the hospital. Developed by a panel of experts to improve safety and reduce the rate of hospital readmissions, responsibilities include:
- assessment of the patient’s health;
- goal-setting to determine desired outcomes;
- supporting self-management to ensure access to resources patients need;
- medication management; and
- care coordination to bring together all members of the health care team.
Read more on safety.
An Active Lifestyle May be Just as Beneficial as Structured Exercise
A new study conducted by researchers at Oregon State University College of Public Health and Human Science suggests that small amounts of activity that adds up to 30 minutes per day can be just as beneficial as longer bouts of physical activity at the gym. More than 6,000 American adults participated in the study by wearing accelerometers on a daily basis. Those who participated in the short bouts of activity could be moving as few as one or two minutes at a time by engaging in activities – such as taking the stairs instead of the elevator or walking while talking on the phone. The researchers found that more than 40 percent of adults in the study reach their 30 minutes of daily exercise by making movement a part of their everyday life. The researchers say such an active lifestyle approach may be just as beneficial as structured exercise to improve health, including preventing metabolic syndrome, high blood pressure, and high cholesterol.
Read more on physical activity.
HHS Launches Year-Long National Dialogue on Mental Illness
As part of the effort toward helping to reduce gun violence in the country, the U.S. Department of Health and Human Services (HHS) has announced some new initiatives. HHS Secretary Sebelius says the agency will join with private and public partners to launch a year-long national dialogue on youth and mental illness, engaging parents, peers and teachers to reduce negative attitudes toward people with mental illness, to recognize warning signs and to improve access to treatment. Read more on mental health.
IOM Committee Says Current Childhood Immunization Schedule Is Safe
An Institute of Medicine report released yesterday supports the safety of the federal childhood immunization schedule, but recommends that it be monitored. The current schedule calls for 24 immunizations by age 2 which results in some parents delaying vaccines, sometimes out of fear that too many simultaneous vaccines may pose a safety risk. The IOM panel said there is no evidence that a different schedule would be safer. Read more on vaccines.
Take a Night to Count — and Help — the Homeless
During the last ten days of January, tens of thousands of volunteers in more than 3,000 U.S. cities and counties will join in Make Everyone Count, a national effort to count the number of homeless adults and youth in shelters and on the streets. The counts provide local planners with both the number and characteristics of people who are homeless to help them develop targeted responses. According to the U.S. Department of Housing and Urban Development, which provides grants for the counts, being able to determine how many people are homeless and why is critical to helping to end homelessness. Volunteer by contacting homeless organizations in your area. Listen to a public service announcement on counting the homeless “Make Everyone Count," by musician Cyndi Lauper.
Study Finds PE Requirement at Universities at All-time Low
A new study from the Oregon State University College of Public Health and Human Sciences finds that the number of college students required to take physical education and exercise requirements is at an all-time low of 39 percent. The researchers looked at data from 354 randomly chosen four-year universities and colleges going back to 1920, a year when 97 percent of students were required to take physical education. Oregon State still requires physical education courses and lead researcher Brad Cardinal says requiring PE sets the tone for students to understand that being active and healthy is as important as their academic courses. Cardinal says he thinks budget cuts and an increased focus on purely academic courses are factors behind the reduction in college PE. And Cardinal says that campus fitness centers don’t take the place of required courses because they can be intimidating for many students. Read more on physical activity.
Yes, today is Wednesday. But as a new year dawns and New Year's resolutions kick in (learning Zumba and building yoga into our weekly schedule are high on the list for NewPublicHealth staffers) let's call today an honorary Monday—a day to embrace a new plan for health. The Monday Campaigns are here to help.
With the slogan "The day all health breaks loose," Monday Campaigns are a public health initiative of the Columbia University Mailman School of Public Health, the Johns Hopkins Bloomberg School of Public Health and the Lerner Center for Public Health Promotion at Syracuse University. The goal is to help prevent chronic disease by offering a weekly prompt that can support people in starting and sustaining healthy behaviors.
Research at Johns Hopkins found that a week is a critical unit of time in planning lives and Monday has special significance as the beginning of the week. People view Monday as a day for a fresh start and a chance to set healthy intentions for the next 6 days. They’re more likely to start diets, exercise regimes, quit smoking and schedule doctor’s appointments on Monday than any other day. And, according to the Hopkins researchers, they’re looking for help in setting and carrying out their healthy intentions for the week.
The campaigns have grown to include government and non-profit organizations, businesses, media outlets and communities. The three schools provide research, case studies, health-related content, marketing concepts and programs ready for individuals, communities and public health departments. Specific campaigns include:
- Meatless Monday
- Quit & Stay Quit Monday
- Kids Cook Monday
- Move It Monday
- Man Up Monday
- Caregiver Monday
The 2013 campaigns began last Monday, with a weekly series that offers tips for 2013. First up: set some long and short term goals:
A long-term goal can be something to work towards, like getting 2 ½ hours of activity each week or eating 5 servings of produce each day. Short-term goals are the smaller actions you take to build up to your objective.
>>Weigh in: Which Monday campaigns will your community try this year?