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May 2009

AB 346: A Health Impact Assessment  [Abstract]  ‘Joint use’ is a practical approach to mitigate money struggles by combining city and school assets and avoiding the  high costs of duplicative infrastructure, while also providing recreational space for a larger segment of the  population. California Assembly Bill 346 will allow more flexibility in the types of joint use projects eligible for state  assistance. The most notable change is the incorporation of physical education or outdoor recreation site  development—an important health component of any school. In order to predict the potential effect of this bill on  California communities, I conducted a health impact assessment (HIA) of AB 346. HIA continues to gain  considerable recognition as a relevant part of community‐ and neighborhood‐based land‐use management  decisions that affect community health and are couched in political resolve. This HIA has thoroughly examined the  evidence on potential health outcomes for expanding opportunities for physical activity, as outlined in AB 346, and  sufficiently supports the conclusion that the bill will positively affect the public’s health through increased funding  allotted for joint use projects, additional physical education and outdoor recreational space, and increasing physical  activity levels in communities granted financial assistance for activity‐related facilities. Based on the findings of this  health impact assessment and information gathered from available evidence, AB 346 is a strong start but not a  perfect solution.  

Meredith Glaser  A Comprehensive Examination Project prepared for:  The School of Public Health | University of California at Berkeley 

Table of Contents  1 INTRODUCTION 





2 4  4  4  6  8  9  9  9  10  12  13  15 




16 19 














INTRODUCTION On average, a resident of Central Los Angeles, a predominantly lower income Latino

community, has about 24 square-feet of available recreational green space * (0.51 acres/1000 residents) while greater Los Angeles has more than six times that amount, or 152 square-feet per person.1 Boston has 166 square-feet per person; New York City, 300; and Minneapolis, a whopping 756 square-feet per person.1 Resolving health inequities in urban communities has become a major task of public health professionals and community-based organizations. We know that obesity in childhood often carries into adulthood and represents a principle risk factor for many chronic illnesses.2 Childhood obesity and overweight is most severely affecting lower income communities.3 Unfortunately, these communities are also those with the “fewest resources to intervene or cope with the consequences” of the obesity-related diseases,4 highlighting the need for interventions focused on: increasing availability of physical activity-related venues, creating health policies that will sustain these efforts, and for community leaders to mobilize members and create change together.5 Some California metropolitan communities are identifying ways that school districts and cities can break down traditional boundaries to provide community members with greater access to available facilities, like playgrounds, pools, gymnasiums, or multi-purpose rooms. Sharing these facilities between the community and local school, also known as ‘joint use,’ is a main strategy for doing so.6,7 Joint use agreements involve partnership and collaboration between local government and school district officials to share cost, use, and responsibility of the available sports facilities or spaces. Joint use is especially useful in urban areas where extra land is scarce and expensive. Although some joint use facilities depend on state-allocated funding for such *

Calculated with US Census 2000 data on available municipal park space and population levels. Does not include national parks.


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projects, joint use is a practical approach to mitigate money struggles by combining city and school assets and avoiding the high costs of unnecessary, duplicative infrastructure, while also providing recreational space for a larger segment of the population. Sharing these resources can alleviate financial pressure and can be a sustainable solution for urban environments to enhance physical activity opportunities and provide an important gathering place for the members of a community.6 As of February 2009, California Assembly Member Tom Torlakson authored Assembly Bill 346, which would allow more flexibility in the types of joint use projects eligible for state assistance. The most notable change is the incorporation of physical education or outdoor recreation site development—an important component of any school. In order to predict and analyze the potential effect of this bill on California communities, I conducted a health impact assessment (HIA) of AB 346. This health impact assessment is most concerned with the physical education or outdoor recreation site development in urban schools, as those in urban areas face more problems due to fewer available resources to serve community needs. This paper provides an overview of HIA and how it is used; I then analyze this bill, discuss alternatives, and compare it to other attempts. Finally, I assess the magnitude, direction, and certainty of the associated health impacts and provide recommendations for next steps.



2.1 HIA OVERVIEW  The World Health Organization defines health impact assessment (HIA) as “a combination of procedures, methods and tools by which a policy, program or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population.”8 Stemming from environmental impact assessment (EIA), health impact –2–

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assessment (HIA) continues to gain considerable recognition as a relevant part of community- and neighborhood-based land-use management decisions that affect community health and are couched in political resolve. Despite the various definitions of HIA, there is consensus that HIA “is concerned with the health of populations and attempts to predict the future consequences of health decisions affecting health decisions that have not yet been implemented.”9 Based on five guiding principles of democracy, equity, sustainable development, ethical use of evidence, and a comprehensive approach to health,10 the ultimate goal of HIA is to “prevent health damage and enhance opportunity for health improvement,”10 and ensure that health is on the political agenda.8 A recent review of 27 HIAs in the U.S. indicated several key characteristics of the HIA process:11 • • • • • • • •

External funding was obtainable or unnecessary, as HIAs were conducted in conjunction with EIAs Most investigators followed the commonly accepted steps for HIA: screening, scoping, risk/impact assessment, recommendations and mitigation strategies, and, if applicable, monitoring and/or evaluation Community involvement was a central component Health disparities was of prominent concern Methods for collecting evidence varied, but included both quantitative and non-quantitative data Most included recommendations to mitigate predicted adverse health outcomes Communication of results successfully relayed to media, decision makers, and/or published in peer reviewed journals Results varied

An important limitation of HIA cited in Dannenberg’s review was the varying results among the case studies. Some HIAs demonstrated direct effects and effectually changed proposed policies; but more commonly, HIA “raised awareness of health issues among decision makers” and it can be reasoned that later changes stemmed from such awareness.11 Nevertheless, each of the above characteristics confirms health impact assessment as a resourceful tool for analyzing the health affects of political decisions within a community.     –3–

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The 1917 California Civic Center Act laid the first policy foundation for joint use of school facilities,7 establishing California’s public schools as “civic centers” and where the citizens…may engage in supervised recreational activities, and where they may meet and discuss…any and all subjects…[which] may appertain to the educational, political, economic, artistic, and moral interests of the citizens of the respective communities in which they may reside.12

Since then, California’s Education Code has added to this policy framework for joint use of schools, detailing important issues such as appropriation of funding, leasing and contractual agreements, and property management.7 Currently, 2007-2008, proposition 1D has provided funding for a narrowly defined type of joint use programs (which identifies school gymnasiums as the only joint use project related to physical activity). This proposition stemmed from SB15 in 2003, which was preceded by AB 16. Schools can apply for joint use grants through the School Facilities Planning Division, California Department of Education. Levels of funding vary depending on the grade level and enrollment of the schools applying for the grant. In applying for the joint use grants, schools are required to pay for 50% of the costs associated with the project (projected by contractors and architects). This 50% can be garnered in partnership with the local parks and recreation and/or the city working with the school on this project. Section 2.3 of this paper will outline the differences between the current law and the proposed AB 346. 2.2.2 SCHOOLS AS CENTERS OF COMMUNITIES 

Schools are a focal point and an important asset of any community; they are also a robust indicator of a community’s health and future wellbeing, as reflected in property tax rates, poverty levels, density, age of infrastructure, and certain characteristics within the school population.13 –4–

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Physically and socially, public schools play a central role as “public infrastructure.”14 Physically, schools use a lot of real estate and building materials within cities. For example, an average-sized California middle school (grades 7-8), with around 85015 students should operate on about 13 acres of land, including buildings and grounds, parking, and physical education spaces.16 More than mere space, the school represents an inherent social infrastructure as well. As of 2007, California has about 10,000 elementary and secondary schools and more than 6.4 million students—a 65% increase in student enrollment since 1984.15 This surge in student population has strained our schools; the need for upgrading and expanding schools places continued pressure on government officials, teachers, and budgets while also offering an unprecedented opportunity to design and create the most efficient and health-promoting educational spaces that maximize social, environmental, and financial capital. Although land use and planning strategies are crucial for local and state level school improvements, especially in urban areas where land is scarce and expensive, and where local economies tend to be weaker and lower-income, school planning has been largely ignored by urban planners.14 Obstacles that planners face include: (1) School districts have separate authority from local planning agencies, creating a “silo planning” effect by alienating municipal planners; (2) School acreage requirements and standards may restrict the building of schools in dense urban areas; (3) School facility funding may place priority of suburban areas, creating more difficulty for urban school sites; (4) Demographic changes, poverty concentrations, fluctuating age structure of neighborhoods, and increasing immigrant population all impact student populations, adding to other challenges schools face.14

Bridging the gap between school districts and local planning agencies through collaboration, negotiation, incentives, and clear communication can be fundamental strategies for improving the vitality of our urban schools and the health of our students. Shared use of school recreational facilities can represent a starting point for many communities to begin this dialogue. According to a recent survey by the Center for Cities and Schools, many California school districts have


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already started this dialogue.17 Among the schools surveyed, almost 60% incorporate some type of joint use in their schools; the most common forms included outdoor parks and recreation facilities.14 Although this number represents a significant portion of those surveyed, AB 346 will nevertheless create a purse of funds available to communities. 2.2.3 PHYSICAL ACTIVITY IN THE SCHOOL SETTING 

Physical activity is one of the best predictors for chronic disease and obesity,2 and establishing a regular physically active lifestyle at a young age is a protective strategy for combating the onset of illness, disease, and especially obesity.18 Increasing rates of vehicle use and sedentary leisure activities in our current environment does not encourage physically active lifestyles, especially for children.19 More than a decade ago the Centers for Disease Control and Prevention recommended increasing physical activity opportunities for youth, specifically citing that schools should be the central component for this increase.20 With larger class sizes, everdiminishing physical education funding, and few or no standards for PE teachers, schools have not had the chance to become this integral part of the youth activity equation. Even in the most important child-centered locale—the school—priorities have shifted so drastically that, in 2003, 61.5% of children aged 9-13 did not participate in any organized physical activity during nonschool hours and 22.6% did not participate in any free-time physical activity.21 Moreover, in the same study, Hispanic and non-Hispanic black children were significantly less likely to participate than their non-Hispanic white counterparts; similarly, income and parental education level were also negatively associated.21 Additionally, more Hispanic and non-Hispanic black parents identified transportation, location, and expenses as major barriers to child participation in physical activities during non-school hours.21 To combat multiple risk factors for chronic disease,


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providing accessible avenues that support safe physical activity is one approach to maintaining high activity levels in children. Story, Kaphingst, and French (2000) document the importance of school as a primary role in obesity prevention, arguing not only that obesity, poor nutrition, and physical inactivity directly increase risk for poor academic achievement but also that “schools are unique in their ability to promote physical activity and increase energy expenditure.”22 Political and school officials, on both local and state levels, have the opportunity to initiate this role by establishing physical education requirements, extracurricular activity programs, structured recess activities, and—as I argue—unlocking the playground gates after school hours, including weekends and holidays.22 Opening playgrounds and field space represent “modifiable factors in the physical environment” that will directly increase access to recreation space, especially outdoor green spaces, translating into increased opportunities to participate in physical activities.23,24 Increasing access is not the question; the aim of this paper is to determine how increasing access will impact the health of these communities. In order to improve physical activity opportunities for disadvantaged and vulnerable populations, especially youth, changing the environment is an essential element.6,25,26 Closed school recreational facilities during non-school hours, such as after school, on weekends and holidays, are part of this environmental equation and ultimately restrict recreational and physical activity opportunities for the surrounding community, especially for children and youth.27 Schools teach more than arithmetic and spelling; they are places where long-standing habits are formed and refined. It is their duty to act as a resource for life-long learning to their surrounding community.28 At a time when the state is setting limits on school spending for health-promoting resources, such as school meals and PE teachers, existing physical infrastructure becomes more important and more relied upon. Joint use represents an innovative, cost-saving strategy that –7–

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expands venues for youth to participate in physical activity outside of school hours,26,27 and has the potential to increase physical activity levels among students and the community.17 2.2.4 JOINT USE LOGISTICS & OPERATIONS   Joint use agreements of school sports facilities are created with a partnership between a local school district and the corresponding city/county or parks and recreation department who agree to share cost, use, and responsibility of the facilities, such as outside tracks and fields, swimming pools, fitness centers, and gymnasiums.6 School sports facilities are a vital and underutilized community resource for youth access to recreational spaces for physical activity purposes. With efficient communication, management, and coordination school district leaders and city officials can successfully share school playgrounds and other recreational facilities by tailoring a joint use agreement to fit the needs of both the school and the community. There are two different types of joint use: (1) new construction and (2) re-purposing. ‘New construction’ denotes a facility is built with joint use in mind, and collaborative efforts happen from the beginning while ‘re-purposing’ means an existing facility is modified or upgraded for public use. Both forms of joint use produce the similar desired effect of allowing community members to engage with the available schools sports facilities. In the case of new construction all parties establish ownership over the facilities, creating communal buy-in from all parties. Modifications to existing facilities can also be successful with strategic planning and solid communication between all members involved. Communities moving forward with joint use face many challenges; though maintenance, operation, liability, and ownership are most common, all can be handled appropriately in the terms of the joint use agreement.6,29     –8–

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2.2.5 CASE STUDY: McCLYMONDS HIGH SCHOOL, OAKLAND, CA  In the West Oakland district of Oakland, CA, McClymonds High School is one example of a joint use facility that is available for community use during non-school hours. * The West Oakland district is a predominately low-income African American community situated between major freeways and jutted up against the port of Oakland. While there are a few parks in the southern area of West Oakland, the map point (A) in Appendix 1 (page i) illustrates an area that is void of any parks and open space, except for a pool that is now available through McClymonds High School. McClymonds High School agreed to share their aquatic facilities with Parks and Recreation during the summer months, as well as a partnership with the YMCA for after school hours during the year. In an effort to respect the space of the school and the existing partnership that the school had with Parks and Recreation, the YMCA of the East Bay entered into the agreement with McClymonds High School during the school year only. The relationship with the YMCA provides peer learning that facilitates interaction between younger children and the high school students. Additionally, the relationship between the school and the Parks and Recreation provides an added opportunity to use the school pool during the summer months, when the school would otherwise be closed. In this way all parties involved were able to embrace each other’s and individual group needs.     2.3 JOINT USE LEGISLATION IN CALIFORNIA  2.3.1 PAST LEGISLATION  Assembly Member Tom Torlakson (D-Antioch), and previous Senator, is a champion for the California school system and former physical education teacher. In February of 2006 and


This is an example of joint use. McClymonds HS did not apply for state funding to repurpose their facilities, only a formal agreement was necessary for this situation. –9–

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2007 he authored Senate Bill 1677 and 35, respectively. Both passed by the Senate, but were quickly vetoed by Governor Schwarzenegger. Both bills, practically identical in legislative language, were based on the same principal of increasing flexibility from the original language; either would have expanded the types of allowable projects to apply for state funds to include “physical education and outdoor recreational site development”—an important lacking component of the original code—and aimed to “expand incentives for cooperation and planning local partners to build school facilities to serve the student population and the greater community.”30,31 While the intent of the legislation was to create opportunities for better collaboration, it had clear implications for improving access to public space and for physical activity opportunities. Governor Schwarzenegger’s veto message of SB 1677, in 2006, expressed a concern that the bill would “seriously undermine the policy goals and fiscal accountability of the Joint-Use Facilities Program” but doesn’t give any reasoning why.32 He also cites that it would eliminate joint use partner contributions when the bill specifically authorizes a school district to enter an agreement with “a combination of existing authorized entities.”31 Lastly, the Governor explicitly states that the bill includes “lower-priority joint-use projects that do not necessarily have direct educational benefits.”32 Furthermore, in 2007, SB 35 was also vetoed. This time, Schwarzenegger’s veto message emphasized funding concerns and clearly communicated that this legislation is not one of the top “educational facility priorities.”33 It’s disappointing that the Governor regards recreational space as having no direct educational benefit and not a top priority, especially when scientific literature—and common sense—demonstrates otherwise. 2.3.2 CURRENT LEGISLATION: AB 346 

Once again authored by Assemblyman Torlakson, AB 346 has its roots in SB 35 and SB 1677 and offers flexibility to community applicants of state joint-use funding. This bill expands – 10 –

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opportunities for prevention, not only with outdoor recreational spaces for physical activity but also with school health centers and career technical buildings. The table below provides an indepth analysis of AB 346 compared to current law and indicates the vast differences between the two, specifically regarding the types and place of joint use projects, partner limitations and contributions, and public access issues. In conducting a health impact assessment of AB 346, these topics are central to collecting appropriate evidence that will inform the bill’s impact on health. Comparisons of Existing Law and AB 346 Topic Existing Law Types of projects

Funds must be used to reconfigure or construct school buildings to provide: • Multipurpose room • Gymnasium • Library • Childcare facility • Teacher education facility

Place of project

New joint use facility must be on a school site A school district must enter into a joint use agreement with a governmental agency, public community college, public college/university or a nonprofit organization to construct a joint use facility on a school site. The total number of partners cannot be more than two. The two joint use school partners must, through combined efforts, contribute 50% of building costs and must contribute hard dollars for their share.

Partner limitations

Partner contributions: hard money

Partner contributions: 50/50

Each of the two partners must contribute 25% of the costs.

Public Access

Existing law vague around public access to the newly created joint use facilities.

AB 346 Expands eligible projects to include (in addition to existing): • School health centers • School health facilities • Science & tech labs • Performing arts centers • Science centers • Historical/cultural education centers • Physical education or outdoor recreation site development Allows facilities to be adjacent to, as well as on, school grounds Authorizes a school district to enter into a joint use agreement with a combination of existing authorized entities.

Expands the allowable contribution by a partner to include the value of the land or real property, equipment, consumable materials, and personnel. Authorizes less than 25% contribution by any partner is an agreement has been reached among partners for a lower contribution. Specifies that a facility created by the joint use agreement shall be a public facility with access to the facility guaranteed for public use.

Adapted from: California State Assembly. AB 346, as introduced, Torlakson. Joint-use school facilities. Accessed March, 2009. and Martinez M. Organizing Communities of Color for Policies that Promote Prevention. Strategic Alliance & BANPAC Conference: Creating a Healthy Food & Physical Activity Environment in Schools & the Community. March 25, 2009.

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2.4 DECISION TO CONDUCT HIA ON AB 346  One of the first steps of conducting an HIA is to identify alternatives to the policy—what other policy options are realistic? California Pan-Ethnic Health Network (CPEHN), a Bay Area public health policy advocacy nonprofit, identified the following as joint use policy options:29 • • • •

Mandating prioritization of high-need communities Including joint use in existing policies Defining a minimum standard ratio of open space to population, including standards for ensuring access Increasing flexibility of existing funding

Without undermining the significance of all four options, it is important to keep in mind the current extraordinary state financial situation. Although the first three points are crucial for proliferating joint use policies in California communities, the fourth point of increasing flexibility of existing funding represents a suitable and practical starting point. The most important aspect of AB 346 is that it includes physical education and outdoor recreation space; without this change, the first two options are obsolete. The third option of creating a set of standards would be timeconsuming and inefficient without an implementation and enforcement plan as well. Hence, the fourth option seems the most feasible—and so happens to be the summary of AB 346. Another essential first step of HIAs includes screening: mapping the “potential linkages between the policy and…health, and what different aspects of health [it] might affect.”8 Screening answers three related questions and informs the decision to conduct a HIA:34 1. Is AB 346 associated with potentially significant health impacts that would otherwise be unconsidered or undervalued by decision makers? 2. Is it feasible to conduct a relevant and timely analysis of the health impacts of AB 346? 3. Are AB 346 and its decision making process potentially open and receptive to the findings and recommendations of a health impact analysis?

Increasing opportunity for activity has been associated with higher levels of physical activity,35,36 which in turn, as previously discussed, is associated with lower levels of obesity and chronic disease. Decision makers may overlook environmental determinants and their long-term effects

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on the health of community members, such as access to public open space and chronic disease. Second, an HIA on AB 346 is most certainly feasible and timely: this bill is on the California Assembly floor right now. The State Allocation Board is reviewing the bond measure associated with the bill and the bill’s success is contingent on its passing. Third, after speaking with representatives from CPEHN and Public Health Law & Policy, both organizations are interested in how the results from this assessment could inform decision makers regarding AB 346. I also contacted and interviewed the following stakeholders: Assemblyman Torlakson’s staff person, Monique Ramos; Senator Lowenthal’s staff person and member of the Assembly Education Committee, Mavonne Garrity; Center for Cities & Schools Executive Director, Jeffrey Vincent; and various members of the joint use team at the Office of Public School Construction, School Facilities Program (part of the state’s Department of Education). Each of above has unique expertise in joint use, including its history, fiscal relevance, and supporting bonds and policies. All interviewees agreed the report findings would be of use to their staff in their current efforts to pass the bond contingent on AB 346.

2.5 POTENTIAL HEALTH IMPACTS RESULTING FROM AB 346  The second step of HIA is scoping, setting the boundaries for the assessment by developing a practical work plan and timeline that identifies priority research questions and methods.9 After the initial literature review on physical activity, joint use, and using the school as an intervention for improving childhood health, I hypothesized two potential pathways between access to recreational green space and urban community health. These diagrams are presented below. In the first scenario, children living near school grounds are prohibited from using the available physical education or outdoor recreational space. In the second scenario, children living near school grounds are allowed to use the available physical education or outdoor recreational – 13 –

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space. In this logic framework, children and youth have increased opportunities to engage in physical activity and neighborhood members also have a communal place for gathering and socializing. Social connectedness or cohesion illustrates social capital—a sense of community, belonging, or emotional connection with the community. Social capital within a neighborhood is associated with many health benefits, and increased physical activity is one such health benefit.37,38

Scenario 1. Children living near school grounds are prohibited from using the available physical education or outdoor recreational space.


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Scenario 2. Children living near school grounds are allowed to use the available physical education or outdoor recreational space.

2.6 RESEARCH QUESTIONS & METHODS The pathways described above demonstrate that increasing community access to physical education and outdoor recreational space could impact youth safety, injury rates, and risk for overweight. By using existing academic literature, stakeholder interviews, and gathering available evidence, the questions presented in table below will guide this investigation. Research Questions & Methods Research Question

Assessment Methods

What is the relationship between local park space and child health? Is the availability of park space associated with decreased rates of childhood obesity? How much open recreational space can schools throughout California offer? How many more communities would apply for state funding with the new legislation? How much more physical activity will take place in the communities that participate in joint use?

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• Relevant academic literature and available empirical research • Relevant academic literature and available empirical research • Office of Public School Construction • CA Parks & Recreation • Center for Cities & Schools • California Nutrition Network GIS • Coalition for Adequate School Housing • Office of Public School Construction • Torlakson and Lowenthal staff • The City Project (Los Angeles) • Relevant academic literature • Key informants

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ASSESSMENT OF HEALTH IMPACTS OF AB 346  I evaluated the research questions above using academic literature, supplemental research

from various California non-profits, interviews, and the California Nutrition Network Geographical Information System. I used these tools and resources for calculating estimated health impacts of AB 346. Based of the findings, AB 346 will effectively and significantly increase recreational space and physical activity levels in communities participating in joint use. The following sections detail these findings. 3.1 EFFECT OF AB 346 ON CHILDHOOD HEALTH  The first two research questions delve into the association of park or recreation space and child health. Current academic research indicates that youth from low-income, urban communities and communities of color disproportionately face challenges and barriers to leading active lifestyles.1,23,24,27,39 The high cost of land, safety concerns, and relatively few parks or playgrounds available make it hard to envision a way to increase activity opportunities. Some research has shown that as poverty levels increase the availability of parks and green space decreases and, correspondingly, higher income communities are more likely to have parks and green space.39 In addition to parks and green space, fewer commercial physical activity-related facilities are located in lower income and minority communities.24,27 Furthermore, a 2002 survey by the Public Policy Institute of California demonstrated that 64% of Californians perceive poorer communities to have less than their fair share of well-maintained parks and recreation spaces and facilities, and Latinos were more likely to express this sentiment over non-Hispanic whites.40 Health disparities between these communities parallel disparities in recreation access, as lower-

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income communities experience higher rates of obesity and overweight as well as other chronic conditions.39,41 Several empirical studies have documented physical activity benefits associated with an increased access to parks and playgrounds. Farley et al (2007) evaluated the effectiveness of opening and supervising an inner-city school playground on children’s physical activity levels. They found that the number of children who were physically active at the intervention playground was 84% higher than the unopened comparison playground.42 Scott et al (2007) assessed whether accessibility and suitability of schools as recreational sites was associated with adolescent girls’ physical activity levels and BMI. With a sample size of 1,556 girls, the researchers used GIS data, observations of facilities, and accelerometers to record activity levels.43 They found that schools represented 44% of potential neighborhood sites for physical activity as well as a significant association between locked school grounds and higher BMI.43 Roemmich et al (2006) examined the association between neighborhood environments and physical activity among children during non-school hours .44 Using accelerometers to measure activity levels and a geographic information system (GIS) to measure neighborhood environment variables within a ½-mile radius of the participant’s home, the study found that a 1% increase in park and recreation area was associated with a statistically significant average of 1.3% increase in physical activity.44 GordonLarsen et al (2006) also found that neighborhoods (as defined by block groups) with only one physical activity-related facility (including parks) were associated with a 5% decrease in the odds of adolescent overweight and increased odds of engaging in five or more bouts of moderate to vigorous physical activity per week.24 Using results from Roemmich (2006) and Gordon-Larsen (2006), I calculated the estimated impact of AB 346 on one particular urban community, South-Central Los Angeles. The community of South-Central Los Angeles can provide a model to more closely examine the – 17 –

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impact of additional park space on childhood health. South-Central LA is home to some of the highest concentrations of poverty and people of color in the entire greater Los Angeles region and the worst access to parks and recreation space, with about .51 total acres of public park space per 1,000 residents (compared to 283 total acres per 1,000 residents in the northern, higher income counties). *45 This is an astonishing and shameful figure, especially when the National Recreation and Park Association’s standard is 10 acres per 1000 residents. As figure 3.1 shows, the amount of park space directly correlates with childhood obesity rates; the highest rates of 35-40%, coupled with the lowest availability of park space, are located in Central Los Angeles. Additionally, LAUSD schools with less than five acres of play space are more concentrated in those areas. Figures 1 and 2 in Appendix 2 (page ii) clearly demonstrate that while few Central LA residents live within close proximity to a public park, LAUSD schools that are also within close proximity could potentially dramatically increase access to park and recreation space. Based on the findings of Roemmich et al (2006), we can predict that if one LAUSD school in an average Central Los Angeles neighborhood added 5 acres of play space and opened them to the surrounding community, we could see a 74% increase in park space and 96% increase in physical activity. ** With the results from Gordon-Larsen et al (2006), we can estimate that this additional “facility” could decrease the childhood obesity rates from 35-40% to 30-35% and increase odds of youth engaging in five or more bouts of moderate to vigorous activity per week.24 These estimates are based on several assumptions embedded in AB 346. First, this hypothetical school must apply for funding allocated by AB 346. Second, the funding must be granted. Third, we assume this new space meets the needs of the community so that it is used. Understandably, these are significant, yet undeniable, assumptions that I elucidate in the next


Park space does not include national forests and other large natural public spaces Based on 2000 US Census data. See Appendix 3 (page iii) for calculations.


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section. Also, although these are very relative estimates for only one urban area in California, they nonetheless demonstrate several key issues relevant to AB 346 and applicable to the entire state. First, rates of childhood overweight are also the highest in communities of color across the state, not only Los Angeles county; 34% of Latino and 29% of African American children are overweight while only 20% of White children are overweight.46 Second, as the amendments to AB 346 will allow for more flexible eligibility requirements, the above estimates illustrate that park and recreational space is much needed in resource-poor communities. Finally, the above calculations also demonstrate the positive health impacts associated with increased access to physical activity-related facilities, substantiating the implications of AB 346. 3.2 EFFECT OF AB 346 ON AVAILABILITY OF PUBLIC SPACE FOR PHYSICAL ACTIVITY  Parks and playgrounds are unfairly distributed among urban neighborhoods, benefiting higher income communities and harming lower income communities. This section focuses on the last three research questions dealing with school recreational space, funding from AB 346, and increased participation in physical activity. Because the scope of this HIA includes the entire state of California, in this section I extend beyond South-Central LA and examine two other metropolitan regions in Northern California, San Francisco and Sacramento, not only as case studies but also as a representation of urban California needs. I used the newest standards for PE facilities released by the Department of Education and the California Nutrition Network (CNN) GIS mapping tool to gather evidence of public park space, school sites, and household income for these two areas. I also conducted interviews with staff from elected officials’ offices, the Center for Cities and Schools, and the Office of Public School Construction (California Department of Education).

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In 2000, the California Department of Education (CDE) released the latest edition of the “Guide to School Site Analysis & Development” (the previous edition was released in 1966). This guide is meant to assist individual school districts in determining land-use needs for their schools. Although the document does set forth legal requirements or hold schools accountable for their final land-use decisions, it outlines minimum requirements specifically for physical educationrelated facilities. The PE facilities required are represented in ‘usable acres’ and depend on enrollment. These site requirements are described in the table below. PE facility requirements for California schools School size

Enrollment range

# of schools in CA

PE facilities required (in usable acres)

Average Acreage of PE facilities required

TOTAL recreation space provided to CA (acres)

Grades 1-6

1 – 6 classrooms


1.2 – 2.7



Grades 7-8

75 – 600 pupils


2.1 – 7.0


Grades 7-8

601 – 1200 pupils


7.1 – 10.7


Grades 9-12

400 – 1200 pupils


11.9 – 18.0

8.7 Ave 7-8: 6.1 15.5

Grades 9-12

1201 – 2400 pupils


19.0 – 22.2

24.7 Ave 9-12: 20.1





The last column (total recreation space available) represents estimates of how much recreation space could be available to the community for physical activity purposes; the totals are based the average acreage of PE facilities required (indoor and outdoor), stratified by school size, and the amount of those schools in California. These totals are fairly conservative because they do not take into account actual acreage of PE facilities, newly constructed schools, continuation or alternative schools, or current joint use agreements, and middle and high schools’ acreage were averaged into one number. If the 8,257 public schools mentioned in the table above met the standards for PE facilities and agreed to share them with the surrounding communities, an extra 42,451 acres of usable recreation space would be provided to the state of California. In other

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words, if all California schools met CDE standards for usable PE facility acreage, California youth under 18 years old would have access to nearly 4 ½ more acres of recreational space (+4.48 acres/1000 youth) and every 1000 California residents would have one additional acre (1.15 acre/1000). * In communities barren of recreational space, such as South-Central LA, this addition would be significant. Apart from South-Central Los Angeles, other metropolitan areas of California will clearly benefit from sharing recreational space. The CNN GIS mapping tool is an on-line resource for assessing environmental and community factors that impact food access and activity levels in California communities.47 I used this tool to visually evaluate the discrepancies between locations of parks and schools in neighborhoods with varying household income in two other urban California areas, San Francisco and Sacramento. San Francisco is the 2nd densest city in the country with a population of 776,000 in 47 square miles and 112 SFUSD schools support over 56,000 students.17 With 7.8 acres of open space per 1000 residents, the San Francisco Neighborhood Parks Council deemed the city’s park space insufficient, especially with the large variability between neighborhoods. The South of Market (SOMA) and Hunter’s Bay Point areas have the least amount of park space in the city. Figure 1 in Appenddix 8, on page vii, illustrates the lack of park space in these predominantly lower income areas. The two main clusters of purple illustrate that more than 35% of households have incomes less than $20,000 annually. These are also the areas that have few green park spaces relative to the other lighter color, higher income areas. The flags represent public schools. Evaluating the red, green and purple areas, it is clear that the very separate locations of the flags (schools) to green space (parks) demonstrate that the recreational space provided by the school could act as an important resource for the surrounding community. In the example of West Sacramento, the results are even more clear, as *

See Appendix 4 on page iii for calculations – 21 –

GLASER | Joint Use of School Sports Facilities

illustrated in Figure 2 (Appendix 5, page v). West Sacramento has a population of 40,030 and 14 public schools serve approximately 10,000 students.48 West Sacramento’s 17 parks offer 117 acres of park space, which calculates out to only 2.9 acres/1000 residents.48 In the area map, in Figure 2, it is once again clearly evident that sharing outdoor or other physical education facilities would offer the West Sacramento community recreation space it would otherwise not have. Together, Los Angeles, San Francisco, and Sacramento represent three major California urban areas where residents will benefit from added recreational space. I recognize that this analysis disregards rural areas, and therefore cannot represent the entire state (see limitations in section 4). To investigate the funding mechanisms of the current joint use facilities program, I contacted the Office of Public School Construction (OPSC), under the California’s State Allocation Board and the California Department of Education. OPSC heads the School Facility Program, under which the joint use facilities granting program falls. I spoke with a member of the joint use team, who directed me to another on-line resource. The table below provides information about funding sources for joint use projects in California and is based on data from 1999 until 2004. Number of joint use projects funded in California Source

# of Projects

Funds Released ($)

Proposition 1D



Proposition 55



Proposition 47






Cook R, Morgan L. School Facility Program's Capital Outlay Report: Statistical and Fiscal Data December 1998 through February 2009. 2009.

From a total of 170 projects, the average is 28 projects per year and $800,000 granted per project. Because other non-activity related projects are accepted as eligible, these estimates are inclusive of those projects. More recently, OPSC reports that in 2008, 17 joint use projects funded for a

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GLASER | Joint Use of School Sports Facilities

total of $21.2 million. Out of those, 9 were gymnasium projects (53%) totaling $16 million (75% of total funds), or about $1.7 million each.49 Gymnasium projects accounted for more than half of the total projects granted and also comprised of the greatest amount of funding than any other facility type, confirming the demand for activity-related joint use projects. Although the specific amount of funding AB 346 will apportion is unknown at this time, it will be greater than what’s available now for joint use projects: $8.5 million. With those remaining funds, we can predict that an additional $6.4 million remains for joint-use gymnasium projects, or almost four more shared use gyms. Here it is important to remember that outdoor spaces, such as fields, basketball courts, and tracks will be eligible for funding with AB 346. These types of activity venues are much less labor and material intensive and are less expensive to build and maintain, meaning that existing and in-coming funding could potentially disperse to more communities and be stretched farther. None of the interviewees could estimate how many additional communities would apply for funding; however, all interviewees agreed that joint use is the “most popular program” evinced by its “oversubscribed” status—meaning that the department has more applicants than funding available. Estimating the increase in physical activity levels among communities with joint use school recreation facilities proved daunting. On-line resources and all interviewees emphatically noted that physical activity would definitely increase, but providing numbers was not an option. Ms. Garrity pointed out that ‘hours of use,’ stratified by party, are typically decided and noted in formal joint use agreements between schools and local agencies. Comparing hours of use prior and then after the joint use agreement can be used as a proxy to measure physical activity. In general, hours of use of a given shared facility will indeed increase; however, analyzing joint use agreements for this information to obtain a California estimate is beyond the scope of this assessment. – 23 –

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4   MAGNITUDE, DIRECTION, & CERTAINTY OF HEALTH IMPACTS   ______________________________________________________________________________________  Using available evidence, this health impact assessment analyzed the research questions proposed in Table 2.5 and predicted health impacts associated with AB 346’s joint use of school recreational spaces. Although it is logical and reasonable to connect improved physical activity levels among youth with opportunities to engage in physical activity and the shared use school recreational facilities, several constraining factors limited this assessment. First, a select amount of academic literature and empirical evidence, qualitative research methods, and models roughly estimated the health impact. Second, HIAs are usually conducted with a collaborative team of professionals from multiple agencies; something this assessment lacked. Also, this was not a full scale HIA; public engagement and dialogue was minimal and no community-based participatory research was conducted. Lastly, tools and methods for calculating impacts are based on models from few academic sources, however, this is consistent with what tools and methods are available and this demonstrates a need for better tools and methods to assess impact of shared community recreational facilities on physical activity levels. Furthermore, the findings are not necessarily representative of the entire population of California. Nevertheless, academic literature and the small amount of empirical evidence corresponded to the logic that increasing access to physical activity-related facilities also increased physical activity levels among youth and adolescents. The literature also verified the inconsistencies among available park space in lower and higher income communities and communities of color and the corresponding lower and higher levels of physical activity in those communities. Based the gathered information from scientific sources, calculations, estimates, and interviews, the following impacts seem to be most likely:

State funding assistance for joint use projects will increase as a result of AB 346.

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GLASER | Joint Use of School Sports Facilities

More physical education and outdoor recreation joint use projects will be funded as a result of AB 346, as supported by interviewees and predicted joint use funding.

Increasing access to physical activity-related facilities will increase levels of physical activity in the surrounding community, as supported by the available evidence.

Increasing levels of physical activity among youth, especially in high-risk communities, will improve health outcomes and decrease overweight, as supported by academic literature and empirical evidence.

Since some of the evidence was less convincing than other parts, the following impacts are reasonable, but not as supported by the evidence:


The exact type of facility or outdoor recreation site to be developed may not necessarily support community needs or reflect the culture of the surrounding community.

Funding more recreational joint use projects will improve access to physical activityfacilities in lower income communities who are granted state assistance.

RECOMMENDATIONS AB 346 is not the perfect solution; however, it represents an outstanding start for two

main reasons. First, by allowing more flexibility with partnership contributions and to include physical education and outdoor recreation spaces, AB 346 will open new doors to physical activity-related facilities previously unavailable to the community. Although the legislation does not prioritize communities in greatest need, the bottom line is that children and youth across the state are not getting the recommended amount of activity every day and childhood obesity rates are high across all races, ethnicities, and incomes levels. In an increasingly sedentary environment, local infrastructure for activity becomes exceedingly important, no matter where it is. Second, the passing of AB 346, and its related bond measure, formally allocates a sum of money to be used solely for joint use projects. Although the State Allocation Board has the power to alter it year-by-year, the popularity of the joint use facilities program and the high demand for

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GLASER | Joint Use of School Sports Facilities

state assistance will stabilize the funding allotments. According to interviewees, in extraordinary financial times such as these, communities realize that joint-use facilities save money and represent a win-win situation among all involved parties. Based on the findings of this health impact assessment and information gathered from available evidence, AB 346 is a strong start but not a perfect solution. To strengthen its positive impact on health in California communities, I recommend the following:


Prioritize low-income, low-resource communities for state assisted joint-use projects

With new school construction, modernization, and other school site redevelopment projects mandate joint use agreements of recreation facilities as part of state funding eligibility requirements

With new school construction, modernization, and other school site redevelopment projects require community input and dialogue about community needs and wants

NEXT STEPS  Despite the limitations, this HIA has thoroughly examined the evidence on potential health

outcomes for expanding opportunities for physical activity, as outlined in AB 346, which sufficiently supports the conclusion that the bill will positively affect the public’s health. Major disparities of park acreage and park access exist between lower and higher income communities and this adversely and disproportionately affects the health of communities of color. These disparities require the attention of city and state government officials and public health advocates. The discrepancy is representative of unfair land use management and political decisions combined with unequal distribution of funding for parks and recreation spaces in low-resource communities. Childhood obesity rates are embarrassingly high in a state with some of the most progressive environmental and land use policies in the country. The issue of access to places to play has legal and environmental justice implications for communities and government alike. All – 26 –

GLASER | Joint Use of School Sports Facilities

children should have equal access to parks and playgrounds and the “benefits and burdens should be distributed equally.”45 Currently, we have a system that endows discriminatory access to parks, and one that obscures the needs and perspectives of the community. AB 346 will encourage the state and the Legislature to take a more holistic approach to safeguarding infrastructure, planning our communities, and sustaining good relations between neighborhoods and schools.



GLASER | Joint Use of School Sports Facilities

1. Kipke MD, Iverson E, Moore D, et al. Food and park environments: neighborhood-level risks for childhood obesity in East Los Angeles. Journal of Adolescent Health. 2007;40(4):325-333. 2. Whitaker R. Predicting obesity in young adulthood from childhood and parental obesity. The New England Journal of Medicine. 1997;337(13):869-73. 3. Wang Y. Are American children and adolescents of low socioeconomic status at increased risk of obesity? Changes in the association between overweight and family income between 1971 and 2002. Am J Clin Nutr. 2006;84(4):707-16. 4. Sallis JF, Story M, Orleans T. A Research Perspective on Findings from Bridging the Gap. American Journal of Preventive Medicine. 2007;33(4S):S169-S170. 5. Sallis JF, Bauman A, Pratt M. Environmental and policy interventions to promote physical activity. American Journal of Preventive Medicine. 1998;15:379-397. 6. Ashe M, Feldstein LM, Graff S, Kline R, Pinkas D, Zellers L. Local Venues for Change: Legal Strategies for Healthy Environments. Journal of Law, Medicine, & Ethics. 2007(Spring Symposium):138-147. 7. Cooper T, Vincent JM. Joint Use School Partnerships in California: Strategies to Enhance Schools and Communities. August 2008. 8. WHO European Centre for Health Policy, ed. Health Impact Assessment: Main concepts and suggested approach. Gothenburg Consensus Paper. Copenhagen: WHO Regional Office for Europe; 1999. 9. Kemm J, Parry J, Palmer S, eds. Health Impact Assessment: concepts, theory, techniques and applications. Oxford: Oxford University Press; 2004. 10. Quigley R, den Broeder L, Furu P. Health Impact Assessment International Best Practice Principles. Special Publication Series No. 5. 2006. 11. Dannenberg AL, Bhatia R, Cole BL, Heaton SK, Feldman JD, Rutt CD. Use of Health Impact Assessment in the U.S.: 27 Case Studies, 1999-2007. American Journal of Preventive Medicine. 2008;34(3):241-256. 12. California CSL. California Laws of Interest to Women and Children, 1917: 1917. In: ; 1918:187. 13. Orfield M. American Metropolitics: The New Suburban Reality. Washington, D.C.: Brookings Institution Press; 2002. 14. Vincent JM. Public Schools as Public Infrastructure: Roles for Planning Researchers. Journal of Planning Education and Research. 2006;25(4):433-437.

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15. National Center for Education Statistics. Overview of Public Schools and Districts. . Updated 2001. Accessed April, 2009. 16. California Department of Education. Guide to School Site Analysis and Development. 2000. 17. Vincent JM, Cooper T. Joint use school partnerships in California: Strategies to enhance schools and communities. August 2008. 18. Muller MJ. Physical activity and diet in 5 to 7 years old children. Public Health Nutrition. 1999;2:443-444. 19. French SA, Story M, Jeffery RW. Environmental influences on eating and physical activity. Annual Review of Public Health. 2001;22:309-335. 20. Centers for Disease Control and Prevention. Guidelines for school and community programs to promote lifelong physical activity among young people. MMWR Weekly. 1997;46(RR-6):1-36. 21. Centers for Disease Control and Prevention. Physical Activity Levels among children aged 913, US, 2002. MMWR Weekly. 2003;52(33):785-788. 22. Story M, Kaphingst KM, French SA. The Role of Schools in Obesity Prevention. Future of Children. 2006;16(1):109-142. 23. Gordon-Larsen P, McMurray RG, Popkin BM. Determinants of Adolescent Physical Activity and Inactivity Patterns. Pediatrics. 2000;105(e83). 24. 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;117:417-424. 25. Boarnet M. Planning's Role in Building Healthy Cities: An Introduction to the Special Issue. Journal of the American Planning Association. 2006;72(1):5-9. 26. Garcia R, Flores Baltodano E. Healthy Children, Healthy Communities, Legal Services. Clearinghouse REVIEW Journal of Poverty Law and Policy. 2005;39(1):52-64. 27. Powell LM, Slater S, Chaloupka FJ, Harper D. Availability of Physical Activity-Related Facilities and Neighborhood Demographic and socioeconomic Characteristics: A National Study. American Journal of Public Health. 2006;96(9):1676-1680. 28. Spengler JO, Young SJ, Linton LS. Schools as a Community Resource for Physical Activity: Legal Considerations for Decision Makers. American Journal of Health Promotion. 2007;21(4 Supp):390-396. 29. Martinez M. Organizing Communities of Color for Policies that Promote Prevention. Strategic Alliance & BANPAC Conference: Creating a Healthy Food & Physical Activity Environment in Schools & the Community. March 25, 2009.

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30. California's Coalition for Adequate School Housing. Legislative Update: SB 35. Accessed March, 2009. 31. California State Assembly. SB 1677, Torlakson School facilities: joint-use facilities. Accessed March, 2009. 32. Schwarzenegger A. SB 1677 Veto Message. Accessed March, 2009. 33. Schwarzenegger A. SB 35 Veto Message. Accessed March, 2009. 34. Bhatia R, Farhang L, Heller J, et al. A Health Impact Assessment of the California Healthy Families, Healthy Worklplaces Act of 2008. July 30, 2008. 35. Giles-Corti B, Broomhall MH, Knuiman M, et al. Increasing Walking: How important is distance to, attractiveness, and size of public open space? American Journal of Preventive Medicine. 2005;28(2S2):169-176. 36. Norman GJ, Nutter SK, Ryan S, Sallis JF, Calfas KJ, Patrick K. Community Design and Access to Recreational Facilities as Correlates of Adolescent Physical Activity Body-Mass Index. Journal of Physical Activity and Health. 2006;3(Supplement 1):S118-S128. 37. Lindström M, Hanson BS, Ostergren PO. Socioeconomic differences in leisure-time physical activity: the role of social participation and social capital in shaping health related behaviour. Soc Sci Med. 2001;52(3):441-51. 38. Cradock AL, Kawachi I, Colditz GA, Gortmaker SL, Buka SL. Neighborhood social cohesion and youth participation in physical activity in Chicago. Soc Sci Med. 2009;68(3):427-435. 39. Powell LM, Slater S, Chaloupka FJ. Relationship between community physical activity setting and race, ethnicity, and socioeconomic status. Evidence-Based Preventive Medicine. 2004;1(2):135-144. 40. Baldasare M. Public Policy Institute of California Statewide Survey: Special Survey on Californians and the Environment VI. June 2002. 41. Sallis JF, Glanz K. The Role of Built Environments in Physical Activity, Eating, and Obesity in Childhood. The Future of Children. 2006;16(1, Childhood Obesity):89-108. 42. Farley T. Safe play spaces to promote physical activity in inner-city children: results from a pilot study of an environmental intervention. American Journal of Public Health (1971). 2007;97(9):1625-31.

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43. Scott M. Weekend schoolyard accessibility, physical activity, and obesity: the Trial of Activity in Adolescent Girls (TAAG) study. Prev Med. 2007;44(5):398-403. 44. Roemmich JN, Epstein LH, Raja S, Yin L, Robinson J, Winiewicz D. Association of access to parks and recreational facilities with the physical activity of young children. Prev Med. 2006;43(6):437-441. 45. Garcia R, White A. Healthy Parks, Schools and Communities: Mapping Green Access and Equity for the Los Angeles Region. 2006. 46. California Center for Public Health Advocacy. An Epidemic: Overweight and Unfit Children in California Assembly Districts. December 2002. 47. California Department of Public Health. California Nutrition Network Geographical Information System. Updated 2002. Accessed April, 2009. 48. City of West Sacramento. Community Life. Updated 2007. Accessed April, 2009. 49. Cook R, Morgan L. School Facility Program's Capital Outlay Report: Statistical and Fiscal Data December 1998 through February 2009. 2009.

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APPENDIX 1 McClymonds neighborhood, West Oakland, CA.

The McClymonds neighborhood in West Oakland has fewer parks and recreational spaces for physical activity compared to other parts of the neighborhood and to the rest of Oakland. McClymonds High School, the Department of Parks and Recreation, and the YMCA formalized shared use of the high school’s aquatic facilities. The facilities are now open to the public during non-school hours (evenings, weekends, and holidays).    


APPENDIX 2 FIGURE 1. Los Angeles park space and childhood obesity rates 1

FIGURE 2. Los Angeles park space & LAUSD schools, <5 acres of play space1


Garcia R, White A. Healthy Parks, Schools and Communities: Mapping Green Access and Equity for the Los Angeles Region. 2006.

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APPENDIX 3 Calculations for increased park space in Central Los Angeles a. Existing data Central LA average population per square mile: 2 53,458 Per ½ square mile, as noted in Roemmich et al (2006): 3 53,458/4 = 13,364 Average park space per 1,000 residents: 4 0.51 acre b. Local LAUSD school opens its 5 acres of park space to public .51 acre/1,000 residents = 6.8 acres/13,364 residents 6.8 acres + 5 acres = 11.8 acres = 74% increase in park space = .88 acres/1,000 residents c. Park space and physical activity According to Roemmich et al (2006), a 1% increase in park space = 1.3% increase in physical activity 74% increase in park space could translate into a 96% increase in physical activity: 0.74 x 1.3 = .96

APPENDIX 4 Calculations for added PE facilities for California If all California schools met CDE standards for usable PE facility acreage, youth under 18 years old would have access to nearly 4 ½ more acres of recreational space (4.48 acres/1000 youth). California population: 36,553,215 California under 18 population: 25.7% or 9,394,176 42,451 added acres/9,394,176 people = x acres/1000 people added 4.48 acres per 1000 youth


US Census Bureau. California State & County Quickfacts. Updated May 2009. Accessed April, 2009. 3 Roemmich JN, Epstein LH, Raja S, Yin L, Robinson J, Winiewicz D. Association of access to parks and recreational facilities with the physical activity of young children. Prev Med. 2006;43(6):437-441 4 Garcia R, White A. Healthy Parks, Schools and Communities: Mapping Green Access and Equity for the Los Angeles Region. 2006.

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APPENDIX 5 FIGURE 1. East San Francisco parks, schools, and household income

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APPENDIX 5 FIGURE 2. West Sacramento parks, schools, and household income


APPENDIX 9 Number of joint use projects funded in California


# of Projects

Funds Released ($)

Proposition 1D



Proposition 55



Proposition 47






Cook R, Morgan L. School Facility Program's Capital Outlay Report: Statistical and Fiscal Data December 1998 through February 2009. 2009.

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AB 346: A Health Impact Assessment  

Comprehensive Exam for the completion of MPH