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Introduction
Community design is one of the issues in a broader topic of environmental health. According to American Public Health Association (APHA, 2017), the built environment is the human-made features of our communities (including sidewalks, public transportation, housing, etc.), and it affects both physical and mental health of community members (para. 2). Therefore, it is essential to identify existing deficiencies and factors inhibiting individuals safety and well-being in community designs, advocate for changes and restructuring, and promote evidence-based solutions. The policy that will be discussed in the given paper aims to achieve these objectives.
Background
According to Jackson, Dannenberg, and Frumkin (2013), those living in substandard housing, persons with no access to safe places for physical activity, the elderly who cannot drive to their destinations, urban children deprived of autonomy and nature contact are among the most vulnerable groups of the population that may require healthier community design at both local and national levels. Additionally, it is considered that lower-income families and neighborhoods are at greater risk of suffering environmental disparities. For instance, Coughenour and Burns (2016) suggest that inefficient community design in lower-income residential areas may define the amount of physical activity, in which local engage, as well as their dietary habits. Thus, it is essential to target attention to various populations at risk.
According to national statistics, nowadays, approximately 50% of the US adults and children do not get the minimum amount of physical activity suggested in the Physical Activity Guidelines for Americans (Centers for Disease Control and Prevention [CDC], 2015). At the same time, a healthy community, infrastructure, and street scale designs providing sufficient space and opportunities for walking, bicycling, etc. can eliminate the given issues. Moreover, according to the CDC (2015), such initiatives can potentially and significantly reduce the annual cost of obesity, which in 2008 equaled the US $147 billion.
Problem Statement
As stated by Creatore et al. (2016), despite public health efforts to reduce obesity through diet and exercise, rates of overweight, obesity, and diabetes remain high, prompting a search for population-wide strategies to help curb these dual epidemics (p. 2212). It is possible to say that community redesign can be one of the given strategies. The researchers claim that in high population density neighborhoods where main destinations are located within walking distances of residential areas, and streets are well-interconnected, people engage in walking and bicycling much more (Creatore et al., 2016). Therefore, to reduce obesity rates, it is essential to decrease the dependence on motorized transportation at the community level.
Solutions
The solutions to the identified problem will be based on the following findings by Gunn et al. (2017): 1) locating of food outlets in about 800 meters can foster an increase in transport walking trips; and 2) settings associated with daily activities (schools, shops, etc.) should be achievable during the 15-minute walk. When the given metrics are applied in the community design strategy, it can be possible to increase the neighborhood walkability. Additionally, since the level of dissatisfaction with community design related to biking safety and infrastructure remains high (CDC, 2015), it is essential to create a sufficient number of interconnected and safer biking lanes in the communities to increase individuals willingness to take bicycling trips. Lastly, the availability of parks and recreation areas in the neighborhood can help stimulate walking and engagement in outdoor sports.
The major stakeholders who can be involved in the implementation of the given policy include community residents, hospital personnel, business owners, local government representatives, etc. Community residents can benefit from the policy most. Thus, it is essential to raise their awareness of the community design issues to gain their support for the initiative. Nurses and clinical personnel will perform the role of advocates for change and will actively participate in the dissemination of findings. The involvement of authorities, i.e., the Department of Transportation, is a necessity because the project is directly linked to their major responsibilities of building the city capacity. Lastly, since the restructuring and construction of new infrastructures will require significant financial investments (i.e., a few million USD at least), the attraction of major local business players, by showing the possible commercial and advertising benefits of their participation, can help facilitate the project implementation.
Conclusion: Impacts on the Health Care Delivery System
According to CDC (2015), investments in transportation infrastructure, such as off-street trails, dedicated bicycle lanes, and pedestrian bridges promote health and save money: about $1.20-3.80 for every dollar invested in such projects (p. 2). The given money can be saved due to a healthier community designs contribution to the overall decrease in obesity and diabetes-related financial burden on the healthcare system. Along with this, the decreased reliance on motorized transportation can reduce air pollution and, in this way, minimize the risks for the development of respiratory problems, as well as stimulate better mental well-being due to residents improved environmental perceptions. It means that the suggested policy can be beneficial for both individuals and the healthcare system as such. It certainly may require a lot of time to implement the guidelines and research evidence in practice, but since their actualization can induce favorable behavioral changes, it can significantly improve the overall public health indicators in the long run.
References
American Public Health Association. (2017). Healthy community design. Web.
Centers for Disease Control and Prevention. (2015). Data on healthy community design. Web.
Coughenour, C., & Burns, M. S. (2016). Community design impacts on health habits in low-income Southern Nevadans. American Journal of Health Behavior, 40(4), 534-544.
Creatore, M. I., Glazier, R. H., Moineddin, R., Fazli, G. S., Johns, A., Gozdyra, P.,& Booth, G. L. (2016). Association of neighborhood walkability with change in overweight, obesity, and diabetes. Journal of American Medical Association, 315(20), 2211-2220.
Gunn, L. D., Mavoa, S., Boulangé, C., Hooper, P., Kavanagh, A., & Giles-Corti, B. (2017). Designing healthy communities: Creating evidence on metrics for built environment features associated with walkable neighbourhood activity centres. International Journal of Behavioral Nutrition and Physical Activity, 14(164), 1-12.
Jackson, R. J., Dannenberg, A. L., & Frumkin, H. (2013). Health and the built environment: 10 years after. American Journal of Public Health, 103(9), 15421544.
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