Chronic diseases and health promotion

Part Four - Taking action: essential steps for success

Chapter One: Providing a unifying framework - the role of government

The built environment. Spotlight: India

As reviewed in Part Three, built environment interventions have considerable potential to increase physical activity patterns. Urban design can positively influence walking, cycling and other forms of active transport. Specific built environment interventions, such as the following, have considerable potential to increase physical activity patterns:

  • provision of easily accessible, well-lit stairs in multi-story buildings;
  • provision of cycle and walking paths in urban and rural communities;
  • provision of accessible sports, fitness and recreation facilities;
  • increased compact urban design rather than urban sprawl.
Implementation steps and suggested milestones

STEP 1 CORE: Leaders and decision-makers in urban design and transport sectors are informed of the impact that design and transport can have on physical activity patterns and chronic diseases.

STEP 2 EXPANDED: Built environment and transport planning, design and construction decisions incorporate physical activity components.

STEP 3 DESIRABLE: Future urban planning, transport design and construction of new buildings are conducive to active transport and physical activity.

Spotlight: Improving the built environment in India

In Chennai, India, the prevalence of diabetes is particularly high among middle income residents and people who undertake little physical activity. Realizing the importance of physical activity, residents mobilized resources from philanthropists and collected donations from residents to construct a park. A piece of land was identified and the local municipality was approached for building permission. The construction of the park was completed in 2002, with bushes, trees, fountains and a play area for children. The residents contribute a nominal annual fee for maintenance of the park.

A follow-up survey showed that there was a threefold increase in people undertaking regular physical activity (from less than 15% to 45%). Based on this success story, which was extensively reported in the local newspapers, another community in Chennai has also built a park (Mohan V, Shanthirani CS, Deepa R. Glucose intolerance (diabetes and IGT) in a selected south Indian population with special reference to family history, obesity and life style factors – The Chennai Urban Population Study (CUPS 14). Journal of the Association of Physicians of India, 2003, 51:771–777).