A healthier transportation system for America’s kids requires change in federal policy. But change will remain out of our grasp absent a sense of urgency from the everyday people on the ground.

The need for a meeting point between policymakers in Washington and citizens in their neighborhoods was evident in today’s roundtable on childhood obesity, titled “Keeping Kids Moving,” sponsored by Transportation for America, the Robert Wood Johnson Foundation Center to Prevent Childhood Obesity, The Convergence Partnership and PolicyLink.

We’re facing an epidemic of childhood obesity and poor health, and as a few people pointed out, this could very well be a generation of children who live shorter, less healthy lives than their parents if we don’t act now to change things.

The shape and structure of streets, sidewalks and the ability to safely use them has an enormous impact on whether children become overweight or obese. Kids get more physical activity and lead healthier lives when they can bike and walk to school, play in local parks and reach recreational opportunities with ease. Among American children between the ages of 10 and 17, 32 percent are overweight or obese, and many are at risk for more serious conditions like type 2 diabetes, heart disease and stroke. Obesity rates are disproportionately high among low-income and minority children.

In search of a solution, many routes invariably lead to transportation policy.

During the panel, several federal officials stressed the need for partnerships that cross departments and jurisdictions, with Roy Kienitz, undersecretary for policy at the Department of Transportation quipping, “transportation is too important to be left to transportation professionals.” Kienitz also emphasized the need for Americans to speak up and utilize the democratic process, noting that “the distance between the top [at DOT] and that sidewalk on your street is vast.”

Chip Johnson, mayor of Hernando, Mississippi, knows just how much of a difference one repair can make. As part of a broader push to repair his town’s streets, Johnson oversaw the pouring of concrete for a new sidewalk right outside his office window. On the old, cracked sidewalk, Johnson used to see a handful of pedestrians every morning, but he saw dozens more walking by once the improvements were completed.

“People want to exercise,” said Johnson, a Republican first elected mayor in 2005, adding that it’s up to officials like him to provide them the chance to do it.

keepkidsmoving2 Originally uploaded by Transportation for America

While people like Undersecretary Kienitz, Special Assistant to the President Martha Coven and others are moving the levers where they can in Washington, local officials like Johnson are stepping up and refusing to wait, behavior encouraged by the federal officials who were present.

Nashville Mayor Karl Dean didn’t wait for Washington. He made safe and accessible streets for all users a top priority and hired a director of healthy living initiatives — Adetonkunbo Omishakin, also a panel participant — to help make it happen in Nashville. Child wellness advocate Julia Lopez, herself a teenager, didn’t wait either. Along with being an instigator of change on the ground around her home of southern California, she has traveled the country to bring a youth perspective to the obesity challenge, calling on elected officials to step up and help make healthy transportation the norm, not the exception.

It’s clear that these advocates on the ground and policymakers at the top can meet in the middle to make real change, but it will take continued pressure on Congress from both ends to get the job done.

That is the conclusion of F as in Fat: How Obesity Threatens America’s Future 2010, a new report sponsored by the Trust for America’s Health and the Robert Wood Johnson Foundation.

Most striking about the report are the persistent demographic and geographic disparities in obesity rates, as well as rising rates among children. One’s zip code or income should never be the greatest determinant of health.

In 40 states and the District of Columbia, adult obesity rates were higher for blacks and Latinos than whites. The South was home to 10 out of the 11 states with highest obesity rates — Mississippi clocked in on top with 33.8 percent of adults considered obese. And, accounting for income, 35.3 percent of adults earning less than $15,000 per year were obese, as opposed to 24.5 percent of adults earning more than $50,000 per year.

Childhood obesity rates were up, but fluctuated by state, from just 10 percent in Wyoming to 21 percent in Kentucky. You can view a complete map with obesity rates in all 50 states and the district here.

The authors write:

Reversing the obesity epidemic will require individuals, families, schools, communities, businesses, government, and every other sector of American society to reduce the barriers to healthy eating and active living. Every American must have the chance to lead a healthy lifestyle.

F is for Fat’s transportation plank calls for a bold and comprehensive reauthorization of the surface transportation law, similar to the draft proposal released by key House chairman Jim Oberstar last year. The report compels Congress to act on Complete Streets legislation to ensure that people who walk, bike and use transit can use roadways safely, and a reauthorization of the Safe Routes to School program, in hopes of reversing the trend of more and more kids getting driven to class each day.

The report also identifies three legislative vehicles for reorienting our transportation policy and increasing travel options.

The Active Communities Transportation Act would give cities and localities added funds for increasing walking and biking rates and making it safer. The National Transportation Objectives Act would attach safety, efficiency and economic competitiveness benchmarks to federal dollars, making our transportation spending much more accountable to the taxpayers. And the CLEAN TEA bill would cap greenhouse gas emissions and target revenue toward clean transportation projects that can get us where we need to go while reducing emissions at the same time.

As the report points out, we are already moving forward on a number of fronts and many policymakers get it.

The Patient Protection and Affordable Care Act of 2010 signed by President Obama earlier this year funds a number of wellness and prevention programs that have the potential to be expanded. A number of states have taken steps toward healthier school lunches, and Congress may act on legislation as well. And First Lady Michelle Obama’s “Let’s Move” campaign is calling attention to how we can ensure children live healthier lives, including through walking, bike and physical activity.

To view the entire report, you can visit the Trust for America’s Health website here.

The Patient Protection and Affordable Care Act signed by President Obama earlier this year was a step toward expanding health coverage while lowering costs. But there’s far more to be done. A truly comprehensive approach to health must account for transportation’s role in our levels of physical activity.

The American Public Health Association tackles that in a new report titled “The Hidden Health Costs of Transportation.”

For decades, Americans have made great use of the interstate highway system, but our transportation system is outdated and in need of retooling. The promise of convenient inter- and intra-city driving came with unseen drawbacks: long commutes and gridlock that keep Americans stuck in their cars and away from their families.

It doesn’t take a doctor to figure out sitting at work for eight hours a day and driving for another 1-2 can’t be all that good for you. Where we live and how we get there matters. The APHA put it well: “transportation investments and the systems that are developed from them shape lives and communities.”

It’s not just a lack of physical activity that ails us. Our current habits expose us to high asthma rates from pollution and unsafe streets for pedestrians and bicyclists, as outlined in our Dangerous by Design report last year.

So what needs to change? One place to start is by expanding transportation options. Driving will always be a necessity, but Americans have shown their desire for public transportation with their votes and feet. Pollsters found that 82 percent of American voters believe the U.S. would benefit from an improved and expanded public transportation system, and 79 percent of rural residents shared that sentiment as well. Build it and they actually will come, it turns out. The APHA writes:

An investment in a “healthier” transportation system is critical. Providing convenient alternatives, encouraging active modes of transport, and a establishing a transportation system that fosters connectivity and social interaction can not only offset health impacts and costs, but generate health benefits.

In addition to increasing access to other transportation options, the APHA also stresses that health impacts should be considered during the planning and decision-making stages of transportation projects to the fullest extent possible.

Growing recognition of the connection between transportation, land development and health has resulted in some studies and examples where health impacts and costs have been considered and assessed. These examples not only demonstrate that health costs should be a significant factor in decision-making, but also show that calculating such costs is indeed possible.

The APHA has laid out the reasons why our long-term health is distinctly linked to how we get around, and the passage of health care reform should serve an impetus to take the right next steps. Will Congress heed APHA’s counsel as the next surface transportation bill advances?

Earlier this month, we highlighted two reports on the integral link between health and transportation. First Lady Michelle Obama’s recent Let’s Move report on childhood obesity goes one step further — endorsing a new surface transportation bill that encourages more walking and biking.

Noting the pivotal impact transportation options and the built environment have on health and physical activity, Transportation for America encouraged First Lady Obama to include the built environment in the final product. We are gratified that the task force did just that.

The full White House Task Force on Childhood Obesity report contains five components: Early Childhood; Empowering Parents and Caregivers; Healthy Food in Schools; Access to Healthy, Affordable Food; and Increasing Physical Activity. Our interest is primarily in the last section, which has a section on the built environment. According to the report:

How communities are designed and function can promote—or inhibit—physical activity for children and adults.  The built environment consists of all man-made structures, including transportation infrastructure, schools, office buildings, housing, and parks.  Children’s ability to be physically active in their community depends on whether the community is safe and walkable, with good sidewalks and reasonable distances between destinations.

The report notes that several studies have already attributed obesity and health problems to aspects of our current built environment, such as sprawling subdivisions and lack of places to walk. It makes intuitive sense too. When we live further and further from where we work, where we go for recreation, where we go to school or where we shop, it makes us all the more reliant on automobiles, especially in the absence of viable alternatives. In urban areas, one-fifth of all automobile trips are one mile or less. These distances could easily be walked or biked with the proper infrastructure in place, as the report notes.

To that end, the task force lends an unequivocal endorsement to “active transportation.” Improving pedestrian and bicycle infrastructure is one place they suggest we start, as is the continuation and expansion of the Safe Routes to Schools program, currently funded through the U.S. Department of Transportation.

Active transport refers to approaches that encourage individuals to actively travel between their destinations throughout the day, such as by biking or walking.  Children who walk or bike to school report being more physically active, including engaging in more moderate to vigorous physical activity, than those who travel by car, bus, or train.

The First Lady’s recommendations also embrace an exciting new way of linking health to the built environment in the form of Health Impact Assessments (HIAs). Many communities are already embracing this approach, which evaluates whether a new project helps or hinders public health.

The built environment section’s key benchmark: increase by 50 percent by 2015 the percentage of children between the ages of 5 and 18 who walk or bike to school. That’s a goal we can all get behind, and one Congress ought to remember as the new surface transportation bill progresses.

Access to jobs, schools, shopping, and critical community services is just as vital for Americans living in small cities, towns and rural communities. Transportation for America has been working closely with our coalition partners on this important issue for some time. Now, it looks like Secretary of Transportation Ray LaHood is also getting on board.

Listening to folks at the La Crosse Interstate Fair in Wisconsin this week, he heard many of the same things that we already know:

• It’s getting harder financially to depend on a truck or car for all of a family’s transportation needs.
• Rural residents need public transportation just like city-dwellers do.
• Access to commercial air service is increasingly difficult for rural areas.
• Shippers of grain and other products need better freight options to get rurally produced goods to markets.

Clearly, the transportation system in rural areas and small towns faces challenges and demands that are unique from those in our metropolitan areas. Small cities and towns have higher concentrations of older Americans and families in poverty who would absolutely benefit from more affordable transportation options, beyond just driving. In addition, children in rural areas are 25 percent more likely to be overweight or obese than those in urban areas and face unique barriers to being active and maintaining a healthy weight. Non-metro areas have a larger share of people over age 65 (15 percent) than the country as a whole (12 percent) particularly across the middle of the country. (According to 2004 numbers.)

These challenges are amplified by global changes in the economic marketplace, insufficient funding to maintain substandard or unpaved roads, improve public transportation services, and upgrade or replace substandard and deteriorating bridges.

Our nation’s transportation infrastructure should provide access for all Americans, regardless of their geographic location, age, income, or disability status. While there are no easy answers here, Secretary LaHood’s comments are a good starting point for reframing the debate towards policy options that benefit all Americans, regardless of geography.

With Congress directing their attention to the contentious debate over health care reform and how to pay for it, it seems that transportation has been relegated to the back burner. In the meantime, evidence is continuing to mount that transportation investments — what we build and where — have an enormous impact on our health and the financial bottom line of providing health care.

Last week the California Center for Public Health Advocacy (CCPHA) released The Economic Costs of Overweight, Obesity and Physical Inactivity Among California Adults. In a state making national headlines for its current budget crisis, the study found that (in 2006) “overweight, obesity and physical inactivity cost the state $41.2 billion – $21.0 billion for overweight and obesity, and $20.2 billion for physical inactivity.”

An even more shocking recent study found that the already-dangerous effects of air pollution are magnified for pregnant women living near busy roads.

According to this study from a team of researchers from the University of California, Irvine, exposure to traffic-generated air pollution during pregnancy increases the risk of preeclampsia and premature birth. The study examined over 80,000 birth records and found that the risk of the life-threatening condition preeclampsia increased 33% and the risk of premature birth rose 128% in women living closest to congested corridors.

Many other negative health effects from vehicle emissions, congestion and air pollution have already been documented — with low-income and minority populations typically experiencing the most harmful side effects due to where interstates and highways get built.

The CCPHA report on obesity included some concrete policy recommendations for improving public health, a few of which are connected to our transportation spending decisions.

• Locate residential, commercial and office buildings close together so more residents can walk and bike to meet their daily needs
• Build neighborhoods with safe and attractive parks and other places for recreational exercise
• Create transportation corridors that support pedestrians and bicyclists

Including some realistic goals for improving public health in the transportation bill — one of T4 America’s six national transportation objectives for the bill — would be a great place to start. If we’re ever going to truly move away from a prescriptive health care model to a preventative model — saving us billions in health care costs — we’re going to have to address more than just the skyrocketing costs of treating illnesses and diseases — we’re going to have to look upstream and address some of the contributing factors.

Doing so could keep us healthier and save us billions.

With research from Becca Homa