1. Local Public Health in Action: The physical, economic and health benefits of polices and planning American Public Health Association Annual meeting San Francisco 2012 1

2. Support for Local Environmental Health: Increasing physical activity options in San Antonio MARY THOMAS M.B.& B.S., M.P.H. Communities Putting Prevention to Work San Antonio Metropolitan Health District San Antonio Texas 2

3. Co-Authors Maggie Thompson, MS Program Manager, CPPW maggie.thompson@sanantonio.gov 3

4. Presenter Disclosures The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: Mary Thomas “No relationships to disclose” 4

5. VISION Increase active living options in San Antonio by supporting local built environment to reduce obesity 5

6. Describe the changes in built environment to increase physical activity options at parks, libraries, and public housing Discuss increasing active transportation through installation of bike kiosks Describe the benefits of the Complete Streets Policy LEARNING OBJECTIVES 6

7. San Antonio Council Districts 1-10 7

8. Demography of Bexar County Population: 1.7 million Multicultural: 59% Hispanic, 30% non-Hispanic, 7% African American, 3% Asian South & Westside population: 80% Hispanic Northeast & North central: 30% Hispanic Persons below 45 years: 79% Some populations have a greater burden of health problems One in three children and two in three adults are of unhealthy weight 8

9. Bexar County 2010 Population by Race/Ethnicity Population Source: U.S. Census Bureau, 2010 Total 1.7 Million 9

10. Bexar County 2010 Age Distribution Population Source: U.S. Census Bureau, 2010 MaleFemale 10

11. Bexar County - Educational Attainment Population Source: U.S. Census Bureau, 2010 11

12. 2010 Household Income Bexar County Population Source: U.S. Census Bureau, 2010 12

13. Obesity in Bexar County One in 3 children Two in 3 adults ChildrenAdults Fitnessgram Data 2009-10 BRFSS 2010 13

14. Built Environmental Changes Safe roads, improved sidewalks & intersections by Public Works Walking trails, fitness stations at San Antonio Housing Authority locations Walking trails & fitness stations at libraries Fitness stations in parks Bike kiosks in downtown San Antonio 14

15. Changes to Make Roads and Intersections Safe ADA ramps - 361 sites in 17 locations Walkways' improvement in 10 locations Traffic calming measures in 9 locations Flashing beacons in 30 locations Traffic designs in 12 locations Traffic inventories in all 10 Council districts Ped signal improvements in 38 locations Cross walks in 33 locations Dynamic signs in 8 locations 15

16. Crosswalks, ADA Ramps, Traffic Calming Measures, Medians, Flashing Beacons, Ped Signals 16

17. Walking Improvement Dynamic Message Sign Crosswalk 17

18. Pedestrian Signal ADA Ramp Safe Routes to School 18

19. San Antonio Housing Authority Locations Walking trails and fitness stations in four locations Alazan Courts Lincoln Heights SpringView Cassiano 19

20. Walking Trails/Fitness Stations Alazon Cassiano 20

21. Walking trails/fitness stations 21

22. Fitness Stations & Walking Trails in Libraries Mission Library (both) Parman Library (both) Johnston Library (trail) Memorial Library (stations Oakwell Library (stations) 22

23. Mission Library 23

24. Changes in Parks Fitness equipment installed in 28 parks Trail Accessibility Information (TAI) posts -133 were installed in 31 parks 24

25. Fitness Equipment Stationary –Stretches, pushups, squats, core and balance exercises Movable – use body weight to do leg press, chest press, rowing machine, cardio walker. 25

26. Trail Assessment High Efficiency Trail Assessment Process (HETAP) used to assess trail characteristics Purpose: provide park users information regarding length, width, elevation, running slopes, surface type 101 miles assessed in 31 parks 26

27. HETAP AND TAI POST 27

28. The Trails Accessibility Information (TAI) includes the trail name, length, elevation change, permitted uses, grade, cross slope, width and surface type (TAI post example, right). Distance assessed 101 miles Number of parks 31 Number of TAI posts 133 28

29. Active Transportation-Bikes Aim: Provide active and alternate transportation and increase physical activity Result: Reduce number of cars on the streets, traffic congestion and parking problems, Improve air quality 29

30. Bike Share Program 30

31. Launched March 2011 Number of kiosks - 25 Annual memberships - 1328 Daily passes - 11,590 Total number of trips - 52,182 Average distance per trip - 4.1 miles Bike-Share Program 31

32. Increase Physical Activity Options in Target Areas Walking trails and easy to use fitness stations in public housing units in target areas with low income, seniors, and residents with disabilities Safe environment for free physical activity and walking and biking options Walking trails and fitness stations in parks and libraries provide easy access to methods of physical activity Bike lanes and kiosks encourage biking to work or for leisure. 32

33. San Antonio City Council passed COMPLETE STREETS POLICY on SEPT 29, 2011 COMPLETE STREETS POLICY on SEPT 29, 2011 http://www.sanantonio.gov/planning/regionalplanning/comp letestreets.aspx 33

34. Complete Streets Policy Definition A. Supports roadways that take into account all users, including people driving cars, using transit, riding bikes, walking, and using wheelchairs. B. Includes people of all ages and abilities, including children, older adults, and persons with disabilities. C. Considers the function of the road (e.g. local, collector, and arterial) and the level of vehicular, pedestrian, and bicycle traffic will be considered. D. Road type determined by land use adjacent to the road 34

35. Complete Streets 35

36. Benefits to the Residents and Neighborhoods Enhance choice of mobility–all modes of travel–bike, walk, car, bus Facilitate physical activity for daily needs–pedestrians, Bike Master Plan Improve quality of life, health and safety Neighborhood connectivity to benefit all members of the city 36

37. Acknowledgement With Thanks to John Berlanga, Senior Management Analyst, Metro Health Dr. Anil Mangla, Epidemiologist, Metro Health Jeremy Beer, Health Program Specialist, CPPW Dr. Isabela Lucas, Technical Consultant ICF Macro 37

38. For more information Mary Thomas, Senior Management Analyst, San Antonio Metropolitan Health District, San Antonio TX mary.thomas@sanantonio.gov 210 207 5371

39. Any Questions ? 39