Indeed, elements typical of rural environments can – and must – be part of any truly livable urban design, as Olmstead and Vaux‘s plan for Central Park in Manhattan demonstrates, and as further proven by the Olmstead firm‘s five-mile long “Emerald Necklace” around Boston, encompassing 1000 acres of parkland, connecting the Boston Common with the 527-acre Franklin Park.

We know that the better connected parks are, the more a park system can provide healthful recreation—and transportation, too. A recent publication from The Trust for Public Land shows how interconnected trails, greenways‚ and parks support bicycling, running, walking, skating, skiing‚ and even wheelchair travel—reaching all the way from home to work for some users. And several small parks can be connected to create a “large-park experience,” with a tennis court in one park, a basketball court in another, a swimming pool in a third. Connections can be a system of sidewalks or bike lanes, complemented by outstanding signage and perhaps dressed up with a catchy name, such as the Wellness Walk or the Fitness Funway.

The easiest way to create interconnections that also extend a park system is in stream valley parks, particularly where a small stream flows into a larger river and both are flanked with trails. This kind of intersection, comparable to a highway interchange or a train junction, more than doubles the usefulness of a given route. An even more effective connection can be made by bridging a river with a pedestrian crossing, either a new bridge or a repurposed old one. Wherever this has been done—including in Austin, Cincinnati, Chattanooga, Little Rock, Minneapolis, Nashville, Omaha, Pittsburgh, and Tampa—the bridges have become instantly popular attractions.

Another great connector is a rail-trail, a park path constructed out of an abandoned train track. Most of the more than 15,000 miles of U.S. rail-trails are rural, but an increasing number are in cities, including Atlanta; Chicago; Dallas; Houston; Portland, Oregon; Orlando; Seattle; and Washington, D.C.

Platte River Greenway, Denver. Credit: Darcy Kiefel.

Even without a stream or an abandoned railroad, it’s sometimes possible to create a linear corridor. It happened in San Francisco after the public utilities commission decided to retire an underground water main through Visitacion Valley, a lower-income immigrant neighborhood. The corridor had been kept free of weighty construction over the pipe, resulting in a six-block swath of weedy lots through the heart of the community. When the commission tried to sell the land, neighbors objected and worked with The Trust for Public Land to turn it into a park and garden. Today the Visitacion Valley Greenway supports both physical exercise and improved nutrition—and introduces visitors to the exotic Asian medicinal plants growing there.

Another example of a successful city creating connectors is Denver.  In 2009, the American Obesity Association rated Denver residents the least obese of big city Americans. The reason, in part, is their sporty lifestyle. Supporting that way of life is the Platte River Greenway.

It took 30 years to create the Greenway from a former industrial backwater. Today its 15 parks linked by 100 miles of trails attract hundreds of thousands of users. The middle 12 miles—which stretch on either end deep into the suburbs—are operated by the Denver Department of Parks and Recreation, with support from the private Greenway Foundation. Its centerpiece is 22-acre Commons Park, constructed as part of a new walkable neighborhood on a former railyard on the edge of downtown.

Not only does the Greenway lure a continual stream of cyclists, runners, and walkers, the South Platte River itself was reengineered with rocks, riffles, and inflatable dams so that it offers whitewater rapids for kayakers and rafters.

Public investment in the Greenway totaling about $70 million has fueled $2.5 billion in residential, commercial, retail, sports, and entertainment projects along the corridor. Denver, which for several decades was losing population, is now growing again—and recreational opportunities are one reason why.

Randall’s article appeared in the August/September 2011 issue of Planning magazine, available here.

Mixing uses in parks has its challenges and requires good design, adequate signage, and clear rules. Trail use, for example, can create conflict between walkers, skaters, and fast cyclists. Many cities appropriately prohibit fast cycling on trails shared by pedestrians. On the other hand, hard pedaling and fast running provide more health benefit than casual spinning and jogging. Other than putting bikes on roadways, the only safe solution is to provide parallel treadways for fast and slow users—and to clearly mark the allowed uses by location or time of day. Then, too, the alternate trails need occasional enforcement.

Even if a park system offers varied spaces for physical activity, not everyone will know how to take advantage of them. Some users need to learn new skills, some need encouragement, some need an exercise regimen, some need social support. Even with all this, many require other assistance—partners, equipment, referees, timekeepers, music, safety paraphernalia, and more. In a word, programming. Good programming can increase park use many times over, make activity more enjoyable, and increase its benefits to health and fitness.

Credit: Phil Schermeister.

Traditional park  programming consists of league sports, exercise routines, children’s camps, and oldies-but-goodies such as ballroom dancing. More recent additions have been Jazzercise, tai kwon do, tai chi, rock climbing, and bicycle “roadeos.” But in response to changing technologies and new immigrant cultures, innovative ideas come along all the time. In Minneapolis, the park department offers open gym periods to play sepak takraw, a remarkable kick volleyball game brought to this country by Hmong immigrants from Cambodia. Raleigh, North Carolina, uses the reward of a free pedometer for diabetic children who sign up for special athletic programming that includes nutrition instruction. Seattle has launched monthly Women of the World swims at two pools at the request of Muslim women whose faith bars them from recreational activities with men. Women of all faiths are welcome, and the sessions are privately funded. Overseen by female lifeguards and held at pools without street-facing windows, the swims provide some women with exercise they otherwise would not get.

Of course, programming has a health impact only if people know about it, and that requires promotion and marketing through advertisements, program pamphlets, TV and radio public service announcements, flyers, email‚ and social networking services such as Twitter. Outreach is difficult in times of tight budgets, but creative park departments attempt to find private sector collaborators in fields such as health, media, banking, and public utilities to help them spread the word.

Finally, every new program and every new facility needs to be evaluated, particularly when dealing with health, since this approach is standard in the medical community. It is not enough to assume that an activity has a positive impact. The only real way to know is through monitoring and before-and-after measurement. Sometimes the research can be done by the park agency itself. But when this is prohibitively time-consuming or expensive, it may be possible to partner with a local university, college‚ or high school whose student researchers can observe usership and even measure such health indicators as body mass index, heart rate‚ or muscle strength.

Credit: Susan Lapides.

When it comes to programming, Cincinnati—the nation’s 56th-largest city—packs a wallop. On a per-capita basis, Cincinnati ranks in the U.S. top ten for its number of ball diamonds, recreation centers, swimming pools, tennis courts, basketball courts‚ and golf courses. More important for public health, the Cincinnati Recreation Commission’s programs attracted over 3.2 million participant-visits in 2009, some 691,000 of which were visits by youth. All this in a city of barely 330,000 residents—giving Cincinnati the highest per-capita recreation participation rate of all cities reporting information to The Trust for Public Land.

Among the hundreds of programs offered are youth and adult league sports ranging from soccer and basketball to track and field and kickball; senior programs such as golf, swimming, tennis‚ and the Senior Olympics; programs for the disabled, including wheelchair football and basketball; and such offerings for youth as afterschool programs, summer day camps, and bike outings. In addition to the formal programming, most of the recreation commission’s 29 recreation centers offer fitness centers and open gym hours. Residents can use the recreation centers and the city’s 26 pools for a yearly membership fee of $25, or $10 for seniors and youth.

The Cincinnati Park Board—a landowning and land management agency separate from the recreation commission—plays a part, too, by working to make Cincinnatians feel safer in their parks. In Burnet Woods, a place with a mixed reputation, the board thinned out invasive vegetation and installed a disc golf course through the forest. The sport, which is growing in popularity throughout the country, drew so many more people into Burnet Woods that the park became safer and more appealing even for visitors not there for the game.

Credit: Rich Reid.

Fitness zones are easy-to-use, accessible outdoor gyms designed to promote general  health within a park experience, creating a supportive social context for getting fit. Using only a gravity- and-resistance weight system, fitness zones require no electricity and employ their users’ body weight to engage different muscle groups. The exercise equipment is durable, vandal- and weather-resistant, and appropriate for people 13 years of age and older of all fitness levels.

Working under the leadership of The Trust for Public Land and with funding from health insurer Kaiser Permanente and the MetLife Foundation, the Community Redevelopment Agency of Los Angeles and Los Angeles County Parks and Recreation Department have installed 30 fitness zones across the region, including six in existing Los Angeles city parks.

Fitness zones are often placed in areas of high need, including communities with high rates of obesity, diabetes, and hypertension. Some are located adjacent to playgrounds to encourage adults to exercise while keeping an eye on children. Others are placed near administrative offices to reduce safety worries.

The El Cariso Regional Park in Sylmar is one example of a successful fitness zone. It includes nine pieces of easy-to-use outdoor gym equipment along with bilingual health and fitness information panels.

“The bottom line is that fitness zones attract new users to parks,” says Dr. Deborah Cohen, a researcher with the RAND Corporation who carried out an exhaustive before- and-after study of the facilities in 12 parks. “We also know that fitness zones are used throughout the day, that fitness zone users increase the amount they exercise, and that they use the parks more frequently than other park users.”

Much of this progress would not have been possible, however, without essential funding from the Land and Water Conservation Fund (LWCF), the nation’s primary tool for protecting open space in urban and rural communities nationwide. Denver, like cities across the country, relies on the fund to match state and local dollars to create and enhance urban parks and restore waterways.

Instead of using taxpayer money, the little-known LWCF is funded with fees paid by oil and gas companies drilling offshore. For nearly 50 years, the fund has protected national parks, wildlife refuges, rivers, parks, and ball fields in every state.

“The Land and Water Conservation Fund continues to be an essential tool to meet the increasing demand for livable communities in cities all across this country,” Denver Mayor Michael B. Hancock said recently. “In Denver, we value our great open spaces and recreational facilities. These investments are as much economic investments for the city as they are quality of life investments for our residents. “

Denver isn’t alone. Recognizing the importance of parks to the vitality and health of their communities, 50 U.S. mayors joined Mayor Hancock in appealing recently to President Obama and Congress to maintain funding for LWCF during these difficult economic times.

With cities facing depressed property values, reduced tourism, and lower tax revenues, urban parks have incurred approximately $6 billion in deferred maintenance costs, according to Will Rogers, president of The Trust for Public Land. Newly released data from TPL’s Center for City Parks Excellence show that many city park systems are struggling to deal with budget shortfalls, resulting in fewer people employed in full-time and seasonal positions, and potential impacts on programs and services.

At a time when the nation is looking for every opportunity to create new jobs, mayors assert that parks are just as important to a city’s prosperity as banks, coffee shops, department stores, and corporate headquarters. In addition to luring tourists, parks bolster community home values. Mayors know that could mean more real estate tax revenue.

Furthermore, parks breathe life into communities. Urban parks are not just safe and beautiful retreats, but also help to address nearly every critical urban need from health to housing, education and environmental justice, countering sprawl, and combating crime.

Just last month, Los Angeles Mayor Villaraigosa announced a plan to create dozens of new parks throughout the city. The initiative is part of his goal to create a livable, vibrant and prosperous community, and at the same time drive economic development and create new jobs.

“Urban parks are more important than ever as cities grow larger and denser,” said Rogers. “Though budgets are tight everywhere, urban parks have consistently proven to be a wise investment, helping to improve health, increase environmental quality, and sustain property values.”

Are President Obama and Congress listening? Working together, we can revitalize and green our cities and create jobs. The Land and Water Conservation Fund is an essential tool for realizing that vision.

-  Catherine Nagel, Executive Director of the City Parks Alliance

This article was originally published in “The Hill” on December 20, 2011.

Twelve parks – one each month – will be featured on CPA’s website home page in 2012.  Each “Frontline Park” story will show how parks and their stewards are on the forefront of creating healthier, more sustainable cities.  With each month’s feature, CPA will coordinate with each park partner a joint press release for local, national, and social media to announce their selection as a “Frontline Park.”  Featured parks will also be included in CPA’s quarterly e-newsletter Benchmarks distributed to hundreds of CPA members and on the City Parks blog.

We are looking for the best stories.  Is there a non-traditional leader who has helped to bring about change in your local park?  How has park programming helped to address pressing urban issues, such as public health, job creation or community revitalization?  Have you done something really fun and innovative to increase revenue, cultivate volunteers or educate young people?  How did a crisis create an opportunity to build a new partnership?  Stories should be related to one or more of the following topics:

• Community Capacity Building
• Design
• Economic Development
• Education
• Environment
• Funding
• Health
• Maintenance
• Programming
• Public/Private Partnerships
• Safety
• Transportation
• Workforce Development

For more information about application guidelines, please click here: Frontline Park Nominations

From Fitness Zones to the Medical Mile: How Urban Park Systems Can Best Promote Health and Wellness.

We’ve written before about the need for urban parks to do more for public health. A new report by the Center for City Park Excellence, From Fitness Zones to the Medical Mile: How Urban Park Systems Can Best Promote Health and Wellness, looks at how individual parks and entire city park systems help people be healthier and more fit.  The report details more than 75 innovative features and programs, including 14 case studies, that maximize a park’s ability to promote physical activity and improve mental health.

Today’s post, a reprint of an op-ed that appeared in yesterday’s The Philadelphia Daily News, serves as an overview of that report.  We will highlight specific best practices in a series of future posts.

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When it comes to health and fitness, the U.S. is in crisis.

Forty-nine percent of Americans get less than the minimum recommended amount of physical activity, and 36 percent of U.S. adults engage in no leisure-time physical activity at all. These people are not all obese, of course, but lack of exercise is certainly a risk factor for being overweight, and we are the most overweight nation on earth. On average, an obese American racks up nearly $1,500 more a year in health-care costs than one of normal weight, for a national total of $147 billion in direct medical expenses.

It’s well-established that physical activity helps prevent obesity and related medical problems. And there’s mounting evidence that providing places for urbanites to exercise (parks, primarily) can improve health.

But the mere presence of a park doesn’t guarantee a healthier population. Thousands of acres of city parks are not, for one reason or another, serving the purpose of helping people become healthier. With a growing clamor from doctors, parents, overweight people and even those who just want to strengthen muscles, lungs, and hearts, it’s time for parks to be more than just pretty places. Individual parks, and entire city park systems, should be designed and programmed to help people be more fit.

The overriding principle for a park system to foster mental and physical well-being is that it must be well-used by the public. But many parks don’t make it easy to exercise. Some are too small, some too big and confusing, some too far away, some too frightening, or too unattractive and unimaginative. Some are mainly athletic complexes for special users – baseball, soccer or tennis players as far as the eye can see. Others are primarily natural areas with occasional trails, too boring for many competitive people.

In the starkest terms, most parks simply don’t offer enough choices for activity. The more facilities and spaces layered onto a park, the more use it can get from people with different interests and skills. A golf course can serve a couple of hundred people a day; add a running track around it and it can serve thousands. (The one encircling Memorial Park Golf Course in Houston hosts 10,000 runners a day and is said to be the most heavily used exercise trail in the country.)

A playground is a nice spot for kids to practice motor skills, but adding a fitness zone of adult exercise equipment lets grown-ups get into shape while watching the kids. A softball field is a great place for 18 players, while unstructured space nearby means twosomes and threesomes can kick a ball, toss a Frisbee, play catch, throw sticks to a dog, and much more. Forests are wonderful sanctuaries for wildlife and the occasional intrepid bushwhacker; woods with manicured trails, an occasional bench and grassy openings can attract many more users.

Even if parks didn’t provide all the urban benefits they are known for – improving the environment, attracting tourists, building community, enhancing property values – they’d still be critically important because of their potential contribution to public health and wellness. But platitudes about healthy parks aren’t enough. If park agencies are to truly justify all the land and tax money they use, they must actually serve their health functions as powerfully as do doctors, hospitals and health agencies.

In the mid-19th century, Frederick Law Olmsted and others called for the creation of parks as refuges from the unhealthful air and stresses of urban life. Today’s urban air quality may be improved, but Americans have found other ways to put their bodies and spirits in jeopardy. Parks continue to be among the best places to offer solace and solutions to public-health problems.

New York City's no smoking sign. Credit: Susan Sermoneta (Flickr Feed).

In early February, the New York City Council (36-12) approved, and Mayor Bloomberg signed, a ban on smoking in the city’s parks, beaches, pedestrian malls and plazas. Effective as of May 23^rd, the city’s Department of Parks and Recreation can now impose $50 fines on rule breakers. Given what we know about the health value of parks, addressing the issue of smoking bans in parks is salient. What restrictions may a city or municipality place on park users in order to achieve some health or environmental value?

As residents of New York know, administrative code already bans smoking in bars, the subway, retail stores, and several other indoor and outdoor locations. But the most recent amendment, as codified in New York City Administrative Code § 17-503(c)(3), expands the scope of the ban to “any park or other property under the jurisdiction of the department of parks and recreation.” Exceptions to this ban extend to sidewalks immediately adjoining parks and public places, pedestrian routes through any park strip, median or mall adjacent to traffic, parking lots, and theatrical productions.

Two common lines of reasoning characterize the smoking ban debate. Arguments against bans on smoking in public parks often reference the overreach of government into the lives of private citizens, whereby the governmental entity unreasonably infringes upon an individual’s right to undertake a particular behavior. Arguments for bans invoke the government’s role to promote public goods, such as health, and to ensure non-smokers are free of a harmful nuisance. The following overview addresses the legal and policy issues implicating both sides of the argument.

Examples of Outdoor Bans

The New York ordinance is not new; towns and cities across the country have enacted outdoor smoking bans. There are 1,313 states, commonwealths, territories, cities, and counties with a law that restricts smoking in public outdoor places such as parks and beaches.[1] Levels of stringency vary from town to town, but the rationale underlying the bans are generally the same – there are environmental and health issues so important as to justify prohibiting individuals from lighting up in a public outdoor area.

Santa Monica, California no smoking sign. Credit: Flickr Feed.

An ordinance in Bellaire, Texas, a suburb of Houston, forbids smoking within the city’s public parks, in part to prevent children from exposure to smoke.[2] The ban, however, does not prohibit smoking on the public streets or sidewalks.[3] Santa Monica, California, passed an ordinance restricting smoking on its public beaches to address the environmental issue of cigarette butts littering the beaches and water.[4] In fact, the ordinance comprehensively prohibits smoking in a variety of outdoor places: public parks, public beaches, anywhere on city pier except in designated areas, outdoor service areas, or within two feet of any entrance, exit or window of a public building.[5] Both cities may impose fines on violators of the ban.

In 2006, the city of Calabasas, a small community northwest of Los Angeles, enacted one of the toughest anti-smoking ordinances in the nation.[6] It characterized its anti-smoking efforts as an attempt to limit exposure to secondhand smoke (SHS), as opposed to an outright ban on the act of smoking itself. The ordinance prohibits smoking in all public places where an individual may be exposed to secondhand smoke, including parks, sidewalks, outdoor cafés, bus stops, and athletic fields.[7] Fines for violation are imposed up to $500 with a misdemeanor criminal classification.

The New York ordinance allows for some smoking outlets if you are at a public park. Like Bellaire park users, visitors to New York parks are still able to light up on sidewalks bordering the outside of the park.

A Right to Smoke?

A man smoking in a Chicago plaza. Credit: Mary Anne Enriquez (Flickr Feed).

A ban on smoking in a public park raises an interesting question: are there particular rights that ensure that adults may freely undertake a legal act using a legal substance or item in a taxpayer-funded public space that may have a marginal detrimental health impact on other people using that space? Think of drinking a bottle of wine with your special lady friend as you lounge about on a picnic blanket (or grasping onto a flask of whiskey for dear life as you curl up underneath a bench to shield yourself from the brutal chill of a relentless winter wind). What about lighting fireworks? Yelling into an oversized bullhorn to warn of an impending apocalypse? Swinging a metal bat to smash a tightly wound baseball?

A court will invalidate law that, either on its face or in its application, violates a constitutional right. The Constitution does not explicitly reference a right to smoke, so any claim to a right to smoke will fall under the auspices of another constitutional right.[8] Here are just a few examples of avenues that right to smoke advocates have pursued to challenge smoking bans.[9]

Fourteenth Amendment. The equal protection clause of the Fourteenth Amendment guarantees that a state government will not treat similar groups of people differently without good reason. However, there are classes of people based on race, alienage, national origin and gender that receive greater protection against discriminatory government acts than do other classes – say, women under 5’2” or bald men. Courts review a law that applies to a protected class under a strict or intermediate level of scrutiny. Strict scrutiny requires a state or local law to be necessary to achieve a compelling government interest.

The Supreme Court has rejected the notion that a classification is suspect when the scope of the class is based on voluntary action.[10] Since smoking is a discretionary act, it does not merit greater scrutiny for equal protection purposes. A smoking ban will be constitutionally valid if there is a reasonably conceivable set of facts that provides a rational basis for the classification, such as the promotion of public health.[11]

First Amendment. Conduct alone, such as smoking, is not generally considered speech and thus not afforded First Amendment protections. Smoking bans not targeted at suppressing speech content, and not favoring a particular group, are deemed “content-neutral.”[12] For content-neutral regulations to be valid, they need only be substantially related to an important governmental interest. For example, the federal court in NYC C.L.A.S.H., Inc. v. City of New York upheld the smoking ban in restaurants and bars, finding that smoking in such venues is not a sufficiently expressive conduct to merit First Amendment protection and that the ban was a valid, content-neutral regulation with an important health interest.[13]

In the 2005 case, Roark & Hardee LP v. City of Austin, a federal district court held that an Austin ordinance prohibiting smoking in enclosed public places did not violate bar owners’ First Amendment right to be free from compelled speech.[14] The city “compelled” bar owners to take “necessary steps” to stop patrons from smoking in order to protect the city’s population from the effects of SHS. Since the ordinance regulated conduct and not actual speech, and the owners were free to express views on the ordinance, the city was within its bounds to regulate smoking.

As long as a smoking ban is rationally related to a legitimate government goal, the Constitution will not stand in the way of its passage.[15] Smoking bans have been uniformly upheld against a variety of challenges to their validity.[16] Courts embrace such legislation because of the time-honored acknowledgement that protecting the public’s health is one of the most essential functions of government.[17]

Legislative Rationale

When smoking bans are challenged on constitutional grounds, legislators must justify the ban by demonstrating a legitimate government interest. A frequent argument is that public health concerns justify infringements on smoking.[18] But the effect of public outdoor exposure to SHS is not conclusive. On the one hand, proximity to smoking, even outdoors, may lead to SHS exposure. A recent Stanford University study indicates that tobacco smoke within three feet of a smoker outside is comparable to inside levels. But, as Michael Siegel stated in a New York Times Op-Ed, there is no evidence demonstrating outdoor exposure causes substantial health damage.

Legislators may also cite “annoyance costs” related to smoking, such as cost of cleaning up cigarette butts.[19] Right to clean air advocates often compare smoking to nuisances regulated by the state, such as noisome factories.[20] There is also an argument for treating smoking like sex—as a legal activity relegated to the private sphere.

Public Support

Attitudes towards smoking bans vary depending on locale. Since 2000, the American Academy of Pediatrics has conducted a nationwide survey asking participants if and where in outdoor parks smoking should be allowed.[21] The latest results, from a 2008 survey of nearly 1,500 people, showed that roughly 20 percent of respondents thought smoking should be banned outright in parks, 39 percent thought it should be permitted, and 42 thought it should be banned in some areas of parks. This differs slightly from the 2000 survey, in which support for some form of restriction was roughly 60 percent (although, at that time, 40 percent supported an outright ban). The same survey also addressed support of smoking bans in Mississippi. It indicated that over 50 percent of Mississippians do not believe smoking should be banned in parks.

Attitudes do differ. A 2006 survey showed that 70 percent of over 1,500 randomly selected Minnesota respondents favored tobacco-free park policies in parks.[22] Supporting rationale for such policies included reducing litter (71%) and reducing youth opportunities to smoke (65%). Prior to the New York’s outdoor ban, the Coalition for a Smoke-Free City commissioned a 2009 Zogby poll that surveyed 1,002 residents and showed that 65 percent supported a smoking ban in parks and beaches.

Smoking and Public Parks

A woman smokes in a park. Credit: Ripton Scott (Flickr Feed).

Cities and municipalities must weigh the benefits of placing restrictions on potentially harmful behavior to help cultivate healthy outdoor environments against the rights of residents in a public venue. For example, part of the context for the New York park smoking ban was a 2009 New York City Department of Health and Mental Hygiene study showing that a greater proportion of New York adults, despite lower levels of smoking, are exposed to secondhand smoke than are adults nationally.[23] While there are rights issues involved with smoking bans, such restrictions generally fall within the ambit of legitimate governmental action. And, ideally, enactments to restrict smoking in a park will be borne out of people’s support for the restriction in a publicly funded venue.

The question then is whether the government action achieves its objective. If New York is attempting to improve air quality for park users, pushing smokers to the sidewalks outside parks may not accomplish that goal. It seems that where a park is quite small, such an outlet renders the ban moot because smoke can still get up into park users’ faces. And whether a park is large or small, or one smokes inside or outside the bounds of the park, the impact on the overall ambient air quality of the park would presumably be the same. However, as we learn more about the impact of secondhand smoke on individuals in an outdoor area, it may be the case that the ban, in its current state, is justified.

According to the Centers for Disease Control and Prevention, 30 percent of Americans are fully sedentary. They are not all obese, of course, but lack of exercise is certainly a risk factor for being overweight. On average, an obese American racks up nearly $1,500 more per year in health care costs than an American of normal weight, for a national total of $147 billion in direct medical expenses.

Urban park facilities are a resource to help city-dwellers be active. As Jason Cissell, administrator of community relations of Louisville Metro Parks puts it, “we’re the largest gym in the city, and we’re free!” But the system only works if people know about it. A 2002 study for the American Journal of Preventative Medicine showed that community-wide fitness campaigns can help, succeeding in encouraging, on average, 4.2 percent of residents to begin engaging in regular physical activity.

If even one in ten of those newly active people transitions from obesity to a healthy weight, medical costs would fall by $6.30 for each man, woman and child in the city per year. In Washington, D.C., with 600,000 residents, that translates to $3.7 million – an amount that dwarfs what is spent on park marketing in Washington.  In fact, that is more than the country’s largest park marketing budget, the $2.7 million spent by the Chicago Park District (for a city of 2.8 million people).  Compared to expected benefits, every city park marketing effort in the country is underfunded.

San Antonio's marketing effort set the standard for cost efficiency. Credit: San Antonio Parks and Recreation Department.

In July 2009, San Antonio, Texas launched a marketing campaign that must have set a record for frugality. The city-wide, multi-media “Get Active. Get Fit. Step Up to Recreation” campaign cost only $28,000, thanks to the use of public service placement rather than paid advertising and the use of city officials and local athletes instead of paid actors. To stir excitement the department used prizes as rewards, handing out free “Step Up to Recreation” water bottles and tee shirts. But since there’s no money to count users, it’s not known if the campaign actually increased park use or fitness.

Louisville's parks and health departments cooperated to raise awareness of the city's "best parks for exercise." Credit: Louisville Metro Parks.

The truth is that marketing parks is too difficult, too expensive and too important to be left only to park and recreation agencies.  The effort needs and deserves to be a partnership between the parks community – with its land and facilities – and the health community – with its science, its funding and its outreach. A few of these partnerships do exist, but they are challenging enough to require strong leadership from above. In Louisville, where Mayor Jerry Abramson was determined to combat Louisville’s high levels of obesity and inactivity, Metro Parks joined with the Department of Health and Well-Being to launch the “Healthy Hometown Movement” in September 2009. The city-wide initiative encourages citizens to get 30 minutes of physical activity at least five times per week. The health department, going further to focus on the eight neighborhoods with the most serious obesity-related risks, granted Metro Parks $25,000 to provide free fitness classes in recreation centers.

The powerful and well-heeled insurance industry has not yet done much cross-marketing with parks, but United Healthcare may be the harbinger of a new approach, having partnered with the City of Denver, Colorado to advertise parks. The company gave the Department of Parks and Recreation $60,000 to print and distribute 75,000 copies of its programming guides, more than three times the number printed in 2008. In addition to recreation centers, libraries and the Sunday Denver Post, the guides are distributed in United Healthcare offices.

With Colorado boasting the lowest obesity rate in the nation, it is either ironic or emblematic that this kind of partnership is coming out of Denver. Regardless, it is the kind of creativity that park departments, health departments and mayors will increasingly utilize in the future: according to The Trust for Public Land’s analysis of 2008 (the most recent year available), the marketing budgets of city park agencies fell by another 11 percent.

The full text of this article, which ran in the August 2010 issue of Parks & Recreation magazine, can be accessed through The Trust for Public Land.

A group looks into a net near a stream at the Milwaukee Urban Ecology Center. Credit: Jeff McAvoy.

We’ve previously looked at ways in which the medical community is using exercise prescriptions as a way to combat obesity and inactivity.  Park prescriptions are only a portion of the spectrum of exercise prescription programs. Fortunately, the growing awareness of the benefits of outdoor exercise – in addition to the cooperation of parks departments, environmental nonprofits, and individual parks – means that these programs should continue to grow.

Once patients have left the doctor’s office with a prescription in hand, there’s still plenty of work to be done. Someone has to ensure that public parks are meeting the needs of people trying to develop good exercise habits, and that newly inspired patients can find interesting and engaging ways to exercise in local parks.

A growing body of evidence that suggests that exercise in the outdoors provides some quantifiable benefits over indoor exercise. A study released February in the journal Environmental Science and Technology analyzed data from 11 different studies that compared benefits from outdoor and indoor exercise programs, and found that outdoor exercise was associated with “greater feelings of revitalization, increased energy and positive engagement, together with decreases in tension, confusion, anger and depression.” Not surprisingly, those who participated in outdoor exercise “stated that they were more likely to repeat the activity at a later date.”[1]

Promoting these mental benefits, which in turn lead to physical benefits, is one of the most effective ways for parks to remain at the center of exercise prescription efforts.  Green Gym, a program in the UK, exemplifies this approach. Green Gym began in 1997 as a project of Dr. William Bird and the British Trust for Conservation Volunteers. Green Gym groups meet at least once a week to do several hours of gardening or conservation work, and results from the program demonstrate both physical and psychological benefits, according to a study done by The School of Health and Social Care at Oxford Brookes University. Researchers found a strong trend in decreased depression scores, as well as increases in muscular strength and improvements in cardiovascular fitness.

Another strategy for encouraging repeat park visits is helping to get family members and pets to join in.

Yes, pets – Albuquerque’s Prescription Trails program, in addition to human park prescriptions, offers walking prescriptions for overweight dogs (whose physiques often mimic that of their owners). Charm Linblad, Executive Director of New Mexico Health Care Takes on Diabetes, quips “from experience, you can’t turn down the dog when it is time for a walk, so when the veterinarian writes a prescription for the pet we get a double bonus – the owner gets a walk!”

Milwaukee’s Urban Ecology Center has seen success in encouraging repeat visits by offering inexpensive family memberships. The Center brings in school groups year-round to its “outdoor classrooms,” and then inspired kids often bring their families back to go cross-country skiing, snowshoeing, rock climbing, or canoeing. The center is committed to never turning away visitors who cannot pay the full membership price, and has built a substantial base of four thousand households, undoubtedly in part due to the welcoming and exciting atmosphere that their website describes:

• We want to get you outside! We love helping people have positive outdoor experiences and don’t mind at all if your experience starts by borrowing our equipment.
• We don’t have sugar. Remember when you had to borrow a cup of sugar (or milk, or doughnuts) from your neighbor? Well, just substitute “kayak” for “cup of sugar.” We’re really just trying to be a good neighbor. A neighbor who shares lots of stuff.

Individual parks also have a role to play in forging connections with health. The Medical Mile, which winds through Little Rock, Arkansas’ Riverfront Park, is a good example of how parks can actively tout their contributions to public health. It is accented with motivating and informative information about the benefits of exercise, good nutrition, and smoking cessation. The Medical Mile is part of the 14-mile Arkansas River Trail, perfect for those who want to gradually ramp up their activity.

In an upcoming series of posts, we will excerpt a new report from the Center for City Park Excellence that looks at the specific relationship between health and parks, how individual parks – and entire city park systems – help people be healthier and more fit.  The report details more than 75 innovative features and programs – including 14 case studies – that maximize a park’s ability to promote physical activity and improve mental health.  We will show you how today’s efforts to design urban parks for their health benefits and to create health-enhancing park programming close a circle that extends all the way back to the beginning of the parks movement.

The growing prevalence of obesity and illnesses related to inactivity underscores the importance of cooperation between the medical community and parks departments. This idea was promoted recently by Michelle Obama’s “Let’s Move” initiative, which stresses the role of the built environment in improving public health.

Some parks departments have reached out to inactive people by providing financial incentives or prizes for participation in parks and recreation programs. The Kids in Parks program in Asheville, North Carolina, offers prizes like walking sticks, nature journals, and backpacks for kids who complete trail hikes and log them online. Insurance companies have joined in – the Senior Dimensions Fit for Life Club, a program of the Health Plan of Nevada, provides free fitness programs at more than 30 park facilities in southern Nevada as part of coverage.

But what do you do if you already have a great park and recreation system but a persistently unhealthy population? The solution might be a doctor’s intervention.

A park prescription. Credit: New Mexico Health Care Takes On Diabetes

Park prescription programs combine a written prescription for increased activity with guidance aimed at eliminating common barriers to outdoor exercise, such as lack of information about facilities or inability to pay for recreation programs. Such initiatives are growing in prominence across the country.

One physician-led program, called Recreation Rx, offers prescriptions that can be redeemed for free community recreation services in the San Diego area. Dr. R. Christopher Searles worked with the Chula Vista recreation director to identify existing programs for which fees could be waived and strategies to offer more free programs with existing staff and space. The program has few expenses other than the printing of prescription pads.

As it turns out, appropriate design of the prescription pads is critical to the success of the program. Dr. Searles noticed early on in the program that the prescriptions were underused, so he supplied participating clinics with wall dispensers so that the pads could be displayed more prominently. Posters were put up in the waiting room to prompt patients to ask about the program. Dr. Searles regularly meets with the recreation director to update the available activities, customizing the prescription forms for season and age range.

The prescription pads tend to be colorful, friendly, and motivational, but also must appear official if they are to be taken seriously. One program initially had patients sign the prescription along with their doctor, but later decided to only have the doctor sign the form so as to convey a greater sense of authority and significance. Some pads have suggestions of different ways to get active outdoors and for gradually increasing exercise frequency, and some programs offer prescription forms in different languages.

Doctors play an important role in tracking the programs to better understand how their recommendations are being put into action. Tracking success is not too difficult when the prescriptions are submitted as vouchers for programs. Dr. Searles found that during a three-month period, 1,304 prescriptions were dispensed and 650 were redeemed at recreation and aquatic centers. The Chicago Exercise Prescription Fitness Center Waiver, started in 2003, offers prescriptions to patients with obesity-related illnesses that can be redeemed for a free 12-week fitness center membership at any of 66 parks in Chicago. Patients must return to their doctors to renew their prescription between sessions.

Prescription Trails, a program of New Mexico Health Care Takes on Diabetes and the Albuquerque Alliance for Active Living, is focused on ensuring that patients can easily locate and access a well-maintained trail. A Parks Evaluation Committee has identified three transit-friendly, wheelchair-accessible parks for each zip code in participating communities. Volunteers evaluated local trail loops, allowing doctors to provide booklets of approved parks accompanied with ratings, amenities, and directions. Trails are periodically reviewed, and the program has worked with the city to install distance markers and make sidewalk improvements.

Portland Rx Play, which this month expanded to 23 park and recreation facilities and 24 pediatric clinics, has doctors provide the contact information of an unhealthy patient to parks and recreation staff. The goal of the physician is to create a “warm handoff” to the recreation center staff, who then take over to help identify activities that might be of interest at a nearby community center, such as karate, yoga, and “active gaming” like Wii or Dance Dance Revolution. The children involved in the program will be part of an Oregon State University study comparing the activity levels of participants with another group who are advised to exercise but not given any structured programming.

Seniors practicing yoga in a Portland, Ore. park.

The American College of Sports Medicine has been at the forefront of this effort in the medical community, developing a program called Exercise is Medicine. It encourages doctors to include a standardized exercise evaluation with every visit and make exercise prescriptions. It is already in use by over 400 medical organizations. But is not focused specifically on encouraging park use, which raises the question of how park departments can ensure that free, public park facilities remain valuable elements of exercise prescription programs. We’ll look at some programs led by parks departments in part two of this article, coming soon.

Portland's Forest Park (Portland Development Commission)

Anahad O’Connor of the New York Times tests the claim that exposure to plants and parks can boost immunity. The finding: yes. According to the article:

For those who can take the heat and cope with the pollen, spending more time in nature might have some surprising health benefits. In a series of studies, scientists found that when people swap their concrete confines for a few hours in more natural surroundings — forests, parks and other places with plenty of trees — they experience increased immune function.

The studies cited can be found here, here and here. They don’t specify city parks, so that should be considered. But many cities, and many parks, are full of forests. (The most well-known urban parks, such as Central Park, Prospect Park (Brooklyn) have them, and places such as Forest Park in Portland and Rock Creek in DC are basically all forest.) The take-home here is that programs and facilities that allow people to get out into these places may help improve their health.