Ken Rose Active Towns Podcast Episode Interview Transcription

Note: This is a software derived transcription of the podcast episode audio file and has not yet gone through final editing, so please ignore any typos or punctuation challenges

John: Ken, it's so wonderful to connect with you here today. Welcome to the Active Towns Podcast.

Ken: Thanks for having me. I really appreciate it. It's an honor to be able to talk to folks who care so much about this work.

John: Thank you. Yes, absolutely - ditto. And to get us started. Just share a little bit about yourself and your role there at the Centers for Disease Control and Prevention. I always like to make sure that we include the prevention part.

Ken: Yeah. I currently lead the Physical Activity and Health Program at the U S Centers for Disease Control and Prevention. We run a national initiative called Active People, Healthy Nation. My particular scientific expertise is in how the built environment can help people integrate physical activity into their daily lives.
So put another way it's how can the places that we live provide safe and easy choices to be physically active going for a walk or taking a bike someplace.

John: Fantastic. And when you look at your branch and the activities that you're doing obviously the Active People in Healthy Nation Initiative is a big part of that. Can you tell us a little bit more about that?

Ken: Yeah. And I should have started by saying we also run the national initiative called Active People, Healthy Nation. We announced that publicly in January of 2020 and it is a national initiative to get. 27 million people, more physically active by 2027. And our goal is to promote evidence-based strategies to increase physical activity or what I like to call strategies that work.

To do that, we have to build a national movement of culture change that really embraces the incredible benefits of physical activity and helps build the cultural support for those strategies. We're working to engage many different sectors at multiple geographic levels through partnerships between sectors, say the public health sector and the land use and transportation sector or the public health sector and the parks and rec sector and so forth.

So we know that for us to be successful to create this national movement, we have to really implement these evidence-based strategies that we have at every level, the local level, the tribal level, the state level, the national level, and to reach our goal of 27 million more people physically active by 2027.
We're going to have to increase or encourage approaches that specifically address equitable and inclusive access, regardless of age, race, education, socioeconomic status, disability status, and so forth. So to be successful to get to 27 million more people we have got to address the inequities in our society that prevent people from being physically active.

John: And I know looking at some of the wonderful PDF documents that you have out on the website there's statistics out there like access to parks and things of that nature where that's part of what you're talking about with that. And the inequities there.

Ken: There's a dramatic inequity across the board in communities impacted by health equity. When you look at these, the access issues, it's not just access to parks. It's as you probably know, a four-lane arterials dangerous roads in a range of other barriers that exist in, neighborhoods that are impacted by health equity.

John: So one of the favorite quotes that I pulled off of some of your materials out there is actually from your division director Dr. Ruth Peterson. And she says if you could package physical activity into a pill, It would be the most effective drug on the market. And so I think that actually partially answers my next question for you, which is why is this work important?

Ken: I'd love to talk about this because most people know that physical activity is good for them, but they don't really know how good it is for them. And your quote is a good one. It's a one that. It really personifies the benefits of physical activity, but it is really important to know that physical activity is one of the best things that you can do for your health today.

And almost anyone can go out today for a short walk or short roll. And so it is something that you can do today to promote your own health. When people are physically active, they receive immediate and long-term health benefits. So immediately physical activity can improve sleep quality, reduce symptoms of anxiety and reduce blood pressure.

Going for a single walk today Is really a great way to improve your health and if you can improve your anxiety, reduce your blood pressure and improve your sleep, then you're going to see other concomitant or associated benefits to your health. So we all know, for example, that sleep quality in and of itself is important to your health.

So if you can do something that improves your sleep quality, then you're getting a double bang for your buck. So over the longer term physical activity has profound impacts on chronic diseases like diabetes, like heart disease several different types of cancers. And so it not only helps prevent those chronic diseases.

It helps people who have them manage them. And if you go online, you'll see story after story of people where physical activity has had an impact on the management of their conditions that is consistent with other types of treatment. I should also note that it is really important to note that.

Over the longer term physical activity also improves brain health and reduces symptoms of cognitive decline. And when you look at that field and you look at the interventions or the prevention strategies that are available, there are really very few. And so physical activity is really an important component of brain health and cognitive health is as people age. And then for younger folks physical activity actually increases academic achievement. And then when you go to the other end of the age range, it reduces falls and adults. So you're getting bookends on both sides of that, where obviously academic achievements are essential and important to young people and reducing falls in older adults is also a really important not only quality of life strategy, but healthcare cost strategy as well. I should also note that in addition emerging data on COVID-19 and physical activity are showing that physical inactivity and that means getting no physical activity at all. So doing nothing beyond what you need to do to get through your daily lives, showing. Inactivity is an important risk factor for severe COVID-19 complications or outcomes.
So one study that was recently released analyzing Kaiser data from California. It showed that adults who reported meeting aerobic, physical activity guidelines, which I'll talk about in a minute of about 150 minutes of moderate physical activity week had less severe COVID 19 outcome.

And so people who did some weekly activity, even if they didn't meet our guidelines also had less severe outcomes. And so when you looked at what was the single one of the single most modifiable risk factors, something that you could do today to reduce your risk for severe COVID outcomes? Physical inactivity came to the top of the list.

So going from doing nothing to doing something. When people ask and I'm going to talk a little bit about what we mean by what you need for benefits to physical activity or how much do you need to accrue benefits. So when people ask how much physical activity you need, the answer, is it really any amount of physical activity is good for you?

But over time, some physical activity is better than none, of course, but you get even greater health benefits when you meet the federal guidelines. We have published what we call the second edition of the Physical Activity Guidelines for Americans.

Everything I'll say here is, contained in much more detail in that document. And if you want to dig deeper, I would just Google Second Edition Physical Activity Guidelines for Americans. Or if you have show notes, I can drop those, drop that link to you later.

John: Yep.

Ken: What they say is adults need to get about 150 minutes of moderate intensity physical activity for a per week.

So that's just going for a walk and getting your breathing rate up a little bit. And it isn't really that intense. It's just going for a brisk walk fast enough to get the breathing rate up. if you really ambitious and you just want to get out there and be vigorous and get the heart rate up quite a bit, then just 90 minutes a week is enough. But, the thing to note here is it doesn't really matter how you do it. You can do it any way you want. You could go out for 15, 10 minute walks. Or you could go out for one 150 minute moderate bike ride.

The point that the guidelines communicate is that you can do it however you want. The important thing is just to get out and do it in some form or fashion. I also want to say that it is important to note that we have data that show that when you create or modify environments to make it easier for people to walk or take a bike or use public transit usually have to walk too. So that's why it's important or visit parks. We know that it helps to increase physical activity across the population. So it makes sense that making it easier for people to be active in their communities also increases physical activity and their communities.

And so this can be done by connecting ways to walk, bike, or take transit as I said to everyday destination. So such as schools, shops, parks places of worship and at the CDC, we call this concept or this strategy Activity, Friendly Routes to Everyday Destinations.

John: Love it

Ken: And it is something that we invest all our programmatic resources in, when it comes to promoting physical activity.

So I should also say that research also shows that these strategies to invest in Activity Friendly Routes to Everyday Destinations can improve local economies can increase employment opportunities, can support neighborhood revitalization and improve safety. And we'd be happy to talk about those if you'd like, but that's, I think just a kind of a quick snapshot of why we're so excited about physical activity, because it is such an amazing way to improve your health and your quality of life

John: Yeah. And I'd like to amplify just a couple of things I heard there is that when we think of physical activity, oftentimes we think of hard workouts and exercise. So the fact that you really made a point of saying that, Hey, even low to moderate levels of physical activity, help.

And even at fairly, incredibly small amounts can actually help improve if you're not physically active now. So that's, that was one thing I wanted to amplify and reinforce for the audience. And the other thing that I really liked what you were mentioning there was you really highlighted some of the short-term benefits as well long-term benefits. We can sometimes think back to, especially when we get diseased focused, we look at our chronic diseases but the point being, and you made this point is that there is immediate benefits of being able to just get out and get moving. And the final thing that I wanted to amplify here and we'll pivot and talk about this a little bit is that you, brought up the fact that with the. Activity Friendly Routes to Everyday Destinations that there's some partnerships that are happening here. Cause obviously that is. Frequently stuff that's beyond the control of any one individual.

So let's talk a little bit about those types of partnerships that you're working with and how, other people can think about helping to improve the environment within their cities.

Ken: Yeah, so. I do just really want to reinforce that any level of physical activity is good for you and these immediate benefits are benefits that people don't normally associate with physical activity. And so particularly in the stressful times we experienced it is something that you can do today to manage stress. Just reinforce that

John: One thing real quick? Can I just say that I think one of the things that we've seen with the pandemic happening is just the explosion of people. Getting outdoors and getting at least here in Austin, Texas, and our neighborhood, we've seen at least a 10 fold increase in the number of people walking and biking in the neighborhood.

And I think a big part of that was an epiphany with a lot of people that there is that immediate short-term direct connection to. I feel better. I need to get out and get some activity in. So in the midst of a devastating, negative things, such as a pandemic from a behavior change perspective.

I was like, whoa this is reinforcing that connection that you're just talking about right there.

Ken: Yeah, we actually did some information collection national survey of folks last summer. 2020 to get a sense of what people were doing from a physical activity perspective. And while it was just a snapshot in time it did reveal interesting results that some proportions of the population were more physical activity than they did before the pandemic. And some proportions of the population we're getting less physical activity than they did before the pandemic. So I think what we saw at least in that one snapshot is a, mixed picture of what was occurring.

And probably it's just important to note everything that we do from the perspective of increasing access for physical activity, it's important to note that we need to do that from an equitable perspective.

And I think to talk about our concept of Activity, Friendly Routes to Everyday Destinations it does need to be started in underpinned with this need to address the inequitable health impacts in the United States, at least that we see in specific places. And so with our work, at least from CDC, we do focus and ask folks that we work with to focus on, as I said earlier, health equity strategies. We do work from CDC's perspective in supporting this concept called Activity Friendly Routes to Everyday Destinations. I do want to acknowledge, and I'll talk a little bit later if I get a chance about other strategies that have credible evidence of effectiveness for increasing physical activity.

I think it is important to note that Active People, Healthy Nation recognizes seven strategies. And our work at CDC and what we support in the field. We primarily support this concept that we call Activity Friendly Routes to Everyday Destinations, which is one of those strategy. But it's an important strategy.
I noted because there's evidence that it has population level impact. And we invest in that strategy because of it's credible scientific evidence of effectiveness, but also what we call scientific power or its impact in the field has the ability to change population levels of physical activity.

And that means that we have to create places for people to be active. And so as I said, bike paths and sidewalks to grocery stores, health clinics, shops, houses of worship and so forth. And we support it because we know it works. Now, I'm going to talk a little bit about what we do within our division and how we support this work within the United States.

I work for part of the U S Centers for Disease Control and Prevention called the Division of Nutrition, Physical Activity and Obesity. And we do exactly what that title implies that we would do. We promote improved nutrition strategies, such as breastfeeding and better food access for older Populations and then we support physical activity on the other side.

So everything I'm going to talk about now has to do with what we support from the physical activity perspective. But we provide funding and technical support to state health departments throughout the country to work in local communities and their states. We fund land grant universities to work through cooperative extension service.

In rural counties with obesity rates with 40% or more. And then we work through community organizations through a program we call a Racial and Ethnic Approaches to Community Health. As I said, they all work in places that are impacted by health equity, but that is different depending on the community that you're in.
And they range in diversity from working in small town, or rural environments to working in suburban areas, to working in neighborhoods within large cities. And they work in a wide range of activities to support this strategy. And as some examples they're working to yield permanent changes like supporting the development of a community-wide bicycle or pedestrian plan or looking at the implementation of a complete streets policy. At the local level or increasing safety and access around transit stops or supporting changes to land use and zoning that increase access to destinations by reducing travel distances.

So the other thing I would say is that our work is not building things. We're not building streets, we're not laying concrete or anything. We're supporting health partners in the field to do the, what I call the soft engagement, the management costs or the community engagement costs, local levels. So for example, in Savannah Georgia, one of our recipients is supporting the community engagement and planning for a project they call Tide to Town, which is a project that is designed to create a network of protected walking and bicycling trails connecting all of the neighborhoods in Savannah, really.

Important project. As another example, we're working on a similar effort in Cleveland, Ohio to do protected bike lane or a protected bike way I should say, and network across their city. And then the third is supporting the planning and community engagement for implementing main street complete street in a small town in the state of Washington. So it ranges the gamut and geography, but it's similar in the type of work that supporting the local level, bringing non-traditional partners to the table to support our goals and Active People Healthy Nation.

John: I think that's so incredibly important to have that. Partnership involved with those groups, those local groups that are out there having been involved with us for pretty actively for the last 15 years, I can tell you that the communities need that additional backdrop that, that backstop credible assistance to be able to move some of these projects forward. And I'm glad you gave the Tide to Town folks, a shout out there in Savannah. I know them, and I know that would be a wonderful community, asset activity asset for that entire region. And that's really good stuff.

And you're exactly right. You're not going to be Directly involved with the building of stuff, but reinforcing the powerful data that is behind what we know about physical activity helps bring the relevance to why those other entities, have everybody kind of heading in the right direction in terms of making it safer for people to have Activity Friendly Routes to Everyday Destinations those safe places, those safe routes. One of the things that I thought of too, when you mentioned that the data showed that we saw some getting in less activity during this time and what immediately my brainwaves was my partner, Laura, because she would previously she was riding her bike to work every day. Suddenly that commute was gone and it affected me too, because I work here, from home, but I would actually ride my bike with her to work and then back in the morning, so that I got my commute in, even though I'm working from home.
And so I found myself having to be very intentional about getting out the door breaking away from the video editing and the podcast editing and get out for a walk in the neighborhood. I do grocery shop by bike making sure that I buy fresh vegetables and produce in small amounts.
So I'm making multiple trips out there because we missed our commute. So we're excited that she's back to riding her bike to work frequently. So that's a good thing.

You can relate to right? ,

Ken: It was an interesting experience for me too, because I also have been a bicycle commuter personally. And it's fairly long commute. And I was in the same place and I actually had to make a conscious decision to go out for a walk every evening.

And one of the ways I did that and it's, and I'm fortunate to live in a place that does have what we call Activity Friendly Routes to Everyday Destinations and similiar to you, the way I did this, as I took a walk every evening and I made a point to stop by a local store as part of that walk.

And so I would always have something I needed to pick up there, but I also made myself walk the in my case, because I'm a physical activity person and I should do this, I should model practice what I preach. So I was walking five miles a day to do this and it seems like that takes a lot of time if somebody were to say to me, before that, you should go walk five miles a day, five days a week and integrate it into your daily life. That's really hard to do. I don't think I can do that. And it was interesting because it wasn't didn't happen overnight. I started with two or three miles but ultimately I got into this routine and I didn't notice it just seemed to be part of the daily ritual and it really helped me a lot.
Just negotiate everything we that we've had to negotiate and our roles at CDC.

John: What's great about what you just said. There is that a bit answers? Partly my next question for you. Because in both of our cases, we needed to think about it more. We needed to be more intentional about it. And so what are some of the other reasons why so many people are inactive?

Ken: Yeah. I So I'm going to talk a little bit about the data here, just so folks understand what the data, at least in the United States is. So when you look at the data, people generally know that physical activity is good for them. So this is not an issue generally speaking, that people don't know that they should be active. I think people do know. But nonetheless we don't get the amount of physical activity that is recommended in the Second Edition that I mentioned earlier, the Physical Activity Guidelines for Americans. We recommend, as I said, 150 minutes a week of moderate intensity, aerobic, physical activity, and for kids to get 60 minutes of moderate to vigorous activity, I should also say.

To fully meet guidelines. We also recommend that adults get two days of strength building exercise a week and for adolescents get three days in. And that can really just be working the major muscle groups. we're not talking about going to a gym and lifting heavy weights or anything.
It's doing stuff that's manageable within your own personal perspective. But the unfortunate reality is that very few people report meeting all of these guidelines. Only about one in four US adults meets fully meets physical activity recommendations that I just mentioned. And one in six high school students reports meeting these guidelines.

And what's worse is that recently published data collected before the pandemic shows that rates are falling for high school students. So I think we do have really an issue in this country with youth physical activity . And then when you look at the data from the perspective of demographics populations with low income people who are black or Hispanic and residents of rural areas have comparatively lower rates of physical activity.

And so when you look at inequities, those are places where you will see health disparities. And when you ask people. Why they aren't or why they don't get the physical activity they need, or why are they depending on where they are, why they are inactive it, generally they respond by saying I don't have enough time to do it.

Or, and, or I don't have safe places to be active. Just as a bit of reporting some of the data that are associated with Why, I'll talk a little bit about just safe places to be active. So as I said we want to be focused on those disparities. And when you ask about barriers that say traffic pose for people being active, we've learned from national data collection.

These are just a few data points. Only one in five black people have access to streets that make walking safe and easy and have access to safe and convenient locations that support walking like parks. Only about 30% of people who are black report, that they live in a neighborhood where drivers followed the speed limit. Only about half of people who are black report that when thinking about whether or not they want allow their kids to walk or bike to school concept of safe routes to schools in the U S half of that population reports concerns about traffic and barriers associated with distance to school.

And then finally 85% of adults who were black report favoring or strongly favoring, safer street design, even if it makes driving slower. So I report these data that are reported from people who identify as being black. I will say that these data are very similar. When you look at other subpopulations, but it's also really important to note that when you are trying to address these barriers of why people are not active in their communities, what it will take to integrate create conditions in which they can integrate physical activity into their daily lives. It really is important to work with the underserved populations and to work with them to understand what are the culturally appropriate solutions for those communities. So for example if you were going to do an open streets program in a community it's important to work with the community in which you're going to have that open street to ensure that open street is implemented in a way that's culturally appropriate for that community. But I think bottom line it is important to create the place for people to be active, it's a necessary condition. If don't have a safe place to go be active and it's not easy to use . Those are the two primary barriers. They're more things that you need to address there, but that's the necessary condition to have in the first place.

John: When we look at the challenges that are out there we know they're, massive in terms of trying to make the environment healthier or more conducive to physical activity. How can just everyday people engage with and get involved with the Active People, Healthy Nation Initiative.
How do they plug in and get involved with that?

Ken: Yeah. Active People Healthy Nation is a national movement, as I mentioned and our goal is for people to get engaged, right? For us to be successful, it means that everyone listening to this podcast hopefully will go and join our movement. And so I'll talk a little bit about ways to engage with Active People, Healthy Nation.

We have three different types of folks that generally we asked to be engaged, or we want everybody to engage, but people engage in different ways. So if you're an individual we want you to work in your community to influence your community. If you're part of an organization doing this work, we'd like for you to join and integrate our work into your work, if possible. And then we're looking to engage in the U S elected officials to support Active People. I will say that if you join one of the things that you will get immediately is you'll get our monthly newsletter that we curate on stuff that matters. You will also get resources that if you're looking for local funding or other types of funding, we get those out to you as well. And we have a number of other resources on our website that you can use to support the work in your own backyard.

And I would also say that we want you to spread the word, Active People. Healthy Nation is something that people I think generally can buy into. And hashtagging active people on social media and so forth. And then finally, I would just say just a few months ago, we provided an example of a proclamation on our website that elected leaders can adapt to show their support for the work that we're doing.

So far we've had good success early on Maricopa county. Another smaller city, Buckeye, Arizona, City of Decatur, Georgia, Grand Rapids, Michigan, and the State of South Dakota have all adopted this proclamation. So this is a way for you at the local level. If you'd like to get an identity and associated with Active People from a more formal perspective. And I think so far, we've got roughly about 5 million people covered in the United States. So we're 2% of the way there and we have 98% of the way to go. Your listeners could really help us and getting there. And then finally, if you do get proclamations adopted in your communities, we'd love to hear about it.

And you can email us at activepeople at cdc.gov. It's pretty easy active people@cdc.gov.

John: I think this is great because we want people to click on through and get over there. So this is another reminder that yes, I will have all the appropriate links in the show notes and in the video description. So don't worry. Fear not. When you're done listening to us, you can head right on over there and click on those links.

So to wrap this up, what advice do you have for our audience? If they're inspired to really create change in their neighborhoods? I think I already know one of the answers and that is get involved with Active People, Healthy Nation. What else do you think would be helpful for folks if they're inspired to make a difference in their neighborhood?

Ken: First of all, recognize that the work that we do through Active People, Healthy Nation is important work that improves individual wellbeing. It promotes health equity and community resilience. And to be honest the work that promotes physical activity doesn't necessarily need to be labeled as physical activity understanding that Active People Healthy Nation, our goal is to get the support for conditions under which physical activity Is there, but it doesn't need to be led that way if that's not what works in your community. And I say that because every community is different. My advice would be to start by learning what your community plans and needs are for supporting Activity Friendly Routes to Everyday Destinations.
Because understanding where your community is, will help you better understand where you might engage. And then once you do understand where your own community is, we have a number of resources available on our website, as you just said that can help you with say communication materials. We have collateral materials like Active People, Healthy Nation Design Elements that you can get directly from our website and put on your own promotion materials. If you want to at the local level, we have a number of fact sheets that describe the benefits of investing in what we call Activity Friendly Routes to Everyday Destinations. We have access to media materials. If you're in media and you want access to free collateral media materials, you can join our community health resource center. And then we ha we've supported a number of partners out there that have technical tools such as the Safe Routes to Schools Report Cards or the National Complete Streets Benefits Index.

And there are a number of different technical resources on our website. And then finally I will say that supporting the strategies. There are other strategies, as I mentioned earlier, we've talked a lot about creating Activity Friendly Routes to Everyday Destinations, but there are other ways to get started as well.
So you can encourage your schools to increase rease access to physical activity in the schools, or increase access to youth physical activity opportunities in your communities for low or no cost sporting activities. For example you can open up local assets like school yards to the broader community, through what we call shared use agreements, or even install wayfinding to help people understand walking routes in your communities are ways to walk to places. You can support what we call social support programs like walking clubs for say, older adults or women of color, or you can invest in community challenges to increase physical activity. Or finally, you can. combine multiple strategies in what we call community wide campaigns to increase physical activity.

I mentioned all of these because they all have credible scientific evidence of effectiveness and investing in any of these that I just mentioned will help to increase physical activity in your community. And then I would end with whatever the strategy you choose. It is important to engage people who have been impacted by health equity to reduce health disparities, and work with these communities to understand the most culturally appropriate solutions.

John: Fantastic. That is great. And you reminded me, I need to work on my strength training. I get the cardio in it's like I'm 56 now. And it's, especially as we get older, we need to make sure we get that in as well. And I loved how you just slipped that in you get, you got all seven of the strategies taken care of.
I love it. That's fantastic. Ken Rose is the Chief for the Physical Activity and Health Branch within the Division of Nutrition, Physical Activity and Obesity at the Centers for Disease Control and Prevention Ken, it has been an honor to chat with you here today. Thank you so much for joining me on the Active Towns Podcast.

Ken: It's certainly been an honor for me and just to go out and join Active People, Healthy Nation. Thanks so much!