Creating a community that is healthy by design: Complete streets changing the face of Yellowstone County

Barriers to physical activity are often found in the built environment, where issues with safety and accessibility can deter individuals' ability to walk and bicycle. To support the creation of healthier environments, the Centers for Disease Control and Prevention (CDC) initiated Action Communities for Health, Innovation, and Environmental Change (ACHIEVE). ACHIEVE represents a shift from programmatic efforts to policy, systems, and environmental change strategies to weave health prevention through all aspects of life, including where and how people live, learn, work, and play. RiverStone Health, the health department in Yellowstone County Montana, like many communities across the United States is dealing with obesity and low levels of physical activity. The 2010 Community Health Assessment (CHA) showed that more than seven in ten adults are overweight or obese (higher than both the statewide and national average). To address the local health issues identified in the CHA, RiverStone Health set out to implement policy, and system changes that intentionally influence the environment. Funded by the National Association of County and City Health Officials (NACCHO) as an ACHIEVE community, RiverStone Health focused on passing a complete streets policy, which is recommended by the CDC as a strategy to increase physical activity and prevent obesity. Over several years, RiverStone Health worked with a diverse coalition to pass a complete streets policy, and were able to demonstrate how investments in community education and engagement empowered people to become active participants in the policy process and the forthcoming implementation of the policy.