Moudon and Lee, 2003). For example, the prevalence of biking by students at 14 elementary schools in Mesa, Arizona, was assessed using a previously validated bikeability instrument that included average daily traffic, number of through lanes, speed limit, bike-lane width, the quality of the pavement, and other specifics (e.g., intersections, curves, and grades) (Sisson et al., 2006).

Furthermore, several community health report cards and indicators that could serve as a basis for further efforts have been developed. CDC’s Healthy Days Measures focus on health-related quality of life and include measures related to physical activity and promoting a healthful diet (CDC, 2000). An example of an innovative approach to community assessment is a community youth-mapping project that involves children and youth in assessing their community’s resources and needs regarding, for example, access to opportunities for physical activity and to fruits, vegetables, and other foods and beverages that contribute to a healthful diet (National Community Youth Mapping, 2006).

What is needed is a robust and well-validated tool to promote healthy communities and foster community action. Similar to the School Health Index for schools (Chapter 7), there is a need for CDC, in partnership with other agencies and organizations, to develop a multicomponent well-validated self-assessment tool (or tool kit) that will assist communities with examining multiple factors relevant to healthy communities. This type of community health index tool could include modules on the availability, accessibility, attractiveness, affordability, and safety of places for physical activity and healthier food choices for community members; the involvement of community organizations; and the measurement of the collective efficacy of a community. Adequate funding is needed to develop this tool; and the committee encourages collaborative efforts among U.S. Department of Health and Human Services, the U.S. Department of Transportation, the U.S. Department of the Interior, and other relevant federal agencies and private-sector and nonprofit organizations.

Expand the Use of Spatial Mapping Technologies

Improving the built environment to provide greater access to opportunities for physical activity and to foods and beverages that contribute to a healthful diet involves the identification of underserved areas and the modeling of potential changes to see if more people can be reached or benefit from the proposed interventions. New spatial mapping technologies, known broadly as geographic information systems (GIS), examine different types of datasets that are spatially referenced (such as road and land-use maps, population census data, housing data, and survey data with a corresponding coordinate system) and provide analyses that identify patterns and trends in



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