Jill S. Litt

Collective efficacy in Denver, Colorado: Strengthening neighborhoods and health through community gardens

Community gardens are viewed as a potentially useful environmental change strategy to promote active and healthy lifestyles but the scientific evidence base for gardens is limited. As a step towards understanding whether gardens are a viable health promotion strategy for local communities, we set out to examine the social processes that might explain the connection between gardens, garden participation and health. We analyzed data from semi-structured interviews with community gardeners in Denver. The analysis examined social processes described by community gardeners and how those social processes were cultivated by or supportive of activities in community gardens. After presenting results describing these social processes and the activities supporting them, we discuss the potential for the place-based social processes found in community gardens to support collective efficacy, a powerful mechanism for enhancing the role of gardens in promoting health.

The Influence of Social Involvement, Neighborhood Aesthetics, and Community Garden Participation on Fruit and Vegetable Consumption

OBJECTIVES We considered the relationship between an urban adult populations fruit and vegetable consumption and several selected social and psychological processes, beneficial aesthetic experiences, and garden participation. METHODS We conducted a population-based survey representing 436 residents across 58 block groups in Denver, Colorado, from 2006 to 2007. We used multilevel statistical models to evaluate the survey data. RESULTS Neighborhood aesthetics, social involvement, and community garden participation were significantly associated with fruit and vegetable intake. Community gardeners consumed fruits and vegetables 5.7 times per day, compared with home gardeners (4.6 times per day) and nongardeners (3.9 times per day). Moreover, 56% of community gardeners met national recommendations to consume fruits and vegetables at least 5 times per day, compared with 37% of home gardeners and 25% of nongardeners. CONCLUSIONS Our study results shed light on neighborhood processes that affect food-related behaviors and provides insights about the potential of community gardens to affect these behaviors. The qualities intrinsic to community gardens make them a unique intervention that can narrow the divide between people and the places where food is grown and increase local opportunities to eat better.

Policy, systems, and environmental approaches for obesity prevention: A framework to inform local and state action

The public health literature has not fully explored the complexities of the policy process as they relate to public health practice and obesity prevention. We conducted a review of the literature across the policy science and public health fields, distilled key theories of policy making, and developed a framework to inform policy, systems, and environmental change efforts on obesity prevention. Beginning with a conceptual description, we focus on understanding three domains of the policy process: the problem domain, the policy domain, and the political domain. We identify key activities in the policy process including the following: (a) assessing the social and political environment; (b) engaging, educating and collaborating with key individuals and groups; (c) identifying and framing the problem; (d) utilizing available evidence; (e) identifying policy solutions; and (f) building public support and political will. The article provides policy change resources and case studies to guide and support local and state efforts around obesity prevention.

Uncovering the Historic Environmental Hazards of Urban Brownfields

In Baltimore, over 1,000 vacant industrial sites persist across its urban landscape, yet little is known about the potential environmental health risks that may undermine future cleanup and redevelopment activities and the health of those in communities near these sites. This study examined the characteristics of urban brownfield properties in southeast Baltimore, Maryland, and screened sites for their potential environmental bazards. In addition, demographic and health data were evaluated to profile the social and health status of those in brownfield communities. The results show that brownfields in southeast Baltimore represent a range of historic operations, including metal smelting, oil refining, warehousing, and transportation, as well as paints, plastics, and metals manufacturing. The screening method identified a range of substances associated with these properties, including heavy metals, chlorinated hydrocarbons, and polycyclic aromatic hydrocarbons, all of which are suspected or recognized toxicants, and many of which are persistent in the environment. Spatially, these sites are concentrated in white, working class neighborhoods in which poverty levels exceed and educational attainment lags behind state and national averages. Moreover, these sites are concentrated in communities in which excess mortality rates due to respiratory disease, cancer, and heart disease exist when compared to the city, state, and national averages. This investigation demonstrated the usefulness of historic archives, real estate records, regulatory files, and national hazard-tracking systems based on standard industrial classification (SIC) to screen brownfield properties for their hazard potential. This analysis provides the foundation for further site monitoring and testing, cleanup and redevelopment priority setting, risk management strategies, and neighborhood planning, and it illustrates the need for increased health surveillance and disease prevention strategies in affected communities.

Active living collaboratives in the United States: understanding characteristics, activities, and achievement of environmental and policy change.

Introduction Changing the built environment to promote active lifestyles requires collaboration among diverse sectors. Multisectoral collaborative groups in the United States promote active lifestyles through environmental and policy changes. The objective of this study was to examine the characteristics of these collaborative groups and the extent to which they have achieved change. Methods We identified, recruited, and interviewed the coordinators of active living collaborative groups in the United States. We used descriptive statistics to characterize groups by composition, stakeholder engagement, and the extent of environmental and policy change in 8 strategic areas. Results Fifty-nine groups from 22 states participated in the study. Most groups had a diverse set of partners and used a range of activities to advance their agendas. Most groups achieved some form of environmental or policy change. On average, groups reported working on 5 strategy areas; parks and recreation (86%) and Safe Routes to School (85%) were named most frequently. More than half of groups reported their environmental initiatives as either in progress or completed. Groups reported the most success in changing policy for public plazas, street improvements, streetscaping, and parks, open space, and recreation. Complete Streets policy and zoning ordinances were the most frequently cited policy types. Engaging in media activities and the policy-making process in addition to engaging stakeholders appear to influence success in achieving change. Conclusion Although many groups successfully worked on parks and recreation improvements, opportunities remain in other areas, including transit and infill and redevelopment. Additional time and resources may be critical to realizing these types of changes.

Amplifying Health Through Community Gardens: A Framework for Advancing Multicomponent, Behaviorally Based Neighborhood Interventions

The article presents a framework for understanding the relationship between community garden participation, and the myriad ways gardens and participation lead to emotional, social, and health impacts. Existing empirical research relating community gardens to health behaviors, such as physical activity and diet, and longer-term chronic disease-related outcomes is summarized. The research areas discussed include the effects of community garden participation on individual, social, emotional, and environmental processes; health behaviors including diet and physical activity; and health outcomes such as self-rated health, obesity, and mental health. Other mechanisms through which community gardens may affect population health are described. Applying a multitheoretical lens to explore associations between community garden participation and health enables us to delineate key aspects of gardening that elicit positive health behaviors and multifactorial health assets that could be applied to designing other types of health interventions.

Risk of bovine tuberculosis for cattle sold out from herds during 2005 in Ireland

A retrospective cohort study was conducted to determine the risk of bovine tuberculosis (TB) among animals sold out from herds that were free to trade animals during the year 2005 according to their bovine TB testing history during the year 2005. The present study sample comprised of 338,960 animals, of which 124,360 animals were sold out from herds that were restricted from trading at some stage during 2005 (bovine TB ‘exposed’) and 214,600 animals that were sold from herds which did not have their trading status withdrawn in 2005 (bovine TB ‘non-exposed’). The overall risk of a diagnosis of bovine TB during the two-year period after the animals were sold out was 0.69 per cent. The odds of bovine TB were 1.91 higher for animals sold out from bovine TB ‘exposed’ herds compared with animals sold out from bovine TB ‘non-exposed’ herds (OR 95 per cent CI: 1.76 to 2.07, P < 0.0001). Ten per cent of animals identified during field surveillance with bovine TB did so less than two months after being sold out in 2005, and similarly, 10 per cent of the animals classified as bovine TB positive by finding a bovine TB lesion at slaughter did so within 25 days (or less) of being sold out in 2005.

Municipal officials' perceived barriers to consideration of physical activity in community design decision making

CONTEXT Built environment-focused interventions and policies are recommended as sustainable approaches for promoting physical activity. Physical activity has not traditionally been considered in land use and transportation decision making. Effective collaboration with non-public health partners requires knowledge of their perceived barriers to such consideration. OBJECTIVE This analysis sought to (a) establish prevalence estimates of selected barriers to the consideration of physical activity in community design and layout decisions and (b) describe how barrier reporting by public health officials differs from other municipal officials among a wide range of job functions and departments in a geographically diverse sample. DESIGN A Web-based survey was conducted among municipal officials in 94 cities and towns with populations of at least 50 000 residents in 8 states. PARTICIPANTS A total of 453 municipal officials from public health, planning, transportation/public works, community and economic development, parks and recreation, city management, and municipal legislatures in 83 cities and towns responded to the survey. MAIN OUTCOME MEASURES Five barriers to consideration of physical activity in community design and layout were assessed. RESULTS The most common barriers included lack of political will (23.5%), limited staff (20.4%), and lack of collaboration across municipal departments (16.2%). Fewer participants reported opposition from the business community or residents as barriers. Public health department personnel were more likely to report the barriers of limited staff and lack of collaboration across municipal departments than other professionals. They were also more likely to report lack of political will than city managers or mayors and municipal legislators. CONCLUSIONS Barriers to increasing consideration of physical activity in decision making about community design and layout are encouragingly low. Implications for public health practice include the need to strategically increase political will despite public health staffing constraints and perceived lack of collaboration with relevant departments such as planning and public works/transportation.

Advancing health and environmental disease tracking: a 5-year follow-up study

OBJECTIVES Our goal was to gain an understanding of the extent to which environmental public health tracking (EPHT) has progressed since the release of the 2000 Pew Environmental Health Commission report examining the nations EPHT infrastructure. METHODS As a follow-up to the Pew Commission report, we conducted a telephone survey of state practitioners in an effort to assess EPHT trends and changes in state-level capacities and activities over the past several years. RESULTS We found that new and enhanced federal-state partnerships; improved surveillance, data analysis, and communication capacities; and enhanced support of tracking personnel have provided a foundation for progress in the area of EPHT. Also, the Centers for Disease Control and Preventions support of EPHT has strengthened the national environmental public health infrastructure and capacity to track environmental hazards, exposures, and health. CONCLUSIONS Improved funding, data access, and translation of data to prevention activities are critical to sustaining progress in EPHT and developing the evidence base necessary for assessing the longer-term impacts and efficacy of EPHT and related environmental health improvements.

Lead Safe Yards: A Program for Improving Health in Urban Neighborhoods

biomedical interventions and prevention strategies. It is an issue that has been a concern of public health officials for decades and has been addressed quite successfully from a national perspective. By eliminating two major sources of exposure—leaded gasoline and leaded paint—blood lead levels for the majority of Americans have dropped dramatically over the past two decades. Unfortunately, for those who live in poorly maintained housing in older urban neighborhoods, environmental lead continues to pose health threats, particularly for those under the age of six. The threats of lead poisoning are most prevalent in poor, minority, and immigrant communities and are compounded by additional environmental hazards including indoor air contaminants (e.g., allergens, combustion by-products, volatile organic compounds, pesticides) and neighborhood factors such as deteriorating infrastructure, housing demolition, abandoned housing, congested roadways, violence, industrial land uses, and vacant land. These environmental hazards are signals of compromised neighborhoods and are linked to declines in community health.