Open Spaces, Healthy Places
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Transcript of Open Spaces, Healthy Places
WE BUILD A BRIGHTER FUTURE
kp.org/communitybenefit
together
2011 Open Space Conference Raymond J. Baxter, PhDSenior Vice President, Community Benefit, Research and Health PolicyMay 12, 2011
Open Spaces, Healthy Places
2
The Epidemic of Overweight and Obesity
“Unless effective population-
level interventions to reduce
obesity are developed, the steady
rise in life expectancy observed in
the modern era may soon come
to an end and the youth of today
may, on average, live less
healthy and possibly even shorter
lives than their parents”S. Jay Olshansky, Ph.D., Douglas J. Passaro, M.D., Ronald C.
Hershow, M.D., Jennifer Layden, M.P.H., Bruce A. Carnes, Ph.D., Jacob Brody, M.D., Leonard Hayflick, Ph.D., Robert N. Butler, M.D., David B. Allison, Ph.D., and David S. Ludwig, M.D., Ph.D. New England Journal of Medicine 2005
3
Obesity Trends Among U.S. Adults
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
1999
2009
1989
*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” personSource: CDC
4
Rising Obesity Rates Could Eat Our Lunch
Total Obesity-Related Direct Health Care Spending, U.S. (2008-2018)
$0
$50,000
$100,000
$150,000
$200,000
$250,000
$300,000
$350,000
$400,000
2008 2013 2018
(Millio
ns)
ProjectedHolding Obesity Rates Constant
Source: Thorpe, 2009
5
Many Factors Drive and Shape Health
Family History and Genetics
30%
Environmentaland Social
Factors20%
Personal Behaviors 40%
Source: Determinants of Health and Their Contribution to Premature Death, JAMA 1993
Health is driven by multiple factors that are intricately linked – of which medical care is one component.
Medical Care
10%
Drivers of Health
6
Behaviors Shape Health
Actual Causes of Death in the U.S. in 1990 and 2000Actual Causes of Death in the U.S. in 1990 and 2000
*Data are from McGinnis and Foege. Percentages are for all deaths.*Data are from McGinnis and Foege. Percentages are for all deaths.
Actual CauseNumber (and %)
1990*Number (and %)
2000
Tobacco 400,000 (19%) 435,000 (18.1%)
Poor diet and physical inactivity 300,000 (14%) 400,000 (16.6%)
Alcohol consumption 100,000 (5%) 85,000 (3.5%)
Microbial agents 90,000 (4%) 75,000 (3.1%)
Toxic agents 60,000 (3%) 55,000 (2.3%)
Motor vehicle 25,000 (1%) 43,000 (1.8%)
Firearms 35,000 (2%) 29,000 (1.2%)
Sexual behavior 30,000 (1%) 20,000 (0.8%)
Illicit drug use 20,000 (<1%) 17,000 (0/7%)
Total 1,060,000 (50%) 1,159.000 (48.2%)
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Social and Economic Factors Drive Health• Education/Literacy• Employment• Income• Family and social support
San Francisco Bay Area – Kaiser Permanente MembersPoverty, Diabetes and Obesity (2010)
• Community Safety• Early Childhood• Race and Ethnicity
Social and Economic
Factors
8
The Environment Shapes Health
San Francisco Bay Area Kaiser Permanente
Childhood Obesity and Park Space
(2010)
9
What We’re Up Against
10
What We’re Up Against
Slide courtesy of Richard Jackson, MD
0
0.1
0.2
0.3
0.4
0 100 200 300 400 500
Minutes Spent in Car Per Day
Pro
ba
bil
ity
of
Ob
es
ity
White Male White Female
Black Male Black Female
7% of Americans’ urban trips arebiking/walking:46% in Holland
11
What We’re Up Against
Change in price of items since 1978, relative to overall inflation, as measured by the Consumer Price Index. The price of carbonated drinks, for example, has fallen 34 percent relative to all other prices.
Source: Leonhardt, 2010
12
We Must Address Health at All Levels
1
Neighborhood /Community
Society
Individual / Family
Home / School /Worksite
Physical and Mental Health Care
Deploying Kaiser Permanente Assets for Total Health
Growing evidence indicates we must take on the issues at multiple levels.
Community Health Initiatives
Environmental Stewardship
Clinical Prevention
Access to Social and Economical Supports
Health Education
Public Education
WorksiteWellness
Public Policy
Research
13
Kaiser Permanente’s Community Health Strategies
Neighborhoods Parks, trails and other active public spaces General Plan amendments Corner store conversion efforts Farmers markets and community gardens
Schools Cafeteria reforms PE standards, after school programs Joint Use Agreements Safe routes to school
Healthcare BMI as a vital sign Breastfeeding promotion Hospital cafeterias
Worksites Stairwell prompts Lactation support Worksite wellness programs
NeighborhoodSchools
Work Site Healthcare
14
Kaiser Permanente’s Healthy Eating Active Living Intervention Sites
Atlanta, GA
Prince George’s County, MD
Cleveland, OH
Denver, CO
Commerce City, Park Hill, Lincoln Park
21 LiveWell Colorado
(statewide)
6 HEAC Sites
Santa Rosa
Portland, OR
Clark County, WA
Modesto
Richmond
We Support 40+ Communities
Community Health Initiative sites
Joint initiatives with other funders
15
The Environment Matters
Climate/Energy
Waste Reduction Water
Safe Chemicals
Sustainable Food
Kaiser Permanente Environmental Strategy Priority Areas
16
The Road Ahead is Challenging
But we can find the way…But we can find the way…
17
Regular walking can prevent
misery of colds
Raises HDL
Aerobic exercise helps strengthen the heart, lungs,
and muscles
Helps people with diabetes to control their blood sugar
Reduces risk of oseteoporosis
and broken bones
Reduces the pain and swelling from arthritis
Improves mood and energy
Gain 1.3-1.5 healthy years
of life
Evidence of Short and Long Term Benefits
Example: Making the Healthy Choice the Easy Choice
Benefits of walking can be expressed in terms of improved environmental and personal health, enhanced quality of life, economic rewards, and more.Benefits of walking can be expressed in terms of improved environmental and personal health, enhanced quality of life, economic rewards, and more.
18
Example: East Bay Regional Park District
Trails Challenge for up to 5,000 participants/year in East Bay Regional Parks
Camp-related efforts (e.g., scholarships for underserved youth, Healthy meals at camp, organic garden at Camp Arroyo in Livermore)
Increase use of parks and outdoor space to promote health
GOAL
19
Example: Trust for Public Land
Increase/enhance more outdoors space for safe physical activity
GOAL
Advocacy for park deficient communities to benefit from state infrastructure bonds
Expansion of Fitness Zones in Southern CA
Analysis of benefits of parks in City/County of Denver
20
Example: Rails to Trails Conservancy
Needs assessment/research and community engagement to identify:Recreational and physical activities resources, needs, and opportunities.
Strategies to increase physical activity for members of target communities.
Trail tours and bike rides for community members
Assess recreational & health needs of communities adjacent to 1-mile stretch of the Metropolitan Branch Trail that can be used for recreation and active transport
GOAL
21
Example: Land Use
Advocated for adding health elements to the Richmond General PlanGOAL
22
Example: Walk There!
Development of walking guidebook with 50 walks in 4-county region
Series of 20 guided walks in Portland area
Increase the number of people walking for short trips rather than using car for both health and environmental benefits
GOAL
23
Example: Organizational Endorsement
Portland Metro Bond Measure 26-80 for Natural Areas, Parks and Streams
(2006, passed)
Oregon House Bill 3141 (2007, signed by Gov)
Opposition to California Prop 23 (to suspend AB 32)
(2010, defeated)
Acquiring natural areas for protecting wildlife habitat, preserving water quality, and enhancing public access to nature
Minimum physical education minutes during school
Data collection on number of physical education minutes provided
AB 32 requires that greenhouse emission levels in the state be cut to 1990 levels by 2020
24
Example: Engaging Organizational Assets
National Get Outdoors Day in Denver
Colorado employees built playground in underserved neighborhood in partnership with KaBoom!
Southern CA facilities services employees adopted Pasadena city parks with baseball facilities
To leverage the assets of the total organization to make a difference in communities.
GOAL
25
How We Partner
Kaiser Permanente looks for:In the last 5 years, we have given over $6M in grants related to open space
Efforts that target underserved communities Creative, multi-faceted partnerships that incorporate “nexus” strategies Opportunities to leverage multiple resources/assets at Kaiser Permanente Efforts that are sustainable and have long-term impact Target healthy eating and active living (primarily)
Health partners care about….health outcomes, and more!
26
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