Local Public Health in Action: The physical, economic and health benefits of polices and planning American Public Health Association Annual meeting San Francisco 2012

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Support for Local Environmental Health: Increasing physical activity options in San Antonio MARY THOMAS M.B.& B.S., M.P.H.

Communities Putting Prevention to Work San Antonio Metropolitan Health District San Antonio Texas

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Co-Authors

• Maggie Thompson, MS Program Manager, CPPW [email protected]

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Presenter Disclosures

Mary Thomas The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months:

“No relationships to disclose” 4

VISION

Increase active living options in San Antonio by supporting local built environment to reduce obesity

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LEARNING OBJECTIVES

• Describe the changes in built environment to increase physical activity options at parks, libraries, and public housing • Discuss increasing active transportation through installation of bike kiosks • Describe the benefits of the Complete Streets Policy 6

San Antonio Council Districts 1-10

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Demography of Bexar County

• • • • • • • Population: 1.7 million Multicultural: 59% Hispanic, 30% non-Hispanic, 7% African American, 3% Asian South & Westside population: 80% Hispanic Northeast & North central: 30% Hispanic Persons below 45 years: 79% Some populations have a greater burden of health problems One in three children and two in three adults are of unhealthy weight 8

Bexar County 2010 Population by Race/Ethnicity 7% 4% 30% 59% Total 1.7 Million Hispanic White NH African Am.

Other 9 Population Source: U.S. Census Bureau, 2010

Bexar County 2010 Age Distribution

Age 80 to 84 yrs Age 70 to 74 yrs Age 60 to 64 yrs Age 50 to 54 yrs Age 40 to 44 yrs Age 30 to 34 yrs Age 20 to 24 yrs Age 10 to 14 yrs Age 0 to 4 yrs 75000 Female 25000 Population Source: U.S. Census Bureau, 2010 25000 Male 75000 10

Bexar County - Educational Attainment

35% 30% 25% 20% 15% 10% 5% 0% Less than high school diploma High school graduate, GED Some college Bachelor's degree or higher 11 Population Source: U.S. Census Bureau, 2010

2010 Household Income Bexar County

Above$ 150,000 $100,000 to $149,999 $75,000 to $99,999 $50,000 to $74,999 $25,000-$49,999 Less than $25,000 0% 5% 10% 15% 20% 25% 30% Population Source: U.S. Census Bureau, 2010 12

33% Obesity in Bexar County One in 3 children Two in 3 adults Children Adults 32% 67% 68% Healthy Weight Unhealthy weight Fitnessgram Data 2009-10 Normal weight Overweight/Obesity BRFSS 2010

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Built Environmental Changes

• Safe roads, improved sidewalks & intersections by Public Works • Walking trails, fitness stations at San Antonio Housing Authority locations • Walking trails & fitness stations at libraries • Fitness stations in parks • Bike kiosks in downtown San Antonio 14

Changes to Make Roads and Intersections Safe

• ADA ramps - 361 sites in 17 locations • Walkways' improvement in 10 locations • Traffic calming measures in 9 locations • Flashing beacons in 30 locations • Traffic designs in 12 locations • Traffic inventories in all 10 Council districts • Ped signal improvements in 38 locations • Cross walks in 33 locations • Dynamic signs in 8 locations 15

Crosswalks, ADA Ramps, Traffic Calming Measures, Medians, Flashing Beacons, Ped Signals

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Walking Improvement Crosswalk Dynamic Message Sign 17

Pedestrian Signal ADA Ramp Safe Routes to School 18

San Antonio Housing Authority Locations

• Walking trails and fitness stations in four locations • Alazan Courts • Lincoln Heights • SpringView • Cassiano 19

Walking Trails/Fitness Stations

Alazon Cassiano 20

Walking trails/fitness stations

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Fitness Stations & Walking Trails in Libraries

• Mission Library (both) • Parman Library (both) • Johnston Library (trail) • Memorial Library (stations • Oakwell Library (stations) 22

Mission Library

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Changes in Parks

• Fitness equipment installed in 28 parks • Trail Accessibility Information (TAI) posts -133 were installed in 31 parks

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Fitness Equipment

• Stationary –Stretches, pushups, squats, core and balance exercises • Movable – use body weight to do leg press, chest press, rowing machine, cardio walker.

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Trail Assessment

• High Efficiency Trail Assessment Process (HETAP) used to assess trail characteristics • Purpose: provide park users information regarding length, width, elevation, running slopes, surface type • 101 miles assessed in 31 parks 26

HETAP AND TAI POST

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The Trails Accessibility Information (TAI) includes the trail name, length, elevation change, permitted uses, grade, cross slope, width and surface type (TAI post example, right). Distance assessed 101 miles Number of parks 31 Number of TAI posts 133

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Active Transportation-Bikes

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Aim:

Provide active and alternate transportation and increase physical activity

Result

: Reduce number of cars on the streets, traffic congestion and parking problems, Improve air quality 29

Bike Share Program

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Bike-Share Program

• Launched March 2011 • Number of kiosks - 25 • Annual memberships - 1328 • Daily passes - 11,590 • Total number of trips - 52,182 • Average distance per trip - 4.1 miles 31

Increase Physical Activity Options in Target Areas

• Walking trails and easy to use fitness stations in public housing units in target areas with low income, seniors, and residents with disabilities • Safe environment for free physical activity and walking and biking options • Walking trails and fitness stations in parks and libraries provide easy access to methods of physical activity • Bike lanes and kiosks encourage biking to work or for leisure.

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San Antonio City Council passed COMPLETE STREETS POLICY on SEPT 29, 2011

http://www.sanantonio.gov/planning/regionalplanning/comp letestreets.aspx

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Complete Streets Policy Definition

A. Supports

roadways

that take into account all users, including people driving cars, using transit, riding bikes, walking, and using wheelchairs.

B. Includes

people of all ages

and abilities, including children, older adults, and persons with disabilities.

C. Considers the

function of the road

(e.g. local, collector, and arterial) and the level of vehicular, pedestrian, and bicycle traffic will be considered.

D. Road type determined by

land use

road adjacent to the 34

Complete Streets

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Benefits to the Residents and Neighborhoods

• Enhance choice of mobility–all modes of travel –bike, walk, car, bus • Facilitate physical activity for daily needs –pedestrians, Bike Master Plan • Improve quality of life, health and safety • Neighborhood connectivity to benefit all members of the city 36

Acknowledgement With Thanks to

• John Berlanga, Senior Management Analyst, Metro Health • Dr. Anil Mangla, Epidemiologist, Metro Health • Jeremy Beer, Health Program Specialist, CPPW • Dr. Isabela Lucas, Technical Consultant ICF Macro 37

For more information

Mary Thomas, Senior Management Analyst, San Antonio Metropolitan Health District, San Antonio TX [email protected]

210 207 5371

Any Questions ?

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