Jim Sallis Explains the Importance of Healthy Communities (And How We Can Get Them)

Ryan Holeywell | @RyanHoleywell | February 9, 2016

The United States' obesity rate of more than 35 percent is the highest among OECD nations. Image via flickr/Tony Alter.

The United States’ obesity rate of more than 35 percent is the highest among OECD nations. Image via flickr/Tony Alter.

U.S. Surgeon General Vivek Murthy launched a new campaign last year calling for the development of more walkable communities as a way to spur physical activity and help prevent obesity.

“Everyone deserves to have a safe place to walk or wheelchair roll,” Murthy said in a statement. “But in too many of our communities, that is not the reality.”

He argued that walking is, quite simply, the most simple and affordable way to incorporate physical activity into our daily lives. Yet in many places, walking is a serious obstacle. His report cited federal data indicating that 30 percent of Americans say they live in communities that lack sidewalks.

The links between health and physical activity have long been understood. But Murthy’s call was atypical. Usually, the surgeon general works closely with health officials. But in this case, he appealed directly to urban planners and community leaders to urge them to develop more walkable areas.

Urban Edge spoke with psychologist James Sallis, whose work is referenced frequently in the Surgeon General’s new report calling for walkability. Sallis, a professor at University of California – San Diego, leads Active Living Research, which studies ways people can increase activity and prevent obesity. This interview has been lightly edited and condensed for clarity.

Q: Is the Surgeon General’s call to action likely to spur any kind of real change?

A: I’m enthusiastic about anything that might elevate issues related to physical fitness opportunity. These issues have been important for a long time, and we have a long history of them not being addressed adequately.

I think I’m hoping we step off a small path towards physical activity and onto a bigger path that’s going to get us to our destination a little more quickly. But time will tell.

Q: You have a background in psychology. How did fitness and active living become your signature topics?

A: After working in a mental health hospital for a while, I got more committed to prevention. We need to prevent problems. Once they get to the point of hospitalization, it’s probably too late for a lot of people.

I got into what was then the new field of health psychology, which allowed me to combine my personal interest in staying healthy with my professional skills in behavior change.

At first, I did what psychologists do. I looked at individuals and said ‘we’ve got to motivate people and educate them about being active. We’re got to teach them the skills to change their behavior.’ But over time I found those approaches aren’t very effective.

Q: What do you mean?

A: Before, we used a study with families in low-income areas. We decided to look at the neighborhoods they’re coming from. I found most of them had parks, but they didn’t look that good. If I were a parent, I wouldn’t want my kid going there. A lot of the streets had traffic that was very fast, with no safe place to cross. A lot of places didn’t have sidewalks.

There were nutrition problems too. We made a list of 75 healthy foods. We simply couldn’t find grocery stores, so we looked in convenience stores and liquor stores and found they had 3 to 5 of those items.

I thought ‘how will they make changes in these environments?’ And, in fact, they make very few changes. That’s what convinced me. We’re not going to get where we need to go working with people if the environment makes it impossible to have healthy behaviors.

Q: Do we have these same challenges with unhealthy neighborhoods internationally? Or this is a uniquely American problem?

A: Unfortunately it’s not unique. I’d say we’re pioneers. American enthusiasm for technology has been leading us astray for many decades. When cars came in and became a mass phenomenon, people said this was a better way to go. And all these trends started that kept getting worse and worse.

The thinking was that we need to keep roads safe and get all the pedestrians off the street so that cars can have them with no obstacles. Now that we can get around with motors, we don’t have to live so close to everybody. Communities have become less and less dense and we have sprawl. It keeps getting less walkable over time. We pioneered these things, and we’ve exported them.

In my travels, I’ll go to an old, extremely walkable city, and when I go out to the edge I see sprawl. I see that in Europe and Asia and Latin America. We’ve exported this and now we pretty clearly understand that this kind of design undermines our health and discourages walking and other physical activity. It’s a huge issue, considering how many millions of people are affected by these designs, living in places where they cannot walk to a store or school.

We’ve really taken the choice away from people in many cases. Even when they may want to be healthy, it’s very difficult to make those choices.

Q: So where does personal responsibility fit into all of this?

A: Obviously, not everyone wants to walk. Think about how much money people spend on things to help them to not be active, from cars to electronic entertainment to the automatic garage door opener and every labor-saving device in your kitchen.

People are very motivated to avoid activity. But people don’t want to be obese and have heart attacks either. Ninety percent of Americans say physical activity is a good thing, but they may not be ready for it. Our goal, from a health perspective, is to make it easier for them to act on those positive motivations and not spend trillions of dollars making it difficult for them.

Q: Are you optimistic that we’ll turn the tide?

A: I’m moderately optimistic that we will. We are changing the way we build places. I’m less optimistic that we’ll do much in the next two or decades to do something about all the low-walkable areas. I think it will take much longer than that.

People are showing that they want walkable areas. The value of walkable areas is going up. The demographics are really driving this. Older people don’t want to have to drive everywhere. They feel trapped by that. They want places where they can walk to get groceries. Meanwhile, a substantial percentage of Millennials don’t even bother getting driver’s licenses. They want to be in places that are interesting, where they can go have a coffee, see some music and have a choice of restaurants.

The market demand is there, but we still have a legacy of zoning laws in our towns and cities, and we don’t allow more walkable areas to be developed. We had a representative from the U.S. Department of Transportation there at the Surgeon General’s announcement, but their goal is still to move as many cars as quickly as possible.

If we can generate enough political momentum to change underlying policies, I think the market will take us in the direction of healthier places.

Q: What other research are you working on?

A: We’re doing a literature review of the other benefits of designing communities for physical activity. It’s very eye opening. Some are interested in reducing pollution; others are interested in creating a sense of community. Everyone’s interested in the economics of it. We found that if you designed a community better for physical activity, there are benefits across the whole spectrum.

We think this kind of information can be more convincing to city leaders. It’s exciting to see leaders across the political spectrum getting interested in active design.

To RSVP for the Kinder Institute’s Feb. 11 event featuring James Sallis, click here.

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