Arthur M. Wendel

Spinach-associated Escherichia coli O157:H7 Outbreak, Utah and New Mexico, 2006

In 2006, Utah and New Mexico health departments investigated a multistate cluster of Escherichia coli O157:H7. A case–control study of 22 case-patients found that consuming bagged spinach was significantly associated with illness (p<0.01). The outbreak strain was isolated from 3 bags of 1 brand of spinach. Nationally, 205 persons were ill with the outbreak strain.

Walking associated with public transit: moving toward increased physical activity in the United States

OBJECTIVES We assessed changes in transit-associated walking in the United States from 2001 to 2009 and documented their importance to public health. METHODS We examined transit walk times using the National Household Travel Survey, a telephone survey administered by the US Department of Transportation to examine travel behavior in the United States. RESULTS People are more likely to transit walk if they are from lower income households, are non-White, and live in large urban areas with access to rail systems. Transit walkers in large urban areas with a rail system were 72% more likely to transit walk 30 minutes or more per day than were those without a rail system. From 2001 to 2009, the estimated number of transit walkers rose from 7.5 million to 9.6 million (a 28% increase); those whose transit-associated walking time was 30 minutes or more increased from approximately 2.6 million to 3.4 million (a 31% increase). CONCLUSIONS Transit walking contributes to meeting physical activity recommendations. Study results may contribute to transportation-related health impact assessment studies evaluating the impact of proposed transit systems on physical activity, potentially influencing transportation planning decisions.

Characteristics of health impact assessments reported in Australia and New Zealand 2005-2009

Objective: To describe the use and reporting of Health Impact Assessment (HIA) in Australia and New Zealand between 2005 and 2009.

Strategic Priorities for Physical Activity Surveillance in the United States.

PURPOSE Develop strategic priorities to guide future physical activity surveillance in the United States. METHODS The Centers for Disease Control and Prevention and the American College of Sports Medicine convened a scientific roundtable of physical activity and measurement experts. Participants summarized the current state of aerobic physical activity surveillance for adults, focusing on practice and research needs in three areas: 1) behavior, 2) human movement, and 3) community supports. Needs and challenges for each area were identified. At the conclusion of the meeting, experts identified one overarching strategy and five strategic priorities to guide future surveillance. RESULTS The identified overarching strategy was to develop a national plan for physical activity surveillance similar to the U.S. National Physical Activity Plan for promotion. The purpose of the plan would be to enhance coordination and collaboration within and between sectors, such as transportation and public health, and to address specific strategic priorities identified at the roundtable. These strategic priorities were used 1) to identify and prioritize physical activity constructs; 2) to assess the psychometric properties of instruments for physical activity surveillance; 3) to provide training and technical assistance for those collecting, analyzing, or interpreting surveillance data; 4) to explore accessing data from alternative sources; and 5) to improve communication, translation, and dissemination about estimates of physical activity from surveillance systems. CONCLUSION This roundtable provided strategic priorities for physical activity surveillance in the United States. A first step is to develop a national plan for physical activity surveillance that would provide an operating framework from which to execute these priorities.

An Introduction to Healthy Places

The environment consists of the external (or nongenetic) factors—physical, nutritional, social, behavioral, and others—that act on humans, and the built environment is made up of the many aspects of their surroundings created by humans, such as buildings, neighborhoods, and cities. Health can be defined as complete physical mental, and social well-being This definition extends beyond the absence of disease to include many dimensions of comfort and well-being. While clinicians care for individual patients public health professionals aim to improve health at the level of populations The design professions include urban planning architecture, landscape architecture, and transportation planning Each of these focuses on an aspect of the built environment. Both the public health profession and the design professions took modern form during the nineteenth century in response to rapid population growth, industrialization and urbanization, and the resulting problems of the urban environment. Leading causes of morbidity and mortality include heart disease cancer, diabetes, stroke, injuries, and mental illness. Many of these are related to community design choices. Even though public health has evolved as a distinct field from planning and architecture, these domains have numerous opportunities to collaborate, and this collaboration can lead to improved health, well-being, and sustainability in many ways.

Designing and building healthy places for children

The design and construction of the built environment have broad implications for the health of children. Healthy places should protect children from injury, pollutants and disease, provide children with a place to be physically active, play and experience nature, and promote a sustainable future. Health promotion can occur at all scales of the built environment, including buildings, communities and global infrastructure. The disabled, poor and other disadvantaged groups may benefit from built environment improvements. These improvements require partnerships among urban planners, engineers, architects, developers, public health practitioners and communities.

Measuring, Assessing, and Certifying Healthy Places

To know whether a community can be considered a healthy place and how it can be improved, tools are needed to measure and analyze health-risk and health-protective factors and to convey such information to decision makers. Instruments such as walkability audits can be used to measure the health components of a community’s physical environment and to predict the potential positive and negative impacts of changes to that environment. Tools such as health impact assessments can be used to assess the potential health outcomes of proposed projects and policies and to provide recommendations to promote healthy aspects and mitigate adverse aspects of proposals. Criteria such as those in LEED for Neighborhood Development can be used to certify that the design of a community reaches certain standards in sustainability, energy efficiency, and health-promoting components.

Healthy Places Research: Emerging Opportunities

Empirical research provides a solid foundation for designing and building healthy places. Such research has not always been used in the design professions. Research performed to date can guide many health-promoting design choices now, although further research is needed to answer remaining questions. Numerous opportunities are available for students and practitioners in public health, planning, architecture, and other fields to advance the evidence base for creating healthy places. Data collected for purposes unrelated to health can sometimes be used creatively to document links between health and the built environment. Natural experiments are a valuable approach to documenting the links between health and the built environment, especially because randomized controlled trials are rarely possible in community settings. Case studies can be helpful for identifying areas in which further research would be useful.