Local Public Health in Action: The physical, economic and health

benefits of polices and planning

American Public Health Association Annual meeting

San Francisco 2012 1

Support for Local Environmental Health: Increasing physical

activity options in San Antonio

MARY THOMAS M.B.& B.S., M.P.H.Communities Putting Prevention to Work

San Antonio Metropolitan Health DistrictSan Antonio Texas 2

Co-Authors

• Maggie Thompson, MS Program Manager, CPPW

maggie.thompson@sanantonio.gov

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Presenter Disclosures

The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months:

Mary Thomas

“No relationships to disclose”

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VISION

Increase active living options in San Antonio by supporting

local built environment to reduce obesity

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• Describe the changes in built environment to increase physical activity options at parks, libraries, and public housing

• Discuss increasing active transportation through installation of bike kiosks

• Describe the benefits of the Complete Streets Policy

LEARNING OBJECTIVES

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San Antonio Council Districts 1-10

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Demography of Bexar County• Population: 1.7 million• Multicultural: 59% Hispanic, 30% non-Hispanic, 7% African American, 3% Asian• South & Westside population: 80% Hispanic • Northeast & North central: 30% Hispanic • Persons below 45 years: 79%• Some populations have a greater burden of health

problems• One in three children and two in three adults are of

unhealthy weight

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Bexar County 2010 Populationby Race/Ethnicity

Population Source: U.S. Census Bureau, 2010

59%30%

7% 4%

Hispanic

White NH

African Am.

Other

Total 1.7 Million

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75000 25000 25000 75000Age 0 to 4 yrs

Age 10 to 14 yrs

Age 20 to 24 yrs

Age 30 to 34 yrs

Age 40 to 44 yrs

Age 50 to 54 yrs

Age 60 to 64 yrs

Age 70 to 74 yrs

Age 80 to 84 yrs

Bexar County 2010 Age Distribution

Population Source: U.S. Census Bureau, 2010

MaleFemale

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Bexar County - Educational Attainment

0%

5%

10%

15%

20%

25%

30%

35%

Less than highschool diploma

High schoolgraduate, GED

Some college Bachelor's degreeor higher

Population Source: U.S. Census Bureau, 2010 11

2010 Household Income Bexar County

0% 5% 10% 15% 20% 25% 30%

Less than $25,000

$25,000-$49,999

$50,000 to $74,999

$75,000 to $99,999

$100,000 to $149,999

Above$ 150,000

Population Source: U.S. Census Bureau, 2010 12

Obesity in Bexar CountyOne in 3 childrenTwo in 3 adults

67%

33%

Healthy Weight Unhealthy weight

Children

32%

68%

Normal weight Overweight/Obesity

Adults

Fitnessgram Data 2009-10 BRFSS 2010 13

Built Environmental Changes

• Safe roads, improved sidewalks & intersections by Public Works

• Walking trails, fitness stations at San Antonio Housing Authority locations

• Walking trails & fitness stations at libraries• Fitness stations in parks• Bike kiosks in downtown San Antonio

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Changes to Make Roads and Intersections Safe

• ADA ramps - 361 sites in 17 locations• Walkways' improvement in 10 locations• Traffic calming measures in 9 locations• Flashing beacons in 30 locations• Traffic designs in 12 locations• Traffic inventories in all 10 Council districts• Ped signal improvements in 38 locations• Cross walks in 33 locations• Dynamic signs in 8 locations

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Crosswalks, ADA Ramps, Traffic Calming Measures, Medians,

Flashing Beacons, Ped Signals

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Walking Improvement

Dynamic Message Sign

Crosswalk

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Pedestrian Signal ADA Ramp

Safe Routes to School

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San Antonio Housing Authority Locations

• Walking trails and fitness stations in four locations

• Alazan Courts• Lincoln Heights• SpringView • Cassiano

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Walking Trails/Fitness Stations

Alazon Cassiano

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Walking trails/fitness stations

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Fitness Stations & Walking Trails in Libraries

• Mission Library (both)• Parman Library (both)• Johnston Library (trail)• Memorial Library (stations• Oakwell Library (stations)

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Mission Library

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Changes in Parks

• Fitness equipment installed in 28 parks

• Trail Accessibility Information (TAI) posts -133 were installed in 31 parks

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Fitness Equipment

• Stationary –Stretches, pushups, squats, core and balance exercises

• Movable – use body weight to do leg press, chest press, rowing machine, cardio walker.

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Trail Assessment

• High Efficiency Trail Assessment Process (HETAP) used to assess trail characteristics

• Purpose: provide park users information regarding length, width, elevation, running slopes, surface type

• 101 miles assessed in 31 parks

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HETAP AND TAI POST

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The Trails Accessibility Information (TAI) includes the trail name, length, elevation change, permitted uses, grade, cross slope, width and surface type (TAI post example, right).

Distance assessed 101 milesNumber of parks 31Number of TAI posts 133

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Active Transportation-Bikes

• Aim: Provide active and alternate transportation and increase physical activity

• Result: Reduce number of cars on the streets, traffic congestion and parking problems, Improve air quality

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Bike Share Program

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• Launched March 2011• Number of kiosks - 25• Annual memberships - 1328• Daily passes - 11,590• Total number of trips - 52,182• Average distance per trip - 4.1 miles

Bike-Share Program

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Increase Physical Activity Options in Target Areas

• Walking trails and easy to use fitness stations in public housing units in target areas with low income, seniors, and residents with disabilities

• Safe environment for free physical activity and walking and biking options

• Walking trails and fitness stations in parks and libraries provide easy access to methods of physical activity

• Bike lanes and kiosks encourage biking to work or for leisure.

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San Antonio City Council passed

COMPLETE STREETS POLICY

on SEPT 29, 2011http://www.sanantonio.gov/planning/regionalplanning/completestreets.aspx 33

Complete Streets Policy Definition

A. Supports roadways that take into account all users, including people driving cars, using transit, riding bikes, walking, and using wheelchairs.

B. Includes people of all ages and abilities, including children, older adults, and persons with disabilities.

C. Considers the function of the road (e.g. local, collector, and arterial) and the level of vehicular, pedestrian, and bicycle traffic will be considered.

D. Road type determined by land use adjacent to the road

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Complete Streets

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Benefits to the Residents and Neighborhoods

• Enhance choice of mobility–all modes of travel–bike, walk, car, bus

• Facilitate physical activity for daily needs–pedestrians, Bike Master Plan

• Improve quality of life, health and safety• Neighborhood connectivity to benefit all

members of the city

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Acknowledgement With Thanks to

• John Berlanga, Senior Management Analyst, Metro Health

• Dr. Anil Mangla, Epidemiologist, Metro Health

• Jeremy Beer, Health Program Specialist, CPPW

• Dr. Isabela Lucas, Technical Consultant ICF Macro

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For more information

Mary Thomas, Senior Management Analyst,

San Antonio Metropolitan Health District,San Antonio TX

mary.thomas@sanantonio.gov210 207 5371

Any Questions ?

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