Changes in Policy-Maker Attitudes Towards Active Living Communities in Hawaii between 2007 and 2013

Background:  Obesity and lack of physical activity are major public health problems in the US.   Well-designed, active living communities (ALC) can help support physically active lifestyles.  This study assessed attitudes of decision makers in 2007 and 2013 in Hawaii to determine if priorities for ALC improved. Methods: Elected and appointed state and county officials were mailed surveys at both time points.  Respondents rated the importance of 23 specified problems, of which one asked about obesity and five asked about ALC variables.  Other problems included general health and social welfare items (e.g. homelessness and drug abuse).  Results:  The survey was completed by 126 (70.4%) respondents in 2007 and 133 (63.0%) in 2013. Among the obesity and ALC issues, only obesity increased in rank moving from 14^th to 9^th place.  Three ALC variables fell more than 2 places:  increasing traffic (5^th to 7^th place), poorly planned development and sprawl (7^th to 11^th place) and pedestrian safety (12^th to 17^th place).  The other two stayed relatively the same:  lack of pedestrian walkways, sidewalks and cross walks (16^th to 15^th place) and lack of recreational activities (22^nd to 23^rd place).  Conclusions:  Over the 6 year period, concern for obesity has increased, but does not seem to be tied to an increase in concern for ALC variables.  More education is needed on the link between obesity, physical activity and the built environment among policy makers.