The vast numbers of communities, their varied organizational structures, and the independence of each community organization makes it difficult to assess the extent of community change directed toward reducing rates of childhood obesity and the effects of the change on a variety of childhood obesity outcomes. Few national surveys assess community actions, and the tracking of policy changes at the local level is limited. Furthermore, tools that can assist communities with evaluating new programs or conducting self-assessments are only beginning to be fully developed.
Only limited national surveys or surveillance systems collect information on community-level outcomes, particularly those relevant to the built environment, community collaborations, and the involvement of the health care system. The National Household Transportation Survey, conducted by the Bureau of Transportation Statistics and the Federal Highway Administration, is one of the few national surveys that collects information on active transport, including daily and long-distance travel, and that measures young people’s motorized and non-motorized travel (BTS, 2006) (Chapter 4 and Appendix D).
Metropolitan planning organizations across the country, which have the responsibility for planning and coordinating the use of federal highway and transit funds, often conduct local travel surveys (through travel diaries or other means) that provide valuable local-level details on travel patterns, often including the means of travel to school. For example, the Spokane and Kootenai County (Washington) Regional Travel Survey (2005) reported on the travel patterns of 1,828 households.
Efforts are under way to explore the type of data on the built environment that should be collected. Examples of these data could include the numbers of miles of bicycle lanes per capita; population and employment densities; and the number of recreational facilities, with the locations and conditions of those facilities (Brennan Ramirez et al., 2006). Furthermore, efforts to improve the geographic coding of the data on physical activity and health collected through surveillance systems such as the National Health and Nutrition Examination Survey, could provide further information to assist with examination of the impacts of changes in the built environment (TRB and IOM, 2005) (Chapter 4).
Community decision makers need data relevant for their own specific locales to make informed decisions about where and to what extent re-