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At the Forefront of Policy and Public Health
CHORI Scientist Spearheads New American Academy of Pediatrics Policy Statement

"Most of the time, policy statements tend to be about clinical recom-mendations. The strength of the current policy statement is really its value as an advocacy tool."

The American Academy of Pediatrics (AAP) released a groundbreaking new policy statement at the end of May on the relationship between the built environment and physical activity, which was spearheaded by CHORI clinical scientist, June Tester, MD, MPH, and her colleague, Richard J. Jackson, MD, MPH, who is the Chair of Environmental Health Sciences at UCLA.

“This is actually a pretty atypical policy statement for the AAP,” explains Dr. Tester, who was the lead author and consultant on the statement.

With childhood obesity at epidemic proportions, researchers and pediatricians are looking for as many ways as possible to help kids maintain healthy weights. Yet the built environment - spaces created or altered by humans - has a huge impact on how much help pediatricians can provide, and has generally not been considered as part of the bigger picture.

"It would be wonderful if pediatricians could simply tell a child or that child's family that they should walk to school as part of a healthy life style. However, only about 13 percent of kids across the nation actually walk to school. A host of factors related to the built environment, like whether there are sidewalks, how far away the school is from their homes, and how much traffic congestion there is - makes it prohibitive to do so," says Dr. Tester.

Too often people think of urban design and public health as having no relationship to one another. But a century ago, when people were struggling with cholera or tuberculosis outbreaks, public health efforts were very effective at separating people from toxins and "bad air" in the environment. Thanks to the efforts of Drs. Tester and Jackson, the new AAP statement on the built environment is part of an emerging effort to link the two again.

"We need to recognize that we have become a society that is sedentary, that we are not connected to our environment, and then we need to make policies that facilitate changing that," explains Dr. Tester.
"You can't just say, 'go outside and get some exercise,' if the environment doesn't support it."
As a result, the new AAP recommendations are not only a sort of 101 primer for pediatricians on how to be more mindful of the built environment when they make health recommendations, but a true, health-community driven advocacy tool that the design community can utilize.

"The explicit acknowledgement from the health community that yes, what you do as designers impacts our health, is incredibly useful for the design community," Dr. Tester says. "Designers are visionaries- their passion is to create livable spaces. Having the backing of pediatricians in their efforts to design communities that improve quality of life is huge."
While Dr. Tester acknowledges that policies can be slow to change, having evidence-based information shaping those policies is critical, and by providing existing evidence of the ways in which the built environment impacts health, the new AAP statement is a first step toward making that a reality.

"The built environment is not shaped by chance, but by policies. Years ago public health and design came together to help people out, and it's the same opportunity for intersection now," says Dr. Tester.

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Tuesday, May 17, 2011 8:19 AM

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