ADVANCING OBESITY SOLUTIONS
Through Investments in the
Built Environment
PROCEEDINGS OF A WORKSHOP
Steve Olson, Rapporteur
Roundtable on Obesity Solutions
Food and Nutrition Board
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was supported in part by the Academy of Nutrition and Dietetics; Alliance for a Healthier Generation; the American Academy of Pediatrics; the American College of Sports Medicine; the American Council on Exercise; the American Heart Association; the American Society for Nutrition; the Bipartisan Policy Center; the Blue Cross and Blue Shield of North Carolina Foundation; The California Endowment; ChildObesity180/Tufts University; Chobani; Edelman; General Mills; the Greater Rochester Health Foundation; Health Partners, Inc.; The JPB Foundation; Kaiser Permanente; The Kresge Foundation; Mars, Inc.; the National Recreation and Park Association; Nemours; Nestlé Nutrition; Nestlé USA; Novo Nordisk; the Obesity Action Coalition; The Obesity Society; Partnership for a Healthier America; Reebok, International; The Reinvestment Fund; the Robert Wood Johnson Foundation; Salud America!; Weight Watchers International, Inc.; and YMCA of the USA. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-47459-7
International Standard Book Number-10: 0-309-47459-0
Digital Object Identifier: https://doi.org/10.17226/25074
Additional copies of this publication are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.
Copyright 2018 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. Advancing obesity solutions through investments in the built environment: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25074.
The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.
The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D. Mote, Jr., is president.
The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.
The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.
Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.
Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.
Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.
For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.
PLANNING COMMITTEE ON ADVANCING OBESITY SOLUTIONS THROUGH INVESTMENTS IN THE BUILT ENVIRONMENT1
MARLON G. BOARNET, Professor and Chair, Department of Urban Planning and Spatial Analysis, Sol Price School of Public Policy, University of Southern California
JAMIE F. CHRIQUI, Professor, Health Policy and Administration, University of Illinois at Chicago
JENNIFER DILL, Professor and Director, Nohad A. Toulan School of Urban Studies and Planning, Portland State University
JANET FULTON, Chief, Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention
KIMBERLEY HODGSON, Principal Consultant, Cultivating Healthy Places
MARJORIE INNOCENT, Senior Director for Health Programs, National Association for the Advancement of Colored People
KELLIE MAY, Director, Health and Wellness, National Recreation and Park Association
MYETA M. MOON, Director, Health, United Way Worldwide
RUSSELL R. PATE, Professor, Exercise Science, and Director, Children’s Physical Activity Research Group, Arnold School of Public Health, University of South Carolina
JAMES F. SALLIS, Distinguished Professor, Department of Family and Preventive Medicine, and Director, Active Living Research, Division of Behavioral Medicine, University of California, San Diego
GISELLE SEBAG, Director, Programs, Center for Active Design
Health and Medicine Division Staff
LESLIE J. SIM, Roundtable on Obesity Solutions Director
HEATHER DEL VALLE COOK, Senior Program Officer
ELEANORE ALEXANDER, Associate Program Officer
AMANDA NGUYEN, Associate Program Officer
DARA SHEFSKA, Research Assistant (until March 2018)
CYPRESS LYNX, Senior Program Assistant
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
This page intentionally left blank.
ROUNDTABLE ON OBESITY SOLUTIONS1
BILL PURCELL III (Chair), Farmer Purcell White & Lassiter, PLLC, Nashville, Tennessee
RUSSELL R. PATE (Vice Chair), University of South Carolina, Columbia
MARY T. STORY (Vice Chair), Duke University, Durham, North Carolina
SHARON ADAMS-TAYLOR, American Association of School Administrators, Alexandria, Virginia
KATIE ADAMSON, YMCA of the USA, Washington, DC
ANDREA M. AZUOMA, Kaiser Permanente, Oakland, California
CAPT HEIDI MICHELS BLANCK, Centers for Disease Control and Prevention, Atlanta, Georgia
JEANNE BLANKENSHIP, Academy of Nutrition and Dietetics, Washington, DC
DON W. BRADLEY, Duke University, Durham, North Carolina
CEDRIC X. BRYANT, American Council on Exercise, San Diego, California
HEIDI F. BURKE, Greater Rochester Health Foundation, Rochester, New York
DEBBIE I. CHANG, Nemours, Newark, Delaware
JOHN COURTNEY, American Society for Nutrition, Bethesda, Maryland
ANNE DATTILO, Nestlé Nutrition, Florham Park, New Jersey
MERRY DAVIS, Blue Cross and Blue Shield of North Carolina Foundation, Durham, North Carolina
CHRISTINA ECONOMOS, Tufts University, Boston, Massachusetts
IHUOMA ENELI, American Academy of Pediatrics, Columbus, Ohio
GARY FOSTER, Weight Watchers International, Inc., New York, New York
DAVID D. FUKUZAWA, The Kresge Foundation, Troy, Michigan
MONICA HOBBS VINLUAN, Robert Wood Johnson Foundation, Princeton, New Jersey
MARJORIE INNOCENT, National Association for the Advancement of Colored People, Baltimore, Maryland
SCOTT I. KAHAN, The George Washington University, Washington, DC
AMY KULL, Edelman, San Francisco, California
SHIRIKI KUMANYIKA, Drexel University, Philadelphia, Pennsylvania
CATHERINE KWIK-URIBE, Mars, Inc., Germantown, Maryland
THEODORE KYLE, The Obesity Society, Pittsburgh, Pennsylvania
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
LISEL LOY, Bipartisan Policy Center, Washington, DC
KELLIE MAY, National Recreation and Park Association, Ashburn, Virginia
MYETA M. MOON, United Way Worldwide, Alexandria, Virginia
JOSEPH NADGLOWSKI, Obesity Action Coalition, Tampa, Florida
BARBARA PICOWER, The JPB Foundation, New York, New York
SUE PECHILIO POLIS, National League of Cities, Washington, DC
ROBERT C. POST, Chobani, New York, New York
AMELIE G. RAMIREZ, Salud America!, San Antonio, Texas
OLIVIA ROANHORSE, Notah Begay III Foundation, Santa Ana Pueblo, New Mexico
NANCY ROMAN, Partnership for a Healthier America, Washington, DC
KEVIN R. RONNEBERG, Health Partners, Inc., Minneapolis, Minnesota
SYLVIA ROWE, S.R. Strategy, LLC, Washington, DC
JAMES F. SALLIS, University of California, San Diego
EDUARDO J. SANCHEZ, American Heart Association, Dallas, Texas
PATRICIA L. SMITH, The Reinvestment Fund, Philadelphia, Pennsylvania
MARION STANDISH, The California Endowment, Oakland, California
MAHA TAHIRI, General Mills, Inc., Minneapolis, Minnesota
KATHLEEN TULLIE, Reebok, International, Canton, Massachusetts
HOWELL WECHSLER, Alliance for a Healthier Generation, New York, New York
JAMES R. WHITEHEAD, American College of Sports Medicine, Indianapolis, Indiana
TRACY ZVENYACH, Novo Nordisk, Washington, DC
Health and Medicine Division Staff
LESLIE J. SIM, Roundtable on Obesity Solutions Director
HEATHER DEL VALLE COOK, Senior Program Officer
ELEANORE ALEXANDER, Associate Program Officer
AMANDA NGUYEN, Associate Program Officer
DARA SHEFSKA, Research Assistant (until March 2018)
CYPRESS LYNX, Senior Program Assistant
ANN L. YAKTINE, Director, Food and Nutrition Board
Consultant
WILLIAM (BILL) H. DIETZ, The George Washington University, Washington, DC
Reviewers
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
KIMBERLEY HODGSON, Cultivating Healthy Places
MARJORIE INNOCENT, National Association for the Advancement of Colored People
KATRINA PIERCY, U.S. Department of Health and Human Services
ANNA RICKLIN, Planning and Community Health Center
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings, nor did they see the final draft before its release. The review of this proceedings was overseen by MARY T. STORY, Duke University. She was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.
This page intentionally left blank.
Contents
Overview of the Built Environment
Organization of This Proceedings
2 THE BUILT ENVIRONMENT, OBESITY, AND HEALTH
Food and Nutrition Environments
3 EXAMPLES FROM COMMUNITIES AND CITIES
Healthy Communities in North Carolina
Regional Transportation Planning in Tennessee
4 ACHIEVING EQUITABLE HEALTHY ENVIRONMENTS
Providing All Children with Opportunities to Play
Community Engagement in Alameda County
Developing Healthy Communities
Boxes and Figures
BOXES
1-1 About the Roundtable on Obesity Solutions
1-2 Workshop Statement of Task
FIGURES
2-2 An ecological framework depicting the multiple influences on what people eat
3-1 An example of a street that does not promote active transportation or healthy eating
3-3 A sidewalk near a bus stop in the city (top), compared with a bus stop in the county (bottom)
This page intentionally left blank.
