Travis Rickford, healthy communities coordinator for the Kansas Department of Health and Environment, spoke during the fifth annual Built Environment and the Outdoors Summit on Wednesday, Oct. 5, 2011, at the Holiday Inn Lawrence. He talked about how to reverse the burden of chronic disease in Kansas. by Richard Gwin

Travis Rickford said Kansas communities need to focus on creating an environment that’s conducive to exercising and eating well. If not, he said, the obesity rate — 1 in 3 adults and 1 in 5 children — is just going to keep growing.

Rickford, healthy communities coordinator for the Kansas Department of Health and Environment, spoke to about 190 people during the “Built Environment and The Outdoors Summit” on Wednesday at Holiday Inn Lawrence. The two-day summit continues today.

Rickford began by talking about the need for change:

• 70 percent — of all deaths in Kansas are caused by chronic diseases. Cancer and heart disease are the leading causes.

• 24 million — Americans have diabetes, which is the leading cause of kidney failure, lower-extremity amputations and blindness among adults.

• 57 million — American adults have pre-diabetes.

Rickford said it’s estimated that one-third of all American children born in 2000 will develop Type 2 diabetes during their lifetime if our current trends continue.

He said 20 Kansas communities, including Lawrence, are working to reverse these trends through a new evidence- and practice-based tool that was approved in 2010 by the Centers for Disease Control and Prevention. It’s called CHANGE, which stands for Community Health Assessment and Group Evaluation.

It’s a step-by-step action guide for communities that begins with an assessment and ends with an action plan. The assessment looks at physical activity, nutrition, and tobacco use in five sectors: community at-large, school, work, institutions and organizations, and health care.

“The goal is to improve the way we work, eat and play, and to make people happier,” Rickford said.

Sue Evans, of Colby, talks about her community's effort to open its first walking trail. She spoke during the Built Environment and the Outdoors Summit on Wednesday, Oct. 5, 2011, in Lawrence. by Richard Gwin

Making headway

The small western Kansas town of Colby is the first community to complete the CHANGE process and already is seeing improvements.

Sue Evans, a Colby native and member of the Northwest Kansas Council on Substance Abuse Inc., said during the conference that wellness really wasn’t on the minds of its residents or leaders just three years ago. The leaders focused on reducing substance use and were happy with that. She said city and county leaders weren’t involved in health initiatives.

She said the CHANGE tool forced its newly structured Healthy Communities Coalition to go out and talk about wellness, and it quickly learned that there were no health-based initiatives in workplaces. The town of 5,300 is mostly an agricultural community and has a lot of jobs in farming, construction and banking.

“There was no access to nutritious snacks. No policies that encourage health. Nothing,” Evans said. “They (employers) had never thought about it before.”

She said they are making headway, but it’s not easy. "There are a lot of guys who do physical labor stuff, and they eat horrible when they go out."

Evans said she served on a committee that had talked for years about building the town’s first walking trail. But they didn’t give up and with a new focus on health, the city agreed to donate land for a half-mile trail.

Then, there were two public meetings that were attended by 68 people.

“We found that people really wanted it,” she said. “There was this huge movement and everybody started getting on board.”

Evans said the project grew to include a farmer, the town’s largest business owner, and a Rotary club, and within three weeks, 29 organizations and 58 households donated $91,200 for a two-mile trail.

Evans said its leaders are no longer on that Ferris wheel going around and around and achieving nothing. They are working together and have an action plan.

“We do believe that one day Colby will be one of the most walkable communities in Kansas,” she said.

Participants in the fifth annual Built Environment and the Outdoors Summit listen to Travis Rickford, healthy communities coordinator from the Kansas Department of Health and Environment, talk about how communities can help improve the health of its residents through changes in policy and environment. by Richard Gwin

In Lawrence

The Lawrence-Douglas County Health Department is using the CHANGE tool as part of a bigger community health assessment and action plan.

Charlotte Marthaler, assistant director, said in a telephone interview it has helped the department think about physical activity, tobacco use and nutrition from more of a policy and environment standpoint.

She said they spoke with about 20 entities last spring ranging from medical safety net clinics to businesses like Hallmark and the Kansas University Endowment Association.

Among the things they learned:

• Health providers often don’t access patients’ physical activity like they do tobacco use.

• Tobacco users often aren’t referred to cessation programs.

• The community needs a Complete Streets policy that creates a safer environment for pedestrians, bikers and the disabled.

Marthaler said the health department is using the information that it collected to help guide strategies to reduce chronic diseases, and it’s working with health groups such as LiveWell Lawrence, the Douglas County Food Policy Council and Douglas County Community Improvement Partnership.

She said the health department is looking at policy and system changes that are going to make a bigger impact on the community’s health, similar to the city’s smoking ban.

“With one big swoop, we made a lot of changes and I believe that has helped us to bring down the smoking rate among adults. It’s helped to reduce the people who start smoking,” she said. “When we can make changes like that through policy and system changes, that’s how we are going to improve health in our community.”