Enhancing access to places for physical activity involves changes to local environments that create new opportunities for physical activity or reduce the cost of existing opportunities (e.g., creating walking trails, building exercise facilities, or providing access to existing nearby facilities). Increased access is typically achieved in a community through a multi-component strategy that includes training or education for participants1. Such efforts are often implemented in neighborhoods that have been structurally disadvantaged and under-resourced.
Expected Beneficial Outcomes (Rated)
Increased physical activity
Improved physical fitness
Other Potential Beneficial Outcomes
Reduced obesity rates
Reduced vehicle miles traveled
Evidence of Effectiveness
There is strong evidence that improving access to places for physical activity increases physical activity and improves physical fitness in urban, rural, and suburban areas1, 2, 3, 4, 5, 6. Access itself is also strongly associated with high levels of physical activity7. Among adolescents, access is associated with increased time spent in vigorous physical activity8, and lower obesity rates9.
A study of adolescents in military families associates moving to a neighborhood with more opportunities for physical activity with increased physical activity8. Temporary street closures to create safe spaces for physical activity can increase physical activity for participants both during the event and afterwards10. Individuals who meet physical activity recommendations and report vigorous exercise are more likely to use recreational facilities, compared to those who report light-to-moderate exercise11.
Increasing access to places for physical activity in conjunction with efforts to address quality, cleanliness, and any safety or security concerns of such facilities may be more effective over the long-term at increasing physical activity levels than increasing access alone4. Research suggests that considering all types of weather such as freezing temperatures and rain when implementing a plan to increase access to places for physical activity can improve the effectiveness of the plan, particularly in cold weather states12. Studies suggest adolescents may perceive a lack of age appropriate features, and sports fields, adventurous playgrounds, trails, and walking paths may encourage visitation of public open spaces and physical activity across several age groups13. To increase the appeal and perception of safety in places for physical activity, experts recommend spaces be well-maintained, appeal to males and females13, and include lighting, vegetation that facilitates open views, areas with street access and higher pedestrian activity, amenities like seating and drinking fountains, and features such as sculptures and food vendors14.
Overall, individuals with higher socio-economic status have been shown to have greater access to physical activity centers than those with lower socio-economic status15, 16. One study suggests physical activity is generally higher in neighborhoods with more recreational facilities, and highest among those with facility memberships; experts suggest efforts to reduce financial and social barriers to membership can increase access to places for physical activity for minorities and those with low incomes17. Among North Carolina middle school students, living in socioeconomically disadvantaged rural areas is also associated with fewer places for physical activity and higher rates of obesity18. One study of military veterans living in a metropolitan area suggests that access to parks and fitness facilities may not be enough to increase physical activity and weight status outcomes; some populations may need more than access alone to improve physical activity19.
Places for physical activity that increase opportunities for active transportation such as walking trails, bike paths, or rails to trails projects may replace automotive trips with biking and walking, which may reduce vehicle miles traveled (VMT) and greenhouse gas emissions that contribute to climate change20.
Impact on Disparities
National non-profit organizations work to increase access to places for physical activity in all 50 states, for example, Rails to Trails21, YMCAs22, JCCs23, the American Community Gardening Association24, the National Recreation and Park Association25, and American Trails26.
Efforts to increase access to places for physical activity are underway at the local, regional, and state level. Such efforts can be broad community initiatives that encompass policy, systems, and environmental changes, as in Hamilton County, OH27 or specific projects such as renovating and promoting the use of a high school track, as in the Yancey County Schools in Burnsville, NC28. As of 2014, Arkansas, California, Kansas, and Texas enacted legislation to enable or encourage shared use agreements for school facilities as one way to increase access to places for physical activity29. Recreational spaces for physical activity can be made available through shared use agreements with public entities, such as colleges, community and senior centers, military spaces, or other unused or underused public land, as well as with private entities such as faith-based organizations, hospitals, and housing, work, and retail developments30. Communities have also created new walking trails with fitness stations along the way, for example the Biser Fitness Trail in Gettysburg, PA31.
Cities with Play Streets programs temporarily close streets to create public, safe, and free spaces for active play10, often in partnership with non-profit organizations and city transportation departments, as in San Francisco and Seattle32, 33. The City of Berkeley, California, operates an outdoor adventure playground with activities designed for children ages seven and older34. The non-profit play:groundNYC operates a 50,000 square foot adventure playground on Governors Island in New York, and offers guidance to communities to establish playgrounds and play initiatives35.
Many state health departments participate in community-based coalitions to support efforts to increase access to places for physical activity, as in Texas36, Arkansas37, and Delaware38. Hawai`i has Healthy Eating and Active Living (HEAL) community coalitions active throughout its islands39. Other states have developed statewide plans to increase access to places for physical activity, as in Oregon40. California has also compiled strategies for local agencies to fund development and maintenance of parks and recreation facilities41.
WHO-E-Edwards 2008 - Edwards P, Tsouros AD. A healthy city is an active city: A physical activity planning guide. Copenhagen, DK: World Health Organization Europe (WHO-E); 2008.
CDC-Park HIA toolkit - Centers for Disease Control and Prevention (CDC). Healthy places: Parks and trails health impact assessment (HIA) toolkit.
CDC-Belza 2015 - Belza B, Allen P, Brown D, et al. Mall walking: A program resource guide. University of Washington Health Promotion Research Center (UW HPRC), Centers for Disease Control and Prevention (CDC); 2015.
ChangeLab-Winig 2013 - Winig B, Ackerman A, Gladstone E. This land is our land: A primer on public land ownership and opportunities for recreational access. ChangeLab Solutions; 2013.
CDC DNPAO-Data - Centers for Disease Control and Prevention (CDC), Division of Nutrition Physical Activity and Obesity (DNPAO). Nutrition, physical activity and obesity: Data, trends and maps online tool.
LHC-Rockeymoore 2014 - Rockeymoore M, Moscetti C, Fountain A. Rural childhood obesity prevention toolkit. Leadership for Healthy Communities (LHC), Center for Global Policy Solutions, Robert Wood Johnson Foundation; 2014.
HealthPartners-CHA - HealthPartners Institute for Education and Research. Community health advisor (CHA): Resource for information on the benefits of evidence-based policies and programs: Helping communities understand, analyze, and model costs.
HOST-PA - Healthy Out-of-School Time (HOST) Coalition. Resources: Physical activity (PA).
WeThrive-Toolbox - WeThrive!, Hamilton County Public Health. Toolbox and resources used as part of the WeThrive! initiative.
PAS-Zoning 2016 - Planning Advisory Service (PAS). Planning & zoning for health in the built environment. American Planning Association (APA); 2016.
US DHHS-Walkable communities 2015 - US Department of Health and Human Services (US DHHS). Step it up! The Surgeon General’s call to action to promote walking and walkable communities. Washington, DC: US Department of Health and Human Services, Office of the Surgeon General; 2015.
* Journal subscription may be required for access.
1 CG-Physical activity - The Guide to Community Preventive Services (The Community Guide). Physical activity.
2 Wolch 2011* - Wolch J, Jerrett M, Reynolds K, et al. Childhood obesity and proximity to urban parks and recreational resources: A longitudinal cohort study. Health & Place. 2011;17(1):207-14.
3 CDC MMWR-Khan 2009 - Khan LK, Sobush K, Keener D, et al. Recommended community strategies and measurements to prevent obesity in the United States. Morbidity and Mortality Weekly Report (MMWR). 2009;58(RR-07):1-26.
4 TRB 2005 - Committee on Physical Activity, Health, Transportation, and Land Use. Does the built environment influence physical activity? Examining the evidence. Washington, DC: Transportation Research Board (TRB), Institute of Medicine (IOM), National Academy of Sciences; 2005: TRB Special Report 282.
5 Cohen 2012 - Cohen DA, Marsh T, Williamson S, Golinelli D, McKenzie TL. Impact and cost-effectiveness of family fitness zones: A natural experiment in urban public parks. Health & Place. 2012;18(1):39-45.
6 ALR-Umstattd Meyer 2016 - Umstattd Meyer MR, Perry CK, Sumrall JC, et al. Physical activity-related policy and environmental strategies to prevent obesity in rural communities: A systematic review of the literature, 2002-2013. Preventing Chronic Disease. 2016;13(1):1-24.
7 Brownson 2006* - Brownson RC, Haire-Joshu D, Luke DA. Shaping the context of health: A review of environmental and policy approaches in the prevention of chronic diseases. Annual Review of Public Health. 2006;27:341-70.
8 Nicosia 2018* - Nicosia N, Datar A. Neighborhood environments and physical activity: A longitudinal study of adolescents in a natural experiment. American Journal of Preventive Medicine. 2018;54(5):671-678.
9 Dunton 2009 - Dunton GF, Kaplan J, Wolch J, Jerrett M, Reynolds KD. Physical environmental correlates of childhood obesity: A systematic review. Obesity Reviews. 2009;10(4):393-402.
10 Umstattd Meyer 2019 - Umstattd Meyer MR, Bridges CN, Schmid TL, Hecht AA, Pollack Porter KM. Systematic review of how Play Streets impact opportunities for active play, physical activity, neighborhoods, and communities. BMC Public Health. 2019;19(1):1-16.
11 Heinrich 2017 - Heinrich KM, Haddock CK, Jitnarin N, et al. Perceptions of important characteristics of physical activity facilities: Implications for engagement in walking, moderate and vigorous physical activity. Frontiers in Public Health. 2017;5:1-8.
12 Copeland 2011 - Copeland K, Sherman SN, Khoury JC, et al. Wide variability in physical activity environments and weather-related outdoor play policies in child care centers within a single county of Ohio. Archives of Pediatrics & Adolescent Medicine. 2011;165(5):435-42.
13 Van Hecke 2018* - Van Hecke L, Ghekiere A, Veitch J, et al. Public open space characteristics influencing adolescents’ use and physical activity: A systematic literature review of qualitative and quantitative studies. Health and Place. 2018;51:158-173.
14 ALR-Nasar 2015 - Nasar JL. Research Review: Creating places that promote physical activity: Perceiving is believing. Active Living Research (ALR); 2015.
15 ALR-Disparities 2011 - Active Living Research (ALR). Do all children have places to be active? Disparities in access to physical activity environments in racial and ethnic minority and lower-income communities. Princeton: Robert Wood Johnson Foundation (RWJF); 2011.
16 Gordon-Larsen 2006 - Gordon-Larsen P, Nelson MC, Page P, Popkin BM. Inequality in the built environment underlies key health disparities in physical activity and obesity. Pediatrics. 2006;117(2):417-24.
17 Kaufman 2019 - Kaufman TK, Rundle A, Neckerman KM, et al. Neighborhood recreation facilities and facility membership are jointly associated with objectively measured physical activity. Journal of Urban Health. 2019;96:570-582.
18 Edwards 2013* - Edwards MB, Bocarro JN, Kanters MA. Place disparities in supportive environments for extracurricular physical activity in North Carolina middle schools. Youth & Society. 2013;45(2):265-85.
19 Slater 2019* - Slater SJ, Tarlov E, Jones K, et al. Would increasing access to recreational places promote healthier weights and a healthier nation? Health and Place. 2019;56:127-134.
20 Salon 2012* - Salon D, Boarnet MG, Handy S, Spears S, Tal G. How do local actions affect VMT? A critical review of the empirical evidence. Transportation Research Part D: Transport and Environment. 2012;17(7):495-508.
21 RTC - Rails-to-Trails Conservancy (RTC). Inspiring movement.
22 YMCA-Fitness - Young Men’s Christian Association (YMCA). Health, well-being & fitness.
23 JCC-Fitness - Jewish Community Center Association (JCC), DiscoverJCC.com. Programs and services at JCCs of North America: Health & fitness.
24 ACGA-Find gardens - American Community Gardening Association (ACGA). Locate your nearest community garden.
25 NRPA-Impacting communities - National Recreation and Park Association (NRPA). Impacting communities: Health and wellness.
26 American Trails-Resources - American Trails, National Trails Training Partnership. Resources by state: Explore training, articles, organization, and agencies by state.
27 WeThrive-Community wellness - WeThrive!, Hamilton County Public Health. WeThrive! Community wellness in action.
28 AHRQ HCIE-Martin - Martin C. School system renovates high school track and promotes its availability to the community, leading to increased use by students and residents. Rockville: AHRQ Health Care Innovations Exchange.
29 NCSL Winterfeld 2014a - Winterfeld A. State actions to reduce and prevent childhood obesity in schools and communities: Summary and analysis of trends in legislation. National Conference of State Legislators (NCSL); 2014.
30 ChangeLab-Gladstone 2018 - Gladstone E. Shared Use Playbook. ChangeLab Solutions. 2018.
31 PA-Fitness trail - Borough of Gettysburg Pennsylvania (PA). Biser fitness trail and walking path located within the Gettysburg Regional Recreation Park.
32 Play Streets SF - Play Streets San Francisco (SF). What is Play Streets?
33 Seattle-Play Streets - Seattle Department of Transportation. Projects and Programs: Block parties and play streets.
34 Berkeley-Adventure Playground - City of Berkeley, CA. Marina-Berkeley Waterfront: Adventure Playground.
35 play:groundNYC - play:groundNYC. Transforming our city through play.
36 TX DSHS-Walking trail - Texas Department of State Health Services (TX DSHS), Chronic Disease, Community & Worksite Wellness Program. How to build a walking trail.
37 ADH-ARCOP - Arkansas Department of Health (ADH). Arkansas Coalition for Obesity Prevention (ARCOP).
38 DE DHHS-PANO - Delaware Department of Health and Social Services (DE DHSS). The Physical Activity, Nutrition, and Obesity Prevention Program (PANO).
39 HIPHI-HEAL - Hawai`I Public Health Institute (HIPHI). Healthy Eating and Active Living (HEAL). Community Coalitions.
40 NCO-OR PA plan - Nutrition Council of Oregon (NCO), Oregon Coalition for Promoting Physical Activity, Oregon Department of Human Services Physical Activity and Nutrition Program. A healthy active Oregon: Statewide physical activity and nutrition plan 2007-2012 (OR PA plan).
41 ChangeLab-Complete parks 2017 - ChangeLab Solutions. Funding complete parks: Strategies for local public agencies in California. 2017.
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