Integrated action for active living and healthy eating: Policy and environmental health promotion strategies by community partnerships

In recent years, the public health community has increasingly embraced policy and environmental approaches to support healthy lifestyles. Community partnerships are considered essential to influencing policy and enhancing built environments. In addition, public attention on the nation's obesity epidemic has led public health professionals, researchers, and funders to focus greater emphasis on preventing overweight by attempting to increase routine physical activity and healthy eating in communities. Despite the importance of enhancing structural supports for both sides of the energy balance equation, little is known about the best approaches for tackling the risk factors simultaneously, or as part of synergistic initiatives. Integration of physical activity and health eating strategies is a worthy goal. Active living and healthy eating initiatives can be combined in a single setting, such as a school. Outside the school setting, however, policy and environmental influences on physical activity and healthy eating can be more difficult to impact simultaneously and reach the same population. Active Living by Design, a national program supported by the Robert Wood Johnson Foundation and located in the School of Public Health at UNC-Chapel Hill, provides technical assistance to 25 community partnerships to implement policy and environmental initiatives to increase physical activity. Twelve of these partnerships were also funded to pilot-test comparable approaches to increase access to healthy foods while continuing active living efforts. These joint initiatives have illustrated surprising results and opportunities over a short time period but have also exposed the difficulties of integrating both risk factors in a unified community partnership.