Where the rubber
hits the road
Strategies, successes, and
lessons learned in
completing the streets of
the Puget Sound region
Cascade Bicycle Club + Public Health –
Seattle & King County + City of Burien
Presenters
• Kadie Bell Sata, (formerly) Public Health –
Seattle & King County
• Tessa Greegor, Cascade Bicycle Club
• Max Hepp-Buchanan, Cascade Bicycle Club
• Dori Babcock, (formerly) City of Burien
Presentation Outline
• Introduction to Communities Putting
Prevention to Work (CPPW)
• Role of Public Health in CPPW and
Complete Streets
• Introduction to Cascade Bicycle Club
• Previous Complete Streets work
Presentation Outline
• Role of Cascade in CPPW and
Complete Streets
• Case study: City of Burien
• The road ahead: Puget Sound region
and beyond
Communities Putting
Prevention to Work
• $15m grant funding from the Centers
For Disease Control and Prevention
(CDC) to Public Health – Seattle &
King County
• Objective to lower obesity rates and
reduce health disparities (largest in
the nation)
Communities Putting
Prevention to Work
• Several areas of intervention: PE
curriculum, healthy foods in cafeterias,
soda tax, safe routes to schools,
healthy food access, land use, joint
use agreements, access to recreation,
etc.
1999
Obesity Trends* Among U.S. Adults
BRFSS, 1990, 1999, 2009
(*BMI 30, or about 30 lbs. overweight for 5’4” person)
2009 1990
Obesity Trends* Among U.S. Adults
BRFSS, 1985
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 1986
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 1987
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 1988
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 1989
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 1990
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 1991
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 1992
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 1993
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 1994
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 1995
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 1996
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 1997
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 1998
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 1999
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 2000
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 2001
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 2002
Obesity Trends* Among U.S. Adults
BRFSS, 2003
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 2004
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 2005
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 2006
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 2007
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 2008
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 2009
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity in King County
• 1 in 5 youth in King County is overweight or
obese
• Although steady since 2004, youth obesity
rates remain unacceptably high
• Rates are highest among males, youth of
color and those in south King County
• Obesity in childhood is likely to continue into
adulthood, and increases the risk for
Disparities in Childhood
Obesity in King County
National Attention Turns
to Obesity Prevention
• In 2008, the annual healthcare cost of
obesity in the US was estimated to be
as high as 147 billion dollars a year,
double the amount a decade ago
• Annual medical expenses for the
obese are estimated to be 42%
higher than for a person of a healthy
National Attention Turns
to Obesity Prevention
• Affordable Care Act expands
healthcare access to 30 million
Americans
Communities Putting
Prevention to Work
“A historic commitment to wellness
initiatives will keep millions of
Americans from setting foot in
the doctor's office in the first
place -- because these are
preventable diseases and we're
going to invest in prevention.”
– President Barack Obama,
$2.2 Trillion Spent in 2007
Health
Behaviors
50%
Environment
20%
Access to Care 10%
Genetics
20%
Prevention 4%
Medical
Services
96%
Factors Influencing
Health
National
Health
Expenditures
SOURCE: CDC, Blue Sky Initiative, University of California at San Francisco, Institute of the Future, 2000Factors that Affect Health
Examples
Eat healthy, be
physically active
Rx for high blood
pressure, high
cholesterol, diabetes
Poverty, education,
housing, inequality
Immunizations, brief
intervention, cessation
treatment, colonoscopy
Fluoridation, 0g trans
fat, iodization,
smoke-free laws, tobacco tax
Socioeconomic Factors
*And Racism
Changing the Context
to make individuals’ default
decisions healthy
Long-lasting
Protective Interventions
Clinical
Interventions
Counseling
& Education
Smallest
Impact
Largest
Impact
Changing the Context
with Complete Streets
Making the healthy choice (walking,
Intro to Cascade
Bicycle Club
• Non-profit organization serving
14,000 members & the Puget
Sound bicycling community
• Mission: to Create a Better
Community Through Bicycling
• Advocacy, Policy & Planning,
Previous Complete
Streets Work
• Since 2007, Cascade has worked with
communities across the central Puget
Sound region to develop, adopt &
implement Complete Streets ordinances
• First ordinance adopted in Kirkland, WA
(2007)
• 19 jurisdictions have a Complete Streets
policy (WA)
Complete Streets
Central Puget
Sound Region
The Impact
Planned Complete Streets Project (Before)
Linden Ave, Seattle
The Impact
Planned Complete Streets Project (After)
Linden Ave, Seattle
The Impact
Complete Streets Project (Before)
Sedro Wooley, Washington
The Impact
Complete Streets Project (After)
Sedro Wooley, Washington
Role of Cascade in
CPPW
• 6 focus jurisdictions in King County
– Communities with high rates of health
disparities
– Burien, SeaTac, Des Moines, Snoqualmie,
Federal Way & Kent
• To provide technical guidance and
education around the adoption of
active transportation policies
Role of Cascade in
CPPW
• Complete Streets
– Best practices for policy & design
– Case studies
• Multimodal Level of Service
– Bicycle, Transit and Pedestrian LOS
models
– Local examples
– Focus tool: 2010 Highway Capacity
Manual (integrated MMLOS
framework)
Integrated Multimodal LOS Framework (2010 HCM) User Type AM PK Hr PM PK Hr Auto C E Transit B C Bicycle D C Pedestrian C D
Role of Cascade in
CPPW
• Non-motorized Transportation
Project Prioritization Methodologies
– Tools for quantifying and prioritizing
non-motorized projects based on health,
safety, environment, mobility & equity
benefits
– Focus tool: King County Transportation
Programming Tool
Transportation Programming Tool Examples
Total Score
Demand (Net Residential Density)
Workshops
• Conducted 13 workshops
• Key participants
– City staff (Public Works, Planning,
Community & Economic Development)
– Elected Officials
– Local advocates and community
stakeholders, residents
Guides
• Developed and distributed
3 comprehensive user
guides on each key
policy/planning topic
Ongoing Support
• Continue to serve as a technical
resource for each community
around active transportation plans,
policies and infrastructure designs
• Provide community engagement to
Ongoing support:
Role of Cascade in
CPPW
Education of the community
Education of city staff
Education of elected officials
Holding elected officials
Holding Elected
Officials Accountable
• Where the education of the
community comes full-circle
• Organization of residents to ensure
elected officials do what they say
they are going to do
Holding Elected
Officials Accountable
• Letter writing/email campaign
• Lobby meetings
• Testimony at public hearings
• Publicly “thank” or “spank”
• Population: 47,000
• Most diverse community within Washington state
Case Study: City of Burien
King
County Des Moines Burien/ SeaTac/ Tukwila Bellevue Mercer