Barriers to Optimizing Investments in the Built Environment to Reduce Youth Obesity: Policy-Maker Perspectives (Qualitative Research) (Report‪)‬

Canadian researchers and policy-makers recognize increasing levels of overweight and obesity as creating a health crisis that requires macro-level policy changes. (1-3) Since eastern provinces have the highest rates of overweight and obesity in the country, (4) the issue proves especially salient for provincial and local governments in Atlantic Canada. Studies of children and youth in grades 3, 7, and 11 in Nova Scotia showed that participants in 2005/06 were less physically active than those in 2001/02. As well, students in grade 11 were significantly less active than those in grade 7, who were in turn significantly less active than those in grade 3. (5,6) Although physical activity levels revealed no significant differences between children in BMI weight categories, (7) income levels and dietary habits did influence weight status. (8) As policymakers increasingly adopt a social ecological model to understand the multiple and interacting factors that influence health, (9-11) they are casting their nets widely for strategies and interventions to address the problem of growing levels of overweight and obesity. (12) Since the early 2000s, community design theory has argued that patterns in the built environment (such as the mix of land uses) affect physical activity rates in ways that may influence obesity outcomes. (13-15) Although empirical tests show mixed results about the significance of urban form on activity and weight, (16-19) policymakers have begun to ask whether strategic investments in infrastructure and community amenities may offer positive health impacts. Governments invest vast amounts annually into facilities and infrastructure improvements. In the context of the crisis of growing obesity rates, governments want to determine whether they can optimize investments to improve health outcomes.