4
Contextual Factors Affecting Physical Activity

The preceding chapter documented many long-term trends in the way the U.S. population lives, works, and travels that have sharply reduced the physical demands of daily life. The persuasive scientific evidence on the importance of physical activity for health presents a challenge: to increase physical activity in a highly technological society with a built environment that is already in place and has evolved over a long period of time. This chapter explores the socioeconomic and institutional context that has resulted in the current situation and holds the key to change. It starts with a discussion of the various factors that affect the individual’s choices about engaging in physical activity. The chapter then turns to the institutional and regulatory forces behind the decisions of planners, engineers, developers, elected officials, and others over the years that have shaped the built environment in place today.

FACTORS AFFECTING INDIVIDUAL CHOICE

As discussed in Chapter 1 (Figure 1-1), physical activity behavior is influenced by both individual characteristics and the social environment. Whether an individual is physically active depends on demographic characteristics such as gender, age, and ethnic background, and on socioeconomic characteristics such as education and income level. It also depends on at least three other factors, the latter two of which are external to the individual: (a) attitudes,



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Does the Built Environment Influence Physical Activity? Examining the Evidence - Special Report 282 4 Contextual Factors Affecting Physical Activity The preceding chapter documented many long-term trends in the way the U.S. population lives, works, and travels that have sharply reduced the physical demands of daily life. The persuasive scientific evidence on the importance of physical activity for health presents a challenge: to increase physical activity in a highly technological society with a built environment that is already in place and has evolved over a long period of time. This chapter explores the socioeconomic and institutional context that has resulted in the current situation and holds the key to change. It starts with a discussion of the various factors that affect the individual’s choices about engaging in physical activity. The chapter then turns to the institutional and regulatory forces behind the decisions of planners, engineers, developers, elected officials, and others over the years that have shaped the built environment in place today. FACTORS AFFECTING INDIVIDUAL CHOICE As discussed in Chapter 1 (Figure 1-1), physical activity behavior is influenced by both individual characteristics and the social environment. Whether an individual is physically active depends on demographic characteristics such as gender, age, and ethnic background, and on socioeconomic characteristics such as education and income level. It also depends on at least three other factors, the latter two of which are external to the individual: (a) attitudes,

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Does the Built Environment Influence Physical Activity? Examining the Evidence - Special Report 282 preferences, motivations, and skills related to the behavior; (b) opportunities or constraints that make the behavior easier or more difficult to perform; and (c) incentives or disincentives that encourage or discourage the desired behavior relative to competing activities. Each of these factors is discussed in turn in this section. Much of the discussion is based on self-reported survey data and focus groups. Relative to observational surveys, self-reported data often provide unreliable estimates because of problems with recall or the well-established tendency of survey respondents to give socially desirable rather than completely truthful answers (see Chapter 2). Results from focus groups cannot be generalized to the population at large. Nevertheless, self-reports and focus groups are the only way to obtain insight into attitudes and motivations that help explain behavior. This type of information is particularly important because the determinants of physical activity behavior are not well understood. Socioeconomic Characteristics The Behavioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (NHIS) have revealed that physical activity levels of U.S. adults decline with age and are lower among women, ethnic and racial minorities, those with less education and low income levels, the disabled, and those living in the southeastern region of the United States (see Chapter 2).1 These results have been corroborated by numerous other studies.2 For example, younger age is positively associated with physical activity, as are university education and higher income levels. Although comparisons by race are often obscured by socioeconomic variables, some studies have shown that ethnic minorities, particularly African American and Hispanic women, are less likely to adopt and maintain active lifestyles. Other personal barriers to walking 1 The BRFSS is discussed in detail by Brownson and Boehmer (2004) and the NHIS by Barnes and Schoenborn (2003). 2 See the commissioned paper by Loukaitou-Sideris (2004), which references several relevant studies on the effect of individual characteristics on the propensity to engage in physical activity.

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Does the Built Environment Influence Physical Activity? Examining the Evidence - Special Report 282 and an active lifestyle cited in the literature include state of personal health and physical disability; lack of time, motivation, and energy; and lack of self-esteem. Further elaboration is not provided here because the committee has chosen to focus its discussion on physical activity behaviors linked with the built environment, such as nonmotorized travel and attitudes toward walking and cycling. Attitudes, Preferences, Motivation, and Skills3 Several national surveys have been conducted in recent years to determine the public’s attitudes toward walking and cycling, as well as the frequency and purpose of these behaviors. Two of the surveys were sponsored by organizations that advocate walking and cycling—the Surface Transportation Policy Project and America Bikes. They found positive attitudes among respondents toward both walking and cycling and strong support for investments that would make communities more friendly to these modes (BR&S 2003; America Bikes 2003). A national survey of walking and cycling sponsored by the National Highway Traffic Safety Administration and the Bureau of Transportation Statistics (BTS) and administered by the Gallup Organization during summer 2002 found that 8 of 10 respondents aged 16 or older had taken at least one walk of 5 minutes or longer in the past 30 days; fewer than 30 percent, however, reported having ridden a bicycle at least once (DOT 2003). When asked the primary purpose for walking trips, respondents most commonly cited exercise or health reasons (27 percent), personal errands (17 percent), and recreation (15 percent). The primary purposes for cycling trips were recreation (26 percent) and exercise or health reasons (24 percent).4 Survey results 3 The following subsections draw heavily on the commissioned paper prepared for the committee by Kirby and Hollander (2004). 4 Although only the primary trip purpose was recorded, the responses can be misleading. For example, the respondent may have indicated commuting to school or work as the primary trip purpose but may also have walked or cycled to work for exercise. Thus, there is likely to be overlap among some of these responses.

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Does the Built Environment Influence Physical Activity? Examining the Evidence - Special Report 282 should be interpreted with caution because of low response rates.5 Another survey, conducted as part of the BTS monthly Omnibus Household Survey (BTS 2003), queried adults aged 18 and older about walking and cycling, among other forms of transportation, during 2001–2002.6 [These results should also be interpreted with caution because of problems with response rates and sampling as detailed in a TRB report (2003).] Approximately 72 percent of those interviewed reported having walked, run, or jogged outside for 10 minutes or more at least once during the month prior to the survey (BTS 2003). Nearly 60 percent of those who walked, ran, or jogged (about 40 percent of all respondents) reported spending about 30 minutes on these activities an average of 13 days per month, as compared with the recommended minimum of 30 minutes per day of moderate-intensity activity on 5 or more days per week (see Chapter 2). Nearly 20 percent of respondents reported a longer duration of activity, but 40 percent reported no outside walking, running, or jogging (BTS 2003).7 Only 16 percent of adult U.S. residents reported cycling outside during the month prior to the survey—spending just over 1 hour per day cycling on an average of 6 days per month (BTS 2002). The Omnibus survey also inquired about the reasons for walking and cycling. Slightly more than three-quarters of those respondents who walked, ran, or jogged reported that they did so 5 The survey was conducted by telephone and used a random sample of listed and unlisted numbers in the 50 states and the District of Columbia, which yielded 9,616 interviews with respondents aged 16 years or older, a 27 percent response rate. The results were then weighted to reflect the national population of this age group, with an estimated sampling error of about ±1.5 percentage points at the 95 percent confidence level. 6 In 2000, BTS began a monthly national telephone survey to ascertain the public’s satisfaction with the transportation system. Approximately 1,000 randomly selected households are telephoned each month, and the results are weighted to allow inferences about the U.S. population aged 18 or older. Periodically, questions are added for specific purposes, such as this survey of walking and cycling behavior. The walking survey was conducted from January to November 2002 and the cycling survey from October 2001 to September 2002. 7 Nearly 30 percent of those who walked, ran, or jogged (20 percent of the total) reported spending an hour or more on these activities on about 13 days during a month.

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Does the Built Environment Influence Physical Activity? Examining the Evidence - Special Report 282 primarily for exercise or recreation. Another 15 percent walked for personal errands, and only 7 percent to get to work or as part of their job (BTS 2003, 1).8 Similarly, the primary reasons for cycling were for recreation (54 percent) or exercise (33 percent); only 6 percent reported commuting by bicycle to get to school or work or as part of their job (BTS 2002). In sum, the surveys indicate that walking is more prevalent than cycling, but reported levels of walking appear to fall short of recommended daily guidelines. To the extent that Americans report walking and cycling, the primary reasons appear to be for exercise and recreation. These results correspond with the behavioral data from public health surveys discussed in the previous chapter showing a trend toward increased leisure-time physical activity. Market research has also been conducted to probe the reasons for engaging in physical activity. Several studies cited by Kirby and Hollander (2004)9 found that adults’ dominant beliefs about moderate physical activity were that it results in feeling better or more energetic, helps reduce stress, and improves physical condition (e.g., feeling less out of breath, stronger). Focus groups with older Americans revealed similar beliefs.10 Notably absent from the survey and focus group results is any mention of the longer-term benefits of physical activity identified by the health community and summarized in Chapter 2, such as disease prevention. The positive health effects of physical activity may have been assumed by the survey and focus group respondents, but the results may also reflect the value placed by many people on more immediate benefits, such as those enumerated above. In any event, the market research 8 As with the Gallup surveys, the respondents were asked their primary trip purpose. However, there can be an overlap in the responses between travel for exercise and for utilitarian purposes. 9 Fridinger et al. 1996; Collette et al. 1994; Wankel and Mummery 1993; Brown 1992; Kotler et al. 2002. 10 For midlife adults, the focus groups revealed that physical activity was perceived as a way to fight aging, to continue to look good, and to cope with a changing life. Older preretired adults mentioned having more energy, prolonging an active life, and protecting their quality of life as benefits of physical activity. Retired adults said they engaged in physical activity to ensure a high quality of life, maintain connections in the community, and maintain everyday functions and independence (Sloan 2001 in Kirby and Hollander 2004).

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Does the Built Environment Influence Physical Activity? Examining the Evidence - Special Report 282 results underscore the importance of understanding the beliefs and attitudes of those whose behavior one wishes to reinforce or change. As marketers are well aware, beliefs and attitudes are likely to differ across subpopulations. For example, a single mother holding two jobs is likely to be motivated to become more physically active by information showing how physical activity can be fit into her busy daily routine, whereas a teenager is likely to be more motivated by information that physical activity will make her more fit and attractive. Thus, tailoring interventions to specific groups is likely to prove more effective than delivering mass messages about the benefits of being physically active. Finally, while beliefs, attitudes, and preferences have a role in determining a person’s physical activity habits, cognitive and behavioral factors come into play as well. To become more physically active, for example, individuals can self-monitor the target behavior, learn how to set realistic and achievable goals, monitor progress toward those goals, identify barriers to achieving the goals, use problem-solving techniques to overcome those barriers, and identify and use peer and family social support to help achieve lasting behavioral change. Interventions using these methods, which are based on psychosocial theories and models such as social cognitive theory and motivational readiness, have been applied successfully in randomized, controlled clinical trials to evaluate methods of helping sedentary adults become more active (Kohl et al. 1998; King et al. 1998; Dunn et al. 1999). The committee is unaware, however, of published reports in which cognitive and behavioral interventions have been incorporated into designs that also encompass environmental and socioeconomic factors. Opportunities and Constraints The results of the surveys reviewed in the previous section and those of other large health surveys presented in Chapter 2 indicate that the majority of Americans are not acting sufficiently on their inclinations to meet recommended levels of total daily physical activity. Personal motivation is one likely explanation, but it is instructive

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Does the Built Environment Influence Physical Activity? Examining the Evidence - Special Report 282 to examine other possible factors—real or perceived—that may be preventing the desired behavior, with particular attention to the built environment as a potential barrier. It should be noted that, although walking and cycling are discussed together here, they generally involve different infrastructure and user characteristics. For example, in urban areas, cycling typically is forbidden on sidewalks and confined to certain streets or bicycle lanes that share the right-of-way with automobiles. Cycling on pedestrian paths can pose a danger for those who are walking. These differences should be kept in mind in interpreting survey results. For example, these differences are likely to make cyclists more concerned with infrastructure facilities for safety. The Gallup survey discussed above revealed that the primary reasons for not walking or cycling were personal (disabilities or other health impairments), weather- or time-related, or equipmentrelated (did not own or have access to a bicycle) (DOT 2003). Environmental factors (no safe place to ride or walk) were mentioned by only a small fraction of respondents (approximately 3 percent) (DOT 2003). Three of four adults reported being “very” or “somewhat satisfied” with the design of their communities for pedestrian safety. Nevertheless, when asked to recommend changes in their communities, presumably to make walking safer, about one-third of those polled suggested providing pedestrian facilities, such as sidewalks, traffic signals, lighting, and crosswalks. Satisfaction with the cycling environment was considerably lower. Only half of those polled were “very” or “somewhat satisfied” with their communities’ designs for cycling safety. Nearly one-half of all respondents recommended new bicycle facilities, such as bicycle trails, paths, lanes, racks, traffic signals, lighting, and crosswalks. The survey results suggest that, even for those favorably disposed to walking and cycling, changes to the physical environment that would enhance the safety and ease of engaging in these activities could make a difference. Results of other surveys suggest that environmental factors may play a more dominant role depending on the activity—for example, transporting children to school. As noted earlier, the private

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Does the Built Environment Influence Physical Activity? Examining the Evidence - Special Report 282 vehicle has become the primary mode of school travel (Dellinger and Staunton 2002). Long distances, dangerous traffic, and crime have been mentioned as the main barriers to children walking and cycling more to school (Dellinger and Staunton 2002; BR&S 2003).11 In fact, children (aged 5 to 18) of parents who reported no barriers [16 percent of all respondents to the Centers for Disease Control and Prevention’s (CDC’s) HealthStyles Survey reported by Dellinger and Staunton] were six times more likely to walk or bicycle to school than those whose parents cited one or more barriers. Interventions to mitigate such barriers can be effective. For example, the California Safe Routes to School Program has provided more than $40 million to municipalities and counties to improve the safety and viability of walking and cycling to school. Typical projects include sidewalk construction and improvements, pedestrian and bicycle crossings, and traffic controls to improve the safety of street crossings (Boarnet 2004). A before-and-after evaluation of projects associated with 10 schools across the state found that walking and cycling had increased, with larger effects if the project was along the child’s usual route to school (Boarnet et al. 2004).12 The Marin County Safe Routes to School Program is a good example of a comprehensive approach to reducing barriers for children walking and cycling to school that appears to be working (see Box 4-1). Constraints and barriers to physical activity are perhaps best illustrated in those low-income neighborhoods where crime, disinvestment, and isolation can be major deterrents to walking and cycling for many residents. Low-income urban populations 11 The HealthStyles 1999 Survey, analyzed by CDC and reported by Dellinger and Staunton (2002), found that major reported barriers to walking and cycling to school included long distances (55 percent), traffic danger (40 percent), adverse weather conditions (24 percent), and crime (18 percent). The BR&S 2003 survey found distance to be the primary barrier (mentioned by 66 percent), followed by traffic danger (17 percent), fear of child being abducted (16 percent), inconvenience (15 percent), and neighborhood crime (15 percent). For both surveys, multiple responses were accepted; hence the percentages do not add up to 100. 12 Survey respondents reported an increase of 10.5 percent in walking and cycling to school associated with the construction improvements. A slightly higher percentage—15.4 percent—was reported if the improvements were along the child’s usual route to school.

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Does the Built Environment Influence Physical Activity? Examining the Evidence - Special Report 282 BOX 4-1 The Marin County, California, Safe Routes to School Program The Safe Routes to School Program in Marin County is one of the programs funded by the California Safe Routes to School Program. Marin County has established a grassroots program that is getting more children to walk and bicycle to school. Program components include mapping of routes and infrastructure improvements to improve access to schools by walking or bicycling, special events and contest promotions, new concepts such as “walking school buses” and “bike trains” to generate and maintain the interest of the community, and a well-integrated communication and promotion strategy. Safe Routes task forces collaborate with public works and law enforcement staff to develop and implement an improvement plan, apply for funding, and effect improvements such as crosswalks and signage to make it easier and more convenient to walk and cycle to school. The California headquarters for the Safe Routes to School Program also provides materials, tips, and tools for community volunteers and organizations. These include a walkability checklist, sample letters to parents in 13 languages, a “guide to success” with instructions on how to create a walking school bus and a bike train, and a guide on how to create safe drop-off points for children walking to school (see www.cawalktoschool.com/dropoff_zones.php). In addition, the California headquarters partners with the state health department’s injury control center to give its safety messages even more credibility with parents. Most important, the program appears to be working. At the second-year mark of the commencement of the program in Marin County, 15 participating public schools reported an increase in walking (64 percent), bicycling (114 percent), and carpooling (91 percent) and a decrease in private vehicles carrying only one student (39 percent) (Staunton et al. 2003). SOURCE: Kirby and Hollander 2004.

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Does the Built Environment Influence Physical Activity? Examining the Evidence - Special Report 282 exhibit the highest levels of walking and bus transit use13 for utilitarian travel out of necessity (Pucher and Renne 2003), but they engage in much less discretionary physical activity than other groups (see Chapter 2). Interventions such as the Sisters Together Program (see Box 4-2), which attempt to address issues of regaining control over one’s environment (e.g., safe walk routes) and combating isolation (e.g., walking buddies), may help overcome barriers to recreational physical activity for some low-income urban populations. Not all low- or moderate-income neighborhoods are affected by fears of crime, however. Physical inactivity of their residents must derive from other causes. Concern for personal safety can also play a role in the use of pathways for walking and jogging in urban and regional parks. Surveys and focus groups have shown that adults, particularly older adults and female minorities, perceive unsafe footpaths and other recreational areas for exercise as deterrents to walking and other physical activity (Hahn and Craythorn 1994; King et al. 2000; Booth et al. 2000). Crime and deteriorated neighborhoods are less likely to be an issue in rural settings, where natural scenery (open fields) and lightly traveled rural roads provide opportunities for walking and cycling. For the rural poor, however, isolation and long distances between destinations may limit these activities (Brownson et al. 2000 in Kirby and Hollander 2004). Providing opportunities for walking and cycling may not be sufficient to change behavior, however, particularly for certain types of travel, such as commuting. Time constraints, long distances between destinations, and the mobility afforded by the automobile make traveling by personal vehicle the preferred option for many commuters. A recent study of commuting behavior in three neighborhoods in the San Francisco Bay Area—one urban and two suburban—attempted to separate the effects of household location preferences from the spatial characteristics of residential neighbor- 13 As noted earlier, transit, particularly bus transit, requires some walking to access the bus stop. Rail transit can also induce walking and cycling, but in suburban locations, park-and-ride facilities make driving an option.

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Does the Built Environment Influence Physical Activity? Examining the Evidence - Special Report 282 BOX 4-2 The Sisters Together Program This obesity prevention pilot program supported by the National Institutes of Health (NIH) and the National Institute of Diabetes and Digestive and Kidney Diseases (www.niddk.nih.gov/health/nutrit/pdf/SisPrmGuide2.pdf) began by targeting young black women in three inner-city neighborhoods of Boston. The campaign focused on creating positive messages to generate normative change and involving existing community programs to build sustainability. The Sisters Together initiative developed a coalition of programs and people in the community, targeting both healthy eating and moving more (www.hsph.harvard.edu/sisterstogether/move.html). In an effort to suggest activities that would resonate with their target audiences, program staff developed tips on dancing, not just walking: “Turn on your favorite music and dance to three songs a day three times a week. It gets your heart pumping, your body moving, and your mind feeling great.” A web page and brochure provided safe walking routes around the city. Radio public service announcements offered women a chance to sign up for a neighborhood walking group if they came to a 2-mile warm-up walking event. Making it easier for women to locate a walking buddy helped promote a positive social norm with regard to walking. The program’s Why Walk cites the top three benefits of walking validated by research—“Walking will … give you more energy, make you feel good, and help you relax.” A traditional method—the bounce-back card—was used to obtain feedback from the target audience and partners on how the program was working and what could be improved. Community partners were engaged to be the sustaining force behind the program once NIH funding for the pilot project ended. Rudd et al. (1999) describe the community development model employed in this project, but no longer-term evaluation data could be located. SOURCE: Kirby and Hollander 2004.

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Does the Built Environment Influence Physical Activity? Examining the Evidence - Special Report 282 BOX 4-6 Two Examples of More Flexible Transportation Infrastructure Design Approaches Context-sensitive design. Many state transportation departments are moving toward a more flexible project design process known as context-sensitive design or, more broadly, context-sensitive solutions. This movement began in the late 1990s, when several states launched initiatives to define better ways of designing roadways. Perhaps one of the best definitions of context-sensitive design is found in a technical memorandum from the Minnesota Department of Transportation: “Context sensitive design is the art of creating public works that are well accepted by both the users and the neighboring communities. It integrates projects into the context or setting in a sensitive manner through careful planning, consideration of different perspectives and tailoring designs to particular project circumstances” (Minnesota Department of Transportation 2000). Such efforts are beginning to focus attention on those aspects of infrastructure design in sensitive community contexts that enable greater flexibility in implementing design standards. Special design districts. Rather than relying on the ability of design professionals to arrive at the desired design ranges, some areas have attempted to circumvent the standardized roadway classification system through the creation of special design districts that indicate the desired dimensions for specific roads. Portland, Oregon, known for its progressive pedestrian orientation, included pedestrian districts as part of its original 1977 Arterial Streets Policy. These districts include special design criteria specifically addressing pedestrian travel (City of Portland 1998). SOURCE: Meyer and Dumbaugh 2004.

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Does the Built Environment Influence Physical Activity? Examining the Evidence - Special Report 282 Another common approach to accommodating nonmotorized travel is traffic calming. Originating in Europe, these measures are designed to slow traffic speeds in residential neighborhoods and near schools and pedestrian ways through self-enforcing physical devices. Examples are vertical deflections (speed humps and bumps and raised intersections); horizontal deflections (serpentines, bends, and deviations in a road); road narrowing (via neckdowns and chokers); and medians, central islands, and traffic circles (Loukaitou-Sideris 2004). The Institute of Transportation Engineers has developed suggested design guidelines for traffic calming measures encompassing applications, design and installation issues, potential impacts, and typical costs (ITE 2004). Finally, more creative use of the cul-de-sac could be considered. Cul-de-sac patterns providing greater connectivity could achieve more of the benefits of the street grid pattern while retaining the cul-de-sac’s higher levels of privacy, safety, and quiet and lower construction costs (Southworth and Ben-Joseph 2004). For example, designing residential communities that connected cul-de-sacs and loop streets through a system of pedestrian and bicycle paths would provide better access to parks, schools, and neighborhood shops (Southworth and Ben-Joseph 2004). Retrofitting existing suburban cul-de-sac developments could prove more difficult,25 but “safe pathways” could be designed by using a combination of existing public rights-of-way, sidewalks, and street space in some closer-in suburbs.26 Transportation Infrastructure Financing Transportation infrastructure financing has been a major factor in the development of the current transportation system. In particu- 25 Building a pathway system to connect cul-de-sacs in a low-density suburban development would probably require building on private rights-of-way along lot lines. Single-use development limits the variety of destinations, although such paths could be used for exercise (Southworth and Ben-Joseph 2004). 26 Locating community facilities and services on secondary streets should also improve traffic access for walking and cycling. Care must be exercised, however, not to congest residential areas or create a safety hazard for pedestrians and bicyclists.

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Does the Built Environment Influence Physical Activity? Examining the Evidence - Special Report 282 lar, funding restrictions on use, matching shares, procedural requirements, and design standards all have had important influences on project outcomes. In general, nonmotorized transportation modes and, to a lesser extent, transit have not fared well in traditional programs and policies (Meyer and Dumbaugh 2004). Funding arrangements differ across transportation modes. Highways have a well-established financing system with a long history of federal assistance, primarily from gas tax revenues set aside in the Highway Trust Fund. Local street and county road improvements, however, are financed from local revenues. Transit funding is a federal and local, and increasingly a state, responsibility. Nonmotorized transportation modes are primarily locally financed. Different funding arrangements provide different incentives and constraints. For example, for many years the emphasis of federal-aid transportation programs was on highways, and matching requirements for state and local funds mirrored this emphasis. Federal funds financed 90 percent of Interstate highway construction, but only 50 to 80 percent of the cost of constructing transit facilities. In addition, projects using federal funds had to incorporate federally required design criteria. For many projects, this meant building an improved facility—adding more capacity for vehicular travel, for example—rather than simply replacing the existing facility as it was. State and local funding arrangements vary widely by jurisdiction. For example, state constitutions restrict the majority of state gas tax revenues to highway expenditures. These projects rarely include pedestrian-oriented improvements, such as sidewalks, which are considered the responsibility of local governments or individual landowners (Meyer and Dumbaugh 2004). Local governments have assumed many responsibilities for transportation financing, including nonmotorized modes. For example, many larger communities finance transit operations with sales tax set-asides approved by voter referendum. Bicycle paths and pedestrian facilities (e.g., street overpasses) are largely a local responsibility or the responsibility of individual landowners (e.g., sidewalks). Local governments can finance such improvements through local taxes or impact fees on new developments but are often reluctant to

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Does the Built Environment Influence Physical Activity? Examining the Evidence - Special Report 282 do so because of political backlash. These strategies shift costs directly to local residents (Meyer and Dumbaugh 2004).27 Since passage of the Intermodal Surface Transportation Efficiency Act of 1991 (ISTEA), the playing field between highways and transit has been leveled significantly. Certain highway funds can be “flexed” for transit and other nonhighway uses, and project matching shares for transit and highways are the same. In addition, several new programs were created that can help finance pedestrian and bicycle projects. One of the principal new funding sources for nonmotorized transportation is the Transportation Enhancements Program, which restricts 10 percent of Surface Transportation Program funds allocated to the states to such improvements as pedestrian and bicycle facilities and roadway beautification (Meyer and Dumbaugh 2004). The Congestion Mitigation and Air Quality Improvement (CMAQ) Program, also created by ISTEA, is aimed at improving metropolitan air quality. Projects such as bicycle, pedestrian, and transit improvements that encourage shifts from single-vehicle travel, thereby reducing vehicle emissions, are eligible for CMAQ funding (Meyer and Dumbaugh 2004). Another source of funding, particularly for enhancing bicycle and pedestrian safety, is the 402 program administered by the National Highway Traffic Safety Administration. Because sidewalks, intersection markings, and bicycle facilities can all be used to improve transportation safety, such projects are eligible for 402 funding (Meyer and Dumbaugh 2004). Finally, opportunities exist to incorporate pedestrian facilities and bicycle paths as part of other projects eligible for federal funding at minor additional cost. REFERENCES Abbreviations AASHTO American Association of State Highway and Transportation Officials BR&S Belden, Russonello & Stewart 27 Developers typically build local streets and parking in subdivisions and charge back the home-owner-users. In the case of parking, this precludes shared parking and charging.

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Does the Built Environment Influence Physical Activity? Examining the Evidence - Special Report 282 SUMMARY Designing Research to Study the Relationship Between the Built Environment and Physical Activity A more rigorous understanding of the extent to which the built environment is a factor in individuals’ choices about physical activity is important in designing effective policies and interventions to address the decline in such activity. A review of the theory and data available to guide research on the links between the two reveals that conceptualization and measurement of the relevant environmental factors are a relatively new area of inquiry. A more complete theoretical framework is needed to provide the basis for formulating testable hypotheses, suggest the variables and relations for study, and help interpret study results. Research designs emphasizing longitudinal approaches are particularly relevant for studying the potential causal relationship between a given aspect of the built environment and the desired behavior (i.e., more physical activity). With few exceptions, however, such studies are not evident in the research conducted to date. The issue of self-selection bias has only recently been incorporated into research designs. Both longitudinal and cross-sectional studies should use analytic approaches that help distinguish the extent to which an observed association between the built environment and physical activity reflects the characteristics of the built environment versus the attitudes and lifestyle preferences of those who choose to live in an environment with particular characteristics (e.g., walking and bicycle paths). To date, most available research in this area has focused on cross-sectional analyses. The primary limitations of this research approach have been a poor understanding of the variables to include, which in turn reflects a deficiency of good theory, and the

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Does the Built Environment Influence Physical Activity? Examining the Evidence - Special Report 282 lack of well-developed measures of the relevant attributes of the built environment at the appropriate geographic scale. The latter can be traced to inadequate data, a function of the relatively immature stage of the research. Measures of physical activity have been the focus of considerable research and are better developed than measures of the built environment. On the other hand, large surveys that measure physical activity and health have been focused primarily on leisure-time physical activity and do not provide information on the location of that activity. Thus, the researcher cannot determine total levels of physical activity or identify where the activity has occurred so these data can be linked with those on the characteristics of the built environment. At a minimum, geocoding the data collected in several of the large surveys on physical activity and health could facilitate linking these rich data sets with information on the built environment. Greater use of technologies that provide automated and objective measures to help verify the accuracy and enhance the precision of self-reported survey and diary data is already possible.