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Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Planning for Healthy
Communities
Dr. Ruth Petersen
Section Chief
Chronic Disease and Injury Section
North Carolina Division of Public Health
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Topics
• Collaborations
• Innovations
• Opportunities
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Public Health
Public health connects us all.
Public health is the science of protecting and
improving the health of families and communities
through the promotion of healthy lifestyles,
research for disease and injury prevention and
detection and control of infectious diseases.
Source: Centers for Disease Control and Prevention Foundation. Available at:
http://www.cdcfoundation.org/content/what-public-health. Accessed April 2015
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
What Works
Strategies to Increase Physical Activity
• Community-scale urban design and land use
• Street-scale urban design and land-use policies
• Active transport to school
Sources: Community Preventive Services Task Force. The Guide to Community Preventive Services.
http://www.thecommunityguide.org/pa/environmental-policy/index.html. Accessed 07/2014.
Physical Activity Guidelines for Americans Midcourse Report: Strategies to Increase Physical Activity Among Youth. United States Department of
Health and Human Services. http://www.health.gov/paguidelines/midcourse/pag-mid-course-report-final.pdf. Accessed 07/2014.
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Physical Activity
To Reduce the Risk of Chronic Disease:
Source: United States Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans.
http://www.health.gov/paguidelines/guidelines/. Accessed April 2015.
Overweight/Obesity
Heart Disease
Type II Diabetes
Stroke
Colon/Breast Cancer
Hypertension
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Physical Activity
30%Lower risk
of early
death
Source: U.S. Department of Health and Human Services. Step It Up! The Surgeon General’s Call to Action to Promote
Walking and Walkable Communities. Washington, DC: U.S. Department of Health and Human Services, Office of the
Surgeon General; 2015.
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Physical Activity Recommendations
Adults need at least:
150 Minutes
every week
moderate-
intensity
aerobic
activity
Muscle-
strengthening
activities on 2 or
more days a week
that work all major
muscle groups
(legs, hips, back,
abdomen, chest,
shoulders and
arms)
75 Minutes
every week
vigorous-
intensity
aerobic
jogging or
running
OR PLUS
Source: United States Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans.
http://www.health.gov/paguidelines/guidelines/. Accessed April 2015.
Key Point: All adults should avoid inactivity. Some physical activity is better than
none, and adults who participate in any amount of physical activity gain some
health benefits.
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Physical Activity Recommendations
Aerobic Activity
Most of the 60 minutes or more should be aerobic activity and should include
vigorous-intensity
at least 3 days a week.
Muscle-Strengthening
Activity
on at least 3 days of the week.
Bone-Strengthening
Activity
on at least 3 days of the week.
Children and adolescents need 1 hour or more of physical activity daily.
This should include:
60 minutes or more of physical activity daily
Source: United States Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans.
http://www.health.gov/paguidelines/guidelines/. Accessed April 2015.
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Physical Activity Guidelines among
Adults, BRFSS 2013
Data sources: United States Department of Health and Human Services Center for Disease Control and Prevention Office of Surveillance, Epidemiology, and Laboratory Services Public
Health Surveillance Program Office. Behavioral Risk Factor Surveillance System, 2013. Participated in enough Aerobic and Muscle Strengthening exercises to meet guidelines.
http://apps.nccd.cdc.gov/brfss/display.asp?cat=PA&yr=2013&qkey=8291&state=US. Accessed April 14, 2015.
North Carolina Department of Health and Human Services, State Center for Health Statistics, 2013 BRFSS Survey Results, Aerobic and Strengthening Guidelines (4-LEVEL)
http://www.schs.state.nc.us/data/brfss/2013/nc/all/_PAREC1.html. Accessed April 14, 2015.
29.4
30.3
8.8
9.4
18.7
18.7
20.5
20.5
0 10 20 30 40 50 60
Met strengthening guidelines
Met aerobic guidelines
Met strengthening guidelines
Met aerobic guidelines
No
rth
Ca
rolin
aN
atio
na
l
Aerobic Only Strengthening Only Both
[ = 50.8 ]
[ = 29.9 ]
[ = 48.1 ]
[ = 27.5 ]
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
*Asked only of those who reported any exercise in the past month.
NOTE: There are 69 exercise categories available for this question. The four categories featured in this table had highest frequency of any single category.
Data source: North Carolina Department of Health and Human Services, State Center for Health Statistics, 2013 BRFSS Survey Results, What type of physical activity or exercise
did you spend the most time doing during the past month?* http://www.schs.state.nc.us/data/brfss/2013/nc/all/pa_type.html. Accessed April 14, 2015.
Most Common Types of Activity Reported by Adults
Engaged in Physical Activity, NC BRFSS 2013
53.7
27.5
10.1
5.43.3
0
10
20
30
40
50
Walking Other Running Gardening Aerobics
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
64%
36%Yes No
Data source: North Carolina Department of Health and Human Services, State Center for Health Statistics, 2013 BRFSS Survey Results, Does your
community have trails, greenways, bike paths, or sidewalks for biking, walking, or other activities?
http://www.schs.state.nc.us/data/brfss/2013/nc/all/nc12q01.html, Accessed April 14, 2015.
Availability of Trails, Greenways, Bike Paths, or
Sidewalks for Biking, Walking, or Other Activities in
Communities, NC BRFSS 2013
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
39.4
14.3
17.4
28.9
At least once aweek
At least once amonth
A few times peryear
Never
0
5
10
15
20
25
30
35
40
Data source: North Carolina Department of Health and Human Services, State Center for Health Statistics, 2013 BRFSS Survey Results, How often
do you use these for biking, walking or other activities?* http://www.schs.state.nc.us/data/brfss/2013/nc/all/nc12q02.html. Accessed April 14, 2015.
Use of Trails, Greenways, Bike Paths, or Sidewalks for
Biking, Walking, or Other Activities in Communities
Where They are Available, NC BRFSS 2013
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
6.1% 5.3%
88.6%
Less than 1 hour per week
1 hour or more hours per week
None
Time Spent Walking or Bicycling as a
Means of Transportation
NC BRFSS 2013
Data source: North Carolina Department of Health and Human Services, State Center for Health Statistics, 2013 BRFSS Survey Results, In the past
week, how much time did you walk or bicycle for transportation, such as to and from work or shopping?
http://www.schs.state.nc.us/data/brfss/2013/nc/all/timewalk.html, Accessed April 2015.
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Step it Up! The Surgeon General’s Call to
Action To Promote Walking and
Walkable Communities
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Research shows:• Destinations within .5 mile = how far people will walk on
average
• Public transit = additional 21 minutes a day of walking
• More access to green environments (e.g., parks) = more
walking
Source: U.S. Department of Health and Human Services. Step It Up! The Surgeon General’s Call to Action to Promote Walking and
Walkable Communities. Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General; 2015.
Emerging evidence:When parks add more signs and
conduct outreach activity, the
physical activity of park users
increases
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Collaborations
NC Departments of:
• Transportation
• Environment and Natural Resources
• Cultural Resources
• Commerce
NC Division of Public Health
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Collaborations
Guidebook on Local Planning for Healthy Communities
North Carolina Guide to Incorporating Health Considerations into Comprehensive Plans
WalkBikeNC: North Carolina Statewide Pedestrian and Bicycle Plan
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Innovations
• Miles and locations of
greenways and trails in NC
• Number and locations of
public parks in NC
Data Day 1.0 – September 17, 2012
Data Day 2.0 – October 29, 2014
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
A Partnership between
NC Department of Transportation
& NC Division of Public Health
Innovations
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
InnovationsProject outcomes reported by Active Routes to School Coordinators
between July 2014-June 2015
Wa
lk t
o S
chool D
ay
• 92 Events
• 22,805 Participants Reached
Bik
e t
o S
chool D
ay
• 96 Events
• 2,405 Participants Reached
On
go
ing P
rogra
ms
• 38 Events
• 10,416 Participants Reached
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Innovations
Transportation Plans • Kannapolis Bicycle Plan
Success Stories: www.communityclinicalconnections.com/ActiveRoutes
3 school’s have adopted Let’s Go NC!
1 school district has adopted Let’s Go NC!
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Opportunities
Obesity, Diabetes, Heart Disease and Stroke Prevention (ODHDSP/1422) Funding
• $3.52 million awarded in October 2014
• Funding through September 2018
• Administered by the Community and Clinical Connections for Prevention and Health Branch, housed within the Chronic Disease and Injury Section of NC Division of Public Health
• For the implementation of population-wide and priority population approaches
• To prevent obesity, diabetes, heart disease and stroke, and reduce related health disparities among adults
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Opportunities
• Signage
• Pedestrian Summit/Training
• Community plans that promote walking
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Opportunities
• Create cross-sector partnerships
• Public health and MPO/RPO partnerships
• Planning and transportation part of
Community Health Assessments
• Support walking and biking to school
efforts
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Settings
• Health care
• Child care
• Schools
• Colleges and universities
• Work sites
• Faith-based organizations
and other community
organizations
• Local government
• Food and beverage
industry
Opportunities
www.EatSmartMoveMoreNC.com
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Opportunities
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
Opportunities
Support communities in creating policies and
environments where people have access to
healthy foods and places to be physically active.
For example: healthy food retail, greenways, trails
and community plans.
Faith Communities
Communities
Provide resources and support to promote physical activity and healthy
eating in faith communities.
Worksites
Provide resources and support to promote physical activity and healthy eating
at worksites.
Chronic Disease and Injury SectionNorth Carolina Division of Public Health
North Carolina
Collaboration, Innovation, Opportunities
www.pedbikeimages.org/LauraSandt