With growing interest in active transport practitioners and researchers have created a large number of tools to measure active transport behavior and environments. The following web sites provide lists or databases of such tools. If you want to measure AT, such sites can be a good place to start. Thye have been sponsored by such groups as the Robert Wood Johnson Foundation, the National Cancer Institite, and the Federal Highway Administration:
- Active Living Research Tools and Measures: A compilation of community audit, park audit, survey, tracking, and related tools for measuring physical activity environments and behaviors.
- National Collaborative for Childhood Obesity Research:(NCCOR) Measures Registry: A database of measurement tools including many related to measuring physical activity behavior and the built environment; oriented toward research applications: http://tools.nccor.org/measures/
- Standardized Questionnaires of Walking and Bicycling Database: A database with approximately 100 tools focused on physical activity: http://appliedresearch.cancer.gov/tools/paq/
- Toole Design Group: 29 case studies of measuring walking and cycling: http://www.pedbikeinfo.org/pdf/casestudies/PBIC_Data_Collection_Case_Studies.pdf
|Pedestrians in suburban Paris. Photo: Ann Forsyth|
For practitioners interested in integrating health research into planning and design, the task can be daunting. There are many articles that touch on the topic of the connection between people, health, and place but with varying levels of relevance, research quality, and cost (and many can be quite expensive to those who don’t have university library subscriptions). Into the gap have come a number of organizations creating practice-oriented research summaries.
- InformeDesign summarizes many articles, and has an easy search interface, which is very helpful: http://www.informedesign.org/Default.aspx. To find syntheses that evaluate the balance of evidence one needs to go to other sources.
- UCLA HIA-CLIC has some helpful summaries of research organized by sector (e.g transportation) and pathway (e.g air quality) http://www.hiaguide.org/sectors-and-causal-pathways. Not every issues has information—a number are forthcoming—but it’s generally a helpful site.
- Design for Health’s research summaries are now 3 or 4 years old: http://designforhealth.net/resources/researchsummaries.html. This is more of a problem in the area of physical activity and food—where there has been a lot of recent research—than in the other topics where there are fewer new studies. For those wanting to get updated research there are larger topical pages listing other resources: http://designforhealth.net/resources/generalhealthissues.html and a list of web sites by topic is available at .
|A screenshot of the online slide show|
With Christine Green from APA and Nisha Bochwey from the University of Virginia I’ve worked to update the program (without changing the voiceover except for one short additional module!)—Christine is the maven of resources and Nisha did a stellar job on quizzes. There are a lot of new examples. The computer generated voice is a bit weird but the content is a good introduction to HIA—and thanks to the CDC it’s free.
This blog has dealt earlier with the logistics of doing an HIA but what does a workshop look like? One source is the Arden Hills Healthy City Planning Workshop Summary Report Appendices. This document contains images of each stage of the half-day workshop. Go to http://designforhealth.net/wp-content/uploads/2012/12/cases/HIA_ArdenHills_Appendices_3June2010.pdf and look at pages 33-36. More information about the process is available at: http://designforhealth.net/cases/ardenhillsworkshop.html.
I typically don’t report on scholarly studies in this blog but recently came across a nicely designed study that makes a larger point—that the links between health and place are complex. Fei Xu, JieQuan Li, YaQiong Liang, ZhiYong Wang, Xin Hong, Robert S Ware, Eva Leslie, Takemi Sugiyama, and Neville Owen have produced a report on the Nanjing High School Students’ Health Survey, published in the Journal of Epidemiology and Community Health in 2010 (64, 1017-1021, http://jech.bmj.com/content/64/11/1017). Titled: “Residential density and adolescent overweight in a rapidly urbanising region of mainland China” the study used data collected from 2,375 adolescents in 2004 to examine the relationship between (large-scale) district level densities and weight.
|New high rise behind village
residences in suburban Shanghai, 2010
Densities are reported per square kilometer but in range from 5 persons per hectare to 307. The study divided the sample into high, medium, low density residents. Youth in the middle and higher density areas (that is over > 35 person per hectare) were roughly twice as likely to be overweight.
The relationship was reduced a bit but still significant after controlling for TV time, study time, recreation, age, gender, and parents education. Physical activity data came from self reports through a version of the International Physical Activity Questionnaire (IPAQ) that only asked about some kinds of activities. Given a lack of data on overall physical activity and food intake the authors speculate on a number of reasons for this difference e.g. youth in higher density and potentially higher income areas eating more, higher density areas having less recreational space, or (and here I am paraphrasing quite loosely) that higher density areas may just be too convenient with too much internet access so youth don’t have to expend much energy getting places. The high densities in China are also quite high compared with the US and Australia in particular, where much research has been done. They are also increasing rapidly—the authors report overall densities in Nanjing, presumably including some rural districts, increasing from 14 persons per hectare in 1997 to 23 in 2007.
The study is interesting because in many studies of adults, those in higher densities walk more for transportation (though they may not walk more overall) and some find they are thinner (though not all studies measure this or find it to be true, including my own). In this study of youth, with a large group and fairly good measures, those in higher densities are chubbier. While it is important not to make too much of one study, this is yet another example of the complexity of the relationship between health and place, and the importance of social factors.
Participatory GIS is a growing field. For those interested in integrating participatory GIS into healthy planning, several web sites provide helpful illustrations of the potential.
Public Participatory GIS based in a company called Vertices in New Brunswick, New Jersey, (http://www.ppgis.info/) provides illustrative maps on topics from bike crashes to a calculator for calories burned walking different routes. Not all maps are local, for example the public health maps rangr from alcohol sales places in New Orleans to food sales in Philadelphia.
Transparent Chennai (http://www.transparentchennai.com/), at the Institute for Financial Management and Research, uses GIS but with a focus on topics such as squatter settlements, environmental hazards, and other aspects of quality of life. What is particularly handy about this site is one can build a map from different kinds of information including environmental, political, infrastructural, and social issues: http://www.transparentchennai.com/buildamap/. This site really shows the potential for a fairly integrated yet still user driven experience that could be particularly helpful for those interested in working with communities on issues of health and place.
|Part of a map from Transparent Chennai|
Map Kibera (http://mapkibera.org/) started in 2009 by several NGOs in a large squatter settlement in Nairobi Kenya, reportedly was an inspiration for Transparent Chennai. The site has a lot of information apart from maps, showing how different kinds of information—spreadsheets, a blog, twitter, a wiki, and so on—can be linked.
For a more technical, expert-led approach to using GIS see the DFH Threhold Analysis HIA and research oriented NEAT-GIS and LEAN-GIS protocols. These can however be used in a participatory setting. The Arden Hills Rapid HIA used similar maps as background information, for example (see report appendices).
My thanks to Azhar Tyabji, at the Institute for Financial Management and Research, for leading me to his colleague Nithya V. Raman (and her team’s) work on Transparent Chennai.
Integrating health into planning often uses the approach called evidence-based practice. An article on this topic by some of the folks from Design for Health, including me, is currently available for free: http://www.informaworld.com/smpp/content~db=all~content=a918403162~frm=titlelink. It was a finalist in the Association of European Schools of Planning Best Paper Prize: [link no longer active]
InformeDesign (http://www.informedesign.org/) is an online database of research on people and environments. With substantial funding from the American Society of Interior Designers, and based in the University of Minnesota Department of Design, Housing, and Apparel, the database emphasizes research at the building and component level. However, there is enough other work to make it worth a visit, even for urban planning scale investigations.
For those not at universities, finding research on the connections between health and places can be a bit tricky. However, a growing number of online resources are meeting these needs. The entry below lists just a few of these:
- Active Living Research, funded by the Robert Wood Johnson Foundation, has sponsored quite a few special issues with free downloadable articles. Many of them are are listed at: http://www.activelivingresearch.org/resourcesearch/journalspecialissues.
- Healthy Eating Research, another RWJF-funded group, also has free special issues: http://www.healthyeatingresearch.org/publications-mainmenu-111/special-journal-issues-mainmenu-118. In addition they have sponsored a number of proceedings and presentations: http://www.healthyeatingresearch.org/publications-mainmenu-111/proceedings-and-presentations-mainmenu-145.
- Pub Med.gov is produced my ythe U.S. National Library of Medicine at the National Institutes of Health: http://www.ncbi.nlm.nih.gov/pubmed. With over 20 million citations, some linke to free downloads. I find their advanced search engine to be most helpful: http://www.ncbi.nlm.nih.gov/pubmed/advanced.
- The U.S. Transportation Research Board’s Transportation Research Information Service (TRIS) is a terrific database of transportation resources, some related to health and some of these available for free: http://tris.trb.org/.
- The U. S. HUD USER research portal is similar, with a bias toward housing: http://www.huduser.org/portal/bibliodb/pdrbibdb.html.
- A terrific resource for free journals is Highwire, a division of the Stanford University Libraries that aims to make research more accessible: http://highwire.stanford.edu/lists/freeart.dtl. For example back issues of Environment and Urbanization are free after 3 years: http://eau.sagepub.com/ and the American Journal of Public Health after 2 years: http://ajph.aphapublications.org/.
- Examples of journals with where authors pay fees, include the International Journal of Environmental Research and Public Health (http://www.mdpi.com/journal/ijerph) and the International Journal of Health Geographics (http://www.ij-healthgeographics.com/). I have reviewed for the latter (for free) but have mixed feelings about this approach of charging to publish, although it is common in the sciences.
- In planning the online journals with free submission and publication are in related areas such as transport and include the Journal of Transport and Land Use (https://www.jtlu.org/index.php/jtlu).
(Photo by Ann Forsyth)
Focusing on gardens and other landscapes, with a particular emphasis on gardens in healthcare settings, the web site of the Therapeutic Landscapes Network is a well-designed and maintained resource. I have found the following sections to be particularly helpful:
The evidence-based design section at http://www.healinglandscapes.org/ resources-ebd.html includes online searchable databases, books, and articles.
For further reading, the Design for Health web site deals with planting and mental health at: http://www.designforhealth.net/resources/mentalhealthissue.html