Making the Health Argument to Boost Walkability Alliance for Biking & Walking Mutual Aid Call Wednesday, May

8, 2013
Walking is one of the best ways to stay healthy. Regular physical activity, like walking, has been shown to lower the risk of cancer, heart disease, diabetes, stroke, arthritis and osteoporosis. Public health researchers have long recognized that walkable neighborhoods have the power to increase regular physical activity, having a hugely positive affect on overall public health. On this call, researchers and advocates shared the latest convincing research on how walkable neighborhoods affect public health and discussed how advocates can use health arguments to win better walking.

Advice from Dr. Brian Saelins, PhD Professor of Pediatrics and Psychiatry and Behavioral Sciences, Seattle Children’s Hospital
A Critical Component of Health
• Walking should be a strong focus of health intervention. Most American adults and children are failing to meet minimum health recommendations for physical activity. For those who are meeting the minimum requirements, walking is often a big part of their success. Built environment • Emerging evidence suggests that walking makes up a larger improvements percentage of overall physical activity than previously thought. have a greater In a recent study, researchers outfitted participants with accel- ability to increase erometers and found that nearly 59% of participants’ physical walking. activity came from walking.1

Built Environment Makes a Difference
• Built environment improvements have a greater ability to increase walking for a sustained period, even compared to programs that aim to increase walking. We need to look for opportunities to make physical activity easy, and the best way to do this is through built environment changes that weave walking into everyday life. • A study examined walking in Seattle, Baltimore and DC, looking at high and low income neighborhoods as well as neighborhoods with high and low levels of “walkability,” or walkable built environments. The study found no correlation between physical activity levels and income, but a very significant correlation between walking and walkability. People in more walkable communities were getting 4-5 minutes of extra exercise each day, leading to 12% lower obesity rates. • Three major factors lead to higher walking: • Density — making things nearby; • Land use mix — having non-residential destinations, like businesses, parks, and schools, in close proximity; and • Transit — greater presence of transit means more accumulation of walk trips. • Walking leads to better health for seniors, too, so built environment in communities with elderly populations is important. For built environments to maximize walking for older adults, distances between destinations need to be shorter.

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Making the Health Argument to Boost Walkability Alliance for Biking & Walking Mutual Aid Call Wednesday, May 8, 2013
Walking to School
• The built environment is the primary determinant for predicting levels of walking and biking to school. Distance to school is important, as are route aspects such as safety, major crossings, access to sidewalks, etc. Walking to and from

• There is evidence that walking to and from school does school is an overall “add not decrease other types of physical activity; it is an over- to a child’s health. all “add” to a child’s physical activity levels.2

Advice from Dr. David Sabgir, MD Cardiologist and Founder, Walk with a Doc
Why Walk?
• Exercise is important to get at the root problem of heart issues, as opposed to just addressing problems as they arise. • Medically, walking is a no brainer. It is harder than ever to find a disease that is not dramatically improved by walking. Even for diseases that we would not expect — depression, breast cancer, dementia — increasing walking and physical activity leads to significant improvements.

About Walk with a Doc
• As a cardiology fellow, David had lots of conversations with patients about the importance of physical activity but realized he was ineffective in actually getting people to exercise. To address his frustrations, he starting holding walks in local parks and inviting his patients, then founded Walk with a Doc in 2005 to spread his work. Walk with a Doc now holds walks in over 100 locations around the country. • The program aims to boost walking among patients while breaking down the barriers between patients and physicians. • While the walks vary, they hold certain common tenants. The walks are free, feature at least one medical doctor, and often include med students and nurses as well. The walks provide healthy breakfast food, feature a brief medical discussion often initiated by participant questions and include a 30-60 minute walk. Walk with a Doc provides pedometers and blood pressure checks before and after the walks. • Walk With a Doc advocates for 150 minutes per week of walking. 70% of the organization’s programs are weekly, while 30% are monthly or twice a month. • It would be easy for individuals or advocacy organizations to start up new Walk with a Doc programs. People who are interested in starting a new branch can contact Walk with a Doc (link) to learn more about program requirements. Potential walk leaders receive a tool kit with template letters to roll out the program, optional liability insurance and a license agreement. WWAD also sends a launch kit with shirts, pedometers and marketing materials.

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Making the Health Argument to Boost Walkability Alliance for Biking & Walking Mutual Aid Call Wednesday, May 8, 2013
• To recruit doctors for the program, organizers often turn to local hospitals, residency programs, and professors emeritus. Local hospitals are often receptive to participating because public involvement around health provides positive marketing.

Advice from Hillary Borcherding Communications Manager, WalkBoston
Zooming In on the Benefits: the Walk Your Way to Health Story
• WalkBoston works to address social and physical barriers to walking. Inspired by a meeting with Surgeon General Dr. Regina Benjamin, WalkBoston advocates decided to champion the health benefits of walking by boiling down existing walking and health research into a small and easy-to-understand handout. • While WalkBoston didn’t have the resources to create new research, advocates were able to find and curate existing research and data to create digestible educational resources about walking and health. Advocates were able to find and curate existing research and data to create digestible • The “Walk Your Way to Health” pamphlet (link) explains educational resources about walking & health why walking is the closest thing to a “magic bullet to health.” It touches on the benefits of walking related to disease prevention and improvement to different body systems. • WalkBoston decided to focus on health rather than weight because advocates were not comfortable to making a claim of the connection between walking and weight reduction. Instead, the pamphlet details the well-documented connection between walking and health living. • Advocates aimed to use the brochure to shock people. “Walk Your Way to Health” includes clear and tangible benefits to walking, which compliments people’s anecdotal thoughts on the benefits to walking. The pamphlet also discusses the connection between walking and children’s increased ability to learn.

Spreading the Knowledge
• To share the knowledge in the guide, WalkBoston created a road show. Advocates first brought the presentation to businesses that wanted to start walking programs, then brought it to school districts interested in promoting walking to school. • The organization targets outreach to areas that have the highest chance of increased walking, based on location of schools relative to where people live. • WalkBoston gives the Walk Your Way to Health brochure to corporate members and local schools. The brochure provides clear examples of the benefits of walking.

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Making the Health Argument to Boost Walkability Alliance for Biking & Walking Mutual Aid Call Wednesday, May 8, 2013
Citations and Additional Resources
• 1Kang et al., 2013 Medicine and Science in Sports and Exercise “Walking Objectively Measured: Classifying Accelerometer Data with GPS and Travel Diaries” • 2Cooper, 2005 American Journal of Preventative Medicine “Physical Activity Levels of Children Who Walk, Cycle, or Are Driven to School” • 2Cooper, 2012 Medicine & Science in Sports & Exercise “Active Travel and Physical Activity across the School Transition: the PEACH Project” • Walk Your Way to Health - WalkBoston’s pamphlet compiling essential research linking health and walking. • Walk your Way to Health presentation (PDF) - WalkBoston’s presentation on the links between health and walking • Walk with a Doc locations - a list of all Walk With a Doc locations, plus tips on how to start a new walk in your community • Active Living Research Briefs & Syntheses - a collection of scientific literature showing links between health and active transportation

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