Background and Purpose
Parks may be one of the only means of accessing nature for the majority of people in urban areas; yet most people are unaware of their full range of potential health benefits. This presentation will describe and highlight lessons learned from the Healthy Communities Project designed to promote the meaningful use of parks to improve health and wellness by increasing physical activity among racial and ethnic minorities, economically disadvantaged and medically underserved individuals in Washington, DC, East Boston, MA and Bronx, NY. The project is a collaborative effort of Community HealthCorps, a national service (AmeriCorps) program of the National Association of Community Health Centers, and the Rivers & Trails Program of the National Park Service.
Description
In urban areas, parks often provide the primary green space for residents to be physically active while being socially engaged. Nonetheless, parks, and particularly national parks, are often underutilized by minorities and economically disadvantaged populations. In a 2009 National Park Service survey of the American public, those U.S. residents who could name a unit of the National Park System they had visited in the two years before the survey were disproportionately white and non-Hispanic. Additionally, among respondents who had not visited in the past two years, the reason for not visiting more often that was most widely endorsed was that they “just don’t know that much about National Park System units.” Hispanic, Asian, and African Americans were more likely to agree with this statement than were non-Hispanic whites, both among recent visitors and among non-visitors. This is troubling because the physical activities to which parks readily lend themselves (walking, biking, hiking, etc.) may contribute to reductions in obesity and obesity-related illnesses that are prevalent among minorities and low income populations. The Healthy Communities Project was developed to raise awareness about the value of parks to increase health and well being particularly among minorities and low income populations who do not traditionally visit national parks. Community HealthCorps AmeriCorps volunteers, called Navigators, operating out of Community Health Centers (CHCs) in DC, East Boston and the Bronx, serving in collaboration with national park staff, developed and delivered physical and fun activities in parks for CHC patients. CHCs remove common barriers to care by serving communities that otherwise confront financial, geographic, language, cultural and other barriers, making them different from most private physicians' offices. Community health centers: 1). are located in high-need areas identified by the federal government as having elevated poverty, higher than average infant mortality, and where few physicians practice; 2). are open to all residents, regardless of insurance status, and provide free or reduced cost care based on ability to pay; 3). offer services that help their patients access health care, such as transportation, translation, case management, health education, and home visitation; 4). tailor their services to fit the special needs and priorities of their communities, and provide services in a linguistically and culturally appropriate setting. Nearly a third of all patients are best served in languages other than English, and nearly all patients report their clinician speaks the same language they do; and 5). provide high quality care, reducing health disparities and improving patient outcomes. The racial and ethnic diversity of the community residents served by CHCs is rich and nationally the scope of diversity is as follows: 1). Asian American / Hawaiian / Pacific Islander - 4.6%; 2). African-American - 25.8%; 3). American Indian / Alaska Native - 1.4%; 4). Caucasian - 64.1% (includes Hispanic / Latino - 34.4% and others - 65.6%); 5. More than one race - 4.2%. The promotion and delivery of programs promoting physical activity in parks by Navigators helps participants to overcome potential barriers such as fear of the unknown or negative safety perceptions when visiting an unfamiliar location in addition to promoting social ties among participants.
Lessons Learned
An evaluation of the project is currently underway. Preliminary lessons learned are as follows: The primary challenge across sites was transportation. This challenge was overcome through developing strong partnerships with parks and other community partners. Once the connection to parks was made, participants spoke of a much greater interest to return. The reasons varied, with adult participants reporting a reduction of chronic illness symptoms and/or increased physical fitness sparking positive commentary from friends and neighbors.
Conclusions and Implications
Partnerships between national service programs and national parks have strong potential to increase physical activity among minorities and low income individuals and may lead to improved physical fitness.
Next Steps
National Park Immersion Excursions are planned for participating community members during fall 2012. The project is scheduled to be replicated in seven additional cities by 2015. Findings will be disseminated through conferences, trainings, workshops and publications. Lessons learned will be incorporated into Community HealthCorps operations nationwide. Additional opportunities to utilize national service and community volunteers as a model for reducing obesity, addressing social determinants of health, and reducing health disparities are being pursued through grant applications.
Support / Funding Source
National Association of Community Health Centers Corporation for National & Community Service Natonal Park Service Rivers & Trails District of Columbia Primary Care Association East Boston Neighborhood Health Center Institute for Family Health
