physical activity policy interventions: the big opportunities in our cities enrique jacoby paho/who
TRANSCRIPT
Physical Activity Policy Interventions: The Big Opportunities In Our Cities
Enrique Jacoby PAHO/WHO
LEADING RISK FACTORS FOR GLOBAL MORTALITY
• High blood pressure 13%• Tobacco use 9%• High blood glucose 6%• Physical inactivity 6%• Overweight & obesity 5%
LEADING RISK FACTORS FOR GLOBAL MORTALITY
• High blood pressure 13%• Tobacco use 9%• High blood glucose 6%• Physical inactivity 6%• Overweight & obesity 5%
RECREATION
WORK
DOMESTIC
TRANSPORT
RECREATION
WORK
DOMESTIC
TRANSPORT
Adults 18-64 should do at least 150’ of moderate-intensity aerobic p.a.
throughout the week
OR
at least 75’ of vigorous-intensity a.p.a. throughout the week
WHO, Global Recommendations on Physical Activity for Health, 2010
1999
0
20
40
60
80
100
1980 1985 1990 1995 2000
Exercise is good for your
health
0
20
40
60
80
100
1980 1985 1990 1995 2000
Physically Active Adults
Overweight
Exercise is good for your
health
ParticipationAdherence
• Education and Communication approaches
• School and Workplace interventions/policies WHO, Interventions on diet and physical activity: What Works, 2009
• Urban policies: Transport & Land Use and
Recreation
Health
1
LAND USE POLICIES:
PROXIMITY & CONNECTIVITY
TRANSPORT OPTIONS
2
Enrique Jacoby, OPS
Walk / Bike to work 3-7 Km per day (3-5 d/wk) • Improve CR fitness (Hendriksen, 2000; P. Oja, Vuori I, et.al. 1998)
• Weight Control (Vuori I, 94; Boyd, 98; Bell et.al, 02; Wen&Rissel, 08)
• ↓ CVD risk (SR: Cavill&Davis, 2007; Meta-A N=18: Hamer & Chida, 2008)
Health Impact
In 8-year: + 2.1 Kg
Enrique Jacoby, OPS
• 40% reduction in mortality (Anderson et. al., 2000)
• 40% reduction in mortality DBT and CV (Matthews, 2007)
• All-cause mortality (n=18): (Meta-A N=18 Hamer and Chida, 2008)
Mortality
Walk / bike to work 7-10 Km per day
Health
LAND USE POLICIES:
PROXIMITY & CONNECTIVITY
TRANSPORT OPTIONS
2
Where do you live?
Enrique Jacoby, OPS
Active Transportation and Obesity Rates (Basset y col, 2008)
Transportation options and urban development: Cuasi-exp Portland, Oregon Ohland 2006
0102030405060708090
100
Transit + Compactdevelopment
Transit Suburban
Car Transit Walking Biking
FACTOR EFFECT STUDIES
Density and Diversity
+ Walking , Biking - Polution + Quality of Life
95/3
Street Connectivity
+ Walking, Biking
29/1
Active Transportation
+ Walking, Biking - Polution 58/4
Hosking J et.al WHO Report, unpublished
55% of Bogotanos are physically active
LF Gomez y col., 2004
37%
55% of Bogotanos are physically active
LF Gomez y col., 2004
37%
3%
15%
55% of Bogotanos are physically active
LF Gomez y col., 2004
Enrique Jacoby, OPS+200 km of bikepaths
2.5 to 4.12 m2 Green Areas
m2
100 km de Ciclovia
+120 km TransMilenio
3
Bogota
A TransMilenio user, compared to a non user, is 70% more likely to be “physically active”
Health
2
LAND USE POLICIES:
PROXIMITY & CONNECTIVITY
TRANSPORT OPTIONS: MOBILITY
Health
2
COMPACTDEVELOPMENT
MASS PUBLIC TRANSPORTATION
Spillover benefits
Spillover
Enrique Jacoby, OPS
IV Congreso de Transporte Sustentable Ciudad de Mexico, 27-29 octubre 2008
50 3000 900
Liters of gas per person / year
Annual miles in mass transportation
Road deaths and mass public transport use
Deaths /100,000
• Physical activity and health• Pollution reduction• Road safety• Mental health• Affordability• Mobility
Annual miles per capita
Mileage Change
Suburban Good Transit
TOD
Automobile
base-case
- 2480 - 3501
Transit travel
base-case
447 687
Walking base-case
119 274
Cycling base-case
21 39T Litman, Evaluating public transportation health benefits, June 2010
Annual health benefits when 1-m residents move TOD
BENEFITS From 10% to 20% From 10% to 40%
ROAD SAFETY 55 m 151 m
↓EMISSIONS 3.3 m 9 m
WALKING 11.5 m 52.6 m
CYCLING 0.8 m 2.9 m
TOTAL BENEFITS
71 m 216 m
T Litman, Evaluating public transportation health benefits, June 2010
Ciclovias
Enrique Jacoby, OPS
Bogota
Guadalajara
Mexico City
41% of Ciclovia’s participants in Bogota participate 3 hours: Cycling (49%),
running or walking (36%) and roller-skeating (38%)
If Ciclovia were not in operation 60% would pursue sedentary
activities
Average cost per user per year (USD) of different physical activity programs
Montes F et.al. Cost-benefit of Ciclovias, unpublished
Cost-Benefit ratio of Bogotá’s Ciclovía for every Dollar invested: 5-year simulation using different values for the Direct Health Benefit
Montes F et.al. Cost-benefit of Ciclovias, unpublished
