Promoting Physical Activity: But is it Safe to Go Outside?

Oct 11, 2012, 10:00 AM

Martin Fenstersheib, MD, MPH, director of the Santa Clara County Public Health Department in California led a session on safe outdoor activity for kids and adults at the 2012 Public Health Law Conference. NewPublicHealth spoke to Dr. Fenstersheib about what is keeping our communities from safely getting outside to play—violence, blight and communities built for cars—and solutions grounded in evidence-based public health law.

NewPublicHealth: You presented at a key session on making outdoor physical activity opportunities safer. What makes this an important issue for you?

Dr. Fentersheib: Often when we talk about physical activity, we hear people say that all we need to do is convince kids to go outdoors. A lot of us then say, “when we were kids, our parents let us out of the house in the morning and we came back at nighttime and all was well.” There wasn’t any problem with that. But, of course, we’ve all become aware of safety as a barrier to outdoor physical activity. And the issue has to do with not only criminal or violence safety, but safe streets generally. Do cars in an area make it less safe for example? And, is our environment built in a way that it is safe for kids to walk to school? My presentation will be an overview of the benefits of physical activity, and what some of the barriers are.

We’ll also look at the legal side of the issue, including a study on mixed use land zoning. I think the bottom line is that safer neighborhoods will have more of a mixed use flavor so that you don’t have to go far to get to work or play or to recreational areas. In such neighborhoods, there are stores and other places for you to go, and you’re closer to public transportation. The data to be presented will show that the crime rates in those areas are lower than in pure industrial areas or areas where there isn’t mixed use. Mixed use is helping to improve the built environment in the communities in which we live by having more eyes on the street, by having people basically looking out for one another and be more of a community.

NPH: What are examples in Santa Clara of new plans to create safer outdoor spaces for children and adults? 

Dr. Fentersheib: We are working very closely with a number of partners. We’ve become the conveners and the catalysts to make a lot of this happen, but there is a partnership involved in many of these areas. The Health Department is working with cities that have been funded to implement active transportation strategies such as biking and walking and the use of transit, so that encourages daily physical activity. Some of the cities are working with us and schools on adopting Safe Routes to School programs and strategies.

I’ve been on a couple of walk around assessments where we’ve taken the teachers and school officials and some of the city council members and walked the streets around the school to see what the kids are facing and we’ve found all kinds of things—perhaps a sidewalk missing, or a busy area where there aren’t crosswalks, or dangerous one-way streets near school—people tend to drive faster on one-way streets. And then we’ve talked to parents and kids about their concerns such as gang activity, and solutions such as having parents supervise walks to school so that we have more eyes on the street, more people looking out for one another.

We’ve been working with the planning departments of the county and several cities and that is an exciting area—creating general plans that have health elements to them including strategies for improving the built environment that would encourage higher rates of daily physical activity. When planning departments look at developing areas, there should be specific policies built in that say you need to have access to public transportation, you need to have parks, you need to have accessible areas where people can safely walk and play. So safe outdoor activity gets built right into the infrastructure and the general plan of communities, which we know is so critically important.

NPH: What do we know about the long term implications of making it safer to get to school, and be in school?

Dr. Fenstersheib: There’s a lot of very compelling data in this country about the numbers of people, especially in ethnic communities, where kids especially are fearful of going outside. That fear, even if it’s perceived, seems to translate into some alarming statistics of kids who don’t feel safe going to school, are less likely to be interested or compelled to attend higher education or to go to college. And among those kids less likely to view school as being safe, we’ve seen higher dropout rates. It has great implications on the lives of these kids, so it’s really imperative that we work to make it safer for them. That includes not just the crime issues, but also the safety issues within their schools such as bullying and handguns.

NPH: What are other ways that law and policies help create and improve safe outdoor spaces?

Dr. Fentersheib: That’s a work in process. We’re working with the cities, which is where law enforcement is and looking at neighborhood watches. Law enforcement doesn’t always have the resources, given today’s economies and city budgets, to do this on their own. They don’t always have the person power to be in every community. Communities are also working within neighborhoods to have them protect each other, to try to discourage gang activity. Parents are a very important part of that to protect their neighborhoods. If people see that parents are with their kids that can be a deterrent to gang activity.

Other opportunities include zoning and joint use policies where you, for example, negotiate an agreement with a school to use their facilities, their schoolyard, play yard facilities for public access after school hours. It’s also important to have city council members come around, as well as the public works folks, and look at each neighborhood and be able to learn and use the information we’ve uncovered such as where to put a crosswalk, or look at traffic flow around schools to divert traffic or something else that would make it a safer route to school.

We have a program called Juvenile Traffic Diversion, which is a joint effort between the Public Health Department and law enforcement agencies in our county. It’s a sort of traffic school for youth and young people for non-motorized violations such as jaywalking or not wearing a helmet when they’re riding their bicycle. The kids are given the opportunity to attend a two-hour educational class with a parent and the families can choose to participate in the program in lieu of paying the fine for the citation, which can be as much as $100. The youth who attend some of these classes are provided, in many cases, with a helmet that’s fitted for them at no charge. I think these types of programs are very helpful for communities. Public health should work with law enforcement instead of just relying on law enforcement coming out there and trying to do it on their own, or having communities being frustrated that they can’t get anything to happen.

This commentary originally appeared on the RWJF New Public Health blog.