1. A PRESENTATION TEMPLATE Systems and Environmental Changes to Support Optimal Nutrition and Physical Activity

2. OVERVIEW The Problem Why focus on the environment? Systems and Environmental Changes Our role The built environment in our community What can be done? Sample strategies Physical Activity Nutrition Breastfeeding

3. ASK A QUESTION HERE For example: How safe is your neighborhood now for riding a bike to school? (think complete sidewalks, crosswalks, bike lanes, etc) Have you seen your lactation room at your work? Is it clean and inviting? How close is a Farmer’s Market from your home? Your work?

4. THE PROBLEM FOR THE MATERNAL, CHILD AND ADOLESCENT HEALTH POPULATION Concerns include: Overall physical environment For kids For adults For moms and babies Food environment Biking/walking to school

5. WHAT WE KNOW To highlight issues of chronic disease, inactivity, or lack of access in your county, use data from these sources: Overall physical environment: http://www.countyhealthrankings.org/#app/ http://www.countyhealthrankings.org/#app/ For kids: http://www.kidsdata.orghttp://www.kidsdata.org For adults: http://www.cdc.gov/obesity/data/adult.html/http://www.cdc.gov/obesity/data/adult.html/ For moms and babies: http://www.cdph.ca.gov/data/surveys/Pages/MaternalandInfantHealth Assessment(MIHA)survey.aspx http://www.cdph.ca.gov/data/surveys/Pages/MaternalandInfantHealth Assessment(MIHA)survey.aspx Food environment: http://www.publichealthadvocacy.org/RFEI/presskit_RFEI.pdf http://www.publichealthadvocacy.org/RFEI/presskit_RFEI.pdf Biking/walking to school* http://nhts.ornl.gov/2009/pub/stt.pdfhttp://nhts.ornl.gov/2009/pub/stt.pdf

6. EXAMPLE DATA SLIDE: HOW CHILDREN* GET TO SCHOOL, COMPARING 1969 AND 2009 *Children ages 5-14 Data from the 2009 National Household Travel Survey (NHTS)

7. SYSTEMS AND ENVIRONMENTAL CHANGES Also known as the built environment The man-made space in which people live, work, and play. Can include: Food access Walkability Breastfeeding accommodations Mixed land use Safety

8. WHY FOCUS ON OUR ENVIRONMENT? “Fifty years ago, children did not avoid obesity by making healthy choices; they simply lived in an environment that provided fewer calories and included more physical activity for all.” David B. Allen MD New England Journal of Medicine April 29 th, 2012

9. MCAH HAS A UNIQUE INTEREST IN ADDRESSING SYSTEMS AND ENVIRONMENTAL CHANGE Addresses a large portion of the population Existing partnerships with organizations Skills and capacity to build new partnerships Systems change is cost-effective and sustainable

10. LET’S LOOK AT THE BUILT ENVIRONMENT IN OUR COMMUNITIES…

11. WOULD YOU RATHER WALK HERE…. Add a local photo of a broken sidewalk, unsafe crosswalks, or badly lit areas

12. …OR HERE? Add a local photo of a safe, creative, and inviting sidewalk

13. COULD YOUR CHILDREN PLAY HERE? Add a local photo of a badly maintained playground, locked up school- yard, etc.

14. WE CAN PROMOTE PHYSICAL ACTIVITY THROUGH CLEAN AND SAFE RECREATIONAL AREAS Add a local photo of a safe and clean park, playground, school yard, etc. here

15. WILL YOU FIND NUTRITIOUS FOODS HERE? Add a local photo of a fast food outlet, convenience store, or a liquor store here

16. Add a local photo of fresh produce or a farmers’ market here WE CAN PROMOTE NUTRITIOUS EATING WITH HEALTHIER FOOD OPTIONS

17. FARMERS’ MARKET

20. WE CAN PROMOTE BREASTFEEDING THROUGH LACTATION ACCOMMODATION Add a local photo of a lactation room, lactation room signage, Baby- Friendly sign, refrigerator for storing breast milk, or breast pump here.

21. SAMPLE INTERVENTION 1: SAFE ROUTES TO SCHOOL (SRTS) What is it? An initiative to help communities assess the bike and pedestrian conditions around schools in order to make the routes safer through various projects:

22. SAMPLE INTERVENTION 1: SAFE ROUTES TO SCHOOL (SRTS) Why? SRTS provides a safe, convenient, and fun way for children to exercise regularly by actively commuting to school.

23. SAMPLE INTERVENTION 2: FARMERS’ MARKETS What is it? Direct-to- consumer markets that provide access to locally grown, farm-fresh produce.

24. Why? Access to neighborhood supermarkets and farmers’ markets reduces the risk of chronic diseases such as overweight and obesity. SAMPLE INTERVENTION 2: FARMERS’ MARKETS

25. SAMPLE INTERVENTION 3: LACTATION ACCOMMODATION What is it? Providing the time, space, and/or resources (such as a breast pump) for mothers to pump and store their milk.

26. Why? It’s the law, both federal and state. Breastfeeding is beneficial to babies, mothers and the community. SAMPLE INTERVENTION 3: LACTATION ACCOMMODATION

27. ACKNOWLEDGEMENTS

28. The End Please complete evaluation.