Community design and policies for free-range children: creating environments that support routine physical activity.

Growing concern over childhood obesity has prompted a focus on underlying epidemics of physical inactivity and poor nutrition. Regarding the former, there is increasing understanding that behavior change promotion alone has not increased population physical activity levels and that an ecological approach is necessary. Therefore, the public health profession has moved beyond traditional behavior change campaigns toward a growing focus on altering policies and the built environment to create settings that support increases in routine, not just exercise or leisure time, physical activity among children. A survey of the literature suggests four broad factors that define settings where routine physical activity, especially active transportation, is more likely to occur: • a compact variety of land uses, with a mix of destinations in close proximity; • a comprehensive network of bicycle, pedestrian, and transit facilities; • inviting and functional site designs for pedestrians, cyclists, and transit users; • safety and access for users of all ages, incomes, abilities and disabilities. Although these principles are increasingly accepted as beneficial, not just to health but to a community's economic, environmental, and social well-being, many contemporary ordinances and development practices undermine these outcomes. Therefore, five specific policy and intervention approaches are recommended to guide communities to these outcomes: 1. zoning and development policies to protect open space, contain sprawl, and focus investment toward thriving, mixed downtowns and village centers; 2. Complete Streets policies, which require roadways that are safe and functional for pedestrians, bicyclists, and transit users, as well as motor vehicles; 3. a transportation- (not just recreation-) oriented trail network; 4. creation of bicycle- and transit-friendly infrastructure and incentive policies; 5. development of policy-based Safe Routes to School interventions. This proposed intervention framework requires evaluation both of effectiveness in increasing childhood physical activity and of the most promising means of getting policies implemented.