Public Health

Maureen L. Cropper, Yi Jiang, Anna Alberini, and Patrick Baur (2010)

Getting Cars Off the Road: The Cost-Effectiveness of an Episodic Pollution Control Program

Ground level ozone remains a serious problem in the United States. Because ozone non-attainment is a summer problem, episodic rather than continuous controls of ozone precursors are possible. We evaluate the costs and effectiveness of an episodic scheme that requires people to buy permits in order to drive on high ozone days. We estimate the demand function for permits based on a survey of 1,300 households in the Washington, DC metropolitan area. Assuming that all vehicle owners comply with the scheme, the permit program would reduce VOCs by 50 tons and NOx by 42 tons per Code Red day at a permit price of $75. Allowing for non-compliance by 15% of respondents reduces the effectiveness of the scheme to 39 tons of VOCs and 33 tons of NOx per day. The cost per ozone season of achieving these reductions is approximately $9 million (2008 USD). This compares favorably with permanent methods of reducing VOCs that cost $645 per ton per year.

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Gerrit Knaap and John Frece (2007)

Smart Growth in Maryland: Looking Forward and Looking Back

Spring of 2007 will mark the 10th anniversary of the passage of Maryland’s Smart Growth and Neighborhood Conservation Initiative; an effort designed to discourage sprawl development, foster more compact communities, protect the best remaining farms and open space in the state, and save taxpayers from the growing cost of providing services and infrastructure to serve far-flung development. Almost before its various provisions took effect in 1997 and 1998, the Maryland initiative generated interest and acclaim across the country. It received numerous awards and became the principal legacy of the program’s primary architect, former Governor Parris N. Glen- dening. Governors in other states, such as New Jersey, Colorado and Massachusetts, instituted their own “smart growth” proposals, often modeled after portions of the Maryland program. Even the popularity and wide usage of the now omnipresent phrase “smart growth” can be attributed in large part to the Maryland program.

But, what has been the effect of Maryland’s Smart Growth pro- gram? Looking at it some ten years later, has it worked? Did it accomplish what it was designed to do? What have been the strengths and weaknesses of the Maryland approach, and how can lessons from the Maryland experience be used to offer a new set of policymakers in Maryland, as well as elsewhere in the nation, practical suggestions on how to make smart growth smarter?

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Anna Alberini (2005)

Determinants and Effects on Property Values of Participation in Voluntary Cleanup Programs: The Case of Colorado

State Voluntary Cleanup Programs (VCPs) were established starting in the 1990s to encourage the environmental remediation and redevelopment of contaminated properties. These programs typically offer liability relief, subsidies and other regulatory incentives in exchange for site cleanup. This paper asks three questions: First, what type of properties are attracted to voluntary cleanup programs? Second, what is the interaction between these state programs and other incentives for remediation and economic development, such as Enterprise Zone and Brownfield Zone designations? Third, what is the effect of participation in the VCP on property values?

We use data from Colorado’s VCP to answer these questions. We find that most of the properties enrolled in this program were not previously listed on EPA’s contaminated site registries, and that most applicants seek to obtain directly a “no further action” determination without undergoing remediation. The main determinants of participation are the size of the parcel and whether the surrounding land use is primarily residential, while other incentives have little effect. Properties with confirmed contamination sell at a 47% discount relative to comparable uncontaminated parcels, and participation tends to raise the property price, but this latter effect is not statistically significant.

Taken together, these findings suggest that the participating properties are those with high development potential, and hint at the possibility that owners or developers may be seeking to obtain a clean bill of health from the State with only minimal or no cleanup efforts. Were these findings confirmed with data from other states, they would raise doubts about the effectiveness of voluntary programs in encouraging remediation and their usefulness in reversing some of the undesired effects of the Superfund legislation.

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Carolyn C. Voorhees, David Murray, Greg Welk, et al. (2005)

The Role of Peer Social Network Factors and Physical Activity in Adolescent Girls

Objective: To study the relationship between peer-related physical activity (PA) social networks and the PA of adolescent girls. Methods: Cross-sectional, convenience sample of adolescent girls. Mixed-model linear regression analyses to identify significant correlates of self-reported PA while accounting for correlation of girls in the same school.

Results: Younger girls were more active than older girls. Most activity-related peer social network items were related to PA levels. More PA with friends was significantly related to self-reported PA in multivariate analyses. Conclusions: Frequency of PA with friends was an important correlate of PA among the peer network variables for adolescent girls.

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Reid Ewing (2005)

Can the Physical Environment Determine Physical Activity Levels?

Can the physical environment determine physical activity levels? Does your place of residence affect your level of physical activity and ultimately your weight and health? There is relatively strong evidence of association between compact development patterns and use of active travel modes such as walking and transit. There is weaker evidence of linkage between compact development, overall physical activity, and downstream weight and health effects.

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Reid Ewing, Otto Clemente, Susan Handy, et al. (2005)

Identifying and Measuring Urban Design Qualities Related to Walkability

In active living research, measures used to characterize the built environment have been mostly gross qualities such as neighborhood density and park access. This project has developed operational definitions and measurement protocols for subtler urban design qualities believed to be related to walkability. METHODS:  Methods included: 1) recruiting an expert panel; 2) shooting video clips of streetscapes; 3) rating urban design qualities of streetscapes by the expert panel; 4) measuring physical features of streetscapes from the video clips; 5) testing inter-rater reliability of physical measurements and urban design quality ratings; 6) statistically analyzing relationships between physical features and urban design quality ratings, 7) selecting of qualities for operationalization, and 8) developing of operational definitions and measurement protocols for urban design qualities based on statistical relationships. RESULTS:  Operational definitions and measurement protocols were developed for five of nine urban design qualities: imageability, visual enclosure, human scale, transparency, and complexity. CONCLUSIONS:   A field survey instrument has been developed, tested in the field, and further refined for use in active living research.

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Reid Ewing, Christopher V. Forinash, and William Schroeer (2005)

Neighborhood Schools and Sidewalk Connections: What Are the Impacts on Travel Mode Choice and Vehicle Emissions

The study reported here was the first to examine the relationship between school location, the built environment around schools, student travel to school, and the emissions impacts of this travel. Students with shorter walk and bike times to school proved significantly more likely to walk or bike—which argues for neighborhood schools. Students who have access to sidewalks along main roads were also more likely to walk—which argues for improvements in sidewalk networks.

Neighborhood schools that can be reached by walking and biking can increase the amount of walking and biking to school, can shorten trip distances,and can reduce motor vehicle emissions significantly.

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Reid Ewing (2003)

Building Environment to Promote Health

Editorial published in the "Journal of Epidemiology & Community Health" on the future of collaboration between public health and urban planning professionals.

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Reid Ewing (2003)

Travel and Environmental Implications of School Siting

Travel and Environmental Implications of School Siting, released by the EPA on October 8, 2003, is the first study to empirically examine the relationship between school locations, the built environment around schools, how kids get to school, and the impact on air emissions of those travel choices. Over the next few decades, communities making decisions about the construction and renovation of thousands of schools will be challenged to meet multiple goals -- educational, fiscal, and environmental. The study finds that:

School proximity to students matters. Students with shorter walk and bike times to school are more likely to walk or bike.

The built environment influences travel choices. Students traveling through pedestrian-friendly environments are more likely to walk or bike.

Because of travel behavior differences, school location has an impact on air emissions. Centrally located schools that can be reached by walking and bicycling result in reduced air emissions from driving.

More data collection and research are needed to add further to the understanding of these effects. Specifically, improved data about both school travel and the built environment as well as new modeling techniques can build on these results.

For some time, there has been a trend toward construction of big schools and requirements for large sites. Guidelines, recommendations, and standards that encourage or require building large schools on new campuses or discourage renovation are embedded in a variety of state and local regulations, laws and funding formulas. This study provides important information about the effect of school location on how children get to school. It shows that school siting and design can affect choices of walking, biking, or driving. In turn, these changes in travel choices could affect traffic congestion, air pollution, and school transportation budgets.

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Reid Ewing, Tom Schmid, Richard Killingsworth, et al. (2003)

Relationship Between Urban Sprawl and Physical Activity, Obesity, and Morbidity

Purpose. To determine the relationship between urban sprawl, health, and health-related behaviors.

Design. Cross-sectional analysis using hierarchical modeling to relate characteristics of individuals and places to levels of physical activity, obesity, body mass index (BMI), hypertension, diabetes, and coronary heart disease.

Setting. U.S. counties (448) and metropolitan areas (83).

Subjects. Adults (n 5 206,992) from pooled 1998, 1999, and 2000 Behavioral Risk Factor Surveillance System (BRFSS).

Measures. Sprawl indices, derived with principal components analysis from census and other data, served as independent variables. Self-reported behavior and health status from BRFSS served as dependent variables.

Results. After controlling for demographic and behavioral covariates, the county sprawl index had small but significant associations with minutes walked (p 5 .004), obesity (p , .001), BMI (p 5 .005), and hypertension (p 5 .018). Residents of sprawling counties were likely to walk less during leisure time, weigh more, and have greater prevalence of hypertension than residents of compact counties. At the metropolitan level, sprawl was similarly associated with minutes walked (p 5 .04) but not with the other variables.

Conclusion. This ecologic study reveals that urban form could be significantly associated with some forms of physical activity and some health outcomes. More research is needed to refine measures of urban form, improve measures of physical activity, and control for other individual and environmental influences on physical activity, obesity, and related health outcomes. (Am J Health Promot 2003;18[1]:47–57.)

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Reid Ewing and Barbara McCann (2003)

Measuring the Health Effects of Sprawl: A National Analysis of Physical Activity, Obesity and Chronic Disease

The findings presented here are from the article, Relationship Between Urban Sprawl and Physical Activity, Obesity and Morbidity, by Reid Ewing, Tom Schmid, Richard Killingsworth, Amy Zlot, and Stephen Raudenbush, published in the September 2003 issue of the American Journal of Health Promotion. This report is intended to make this important piece of research more accessible to the general public. In addition to presenting research findings, this report summarizes recent research done by others on the links between the way we’ve built our communities, physical activity, and health. It also includes recommendations for change and resources for those interested in further exploration of this topic.

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Gerrit Knaap (2002)

Talking Smart in the United States

As in many countries around the world, concerns about contemporary urban development patterns and their effects on the natural and social environment are high and rising in the United States. Though these concerns are not new, the recent period of sustained economic growth has led to both rapid urban expansion and falling relative concerns about other problems like crime, unemployment, and government deficits. Urban sprawl is now a major public policy issue (U.S. Office of Technology Assessment 1995, U.S. General Accounting Office (GAO) 1999, GAO 2000).

How to address -- even define -- the problem, however, remains unresolved and contentious. Some view urban sprawl as a major threat to environmental quality, fiscal stability, and human health. Those with this point of view support policy reforms sometimes called smart growth, new urbanism, and sustainable development (Ewing 1997, Smart Growth Network 2002). To others, sprawl is simply the result of increases in population, rising real incomes, and the expression of consumer demands (Brueckner 1999). To those with this point of view, there is little evidence that urban sprawl has adverse social or environmental consequences or warrants a policy response (Gordon and Richardson 1997, Urban Futures 2002). In a nation rich in land resources and steeped in traditions of private property rights, this view is not easily dismissed.

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Deborah Young and Carolyn Voorhees

Personal, Social, and Environmental Correlates of Physical Activity in Urban African-American Women

African-American women are at risk of chronic diseases for which regular physical activity can provide benefits. This group, however, remains predominantly sedentary. Little research has been undertaken to elucidate the multiple factors that influence their physical activity levels. This study was designed to determine associations among personal, social environmental, and physical environmental factors with physical activity level in urban African-American women.

The Women and Physical Activity Survey, an interviewer-administered survey consisting of demographic, personal, and social and physical environmental factors, was given to 234 African-American women living in Baltimore, Maryland. Physical activity level was determined from the Behavioral Risk Factor Surveillance System survey. Women were divided into three groups: meeting current recommendations for moderate or vigorous physical activity, insufficiently active, and inactive. Comparisons were made between the group of women that met recommendations versus women who did not, and women who reported any activity versus women who were inactive.

Twenty-one percent (48) of women met recommendations for physical activity, 61% (143) were insufficiently active, and 18% (43) were inactive. Women who had a partner or who had no children were less likely to engage in some physical activity. Inactive women were more likely than women who participated in some physical activity to know people who exercised.Women who belonged to community groups were more likely to be inactive than women who met current recommendations for physical activity. Women with fewer social roles were more likely to meet current recommendations. Physical environment factors were not associated with physical activity level.

Further exploration is needed to determine how personal and social environmental and physical environmental factors relate to physical activity in African-American women.

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Carolyn Voorhees and Deborah Young

Personal, Social, and Physical Environmental Correlates of Physical Activity Levels in Urban Latinas

Nationwide, Hispanic women report low levels of physical activity and bear excess health risk associated with inactivity. This study investigated the relationship between physical activity levels and sociodemographic, social environmental, and physical environmental factors.

A cross-sectional, community-based convenience sample of 285 Hispanic/Latino women completed a face-to-face survey administered in Spanish.

Main Outcome Measures:
The following categories of physical activity were used in analyses: “meets current national recommendations,” which includes women who reported engaging in moderate activity at least 5 days per week for at least 30 minutes or who engaged in vigorous activity at least 3 days per week for at least 20 minutes; “insufficiently active” for women not meeting moderate or vigorous objectives; and “inactive” for women who report no moderate or vigorous physical activity.

The majority of women (46%) were aged 20 to 29 years, 48% have less than or equal to a high school education, 72% are employed, 43% speak Spanish, and 76% are from Central or South America. A total of 37% of the women met physical activity recommendations, 23% were inactive, and 40% were insufficiently active. Personal and physical environmental factors were not statistically significant correlates of activity level comparison groups; however, most indicated trends in the hypothesized direction. Social environmental factors that showed statistically significant relationships with various physical activity comparison groups included the following: Women were significantly less likely to be active if they reported knowing people who exercise (odds ratio [OR]0.42; 95% confidence interval [CI], 0.23–0.76), reported that there are people in the neighborhood who exercise (adjusted OR0.19; 95% CI, 0.09–0.42), belonged to community groups (OR0.32; 95% CI, 0.15–0.69), or attended religious services (OR0.41; 95% CI, 0.41–0.72).

Conclusion: Social environmental factors appeared to be the most important factors related to physical activity in this group of Latino women. Physical environment and personal factors, although not statistically significant, showed trends in expected directions and should be explored further.

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