A Look Inside New York’s “Active Design” Initiative to Fight Obesity

Bloomberg has tackled New Yorkers’ health and fitness one step at a time. His latest mission is to promote the use of stairs in order to ensure that people make physical activity a regular part of their daily routines.
A Look Inside New York’s “Active Design” Initiative to Fight Obesity

As New Yorkers power through a crippling heat wave, the last thing on their minds when they finally enter an air-conditioned building is sprinting up a flight of stairs. But, if Bloomberg has any say in the matter, elevators may soon go out of style.

In the past 12 years, the NYC mayor has ordered food chains to post calorie counts, banned the use of trans fat in restaurants, banned smoking in many public places, and tried to stop the sale of oversized cups of soda. Now, with just a few weeks left in office, he’s issued orders and proposed legislation designed to make staircases more visible and accessible in city buildings. His goal is to see New Yorkers sweat — essentially, to make exercise a bigger part of daily activity.

What’s the Deal?

Some of Bloomberg’s proposed strategies for getting people to use the stairs are simple, such as tacking up signs near elevators that encourage people to hoof it instead. Bloomberg also announced that the Center for Active Design, a nonprofit organization based at The New School, in New York, will lead efforts to create buildings that promote physical activity. Some potential strategies include making sure stairs are clean, well lit, and completely visible.

These recommendations are based on the city’s Active Design Guidelines, issued in 2010, which help city planners figure out how the environment can encourage a healthy lifestyle Developing and implementing the Active Design Guidelines in New York City. Lee, K.K. Built Environment Program. New York City Department of Health and Mental Hygiene. Queens, NY, USA. Health Place 2012 Jan;18(1):5-7.. Bloomberg’s campaign to increase stair usage is one step in making those guidelines applicable to daily life.

Why It Matters

In the wake of rising obesity rates (as of 2012, 36 percent of U.S. adults were obese), city governments across the U.S. have tried to implement different policies that motivate people to get their daily dose of physical activity. The idea is to make exercise accessible to everyone, even if they don’t hit the gym for an hour every day. Most of these efforts have focused on making cities more conducive to walking and biking instead of driving everywhere Active Seattle: achieving walkability in diverse neighborhoods. Deehr, R.C., Schumann, A. Public Health/Seattle and King County, Seattle, Washington, USA. American Journal of Preventive Medicine 2009 Dec;37(6 Suppl 2):S403-11. Get Active Orlando: changing the built environment to increase physical activity. McCreedy, M., Leslie, J.G. City of Orlando, Orlando, Florida, USA. American Journal of Preventive Medicine 2009 Dec;37(6 Suppl 2):S395-402. Achieving built-environment and active living goals through Music City Moves. Omishakin, A.A., Carlat, J.L., Hornsby, S., et al. Metro Planning Department, Nashville, Tennessee, USA. American Journal of Preventive Medicine 2009 Dec;37(6 Suppl 2):S412-9..

Bloomberg’s specific focus on stair usage may be the key to his success. There’s a lot of evidence that, in buildings where stairways are visible and accessible, people are more likely to use them Spatial measures associated with stair use. Nicoll, G. Department of Architectural Science, Ryerson University, Toronto, Ontario, Canada. American Journal of Health Promotion 2007 Mar-Apr;21(4 Suppl):346-52.. Moreover, research suggests that sometimes it’s less about making structural changes in the environment and more about changing people’s perception of their environment Correlates of non-concordance between perceived and objective measures of walkability. Gebel, K., Bauman, A., Owen, N. Cluster for Physical Activity and Health, School of Public Health, University of Sydney, Sydney, Australia. Annals of Behavioral Medicine 2009 Apr;37(2):228-38. Mismatch between perceived and objectively assessed neighborhood walkability attributes: prospective relationships with walking and weight gain. Gebel, K., Bauman, A.E., Sugiyama, T., et al. Prevention Research Collaboration, School of Public Health, University of Sydney, Australia. Health Place 2011 Mar;17(2):519-24.. So a simple strategy such as placing motivational signs near stairways and elevators may be highly effective in getting people to take the stairs more often Point-of-decision prompts to increase stair use. A systematic review update. Soler, R.E., Leeks, K.D., Buchanan, L.R., et al. National Center for Health Marketing, CDC, Atlanta, Georgia, USA. American Journal of Preventive Medicine 2010 Feb;38(2 Suppl):S292-300. The effects of signage and the physical environment on stair usage. Bungum, T., Meacham, M., Truax, N. Department of Environmental and Occupational Health, University of Nevada, Lass Vegas, NV, USA. Journal of Physical Activity and Health 2007 Jul;4(3):237-44. Six-month observational study of prompted stair climbing. Kerr, J., Eves, F., Carroll, D. School of Sport and Exercise Sciences, Birmingham, United Kingdom. Preventive Medicine 2001 Nov;33(5):422-7..

The only remaining question is what will define “success” for Bloomberg and the Active Design team. If the goal is to get people moving more, the mayor is on the right track. The benefits of walking, even just a little bit more every day, include lower blood pressure, lower cholesterol, and a reduced risk of diabetes and cardiovascular disease Walking versus running for hypertension, cholesterol, and diabetes mellitus risk reduction. Williams, P.T., Thompson, P.D. Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA. Arteriosclerosis, thrombosis, and vascular biology 2013 May;33(5):1085-91.. But research suggests that getting people to take the stairs more often won’t do much to help them lose weight and reduce obesity rates ‘Take the stairs instead of the escalator’: effect of environmental prompts on community stair use and implications for a national ‘Small Steps’ campaign. Dolan, M.S., Weiss, L.A., Lewis, R.A., et al. University of Pennsylvania School of Medicine, Philadelphia, PA, USA. Obesity Reviews 2006 Feb;7(1):25-32..

Overall, the mayor’s efforts may be a great way to encourage people to incorporate more physical activity into their daily lives. After all, one healthier choice, such as swapping the stairs for the elevator, may lead to others. At the very least, it’s a comfort to know we may actually get to work faster on foot.

Do you think Bloomberg’s efforts to promote stair use will actually get people exercising more? Let us know in the comments below or tweet the author at @ShanaDLebowitz.

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