Senior Project Write-up Devin Myers April 25, 2014 Community, Environment, and Planning Abstract The top

public health concern in the United States is obesity. While many are aware of the issue and much has been done to address it, obesity rates continue to climb. Obesity rates have moved upward from about 15% to more than 40% of the adults population. Recent projections show that by 2020 obesity rates might be as high as 50% of the population. This literature review project attempts to explain many of the root causes of obesity from a built environmental perspective as well as understanding the socio-economic factors that contribute to it. It also seeks to explain what efforts are being committed to reduce obesity rates. Finally, I offer my own perspective about how we can address obesity through education, physical exercise, and environmental changes.

Background The idea to report the issue of obesity sprung up from my educational experiences in CEP. Through the courses Ive taken in nutrition, cultural food studies, agriculture, and community food systems, Ive developed a basic background revolving around the issue of food and health. Also, through my experiences in the UW Farm and the Student Food Cooperative, Ive also experienced working with people who are trying to address the issue of food justice, food sustainability, and spreading awareness. I also volunteered my time at a

Duvall farm planting vegetables for a local community supported agricultural organization. When it came to cultivating ideas for my senior project, I wanted to pursue my interest in food studies. It had evolved originally from doing a scientific food diary on myself and see if it had any correlation to my allergies. I decided that wasnt a suitable idea and decided to pursue a literature review of how the built environment affects the conditions of peoples health. It would also highlight ways that we can improve our health through case studies of interventions, education, community support, structural changes, and policy changes. I wanted to do a report that could help develop my writing and research skills. Its also to tap into my burgeoning interest into public health.

Summary This literature review examines on issues that impacts Americas health. Specifically, it examines the issue of obesity or peoples body weight as the primary issue since its one of Americas top public health concerns. These concerns are well documented, and much work is underway to address them. The built environment has a large role in in peoples behaviors. These behaviors have a cumulative effect on personal health. I argue that urban sprawl and dis-investment in urban cities are key built environmental factors that have significant impacts on our health. Urban sprawl discourages people from engaging in physical exercise. It also endorses people to diet in food that might be detrimental to their health.

The subject of urban dis-investment or inner-city decay is often associated with problems related to socio-economic challenges. People who are poorer and more uneducated often have less access to healthy food. Barriers exist, such as; financial means, transportation, healthy food options, and physical/psychological stressors that make it more difficult for people to eat healthier. The food environment has a significant role in our food choices. Many of those food choices are dependent on factors such as personal decisions, environmental settings, social settings, cultural norms, and values. A theoretical model has been applied in this report to support how people make food choices. These food choices are shown through a social-ecological model; which illustrates what factors influence our food choices. These choices affect our health and understanding those factors can be used to try to improve existing conditions. For the last chapter, I highlight issues of childhood obesity and how current efforts are being addressed to improve it. Facts and figures are provided to give the reader an idea of the current state of educational programs on school meals and physical education. For each chapter, I provided a background into the subject matter I chose. I then would follow it with a list of solutions to those problems. For the built environment chapter, I provided ideal solutions to urban sprawl which covers a range of transportation design changes. For the subject of urban decay, I discuss how social capital can be a resource to improve communities on a local level. On the subject of the food environment, I use a number of case studies of how communities

have created an environment where people can get access to healthier and affordable food. There are also examples of land-use strategies on how to create opportunities for urban agriculture in cities. In the last chapter, I write about solutions in K-12 education. Solutions include school meals reform including more meals, subsidizing school meals, nutrition education, physical education reform, and offering students opportunities that opens them up to agriculture.

Methods For this project, my primary methodology was to use a variety of sources from different disciplines to get a better picture on the issue of obesity. My research came from scholarly journals, textbooks, popular magazine and newspaper sources, and books. I developed an outline which evolved over time that would help me focus on what I would be researching and writing about. My research would start by either doing an internet search on the subject or try to find a book that was relevant to the subject. I would gather key information by writing key facts into a word document. Once I would gather all the relevant information that I needed for a particular section in the report, I would write a draft into the actual report where it would be used for the final report. The report has 4 chapters, with three chapters exploring into the realm of disciplines that has an impact on how we perceive obesity. The disciplines that I focused on in this report include urban planning, nutrition, sociology, geography,

psychology, and public health. The different disciplines are important to note because in the research, I found it often connected to each other. For example, when I did some research on how socioeconomic factors can correlate with obesity, much of the research came from scholarly journals from disciplines in sociology, nutrition sciences, geography, and urban planning. Coming up with a systematic approach between different disciplines was a difficult approach because there were different overlaps but I focused on the research questions that I had. The first chapter is about obesity, the second is about the built environment, the third is about the food environment, and the last is about education. The report itself has evolved from its original conception. After I learned about the root causes of how our built environment and food environment has an effect on our physical behaviors, I realized I needed an additional chapter devoted to the subject of education to address the problems of our physical behaviors. It was an attempt to bridge the gap between the theoretical knowledge that exists in urban planning as well as public health with how we teach people about promoting good health. I had to prioritize what I wanted to focus on. In this case, I focused on the efforts of government intervention into creating healthier communities. There are many different ways for communities, institutions, and individuals to educate to promote good health and trying to reduce the rates of obesity.

Reflection

My experience with this project can be summarized as one that didnt have a clear goal or scale in mind. However, I did have the opportunity to learn about a subject from a broad perspective. This journey started in 2012 where I was a senior in the CEP program. For this project, I originally set out to do a project that would take me about 3-4 months to do. However, my mistake was not clearly defining what my goals were going to be. Furthermore, I did not come up with a real deadline and did not scale a project where I could see what I needed to do and how to do it. In other words, I ended up exploring into my research without any real foresight about how much work it would take and when I going to finish it. Now, after two years, I finally realized that I needed to cut my losses short because I had over 100 pages worth of material and it has caused me a great deal of stress. My family, friends, and professor, who were my biggest supporters encouraged me to never quit, had also said it was time to finish. However, I had to make that decision myself. I looked at the work that I had and realized that I accomplished a great deal. I had enough material to put out a report that I was satisfied with. I also realized that the subject of obesity is vast and I could never write enough about it. Finally, there is a great deal that I learned from this experience that I can carry through the rest of my life. For one, I learned to never give up. There were many times when I thought about quitting this project and moving on with my life. In hindsight, that would accomplish very little and I would have regrets for the rest of my life if I wasnt able

to complete this senior project. That is in addition to having the honor of receiving a degree in CEP and from the University of Washington. I would be able to get the monkey off my back by accomplishing one of the most difficult tasks that Ive accomplished in my life. Writing has always been a difficult endeavor for me. However, I feel that Ive become a better writer as a result of constant practice and have also become a better researcher by being selective and picking up keywords that I need to know by analyzing what is relevant to the subject and discriminating what is not. It was something that I also struggled a lot as well. During the research phase, I often had difficulty turning material away that I thought was relevant to the report. For example, it wasnt necessarily beneficial to devote time into discussing environmental degradation in the report because its not related to obesity. Structuring what is really important to the subject at hand is something that I will learn to focus on as it will help me complete tasks much more quickly. Its also important to note that I need to figure out how to manage my time more wisely so that we can move on to the next endeavor. The biggest challenge that I faced during the project was not creating a real deadline which also affected the scale of the project. I didnt create a timeline that would document a work plan. If I did something like this, I would be able to measure how much I had done and knowing how much I had left to finish it. I knew I had a project that needed to eventually be done but I got stuck on a commitment that wasnt possible.

What I did accomplish from the project was completing the most arduous project in my college career. I spent the most time and the most effort on a single project to pursue knowledge of obesity and public health. I was able to get a better understanding how the government has attempted to address public health issues through various funding and encouraging schools and workplaces to become healthier. I was able to touch on various perspectives on the issue of obesity by relating public health with other disciplines. By reading through various scholarly journals, I was able to have a broader understanding of how obesity not only affects us, but affect society as a whole. I learned how it affected families, but also learned how there is tremendous support devoting to the cause. One insight I discovered is that public health doesnt interact with other disciplines as much as it should. Planning has a new emerging field that relates to public health as our built environment has enormous impacts on our personal health. In the future, planners will increasingly rely on the knowledge and tools that public health officials have to make decisions that improve the lives of people in their communities. There are some examples where public health officials work with urban planners. Much of it is in research and intervention activities. For example, there are some cross-discipline work in health promotion for older adults and persons with disabilities. A report was done to document the urban design of streets and how land-use policies affect levels of physical activity. There are also academic

programs that have offered an integration between the two disciplines as many recognizes for both fields to work together. What is lacking in this field is identifying those with a shared expertise in planning and public health that can address issues such as obesity. Planning officials lack certain kinds of knowledge and tools that are specialized by public health officials. These include health impact assessments or community assessment tools for environmental health. As a whole, this project taught me how to persevere. While there were academic components that I learned such as project management, research, and writing, it was more of a test to see whether I could complete a major project done. While there were regrets, I can now finally say Im done.