Authored by Christopher John Arroyo
Art by Jenny Li
State variation in environmental policy, both in our built and natural environments, may prove insightful to state variation in lifestyle and exercise habits among residents. Both lifestyle and physical activity are essential requisites to an effective preventive health model, very likely improving health outcomes in the United States while reducing waste and costs. New York State provides a lovely microcosm for the question of “exercisability.” Always making for an interesting case study, New York State has over eight of its nearly 20 million residents located in New York City and the remainder are dispersed through wide suburban and rural geographies. These urban and more rural natural environments and populations experience a range of weather conditions throughout a given year. Thus, if New York can successfully facilitate physical activity among its population, nearly any and every state can follow in its footsteps.
Nationally, New York State ranks only behind the state of Hawaii for its natural environment in U.S. News’s “Best States” rankings, making New York the top-ranked state in the continental United States. Said rankings incorporate the pollution health risk index, the air quality index, water quality, and other measures [1]. Nevertheless, NY ranks 8th in terms of adult non-obesity rates, with an obesity rate of 29.9% in 2022 [2]. Further, compiling data from 2017 to 2020, NY sits at having a just-over-average rate of physical inactivity of 25.9% compared to a national mean of 25.3%. This makes New York one of the 21 most physically inactive states [3].
Perception of greenness, trees, shaded outdoor areas, and nature in a given neighborhood, for example, are well-associated with physical activity among occupants [4]. For older adults, physical activity can be especially important, where inactivity can contribute to frailty and thus more inactivity. Outdoor fitness equipment and outdoor gyms, more common in European countries compared to the United States, improve physical health, mental health, and socializing among older adults, based on self-reported data [5]. Another study found that older adult utilization of an outdoor gym for moderate to vigorous physical activity increased from 1.6% to 5.1% of users in the year after the gym’s installation, helping to normalize exercise for this demographic [6]. As heart disease, cancer, stroke, Alzheimer’s, and diabetes are among the top ten causes of death in the United States [7], aerobic exercise should likely be prioritized over resistance exercises, which admittedly promote a musculoskeletal strength uniquely valuable in older adulthood [8]. Returning to the built environment, physical activity is strongly associated with an area’s “walkability,” which is a metric based on walking option availability such as with sidewalks, mix of residential and commercial land, and access to destinations of interest or local transportation [9].
Though New York State excels on our natural environment, it is time to deeply consider our built environment policy as a way of in-part addressing trends in New Yorker inactivity, obesity, and health. From Scenic Hudson v. FPC’s protection of Storm King Mountain to our clean-up of hazardous school grounds in Love Canal, we have a rich judicial history in environmental law [10]. Looking at New York statutes, our Obesity Prevention Programs, for example, focus primarily on health care provider education and public health information campaigns, with only one component that more actively seeks to create healthy schools and communities [11]. Operationalizing a campaign focused on increasing the physical activity of New Yorkers does not require a reinvention of the wheel; both precedent and roadmaps exist for us. The New York Health Foundation, for example, is a private organization that has to a degree stepped in for New York State in funding activity-focused initiatives and investments on a local level [12]. Additionally, academically proven frameworks for physical activity environment policy are readily adaptable, conceptualizing both policy and infrastructure implementation as well as providing best practices for governments to adopt [13]. In advancing beyond only traditional health care system reforms, New York has an opportunity to earn back dividends on an investment in physical health as well as lead the nation in health policy innovation.
References
U.S. News & World Report L.P. (2023). Natural Environment. U.S. News & World Report. https://www.usnews.com/news/best-states/rankings/natural-environment
Robert Wood Johnson Foundation. (2023, September 25). Adult Obesity. State of Childhood Obesity. https://stateofchildhoodobesity.org/demographic-data/adult/
U.S. Department of Health and Human Services. (2022, January) Adult Physical Inactivity Prevalence Maps by Race/Ethnicity. CDC. https://www.cdc.gov/physicalactivity/data/inactivity-prevalence-maps/index.html#overall
Tabatabaie, S., Litt, J. S., & Carrico, A. (2019). A Study of Perceived Nature, Shade and Trees and Self-Reported Physical Activity in Denver. International journal of environmental research and public health, 16(19), 3604. https://doi.org/10.3390/ijerph16193604
Chow, Hw. (2013). Outdoor fitness equipment in parks: a qualitative study from older adults’ perceptions. BMC Public Health, 13(1216). https://doi.org/10.1186/1471-2458-13-1216
Cranney L., Phongsavan P., Kariuki M., Stride V., Scott A., Hua M., Bauman A. (2016). Impact of an outdoor gym on park users’ physical activity: A natural experiment. Health & Place, 37, 26-34. https://doi.org/10.1016/j.healthplace.2015.11.002.
U.S. Department of Health and Human Services. (2023, January 18) Leading Causes of Death. CDC. https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
Schroeder, E. C., Franke, W. D., Sharp, R. L., & Lee, D. C. (2019). Comparative effectiveness of aerobic, resistance, and combined training on cardiovascular disease risk factors: A randomized controlled trial. PLoS One, 14(1), e0210292. https://doi.org/10.1371/journal.pone.0210292
United States Environmental Protection Agency. (2021, June 16). National Walkability Index User Guide and Methodology. EPA. https://www.epa.gov/smartgrowth/national-walkability-index-user-guide-and-methodology
Salzman, J., & Thompson, B. H. (2019). Environmental law and policy (5th ed). Foundation Press.
New York State. (2023, August). Obesity Prevention Programs and Activities. Department of Health. https://www.health.ny.gov/prevention/obesity/prevention_activities/
New York Health Foundation. (2023). Physical Activity and the Built Environment. https://nyhealthfoundation.org/what-we-fund/building-healthy-communities/physical-activity-built-environment/
Woods, C. B., Kelly, L., Volf, K., Gelius, P., Messing, S., Forberger, S., Lakerveld, J., den Braver, N. R., Zukowska, J., & García Bengoechea, E. (2022). The Physical Activity Environment Policy Index for monitoring government policies and actions to improve physical activity. European journal of public health, 32(Suppl 4), iv50–iv58. https://doi.org/10.1093/eurpub/ckac062