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The Positive Power of Walking

Walker 

Many things leap to mind when someone mentions walking: fitness, fun, fresh air, relaxation, friends and maybe your most comfortable pair of shoes.  But a word that rarely arises is “power”.

That will begin to change after the 2017 National Walking Summit (held in St. Paul, Minnesota September 13-15), which is themed “Vital and Vibrant Communities—The Power of Walkability”.

Like earlier summits, this event brings together people of all backgrounds to strategize ways of making sure the advantages of walking can be shared by all, no matter what their income or where they live.

Walking advocates once focused primarily on physical health —spurred by mounting evidence that physical activity is key to preventing disease—but now are stepping up to promote social, economic and community health. Their ultimate goal is to transform towns and neighborhoods across America into better places for everyone to live.

 “The power of walking is becoming more clear all the time,” declares Kate Kraft, executive director of America Walks. “Community connections, social equity, a sense of well-being, business opportunities, affordable housing, more choices for kids and older people, a cleaner environment—these are some of the benefits of walkable places.”

Walking Boosts Health & Happiness

Streams of medical studies now document the central role physical activity plays in fending off disease and disability. Chances of depression, dementia, colon cancer, heart disease, anxiety, diabetes and other conditions drop by at least 40 percent among people engaging in moderate exercise such as walking. 

A landmark study issued last year found that sedentary habits are a bigger health threat than high blood pressure or cholesterol— about the only thing more dangerous than inactivity is smoking reported the New York Times.  This followed on the heels of a Cambridge University study showing that a lack of exercise increased your risk of death twice as much as obesity. 

All the scientific data persuaded former Surgeon General Vivek H. Murthy to issue a landmark Call to Action to Promote Walking and Walkable Communities in 2015, which has been compared to the 1964 Surgeon General’s report on the dangers of smoking. “Walking helps people stay both physically and mentally healthy,” Murthy wrote, calling on us “to increase walking by working together to increase access to safe and convenient places to walk.” 

Walking stands out among all other exercise because: 1) It is free; 2) It requires no special training or equipment; 3) It can be done almost anywhere at any time; and 4) It is already Americans’ #1 favorite physical activity.  The US Department Transportation reports that Americans reported walking 14 percent more in 2012 than in 2002 (latest figures available).

Walking Advances Social Justice

“The health benefits of walking are so overwhelming that to deny access to that is a violation of fundamental human rights,” declared sociologist Robert A. Bullard, founder of the environmental justice movement, at the 2015 Walking Summit. “All communities should have a right to a safe, sustainable, healthy, just, walkable community.”

Unfortunately, that’s not the case across America today. People walking in lower-income neighborhoods are twice as likely to be killed by traffic than those in more affluent areas. African-Americans on foot are 60 percent more likely to be killed by cars than whites, while Latinos are 43 percent more likely.

“If you have walkable communities, kids will do better in school…seniors will be healthier,” said Ron Simms—a neighborhood activist from the African-American community of Seattle who later became Deputy US Secretary of Housing and Urban Development, at the 2015 Summit. 

Better walking conditions also help low-income families economically.  Surprising new research from the George Washington School of Business shows “the most walkable urban metros are also the most socially equitable. The reason for this is that low transportation costs and better access to employment offset the higher costs of housing.”

This is backed up with Federal Highway Administration data finding that families living in auto dependent communities spent 57 percent of their income on housing and transportation, compared to 41 percent in walkable communities.

This refutes widespread rumors that making a street safe for walking is a luxury important only to well-off people. Actually, low-income residents benefit the most because they travel by foot the most, especially kids.  “The fact is that we have twice as many low-income children [nationally] who are walking or biking to school than those in affluent neighborhoods, even lacking the infrastructure to protect the children,” reports Keith Benjamin, Transportation Director in Charleston, South Carolina.  

“A big thing we could do to help low-income families is to make it easier to live without a car,” says community consultant Gil Peñalosa.  “And it would help middle-class families to switch from two cars to one.” The American Automobile Association calculates the annual pricetag of owning one car at  $8,500 a year—which goes a long way toward easing household budgets.

Safe, convenient and comfortable places to walk are fundamental to the forgotten one-third of Americans who don’t drive— the young, the old, the disabled and those too poor to buy a car. These people live under a form of house arrest in many US communities, unable to do much of anything—buy groceries, see friends, go the doctor, engage in favorite activities—without begging someone to chauffeur them. Communities from San Francisco to Birmingham to rural Iowa are pulling together to eliminate the roadblocks that deter people of all ages, incomes and racial backgrounds from walking.

Walking Expands Economic Opportunities

People on the street mean business—literally.  Neighborhood and downtown business districts thrive on foot traffic.  West Palm Beach, Florida discovered this after making a major avenue more comfortable for pedestrians, and attracting $300 million in new business investment.  Albert Lea, Minnesota—a blue-collar rural town of 18,000—found the same thing when a walk-friendly makeover of its Main Street drew 15 new businesses in two years, with $2-5 million more in investment planned.

Even companies not dependent on local customers are eager to locate in walkable districts—especially firms in the booming tech and creative fields, who realize the young talent they depend on to stay competitive want to work within walking distance of cafes, parks and cultural attractions.  “We moved from the suburbs to downtown Minneapolis to allow our employees to take advantage of the area’s many trails and to put the office in a more convenient location for commuting by pedal or foot,” explained Christine Fruechte, CEO of large advertising firm Colle + McVoy, in a newspaper op-ed. “Our employees are healthier, happier and more productive. We are attracting some of the best talents in the industry.”

Many other companies find that walkable locations pay off in lower health insurance premiums. Thomas Schmid of the Centers for Disease Control and Prevention points to Volkswagen, which built a manufacturing plant in Chattanooga only after local officials agreed to extend a popular walking-biking trail to their door.

Walking Connects People & Strengthens Communities

Eighty five percent of Americans express the desire to live somewhere walkable, making it the #1 quality they want in  a home, according to  the National Association of Realtors’ Community & Transportation Preference Survey. This is even more true for Millennials, millions of whom will be looking to buy their first home over the next few years. 

 “What makes people walk is [also] what makes great places to live,” emphasizes Harriet Tregoning, until recently a director in the Office of Community Planning at the US Department of Housing and Urban Development (HUD). “Walkability is the secret sauce that improves the performance of many other things” in our communities.

Former Surgeon General Regina Benjamin emphasizes that taking a stroll “is good for the social fabric of our communities”—creating new opportunities to connect with friends and neighbors, which is not only good for your soul but also your health. That’s why Benjamin added a walking path to the grounds of the health clinic she founded in rural Alabama.

Walking Protects Our Environment

Walking more is an important step you can take to avert climate disruption, air pollution, urban sprawl and other environmental threats. More than half the suggestions in 50 Steps Toward Carbon-Free Transportation, released last year by the Frontier Group research organization, involve walking.

Walking in the Heartland

Drawing a crowd ranging from block club organizers and grassroots advocates to elected officials and medical experts, the 2017 Walking Summit features two-and-half days of workshops, major addresses, trainings, break-out discussions, success stories and on-the-ground exploration of solutions in Minnesota communities.

Among the more than seventy sessions are:  How to Build Safe Walking Networks; Walking in Rural Communities; Creating Walkable Communities Without Displacement; You Are Where You Live and Creative Walkable Interventions.

Keynote speaker Tamika Butler—director of the Los Angeles County Bicycle Coalition—will showcase how her organization broadened their mission from sustainable transportation to social justice. “We must talk about public health, gentrification, people of color, women who feel harassed on the streets, older people, black men who fear for their lives on the street, immigrants who fear deportation,” Butler says.  “Walking for many people has everything to do with living full lives and being able to get around.” 

St. Paul Mayor Chris Coleman—who launched a first-of-its-kind $42 million Vitality Fund to promote walking and other community improvements—will also speak at the conference along with racial and social justice leader Glen Harris from the Center for Social Inclusion and George Halvorson of the Institute for InterGroup Understanding, who made strides in launching walking movement as CEO of the  Kaiser Permanente health care system.  

Participants will find specific information and inspiration to take back home by following one or more of the Summit’s six “paths” of subject matter:

Healthy Communities: People’s zip codes are as accurate as their genetic code in predicting a healthy life. That’s why it’s essential to put in place policies, programs and resources to ensure everyone has an equal chance for a healthy life.

Safe, Well-Designed Communities: Too many communities are designed for the ease of motorists with little thought of people who get around other ways. The focus here is practical approaches to provide safe, convenient transportation and affordable housing for all.

Artistic and Innovative Communities:  Creativity flourishes in places where people regularly connect face-to-face on sidewalks and in public spaces.  Discover ideas about fostering foot-friendly settings that spark community engagement, cultural diversity and imaginative energy.

Productive and Thriving Communities: Walkability is closely linked with socially and economically successful places. Here’s where to start in creating vibrant neighborhoods, equitable development, affordable housing and strong downtowns or Main Streets.

Open and Collaborative Communities: Wide-ranging collaboration explains the difference between towns, suburbs or cities that blossom and those that wither. What’s the key in getting people together for authentic conversations and effective partnerships?

Engaged and Informed Communities: Access to information and decision makers are two powerful tools for transforming a community. These sessions offer a detailed look at new methods to gather data, engage communities, mobilize citizens and influence local government and businesses to catalyze walking. 

This is the first Walking Summit held outside Washington, DC.  “We’re really excited to showcase some of the success we’re seeing, but also share the challenges we have in Minnesota,” says Jill Chamberlain, chair of the local host committee and a senior program manager in the Center for Prevention at Blue Cross and Blue Shield of Minnesota, a featured sponsor of the event.

The Twin Cities metropolitan area in many ways represents a microcosm of America when it comes to walking. Minneapolis and St. Paul both rank relatively high for the rate of pedestrian trips among US cities, but until recently autos were the centerpiece of all urban planning in the region. Many suburbs lack sidewalks and other basic infrastructure for pedestrians. Concentrated populations of low-income households and/or people of color are found in both suburbs and cities. But there is a growing awareness that walking is important to future prosperity and quality-of-life—and growing numbers of projects to get people back on their feet.

Mobile workshops on the first day of the conference will fan out across the  area to investigate local initiatives that illustrate the power of walking— from  a police department campaign for pedestrian safety to a residential neighborhood with a small town feel to an inner city community torn apart by a freeway, which is exploring plans to reconnect itself by building a land bridge over the road.


Jay Walljasper—author of the Great Neighborhood Book and America’s Walking Renaissance—writes, speaks and consults widely about creating healthy communities. 


Clear-Eyed Return to the Scene

Louis Iacona
Louis Iacona left, of Long Island, founded LI Helps to assist drug addicts into treatment. Logan McDermott, a friend from sober living houses, helped launch it.

When Lou Iacona was six and selling blow pops at recess, he had no ambition to be selling marijuana at 13, which he did.  He had simply failed to earn the blow pops as a reward for being good, so he stole them and sold them. He loved attention, and as the third of four children of a Massapequa, Long Island, insurance adjuster and stay-at-home mom, he felt unnoticed at home. So when he sought attention elsewhere with mischief, that seemed to go unnoticed too.

 Nor did anyone call attention to these events as early steps toward heroin addiction. Iacona was an able athlete with a girlfriend at ten, whose name he carved in a school desk.

In his affluent family, he said, “I got what I wanted. I was spoiled.”

Massapequa, a hamlet of four square miles, has a median family income of $116,000.

 At twelve, when Iacona first smoked marijuana, he was nonplussed. He smoked with friends in a gathering at a South Massapequa catering hall.

“I felt funny, paranoid. I didn’t really like it,” he said.

He continued to smoke marijuana because his older sister’s ex-boyfriend kept supplying him with generous quantities to sell. At 13, he would peddle his pot at handball courts where his friends hung out after school.

“I liked the sense of control, and having people seek me out for marijuana and to be with me,” he said.

He saw that he could manipulate others to give him rides by plying them with dope, money, and food, he said. But he found what really suited him while partying with friends at a backyard pool. He bought two Vicodins for five dollars each.

“I got an itchy nose, because it messes with your histamines,” he said. “But then I was calm and relaxed. It was doing what it was supposed to do.”

He was 15. He thinks now that maybe he had an attention deficit hyperactivity disorder, and opiates slowed those racing thoughts. He kept taking them and selling them. His outlaw lifestyle retained its romantic appeal for a while, as he went in and out of school and adolescent jail programs. He was kicked out of school during his sophomore, junior, and senior years for fighting, drug possession and sales, and chronic insubordination—doing and saying what he pleased.

“I wanted to be known as a badass,” he said.

 In jail, the adolescent dorms were more turbulent than the adult ones, he found. Although he was relatively small and light, he protected himself with karate skills he learned in classes he began in elementary school. He would encounter the same people over and over.

“Some of them are probably still criminals,” he said.

Although that juvenile program failed to extricate him from his addict lifestyle, it left an important impression. For the couple of months that the Outreach bus took him to school and picked him up, he had a glimpse of himself as a sober, successful student. 

But one day during the summer Iacona turned 18, an older “friend,” whom he often manipulated for rides, said he could find no pills, but could get heroin.

“I said I would never do heroin, but ‘yes’ rolled off my tongue. I’d use it to not be sick,” he said.

They met a dealer at a KFC on Sunrise Highway two towns away from Massapequa, but they bought no fried chicken.

 “Heroin worked like 80 mg of oxycontin, but faster,” said Iacona. “It’s no party drug. We just drove with the music on and the dopamine dumping.”

That day he sniffed the heroin, but within a year he was shooting it. Meanwhile, his parents kicked him out. He lived in motels for seven months.

“I felt like, ‘Look at me. I’m out on my own,’” he recalled.

His parents begged him to come home. He finally did when he was arrested and needed their help.

Between the ages of 18 and 25, he was frequently arrested, and consequently started inpatient and outpatient treatment 40 times, overdosing eight times along the way.

“Detectives harassed me, waiting around the block to catch me,” he said. They would sometimes search his house. “I wanted to stop being an addict and just sell drugs, but I wasn’t just doing drugs. They were doing me. Secretly, I liked being in shape and doing well, but I didn’t think it was cool.”

But at 25, he had no friends, “no free rides or couches.”

“I only knew how to go to treatment, a refuge on insurance,” he said. “I had no idea what I would do sober.”

 He was just a depressed addict. He would wake up in mid-afternoon and eat whatever cereal was in the house, if he could keep it down. Even if not sick from withdrawal, his stomach was often upset. Then he would seek out drugs, contributing a ride or money to get where he needed to go.

He would come home and watch “Law and Order,” and go to sleep, “thinking about nothing,” he said. “The lifestyle I was in love with beat me down. I thought this was what life would be. I was an empty shell.”

At one point, he came out of treatment in South Florida and shot cocaine that kept him awake for several days. He met someone who had also been in treatment and relapsed, and they were in a train bathroom in adjacent stalls, when, Iacona fell and hit his head.

“My brain short-circuited. I had a seizure,” he said. His companion slapped him awake, but when he regained consciousness, he said, “My legs weren’t there.”

“Transit police detained them, and Iacona was taken to a hospital, where the EMT who had accompanied him visited later.

“She was sympathetic but didn’t sugarcoat the situation,” Iacona recalled. “She said, ‘You’ve been doing this a long time. Maybe you’ll do it forever. Did any of your friends succeed? You’re intelligent, but you’ll let them pass you by.’ After almost dying again, that kicked recovery into gear.”

At that point, he surrendered to family, friends, a 12-step program, and medications to stave off cravings.

“I grasped for help and listened better,” Iacona says. “My best thinking failed me. I had no idea how to be an adult and pay bills and shop for food.”

He went back to Florida for treatment and a sober living transitional home. Then, at 25, he took a place with a roommate and a job as waiter at Anthony’s Coal Fired Pizza in Aventura. After two years, he transferred to an Anthony’s in Long Island, ready to return.

He aimed to put the same energy into sober living that he put into serving his addiction, he said. He woke up at 5am to write in a journal to work out his thoughts and path. He decided he wanted to help addicts get sober by filling in the gaps in assistance for them.

So he and a friend who had also put drugs behind him started a Facebook page to announce their intent, and they began visiting treatment centers.

“As our presence grew, treatment centers reached out to us,” said Iacona.

On January 26, 2016, they formed what became L.I. Helps, to guide addicts into treatment and staying sober. Iacona and four colleagues now advise addicts and their families, aided by training and their own experience to do interventions and counseling. Several treatment centers pay them for this work, though Iacona says they have no quotas, and their interventions are free. His cohorts are some of the same people with whom he had previously gotten high, now sober.

They get eight to 15 calls per day seeking help, Iacona says. Most commonly, an addict’s mother calls. Iacona recalls his discomfort on his first visit. A mother had called about her son, who was 21, using heroin, and living at home. The father was a union worker; the mother had a small business.

“It was similar to my home,” said Iacona. “The kid didn’t know I was coming. I said, ‘I’m Louis. I hear you’re using heroin. I’m not a counselor, but I’ve lived that lifestyle. Don’t be mad. Your parents are terrified. I want to help you to the best of my ability.”

Iacona says he guided him into a Florida treatment center.

“I talked to him in treatment. He said he felt like leaving and not going to a sober living house, but I gave advice that he took. I’ve kept in touch,” Iacona says. “We’ve touched about 1000 families, but not all go to treatment, and some go in New York.”

Other stories take different turns. There was Joe, from West Islip, and his girlfriend, who went to separate facilities in California.

“I said, ‘Stay out there,’ but they came home and overdosed together,” said Iacona. The girlfriend died the next day, but Joe lived and stayed in the hospital for two months for surgery on his legs, to which he had lost circulation. “He went to Florida for treatment, and we talk every day. Getting out of your environment won’t keep you sober, but it’s better, with the right treatment and follow-up,” said Iacona.

He also remembered a call he got from a woman whose daughter, about 19, had been using heroin. Iacona was out for dinner with his girlfriend, but he offered to come right away. The mother told him to wait until the next day, but the daughter died of an overdose that night.

Jobs, spouses and partners are the most often cited obstacles to getting treatment, Iacona says. Still, he estimates that about 80% of addicts that he and his partners advise end up in treatment. He encourages families to refuse financial support to addicts in their midst, instead giving them the option of getting treatment or leaving.


Jessica Cohen is a freelance writer based in Pennsylvania. She most recently reported on health issues related to fracking for Utne Reader.

Without Care There Is No Democracy: A Cognitive Approach to Beating Trumpism

 Cognitive Dissonance

Photo by iStock/Balefire9

In a recent episode of Tavis Smiley, cognitive scientist and linguist George Lakoff explains how President Trump has managed to spread his worldview despite the dissonance many find is inherent in his viewpoints. Lakoff describes how Trump uses repetition to slowly eat away at peoples’ previously held beliefs. For instance, Trump’s repeated use of the phrase “fake news” has had an enormous negative impact on the reputation of all news media. Lakoff explains how most people are unable to consciously resist the bombardment of such repeated claims from politicians.

Lakoff goes on to speak of the broad distinctions between progressive and conservative worldviews. He says that progressives tend to empathize with people throughout the world whereas conservatives have more of what is called the strict father morality. This belief system posits that a hierarchy of importance exists naturally in the world and that people are directly responsible for their place in the hierarchy. “The people who have won out are the best people. Religions have won out, so you have God above man. Rich above the poor. Employers above employees. Adults above children. This moral hierarchy defines virtually all radical Republican positions on every issue.”

To combat people with this worldview Lakoff encourages activating care and nurturance in others. “Students will come to me and say, ‘Thanksgiving is coming up and I’m going to encounter my grandfather. We are going to fight about politics and I hate it.” Lakoff responds by saying, “Don’t fight with your grandfather. Ask him ‘What are you most proud of that you’ve done for other people without consideration for yourself?’ 100% of the time students come back and say, ‘I don’t agree with him on a lot of issues, but my grandfather has done some really good things for people.’” Lakoff encourages his students to only talk with their grandfather about what it means for him to behave selflessly. This method is one of the best ways for people to activate care and nurturance in others.

Smiley and Lakkoff also discuss how words affect political action, what the definition of truth is, and how the heart connects to the mind. Watch the full interview below.

MDs Now Prescribe Walking as a Boost to Health

Everyone knows walking is good for you.

It’s plain common sense, backed by a wealth of recent medical research. In fact, a major new study found that lack of physical activity is twice as deadly for us as obesity.  

Health data shows that as little as 30 minutes of walking a day cuts the incidence of Alzheimer’s Disease in half, lowers the likelihood of diabetes by 60 percent,

limits colon cancer by 31 percent for women and reduces risk of dementia, heart disease, depression, osteoporosis, glaucoma and catching a cold. 

This kind of evidence prompted US Surgeon General Vivek Murthy to issue a call for Americans to walk more. “Physical activity — such as brisk walking — can significantly reduce the risk of heart disease and diabetes,” Murthy explains. “Even a small first effort can make a big difference in improving the personal health of an individual and the public health of the nation.”

 “Walking is the most common form of physical activity across incomes and ages and education levels,” adds Thomas Schmid of the federal Centers for Disease Control and Prevention (CDC). That’s because it’s free, easy, relaxing, available right out your front door and easily incorporated into daily schedules.  Plus it’s fun. The CDC’s most recent research shows the number of Americans who take a walk at least once a week rose six percent in the last decade.

Hiking

Walking for as little as thirty minutes a day is enough exercise to make a difference in adults' health.

Still less than half of all adults meet the minimum recommended guidelines for walking, rolling in a wheelchair or other physical activity (30 minutes a day five days a week), according to the federal Centers for Disease Control and Prevention.  Even worse, only a quarter of high school students today reach the mark (an hour a day seven days a week), according to the Surgeon General’s report.

What can be done to ensure the health of our country?  The Surgeon General encourages everyone to walk and work to make their hometowns more safe and inviting for people on foot.  He lauds the new walking movement that’s emerged over the past few years for getting Americans moving again.

Health care professionals are on the frontlines of this effort, and many are bringing the message back to their clinics by including physical activity as one of the vital signs — like blood pressure and tobacco use — they check on with patients. Some MDs even write prescriptions for walking. Several health care systems track physical activity in their health care records, including Greenville Health in South Carolina, Intermountain Healthcare in Utah and Idaho, and Kaiser Permanente, an integrated health care delivery system, in California and seven other states.

If Walking Were A New Drug, It Would Make Headlines

“What if there was a pill you took one day that lowered your blood pressure, prevented diabetes, improved your mood and protected against depression, increased bone density and prevented fractures, helped you remain independent as an older adult, enhanced your ability to think, and gave you more energy?” ask Dr. Robert Sallis and Dr. Karen J. Coleman in Sports Medicine Bulletin.

“Would you be asking your doctor to prescribe it for you?”

Such a drug already exists, Sallis notes, it’s called walking. “If walking was a pill or surgical procedure, it would be on 60 Minutes.”

Sallis, a family practitioner at a Kaiser Permanente clinic in Fontana, California, keeps special walking RX prescription pads in his exam rooms, which he fills out for some patients saying, “This is what I want you to do to treat your high blood pressure or depression or diabetes etc.  If it’s not enough, then we will consider using a medication.”

What are patients’ reactions?  “They respond very well to this message,” Sallis says. “This approach really frames for them how important exercise is to their health and treating their disease.” 

Sallis first spoke up about walking and other physical activity being recognized as a vital sign in 2007, when serving as president of the American College of Sports Medicine and helping launch the Exercise is Medicine initiative with the American Medical Association.  The aim of that project is to highlight the mounting research proving that physical activity should be seen as essential to health and the treatment of disease.  It’s obvious that doctors, nurses and other clinicians should raise the idea of walking during medical exams, when people are paying particularly close attention to their health and how to maintain it.

Putting the Plan Into Action

In 2009, physical activity was designated as a vital sign for Kaiser Permanente facilities in Southern California and the idea was quickly adopted throughout the rest of the non-profit organization — the nation’s largest integrated care health system with 10.2 million members, seventeen thousand physicians, fifty thousand nurses, 620 clinics and 38 medical centers on the West Coast, the Mid-Atlantic region, Colorado, Hawaii, and Georgia.

Patients are asked how many days a week on average they engage in moderate or strenuous physical exercise, like a brisk walk, and for how many minutes? These two simple questions frequently spark conversation about the value of walking (or yoga, Zumba classes, bicycling, gardening and other physical activity) in treating and preventing disease.

A follow-up study published in the journal Medicine and Science in Sports and Exercise found that 18 months after Kaiser Permanente adopted physical activity as a vital sign in Southern California, 86 percent of all adult patients had a record of their activity levels included in electronic medical records. In 2013, Kaiser Permanente’s Exercise as a Vital Sign program was honored with an Innovation Award by the National Business Coalition on Health. 

“Asking an individual about their daily physical activity helps our providers learn what matters to our patients and prompts our patients to think about healthier habits,” explains Lisa Schilling, vice president for Healthcare Performance Improvement with Kaiser Permanente's Care Management Institute.  “It also allows us to connect the individual to resources and habits that promote better health.”

Gym

While going to the gym can seem like an imposing task, walking requires no special equipment or facilities.

Even health care professionals sometimes need encouragement to live more healthy. Zendi Solano, a research assistant for Kaiser Permanente in Pasadena, California, admits that she knew the importance of exercise but “really didn’t take it seriously” until her doctor asked about it during a check up.  Diabetes runs in Solano’s family, and she was obese with elevated blood sugar. Right then and there, she decided to take up running. At her next physical, Solano had lost 30 pounds and her blood sugar levels were normal. Being asked about exercise as a vital sign, she says, “is a great reminder.”

About 2/3 of Sallis’s patients fall below the minimum federal guidelines for exercise, and half of those report no moderate physical activity at all during an average week, he says.  ‘Talking about physical activity can have an impact on everyone,” he says, especially high risk patients with diabetes, lung disease, heart disease, hypertension, arthritis or other chronic diseases.

“Anyone who is at risk for chronic disease should consider exercise an essential vaccine to greatly lower risk of illness and … extend life,” he wrote in a guest editorial for The British Journal of Sports Medicine

The power of exercise to heal really hit home for Sallis after meeting Valerie, a 68-year-old patient with Parkinson’s Disease who hobbled into his office with a walker.  She was desperate and depressed because her medication was no longer working. He recommended she visit a fitness professional to walk on a treadmill at one mile-per-hour speed along with some resistance training and stretches. 

“In a month-and-a half, she came back to my office without the walker, and telling me she had more energy and a more positive outlook,” he remembers. This convinced him, “if something so simple and inexpensive as exercise can have such a profound effect, shouldn’t we try to prescribe this powerful medicine to all of our patients?”

Something You Can Say ‘Yes’ to For Better Health

For Liz Joy, Medical Director for Community Health at Intermountain Healthcare based in Utah, the “a-ha” moment about physical activity as a vital sign came in 2008 at a meeting focused on preventing obesity among youth.  “It was a roomful of physicians, health care directors, scientists and coaches,” she remembers, “and one speaker got up and asked: ‘What is health care doing about this crisis?’  That’s when it came to me that physical activity needs to become a vital sign.”

Intermountain adopted the idea in 2013 in its electronic health record for use by clinicians in Utah and Idaho. “It’s a way to bring discussion of physical activity into the exam room,” Joy explains.  “Even if it’s just a brief conversation about how important it is to your overall health. I can let patients know it’s as important as blood pressure, and more important than obesity and cholesterol to your overall health.”

“I generally start by talking about walking, because it’s free and everyone knows how to walk,” she adds. “I’ll tell them just start with 10 minutes at a time — and no one has ever said they can’t do that.  Do that three times a day, and you have your 30 minute daily minimum.”

Joy notes that doctors have been charting people’s weight for generations, telling them to lose weight while watching the national obesity rate continue to rise.  “Talking about physical activity is a positive conversation — something people can do to improve their health. And when they take that first step, sometimes their eating habits begin to change too. You’ve helped enhance their self-efficacy.”

Walking

Simple as it is, walking is often overlooked as a source of exercise.

Some of her patients don’t consider walking real exercise, so the conversation can offer new motivation to get back on their feet.  “I saw a patient and was surprised his records showed that his physical activity was zero. I knew he had a dog, and I asked if walked the dog? Yes, he said 30-60 minutes a day. But he didn’t think of it as exercise.”

“The physical activity vital sign is a great prompt to have a conversation with patients about activity and exercise — to let them things like gardening and dog walking count,” she adds. 

Joy points out that health care systems have a strong incentive for adding physical activity to their lists of vital signs.  “Physical activity is stressed in Medicare reimbursements as one of the HEDIS (Healthcare Effectiveness Data and Information Set) measures, which Medicare and others use to assess the quality of health care delivery to determine level of payments.  It’s a huge financial driver.”

Spreading the Message into Exam Rooms Everywhere

The American College of Sports Medicine (ACSM) has joined with other groups in the walking movement to alert health care professionals about the promise of adding physical activity to their list of vital signs. 

“One strategy is to get influential medical organizations to formally adopt physical activity as a vital sign, and then activate their individual members,” says ACSM CEO Jim Whitehead.  They’re already working toward that goal with 10 medical societies, including the American Medical Association, the American Hospital Association, American Academy of Pediatrics, American College of Cardiology and the Preventive Cardiovascular Nurses Association.

“This is for all health care providers, not just physicians.  Nurses can often make a greater impact because they typically spend more time with you, ” notes Brenda Chamness, ACSM Strategic Health Program’s Senior Director.

Working with Kaiser Permanente and the Every Body Walk! Collaborative — a coalition of organizations ranging from the CDC to AARP to NAACP to the PTA — ACSM hosted a two-day scientific roundtable on the subject last April, which detailed recent research and presented best practices used by working physicians, including Robert Sallis and Liz Joy.  In October, several hundred health professionals around the country took part in a webinar on “Making Physical Activity a Vital Sign.”

“All this can have a major impact by showing people that they all don’t have to go to the gym to be healthy,” says Adrian Hutber, Vice President of Exercise is Medicine at ACSM. “They can just go out and take a walk.”


Jay Walljasper writes regularly about public health and healthy communities.  The former editor of Utne Reader, he is author of The Great Neighborhood Book. His website is JayWalljasper.com.

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Middle photo by Fotolia/zhu difeng

Bottom photo by Fotolia/Alextype

Walking is a Basic Human Right

People walking

Safe spaces to walk are essential for decreasing health disparities among Americans.

“We are a nation of walkers,” declared US Surgeon General Vivek Murthy at the 2nd National Walking Summit October 29. “Walking is a simple thing we can do” to make America more healthy.

That’s the message of his recent Call to Action on Walking and Walkable Communities, which highlighted the powerful fact that, “an average of 22 minutes a day of physical activity — such as brisk walking — can significantly reduce the risk of heart disease and diabetes” as well as other debilitating chronic diseases.

Dr. Murthy told on overflowing crowd of 500 people from 44 states that, “we need to improve infrastructure in communities to make walking easier.” It’s about justice, he emphasized. It’s about making sure “everyone in America has a good shot at being healthy.”

Equal access to good health was a goal that resounded throughout the Walking Summit in Washington, D.C., organized by America Walks and presented by the Kaiser Permanente integrated health care delivery system, along with two dozen co-sponsors spanning the health care, philanthropy, business, non-profit and transportation fields.

“The health benefits of walking are so overwhelming that to deny access to that is a violation of fundamental human rights,” noted opening keynote speaker Dr. Robert A. Bullard, founder of the Environmental Justice movement and dean of the School of Public Affairs at Texas Southern University.

Jaw-dropping silence seized the room as Bullard showed a succession of US maps illustrating how historic segregation and current poverty strongly correlate with low levels of walking and childhood opportunity as well as high levels of obesity, diabetes, hypertension and heart disease. “Health disparities don’t just happen by accident,” he explained. They are the tragic legacy of racism and unequal economic opportunity.

“Tell me your zip code and I can tell you how healthy you are,” Bullard said. “That should not be… All communities should have a right to a safe, sustainable, healthy, just, walkable community.”

Ron Sims, who sponsored some of the first research identifying zip codes as an ironclad determinant of health while chief executive of King County, Washington, closed the three-day event on an equally powerful note. “If you have parks, playgrounds, community gardens, and wide sidewalks, you have good health outcomes,” he offered. “If you have walkable communities kids will do better in school…seniors will be healthier.”

He drew on his experience as an activist in African-American neighborhoods of Seattle, as well as a former Deputy US Secretary of Housing and Urban Development, to map out the starting point to reach healthy communities: new or improved sidewalks, better lighting, access to water and greenspace. “You have no idea how powerful you are,” he said to the hundreds of walking activists in the room. “I can’t overstate that you are a movement that can ensure this country achieves its great dreams.”

Bridge

The Rails-to-Trails Conservancy works to turn unused railroad lines into walkable trails.

Sims’ optimism is grounded in firm evidence that Americans are getting back on their feet. The number of Americans walking has increased 6 percent since 2005, according to the Centers for Disease Control and Prevention. That adds up to 20 million more people on sidewalks and trails.

Americans are walking not just for health, but also for relaxation, community connection, neighborhood revitalization and the sheer fun of it. The co-chairs of the Every Body Walk! Collaborative —Joan Dorn of the City University of New York School of Medicine and Kevin Mills of the Rails-to-Trails Conservancy — outlined some of the reasons for this good news:

• The Surgeon General’s Call to Action on Walking and Walkable communities generated huge public discussion, including more than six billion media impressions

• The US Department of Transportation is improving life for people who walk or bike with Secretary Anthony Foxx’s Safer People, Safer Streets initiative, which more than 200 cities have joined.

• In recent years, $1.5 billion dollars have gone toward walking and biking improvements, although that’s still less than one percent of overall transportation spending, as Sims noted.

Vision Zero campaigns — redesigning traffic policies with the goal of no fatalities for walkers, bikers and motorists — have been launched in New York, San Francisco, Chicago, San Jose, Boston and other cities.

• More than 700 towns, counties and states have enacted Complete Streets policies, which consider the needs of all users — not just vehicles — in building and maintaining roads.

Safe Routes to School programs are ensuring kids can walk or bike to school in virtually every corner of the country.

• On the first day of the Summit, Capitol Hill was swarming with more than 150 walking advocates, who met with 147 Congress members from 33 states, almost evenly divided between Republicans and Democrats.

• The Summit attracted more than 520 participants, up 30 percent from the first Summit in 2013 and was more racially and regionally diverse. Nearly a hundred received scholarships to make the event more accessible to people with limited resources. “All of us with divergent missions — from health care to social justice to land trusts to neighborhood revitalization — have a convergent strategy to get more people out walking and create safe places to walk everywhere,” noted Kaiser Permanente vice-president Tyler Norris.

The Summit’s message of walking as a fundamental right drew new attention to groups that suffer the most from unsafe streets for pedestrians in many American communities: people of color, low-income people, older people, children and the disabled.

Statistics that were frequently quoted in workshops and conversations in the corridors included:

• People walking in the poorest one-third of urban census tracts are twice as likely to be killed by cars.

• African-Americans are 60 percent more likely to be killed by cars while walking, and Latinos 43 percent.

• The pedestrian fatality rate rises significantly for people 45 and over, according to the National Highway Traffic Safety Administration.

• Roughly half of all US kids walked or biked to school in 1970, compared to 16 percent today (up from 13 percent in 2007), according to Safe Routes to Schools National Partnership.

Practical solutions to these problems were detailed walking advocates from around the country in 70 breakout sessions focused on specific walking issues.

In the San Joaquin Valley of California, Latina women started walking groups to improve their health and when local officials said it would cost too much to build walking trails, they enlisted their construction-worker husbands to do it. In nearby Ceres, California, sixth-graders did an assessment of walking conditions near their school, which was incorporated into a Safe Routes to Schools masterplan. In Clarksdale, Mississippi, older African-Americans who felt scared to walk because of crime organized neighborhood watch groups to make their community safer. In Raleigh, North Carolina, a graduate student created signs informing people how easy it is to walk to local attractions all on his own, which were later adopted by the city government.

“The Summit shows the movement is expanding from walking as a way to improve public health to walking as a human and civil right, a moral imperative,” said Kate Kraft, National Coalition Director for America Walks and the Every Body Walk! Collaborative, which co-hosted the Summit. “A community that is walkable for everyone means less disenfranchisement and more connection.”


Jay Walljasper — author of The Great Neighborhood Book — consults, writes and speaks about how to create healthy, strong communities. He is Urban Writer in Residence at Augsburg College in Minneapolis, and can be reached at Jay Walljasper.

Top photo by Fotolia/Pavlo Vakhrushev

Bottom photo by Fotolia/digitalfarmer

Floating in a Sensory Deprivation Tank

Sensory deprivation tank

 

"There’s no crime in wanting to balance your life with a little bit of silence," says Alan Goltl, owner and operator of TankHouse Float and Massage in Wichita, KS. TankHouse offers the experience of "floating" in a sensory deprivation tank, or as Goltl likes to call it, a sensory reduction tank. "I don’t think anybody knows exactly what the significance is [of floating], but it is a healing experience, if anything, because people come out and are baffled by it in a good way."

 

 

In the fourth installment of the Abstract Notions podcast, Utne Reader editor Christian Williams and Alan Goltl discuss the history of floating, how to prepare for your first float, and what to expect when you get in the tank. If you are familiar with floating, jump to minute 43 for a discussion with Alan about his experiences with other altered states of consciousness including lucid dreaming, ayahuasca ceremony, and darkness retreats.


Utne Reader editor Christian Williams hosts this podcast that explores the nature of consciousness through art, culture, and spirituality. Read more in the Abstract Notions blog.

A Good Place for Everyone to Walk

Man enters bus

People have walked for justice and economic opportunity throughout American history.

Workers wanting a better life for their families walked on picket lines and at protests, rallied by advocates like Cesar Chavez. People demanding civil rights marched in Selma, Alabama and Washington, DC led by Rev. Martin Luther King Jr.

Walking is a powerful tool to change the world as well as a fundamental human right. To be restrained from free movement is a denial of our liberties, a betrayal of American ideals.

Yet many disadvantaged people now think twice before traveling on foot due to dangerous traffic, street crime, or a lack of stores and public places within walking distance, which heightens serious problems of poor health, limited transportation options, and overall disillusionment in their communities.

A wealth of recent medical research, highlighted in the Surgeon General’s recent Call to Action on Walking, promotes walking as a way to prevent chronic disease, heart disease, diabetes, depression and some cancers. The US Centers for Disease Control and Prevention recommends everyone walk or engage in other moderate exercise half an hour a day five days a week. (An hour a day for children.)

Poor conditions for walking among low-income households, people of color and some immigrant communities limit their access to jobs and education. One-third of all African-Americans and one-quarter of all Latinos live without access to a car, according to a report by the Leadership Conference Education Fund, which means walking and public transit (which involves a walk) represent important pathways to opportunity.

Improving walking options can also help ease the financial burdens on poor families, which spend 42 percent of their income on transportation compared to 22 percent among middle-income Americans. That’s because the average cost of owning and operating one car is $8700 a year.

“This is an issue of equity,” says Gil Peñalosa, founder of 880 Cities and an immigrant from Colombia. “A big thing we could do to help low-income families is to make it easier to live without a car. And it would help middle-class families to switch from two cars to one.”

Making America more walkable for people of all incomes and races is a major focus of the National Walking Summit, held in Washington, DC Oct. 28-30. Our mission is “to make sure walking is accessible for everyone, especially vulnerable populations in lower socioeconomic communities where infrastructure has not been invested in and pedestrian and public safety are significant issues,” says Tyler Norris, one of the events’ organizers and vice-president of Kaiser Permanente, which is among 20 co-sponsors including AARP, the National Association of Realtors, the Every Body Walk Collaborative, The Robert Wood Johnson Foundation, the Kellogg Foundation, the Knight Foundation and America Walks. The summit is organized by America Walks.

Barriers to Walking

So what stops people of color and those living low-income communities from walking more?

There are “disproportionately high pedestrian deaths in low-income communities,” according to US Department of Transportation specialist Paul Heberling. He notes that pedestrians in the poorest one-third of urban census tracts are twice as likely to be killed as those in other neighborhoods. African-Americans are 60 percent more likely to be killed by cars while walking, and Latinos 43 percent. This disparity helped spur US Secretary of Transportation Anthony Foxx to launch his Safer People, Safer Streets initiative to help everyone walk and bike more.

In addition to traffic injuries, there’s a stigma in low-income communities that people on foot are “losers,” explains Yolanda Savage-Narva, Director of Health Equity at the Association of State & Territorial Health Officials. Growing up in an African-American community in Jackson, MS, Savage-Narva recalls, “In Mississippi, it wasn’t normal to walk. It was something that only really poor people did.”

How you travel looms large as an emotional issue in disadvantaged communities, according to Peñalosa. “Walking is seen as a symbol of failure. And you can see why when you look at the places where many people are forced to walk — deteriorating infrastructure, dangerous intersections. It’s like we are telling these people every day that they are second class citizens.”

Anita Hairston, Associate Director and transportation specialist at Policy Link, a national institute focused on social equity offers another reason straight out of today’s headlines to explain why many African-Americans, Latinos and immigrants are wary about taking a stroll. “The issue of racial profiling is front and center. Who’s got the right to be on the streets? If a group of young black men are dressed casually, people think: Where is this gang going? What are they going to do? Not everyone has the same experience on the street.”

Despite all these roadblocks, people in disadvantaged communities still walk more than other Americans. “The fact is that we have twice as many low-income children who are walking or biking to school than those in affluent neighborhoods, even lacking the infrastructure to protect the children who walk and bicycle,” reports Keith Benjamin, a Campaign Manager for the Safe Routes to Schools National Partnership.

RX for a Hidden Health Care Crisis

A little publicized crisis for African-Americans is the high rate of heart disease and diabetes, especially among women, says Vanessa Garrison, co-founder of the health empowerment program Girl Trek.

“The leading cause of death for black women is heart disease,” Garrison notes. “We are dying younger and at higher rates from preventable diseases than any group of women in this country. Eighty percent of black women are overweight. Half of all black girls born in 2000 will get diabetes by 2034 if present trends continue.”

Girl Trek aims to improve black women’s health by organizing communities to walk, even in places where sidewalks are absent and crime rates are high. More than 35,000 African-American women have taken Girl Trek’s pledge to re-establish walking as a healing tradition in their neighborhoods. More than 500 Girl Trek members traveled to Alabama last spring to walk in celebration of the Selma-to-Birmingham Civil Rights March.

On Foot in Urban America

Fifteen to 20 women in Anacostia, one of the poorest neighborhoods in Washington, D.C., take an invigorating 3.3 mile walk every Saturday morning as part the Just Walk club sponsored by the neighborhood’s Community Wellness Collective. “People here have this idea that exercise is just for people with money, people with time,” public health consultant Khadijah Tribble. “That’s why we walk. To show that’s not true.”

A walking club can be spotted every Thursday evening on the sidewalks of West Humboldt Park, a largely African-American and Latino neighborhood on the West Side of Chicago.  They’re part of a program to increase walking and improve health sponsored by the West Humboldt Park Development Council (WHPDC).

“This area has one of the higher diabetes rates in the nation,” explains Isaiah Ross, until recently WHPDC’s community development manager. “People haven’t walked much here because the traffic makes it hard to get to school or work, and people are afraid to go out because they don’t know their neighbors.”

The Healthy Community Initiative aims to break down people’s isolation, first by bringing neighbors together and then tackling issues that discourage healthy lifestyles. Groups of 8-10 are being organized to tour their immediate neighborhood conducting walk audits and public safety audits. “Are the crosswalks visible at intersections? Is the lighting good enough?... What can be done to slow down traffic? What’s a safe route for kids to go to school?” are among the questions they seek to answer, according to Ross.

Five new playgrounds have been built recently in the neighborhood and the city of Chicago has begun sponsoring Play Streets events, where a block is closed off to traffic and people of all ages come to hang out and get to know one another.

Stepping Up in Suburbs and the Country

Not all low-income families and people of color live in cities, of course. Suburban residents now outnumber those living in cities among African-Americans, Latinos and Asian-Americans.

More poor people live in suburbs today than in cities, too, and often experience even greater problems because of spotty public transit, lack of sidewalks, wide streets with few pedestrian safety measures and greater walking distances to destinations.

Almost 20 percent of the population of Richmond, a suburban city of 100,000 in the East Bay region of California, live below the poverty line. The city’s struggling Iron Triangle neighborhood—which is approximately 2/3 African-American and 1/3 Latino—has long suffered from poverty and high crime rates, says Dan Burden, a walkability expert at Blue Zones, who has worked in 3000 US communities. Local people seeking to improve their community joined hands to restore Pogo Park, and are now working to make neighborhood routes to the park safe for pedestrians by improving the street design to encourage slow traffic and create a more appealing environment for walking. “This is creating a place filled with lots of things for people to do, where gangs will not go to sell drugs or bully everyone,” Burden says.

In rural America—which is poorer on average than urban regions and where one in five residents is Latino, African-American or Native American—walking is more common than most people think. Even with long distances to destinations and very limited public transit options, 1.6 million rural households do not have access to cars.

Small town residents walk almost as much as Americans living in metropolitan areas, according to a report from Rails to Trails Conservancy. In towns sized 2500-10,000, 7.2 percent of all trips are made on foot and 8.5 percent in towns 10,000 - 50,000, compared to national average of 10.5 percent (and 6.7 percent in newer suburbs), according to the US Department of Transportation.

And rural Americans are enthusiastic about walking. Nine out of ten want to see their communities become more walk-friendly according to a recent survey from the Safe Routes to Schools National Partnership, and 81 percent want to increase or maintain current public spending on sidewalks and bikeways.

In Winton, a largely Latino town of 10,000 in California’s Central Valley, parents were wary about kids walking or biking to school due to traffic congestion and lack of sidewalks. The school district responded by declaring walk-to-school day, plus hosting events and teaching classes about safety on the streets. Then they drafted their own Safe Routes to Schools policies, with help from the Safe Routes to Schools National Partnership and ChangeLab Solutions.


Jay Walljasper, author of the Great Neighborhood Book, is a writer, speaker and consultant on making communities better places to live for everyone. Contact him at Jay@JayWalljasper.com.

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