Childhood obesity and the built environment: The role of health impact assessment

Issues: In Moore County, North Carolina, 20 percent of children in grades K-9 are obese. An additional 16 percent are overweight. Overweight children face a variety of physical and psychological health problems throughout the lifespan. Improving the built environment, including the pedestrian infrastructure, is one promising strategy to increase children's physical activity. Description: Our team of students from UNC Chapel Hill School of Public Health partnered with FirstHealth of the Carolinas and the Town of Aberdeen to conduct a health impact assessment (HIA) on the proposed Aberdeen Pedestrian Transportation Plan (APTP). The HIA examined the potential impact of the APTP on physical activity and obesity among Aberdeen children. Our data sources included quantitative health behavior data from community health assessments, photovoice and survey data from children at Aberdeen Elementary School, spatial data (maps) from the local government. In addition, we conducted a literature review, consulted with experts, and conducted a windshield tour to gather observational data. Lessons Learned: Aberdeen children currently face barriers to walking in town: lack of sidewalks, lack of street crossings, parental perceptions of danger, prohibitive distances to destinations, and time constraints. The APTP addresses some of these barriers by adding sidewalks, calming traffic, and improving street crossings. Pedestrian education, safety enforcement, and a Safe Routes to School program could help maximize use of the new walkways. Recommendations: The HIA results will be disseminated to policymakers to inform implementation of the APTP. Aberdeen is planning a pedestrian education program and a new Safe Routes to School program.