The present historical moment may seem a particularly inopportune time to review Bowling Alone, Robert Putnam's latest exploration of civic decline in America. After all, the outpouring of volunteerism, solidarity, patriotism, and self-sacrifice displayed by Americans in the wake of the September 11 terrorist attacks appears to fly in the face of Putnam's central argument: that \"social capital\" -defined as \"social networks and the norms of reciprocity and trustworthiness that arise from them\" (p. 19)'has declined to dangerously low levels in America over the last three decades. However, Putnam is not fazed in the least by the recent effusion of solidarity. Quite the contrary, he sees in it the potential to \"reverse what has been a 30to 40-year steady decline in most measures of connectedness or community.\"' As an example of how the current \"war on terrorism\" could generate a durable civic renewal, Putnam points to the burst in civic practices that occurred during and after World War II, which he says \"permanently marked\" the generation that lived through it and had a \"terrific effect on American public life over the last half-century.\" 3 If Americans can follow this example and channel their current civic

Bowling alone: The collapse and revival of American community

Objective:This report surveys and evaluates the scientific research on evidence-based healthcare design and extracts its implications for designing better and safer hospitals.Background:It builds o...

/pdf/a-review-of-the-research-literature-on-evidence-based-2oeftve5sd.pdf

A Review of the Research Literature on Evidence-Based Healthcare Design

Neighborhood environment and physical activity among youth a review

In the United States, health disparities in obesity and obesity-related illnesses have been the subject of growing concern. To better understand how obesity-related health disparities might relate to obesogenic built environments, the authors conducted a systematic review of the published scientific literature, screening for studies with relevance to disadvantaged individuals or areas, identified by low socioeconomic status, black race, or Hispanic ethnicity. A search for related terms in publication databases and topically related resources yielded 45 studies published between January 1995 and January 2009 with at least 100 participants or area residents that provided information on 1) the built environment correlates of obesity or related health behaviors within one or more disadvantaged groups or 2) the relative exposure these groups had to potentially obesogenic built environment characteristics. Upon consideration of the obesity and behavioral correlates of built environment characteristics, research provided the strongest support for food stores (supermarkets instead of smaller grocery/convenience stores), places to exercise, and safety as potentially influential for disadvantaged groups. There is also evidence that disadvantaged groups were living in worse environments with respect to food stores, places to exercise, aesthetic problems, and traffic or crime-related safety. One strategy to reduce obesity would involve changing the built environment to be more supportive of physical activity and a healthy diet. Based on the authors' review, increasing supermarket access, places to exercise, and neighborhood safety may also be promising strategies to reduce obesity-related health disparities.

http://www.ced.berkeley.edu/downloads/pubs/faculty/hutson_2009_epi-reviews.pdf

Built Environments and Obesity in Disadvantaged Populations

Context: Environmental, policy, and societal changes are important contributors to the rapid rise in obesity over the past few decades, and there has been substantial progress toward identifying environmental and policy factors related to eating and physical activity that can point toward solutions. This article is a status report on research on physical activity and food environments, and it suggests how these findings can be used to improve diet and physical activity and to control or reduce obesity.

Methods: This article summarizes and synthesizes recent reviews and provides examples of representative studies. It also describes ongoing innovative interventions and policy change efforts that were identified through conference presentations, media coverage, and websites.

Findings: Numerous cross-sectional studies have consistently demonstrated that some attributes of built and food environments are associated with physical activity, healthful eating, and obesity. Residents of walkable neighborhoods who have good access to recreation facilities are more likely to be physically active and less likely to be overweight or obese. Residents of communities with ready access to healthy foods also tend to have more healthful diets. Disparities in environments and policies that disadvantage low-income communities and racial minorities have been documented as well. Evidence from multilevel studies, prospective research, and quasi-experimental evaluations of environmental changes are just beginning to emerge.

Conclusions: Environment, policy, and multilevel strategies for improving diet, physical activity, and obesity control are recommended based on a rapidly growing body of research and the collective wisdom of leading expert organizations. A public health imperative to identify and implement solutions to the obesity epidemic warrants the use of the most promising strategies while continuing to build the evidence base.

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Physical Activity and Food Environments: Solutions to the Obesity Epidemic

http://walkboston.org/sites/default/files/Walkability%20and%20Safety%20Around%20Elementary%20Schools%20Economic%20and%20Ethnic%20Disparities.pdf

Walkability and Safety Around Elementary Schools: Economic and Ethnic Disparities

Problem, research strategy, and findings: Increasing walking and bicycling to school has been a national policy goal since Congress created the Safe Routes to School (SRTS) program. While previous research has suggested positive program impacts, there have been no large-scale studies with strong research designs. Here we study 801 schools in the District of Columbia, Florida, Oregon, and Texas to assess how the proportion of students walking and bicycling to school changed after the introduction of SRTS programs. By including schools with and without SRTS programs and analyzing data collected over time (2007–2012), we are able to distinguish SRTS impacts from secular trends. We find increases in walking and bicycling after schools implemented SRTS programs. Engineering improvements are associated with an 18% relative increase in walking and bicycling, and the effects of education and encouragement programs are cumulative. Over the course of five years, these education and encouragement programs could lead...

Impact of the safe routes to school program on walking and bicycling

Long distance is a leading environmental barrier to walking to school and requires long-term, multilevel interventions. Meanwhile, childhood obesity remains highly prevalent, calling for more immediate solutions. The purpose of this study was to examine attitudinal and environmental correlates of walking to the elementary school, controlling for distance. Using parental survey data, 601 child pairs with matched home locations and different school travel modes (walking vs. private automobile) were examined, using conditional logistic regressions. Despite the same/similar objectively measured distance and home location, perceptions of distance, sidewalk and traffic conditions, park presence, and convenience of walking differed between walkers and automobile users. Parental attitudes and children’s preferences were associated with the odds of walking. Safety concerns (traffic danger, stranger danger, and getting lost) were higher among drivers, but only significant in bivariate analyses. To promote walking to school, route/street improvements appear promising, but parallel educational and promotional efforts may be needed to address perceptual and attitudinal barriers.

/pdf/beyond-distance-children-s-school-travel-mode-choice-2auajt9f5p.pdf

Beyond Distance: Children 's School Travel Mode Choice

Walking can be a healthy, sustainable, and equitable mode of transportation, but is not widely used for children’s school travel This study identifies multi-level correlates of walking to/from school and relevant policy implications We surveyed parents/guardians of 2,695 students from 19 elementary schools in Austin, Texas, which featured diverse sociodemographic and environmental characteristics Among the personal and social factors, negative correlates were parents’ education, car ownership, personal barriers, and school bus availability; positive correlates were parents’ and children's positive attitude and regular walking behavior, and supportive peer influences Of physical environmental factors, the strongest negative correlates were distance and safety concerns, followed by the presence of highways/freeways, convenience stores, office buildings, and bus stops en route Our findings suggest that society should give high priority to lower socioeconomic status populations and to multi-agency policy interventions that facilitate environmental changes, safety improvements, and educational programs targeting both parents and children

Xuemei Zhu

Papers

A Review of the Research Literature on Evidence-Based Healthcare Design

Walkability and Safety Around Elementary Schools: Economic and Ethnic Disparities

Impact of the safe routes to school program on walking and bicycling

Beyond Distance: Children 's School Travel Mode Choice

Correlates of walking to school and implications for public policies: survey results from parents of elementary school children in Austin, Texas