Communities Putting Prevention to Work: by Completing Their Streets

While Secretary LaHood and the U.S. Department of Transportation have gotten lots of attention for efforts to promote livable communities, another federal agency is determined to invest in livability – for health. The Department of Health and Human Services (HHS) is directing $650 million in ARRA (‘stimulus’) funds to 44 communities through the Communities Putting Prevention to Work (CPPW) program to combat the behaviors that are the factors that most often lead to premature death: smoking, poor nutrition, and physical inactivity.

But instead of the approaches you’d expect – ad campaigns and educational efforts aimed at individuals – HHS has determined that success will only come if we can, in the words of the Centers for Disease Control and Prevention’s Ursula Bauer, “redesign our communities to promote health instead of disease.” This is where Complete Streets comes in: as an effort that will help create inviting places to walk and bicycle over the long haul. We were invited to serve as faculty at a recent series of three Action Institutes held for the communities receiving the CPPW funds. Each community has assembled a diverse team that goes beyond public health agencies to include elected officials, planners, business interests, advocacy groups, and others, who are charged with making change in just two years.

And the changes they will be making will be designed to ‘stick’ long after this program’s funding runs out. Over and over again, the public health community has seen physical activity and nutrition educational efforts lose steam shortly after the programs end. They have also observed that smoking rates really started to drop only when cigarettes cost more and when smoking bans made lighting up less convenient.

The CPPW teams will be working to institute policy and environmental changes that will help ‘make the healthy choice the easy choice,’ so that walking to the store and picking up an apple will be as easy as pulling into a gas station and buying potato chips. Among them: Complete Streets policies and Safe Routes to School programs. The effort reflects a growing understanding that public health will be imperiled until we face up to the heavy costs of an unhealthy environment – costs recently detailed by an American Public Health Association report (.pdf) showing the cascade of effects from transportation investments that emphasize auto-mobility above all other factors.

CDC Director Thomas Frieden has called CPPW “the most ambitious prevention effort ever undertaking in the United States.” It could get even more ambitious if prevention funds from the new health care bill are used for similar purposes. And it represents a powerful new ally in the fight for Complete Streets.

Complete Streets