Obesity is prevalent in Mexico where fast food is abundant. Photo by waywuwei.

About half of the world now lives in cities, and this figure is expected to grow to 70 percent by 2050, with most urban growth projected to occur in developing countries. As people move to cities at this unprecedented pace and scale, they face altered lifestyles, behaviors and economic circumstances, many of which are contributing to a global health crisis of obesity. In developed countries, one out of every two people is overweight or obese, and the trend is moving to poorer countries.

In Latin America, there’s a greater prevalence of obesity in cities.  There are also estimates in India that 50 percent of urban woman are obese compared to 20 percent of rural women. In Hong Kong, “general obesity rates among primary-school students climbed to 22.2% in 2009-2010, from 16.7% in 1996-1997,” according to the Wall Street Journal. And childhood obesity rates in China’s coastal cities have grown 20-fold since 1985.  (In Mexico, on the whole, 70 percent of the population is overweight and 30 percent is obese. The United States is not far behind, with 68 percent of people overweight and 28 percent obese.)

As urbanization occurs alongside these rising obesity rates, this presents an opportunity to change people’s behaviors through sustainable urban design, active transport, and policies that encourage physical activity and other healthy ways to live in cities. 

GROWING PROBLEM

There are many reasons for expanding waistlines, but the behavioral and lifestyle changes that come as a result of  rural-to-urban migration are key contributors. In cities, the increased consumption of low-cost and accessible processed foods has supplanted more traditional diets that offer a better micronutrients. There are also disparities in access to food, sometimes resulting in urban “food deserts,” where food supermarkets are rare, understocked or overpriced, which further encourages or necessitates the need to drive a car in order to eat healthy food. Food advertisements, also more prevalent in cities, are targeted specifically at children, literally feeding the addiction to unhealthy food. What’s more, city life can more often mean a family of two income earners that have less time to prepare food for their families.

The transition away from physical labor, too, results in a loss of physical activity and weight gain. But even in rural areas, the rise in obesity is a problem. Farmers, for instance, who use mechanical farm equipment and may grow one type of crop as opposed to a diversity of vegetables, live in isolated areas where there is often easy access to highly processed food.

Obesity used to be associated with affluence but now there is no clear correlation in the developing world, as the foods highest in fats and sugar have become so widespread. Rebecca Kanter, a Ph.D. candidate at John Hopkins Bloomberg School of Public Health, conducted field research on obesity in Mexico and Brazil between 2007 and 2009. “At least in these two countries obesity rates are rising among all socioeconomic groups, not just the poor,” she says. “Historically, the way the pattern worked in many developed countries is that overweight/obesity would increase  among the upper classes first and then increase more rapidly among the poor as the most low cost and convenient foods are those that are highest in fats and sugars and thus, inherently, also high in calories.”

The number of overweight individuals now rivals the number of underfed people on the globe. The irony of obesity is that “while some of the poor are becoming plumper, they are not necessarily better fed,” says the Food and Agriculture organization of the United Nations.  “Obesity often masks underlying deficiencies in vitamins and minerals.”

WEIGHING OTHER OPTIONS

The global health crisis of obesity can be alleviated with active forms of transit, specifically biking and walking, and sustainable urban design, that promotes density and transit-oriented development. Such lifestyles can help prevent, reduce or stabilize excess weight gain by increasing energy expenditure, says Kanter. They also tend to make people feel safer and more socially connected—both factors that contribute to an overall healthier lifestyle.

In TheCityFix, we’ve written about a few of these initiatives:

• Encouraging physical activity for children. In Lecco, Italy, parents and staff lead chaperoned walks, known as the Piedibus, to make children feel safe walking from home to school and also to encourage physical activity, similar to the Safe Routes to School initiative in the United States. First Lady Michelle Obama also recognizes the importance of “active community design,” as promoted through her national Let’s Move! campaign. And the French have a national obesity prevention initiative called Epode, focused on healthy eating and physical activity.
• Hosting car-free days. These auto-less events, gaining popularity in cities around the world, force people to reconsider their relationship to the car. As an example of a more prolonged attempt to keep people out of their cars, the city of Arlington, Va. launched the Car-Free Diet campaign, which provides drivers with a calculator to see how many calories they burn, dollars they save, and CO2 emissions they reduce by following a car-free diet.
• Banning junk food. City officials in California banned the construction of any new fast food drive-thrus, in an attempt to deter people from “in-car dining” culture, which contributes to congested roads and clogged arteries.

Jessica Meaney advocates for safe walkable streets.

This interview is part of a series of interviews featuring sustainable transportation advocates, planners, engineers, journalists, sociologists, and other experts working to shed light on best practices and solutions from across the globe. We welcome your suggestions for future Q&As.

As we wrote about last month, communities all over the world celebrated International Walk to School events. We interviewed Jessica Meaney, California policy manager for the Safe Routes to School National Partnership, a national non-profit advocacy group, to better understand efforts and the benefits of getting kids to walk to school in Los Angeles. Based in Los Angeles’ Echo Park neighborhood, Jessica coordinates two Safe Routes to Schools networks: one at the state level in California, and one at the regional level in Southern California. These networks (that residents are totally open to joining) bring together advocacy groups, parents and community members, government agencies and other leaders to ensure that Safe Routes to School (SRTS) succeeds in California by leveraging resources and addressing and improving regional transportation policies.

Jessica has also been living car-free in Los Angeles for more than 10 years.

Tell me a little about yourself and how you came to be a SRTS National Partnership staffer.

I’d been working as a Regional Transportation Planner for the Southern California Association of Governments (SCAG) for over three years. Last October, thanks to a scholarship from APBP and support from SCAG, I was able to attend Walk 21, an international conference on walking.  I came home from that conference totally fired up and motivated. Working on bicycle and pedestrian issues in Southern California can be very challenging at times, and this conference re-inspired me, reminding me that change was doable and was happening all over the world. It made me to want to step outside the realm of a public agency and into a role of advocacy. I’d also heard a lot about the director and founder of the Partnership, Deb Hubsmith. She was someone who really had a reputation for getting things done, and I welcomed the opportunity to work and learn alongside her.

How did SCAG prepare you for your Safe Routes to School work? What has that work been about?

What I’d learned at the Southern California Association of Governments (SCAG), a public transportation agency concerned with regional transportation policy, made me a marketable candidate for this position.

I’d worked on their 2009 Regional Transportation Plan (RTP)–something the partnership is looking to directly impact. My master’s degree is in sociology, so I’m not trained as a planner, but the years I worked at SCAG gave me hands-on experience in transportation planning processes, not to mention exposure to some great regional thinkers and studies.

My approach to transportation began with looking at the key roles public transit, walking and bicycling play in social cohesion, so the years at SCAG helped me continue to further develop my perspective with hands-on experience and observations on policy development and adoption.

Safe Routes to School is a movement. It’s something everyone can be a part of. It’s about walkable and bike-able communities for everyone, regardless of age or ability. One of my favorite things about Safe Routes is that you don’t have to be a student, a parent or a city employee to care about having a neighborhood where families can live and have their kids go to school safely.

It’s also about mobility and independence–creating spaces we can enjoy walking and biking to with ease. Can kids in your neighborhood run around and have independence? Can they get to school safely? If not, why not? Answering these types of questions are a key priority for the health of our communities.

It’s fun to think about this movement expanding beyond students and schools–a Safe Routes for all. It’s an idea they’re talking about in Sacramento as they develop their regional, long-range transportation plan.

You’ve been working hard on developing a SRTS platform to try to influence SCAG’s next RTP. Why focus on an RTP?

Much of my regional work is modeled after successes gained in the Bay Area, where they were able to have the Metropolitan Transportation Commission (MTC), the area’s Metro Planning Organization (MPO), dedicate regional funding to Safe Routes and active transportation policies and programs. So now, the Bay Area has federal, state and now regional Safe Routes to School funds. It’s pretty awesome. Communities all over California want Safe Routes funds.  In fact, only one out of five Safe Routes projects in California gets funded. So it’s great to see regional leaders recognize this and address it.

How the Southern California Regional Network works, via Facebook.

In the SCAG Region, less than 0.5 percent of all regional transportation funding goes toward bike and pedestrian projects, yet 12 precent of all trips are made by bicycling and walking. And, worse yet, 25 perecent of all roadway fatalities and accidents involve pedestrians and bicyclists. It is a huge problem that these numbers are acceptable to our policy makers. Safety should be our number one priority for all of our communities, especially for our most vulnerable community members such as kids. All users of our roadways and community space should be safe and protected–not just  for those in cars. The other day I read that according to the Center for Disease Control and Prevention, motor vehicle accidents are the leading cause of death for people in the U.S. under age 34—that blew my mind.

Here in California, we are fortunate to have climate legislation that is working to further increase the sync between our land use and transportation investments to reduce car tips (SB 375). Now more than ever, local short trips (40 percent of all trips are less than 2 miles) become great solutions to our regional challenges, and it’s key that our policy makers know this. Many still see the need for big regional infrastructure investment, which in many instances is great—yet we still seem to continue to overlook that creating walkable and bike-able communities offer a great, cost efficient investment to meet these challenges, not to mention the co-benefits that it brings.

We’re lucky in California; we have a lot of great existing legislation and policy for active transportation. We need to now see it implemented.

Everything. I’m really lucky to get paid to do what I love and am continually inspired by the opportunities for change, change towards community wellness for all members.

The concept that transportation change is doable and is in fact happening in communities all over is an exciting story to share and to hear about. Many of our transportation decision makers still value speed and capacity as the key indicators for success of a transportation network. We need a way to help them see that that is no longer the only metric to be measuring our investments by.  Stories from their constituents help do that.

By creating a space to hear about best practices and local stories about how peers are being leaders in their own communities fires me up, and I think that fires up others, too. I also find it really valuable, and in fact, a key part of my work, to be able to then share their Safe Routes stories with policy makers across the state. We need champions all over for this, and we need to celebrate all those who are working so hard, many unpaid for their efforts. This is an issue anyone can relate to and talk about. I’d love to think I am part of a movement that is working to be more inclusive and recognizes all the important contributions of many. To me, working to see transportation policy that truly values walkable and bike-able communities is going to take team effort, and a big team at that.

Anything else?

Thanks for providing me the chance to talk about this. I’d love the opportunity to thank Congressman Oberstar for his legacy of creating the Safe Routes to School program. It is tough to lose such an amazing champion for walkable and bike-able communities. We will all have to work really hard to maintain his legacy.

Also, there are a lot of great resources to get something going in your own community. While the organization I work for has a focus on policy, the National Center for Safe Routes to School, which is funded by the Federal Highway Administration (FHWA), has amazing programmatic resources. And if you live in California, please join the State and/or Regional Network and get involved. We’re on Twitter, Facebook and WordPress, too. Or, just send me an email to find out more: Jessica (at) saferoutespartnership.org.

A "walking school bus" with Mayor Ron Loveridge of Riverside, California. Photo via Facebook.

The big city may wear them out, but at least they'll keep their free MetroCards. Photo via shell belle.

As school systems around the country start charging kids for their rides on the yellow school bus – or even cutting bus service altogether - a tentative deal worked out with state legislators in Albany reportedly will give the Metropolitan Transit Authority (MTA) $25 million to subsidize New York kids’ rides to school.

The MTA’s school transportation program gives 300,000 New York City schoolchildren free passes to ride the subway or the bus to school, and 285,000 more receive reduced-fare cards.

The MTA’s school transit program is really a huge bargain for the state – transporting far more students at a far lower cost than the Department of Education’s yellow school bus program. And the $25 million is less than 1/8 of the $214 million that the program costs. But it was enough to keep the MTA from scrapping the program altogether, as it thought it might be forced to in an attempt to redress this year’s $750 million deficit after the state lowered its contribution to just $6 million (from $45 million annually) in November 2009.

The city government will continue to contribute $45 million for the students’ MetroCards – the same amount it has contributed annually for the past 15 years. Prior to 1994, the city and state governments split the cost of the program; in 1995, the city, state, and MTA agreed to divide the costs equally. But since then, MTA has covered more and more of the costs. (Read this post to learn about how  ”multiple layers of government don’t always support each other.”)

Free Rides Too Scarce in United States

Free rides for students can relieve low-income families of a huge financial burden while encouraging a culture of public transit ridership that kids will carry into adulthood.

Few cities around the country give free rides to students; reduced-fare rides are much more common, particularly now that public transit systems are struggling across the country from state and city budget cuts.  Boston, Mass. for instance, gives junior high and high school students a 50% discount on their T passes, while younger students ride for free with adults.

Portland, Ore. however,  offers a unique case of a new free student ridership program. Just under a year ago, Portland started letting high school students ride TriMet for free using a special TriMet student pass. In this case, the funding comes from Portland’s business energy tax credit, which gives tax credits to businesses that support transit solutions to reduce Oregonians annual 39 billion vehicle miles traveled (VMT).

Roanoke, Va. also recently implemented a free pass for all students under 18 to ride the city’s buses.  In this case, the city implemented the new free passes along with a 20% fare increase for other riders, which boosted revenue enough to pay for the “Students Ride Free” program. The idea for free rides came from the V.O.Y.C.E. (Valuing Our Youth through Community Engagement) initiative, which works toward creating a safer environment and more opportunities for low-income youth in Roanoke. The city also implemented the plan in the hopes that free rides will encourage a culture of bus-riding.

The Let's Move Task Force can look to France's national obesity-prevention program, Epode, for ways to incorporate active community design. Photo: Epode.

Four weeks ago, TheCityFix covered the launch of Michelle Obama’s Let’s Move campaign, noting the omission of an active community design component. As we speak, the Task Force on Childhood Obesity is developing the campaign’s agenda. Its recommendations are due out in early May. Now is the time for them to consider how urban planning and design strategies could contribute to their goals.

The Task Force should join the global movement recognizing that active urban design is a key component of community-based obesity prevention. Modern life – where we move from our homes to our cars to our office computers to our cars back to our couches – doesn’t include a whole lot of daily physical activity. When we build that activity back in, the results are very positive but not all that surprising. According to an Active Living Research report, adults who use public transportation are less likely to be obese than those who do not use it. People with access to sidewalks and trails are more likely to meet physical activity guidelines. Walking or bicycling to school has been related to higher overall physical activity for children and adolescents, and the efforts of programs such as Safe Routes to School, like installing sidewalks, crosswalks and traffic-control devices around schools, have been linked to increases in the percentage of students who walk to school. So, providing people with the infrastructure and awareness they need to be active in their everyday lives is a common-sense response to the obesity epidemic.

The Task Force on Childhood Obesity can look to other countries for guidance on how to do this. For instance, the French program known as Epode (an acronym for Together Let’s Prevent Childhood Obesity) is a national obesity-prevention initiative focused on healthy eating and physical activity that has spread to 225 towns across the country. It was established under a pilot program in the mid-1990s, whose two participant towns have succeeded in reducing their percentages of overweight and obese children. The Epode model is now being applied throughout Europe and in Australia.

Epode shows us the benefits of a nationally led initiative. Simply put, a national program can be effective. With higher visibility, it can successfully raise awareness and stimulate state, regional and local decision makers to act. This visibility also attracts private partners who want the good publicity and who are willing to contribute to public-private initiatives, reducing program costs. A federal program can steer resources toward national priorities (i.e. strategies that simultaneously address climate change) or the neediest geographic areas (i.e. low-income areas). Additionally, a national program in the U.S. can coordinate with existing, complementary federal efforts and federal guidelines, such as the Department of Health and Human Service’s physical activity guidelines.

Building on the Epode model, an active design effort incorporated into the Let’s Move campaign could take on the following roles:

• Raise awareness about the role of urban planning and design in obesity prevention and Let’s Move projects through a Web site, newsletters and press outreach.
• Train local project managers to mobilize local stakeholders and apply solutions.
• Prepare tools and action kits for use by local project managers. These could include school curriculum and educational materials for doctors and parents. For example, Epode’s national coordination team designed a general “walking school bus” program, which was then adapted and implemented by local teams.
• Follow up on local stakeholder activities and evaluate the program’s success.
• Facilitate coordination between scientific experts and policymakers. Work with universities to encourage new research on urban planning and public health issues, and help translate this research into concrete and transferable policies. A committee of independent experts from the urban planning, public health, architecture, psychology, sociology, education and nutrition fields could be appointed to advise Let’s Move initiatives.
• Develop monthly or biannual themes for the campaign (for example, “learn to be a safe cyclist” or “discover your local park.”) Themes should be consistent with public health recommendations and applicable across the population.
• Serve as ambassadors for the program among different stakeholder groups (federal agencies, associations of governors and mayors, teachers’ unions, medical associations), mobilize support and recruit new participants.
• Seek new partners/financial support for the program.
• Hold an annual conference to publicize progress, share best practices and facilitate collaboration between the members of a national network.

An active community design component of Let’s Move could also:

• Encourage local and regional officials to incorporate active living considerations into the planning process. Make grants, matching funds or technical assistance available to communities that develop pedestrian, bicycle or greenways master plans or incorporate non-motorized transportation elements into comprehensive plans.
• Develop a performance-based funding system for active design infrastructure projects. Define active living indicators related to walking and biking infrastructure, safety, and parks and open spaces, develop tools to measure them, and help local policy makers identify goals. Communities that reach their goals would be eligible for special funding. For performance measures related to active transportation, the Let’s Move Task Force could promote their incorporation into the next transportation reauthorization, likely to be performance-based. The Centers for Disease Control and Prevention has already developed a set of measures that governments can use to monitor the effectiveness of urban planning and policy programs targeting obesity prevention.
• Coordinate with other relevant federal initiatives, including the HUD-DOT-EPA Livability Initiative, the TIGER grant program, other stimulus programs, the National Complete Streets Coalition and Safe Routes to School.
• Identify priority areas and apply the holistic approach of the Epode program (or closer to home, the Harlem Children’s Zone). These areas would be targeted for infrastructure investments and educational efforts relating to all four pillars of the Let’s Move initiative, and could serve as pilot programs, informing future actions nationwide.

*****
International experience, scholarly research and common sense all tell us that the Let’s Move campaign needs to incorporate urban planning and design considerations into their fight to curb obesity. One of the most important things Let’s Move can do is to simply start a national dialogue that connects health with urban and transportation policy. Guiding a discussion about the benefits of smart growth and other policies that promote active living will elevate these solutions to a new level.

Let’s Move as it stands is an interesting start, but Mrs. Obama and her team have the opportunity to be leaders in developing strategies that not only improve public health but also address climate change, oil dependence and economic development. This will require the involvement of the federal government as coordinator, trainer and norm-changer.