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Ask any kid: you know you're in trouble when the high point on your report card is a C among 2 Ds, 5 Fs, and an "incomplete." That's precisely the spot the US is in when it comes to walking and walkable communities, according to a recently released report card from the National Physical Activity Plan Alliance (NPAPA). APTA is an alliance partner.

Released this fall, the Walking and Walkable Communities Report Card reflects the NPAPA's assessment of “the extent to which the US population and US communities meet selected standards for participating in walking and providing physical and social supports for behavior." The NPAPA used a similar approach in 2014 when it released a report card on physical activity across the country that reflected an overall 1.5 GPA. Like the earlier report card, the results this time around aren’t honor roll material.

The best the country could muster, according to the alliance, was a “C” for “adult walking behavior”—the number of adults who report walking on a regular basis for work, recreation, or planned exercise. Assessors were looking for the percent of adults who reported walking for 10 minutes or more at least once in the preceding week: the 63.9% of respondents who reported meeting that mark earned the US its highest grade. The narrative that accompanies the report card points out that walking prevalence has not increased much between 2010 and 2015, though women did experience a 2.6% rise during that time.

It was all downhill from there.

In the areas of “pedestrian policies” and “walkable neighborhoods,” the alliance gave the US a D grade for each. Pedestrian policies fall short, says the alliance, because communities aren’t doing enough to support a “complete streets” model that ensures streets are built to support all forms of transportation, not just automobiles. The low grade for walkable neighborhoods reflects the fact that only 16 states report that 30% or more of residents live in a highly walkable neighborhood.

But the most prevalent grades, by far, were Fs, with 5 failing grades issued by the alliance. According to the report card, the US earned Fs on children and youth walking behavior, pedestrian infrastructure, safety, institutional policies, and public transportation. A grade of “incomplete” was assigned to walking programs because there is no system in place that monitors the prevalence of those programs across the US, according to the alliance.

Dianne Jewell, PT, DPT, PhD, who served on the advisory panel for the report card, says the report card should be understood more as a way to encourage serious dialogue and advocacy for walking and community walkability, and less a hard-nosed assessment.

“These grades should be viewed thoughtfully,” Jewell said. “I see them as flares indicating serious potential hazards ahead if we don’t address the issues in each domain, rather than as absolute indicators of performance.”

"We now have a consolidated baseline picture of our successes and challenges in supporting walking and walkability, and we now can measure change over time,” Jewell added. “There are important lessons underneath those grades, including data on differences in walking behavior by age, gender, and ethnicity, as well as some examples of state-level successes in some of the walkability domains.”

Jewell has since stepped down from the NPAPA. These days, Chris Hinze, PT, DPT, serves as APTA’s representative to the group.

Like Jewell, Hinze believes that the report card points to the need for societal change. And he thinks physical therapists (PTs) and physical therapist assistants (PTAs) can play an important role in making that change happen.

“With their expertise in human movement, PTs, PTAs, and students can and should be key voices in this discussion,” Hinze said. “First, PTs and PTAs should educate themselves on social determinants of health—specifically, how the built environment influences health and health-related behaviors. Then they should consider becoming advocates for policies and infrastructure that encourage active transportation in their communities.” Hinze points to a comprehensive set of strategies and tactics developed by NPAPA that can help inform and guide PTs and PTAs in this work.

For both Hinze and Jewell, the bottom line is clear: things need to change, and soon.

“For decades, communities have largely been designed around the automobile, with human movement an afterthought—this needs to change,” Hinze said. “Cities and communities need to be intentional with their policies, planning, and design to make active transportation a safe and convenient choice for moving about."

“If we can’t even meet the minimum threshold of safety, then efforts in other areas will ultimately be limited,” Jewell said. “Common sense says injury or fatality while walking or cycling should be socially unacceptable without the need for debate, yet we still favor policies and infrastructures designed for motorized vehicles moving at speed with a minimum of interference. Until that perspective changes, I think we will only see small, incremental improvements in many of these grades.”

Want to learn more about the NPAP and the work of the NPAPA? Check out this video, and read the entire National Physical Activity Plan , a revised roadmap for community-level change.

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