Research highlights from the Status report for step it up! The surgeon general's call to action to promote walking and walkable communities

In September 2015, the Office of the Surgeon General, U.S. Department of Health and Human Services, released Step it up! The surgeon general's call to action to promote walking and walkable communities (Call to Action) to increase walking among people across the USA.¹ The Call to Action also recognized that walkable communities can accommodate wheelchair rolling and are inclusive of persons with disabilities. The Status Report for the Call to Action was released in 2017, summarizing the state of walking and walkability in the USA when the Call to Action was released and describing select actions done since to sustain the messages and promote the goals of the Call to Action (Table 1).² These Research highlights briefly summarize the key findings of the Status Report.

Table 1.

The 5 goals of Step it up! The surgeon general's call to action to promote walking and walkable communities.¹

1.Make walking a national priority 2.Design communities that make it safe and easy to walk for people of all ages and abilities 3.Promote programs and policies to support walking where people live, learn, work, and play 4.Provide information to encourage walking and improve walkability 5.Fill surveillance, research, and evaluation gaps related to walking and walkability

1. Key findings

1.1. Physical activity needs to be improved in the USA

Thirty percent of U.S. adults were inactive during their leisure time, and 50% of U.S. adults did not meet the guideline for aerobic physical activity in 2015.³ In addition, 73% of high school students did not meet the aerobic guideline for youth in 2015.⁴ Adults and youth can add brisk walking to the activities they are doing or rely exclusively on brisk walking to meet aerobic physical activity guidelines.⁵

1.2. The Call to Action received web and media attention

A live webcast of the Call to Action release was viewed by almost 2000 participants. From September 2015 to March 2016, there were over 62,000 web page views and 4600 downloads of the Call to Action. Interest was highest during the first month after the release, and gradually decreased over time. Ongoing activities, such as those mentioned below, may help sustain interest in using the Call to Action for increasing walking and walkable communities.

1.3. Activities by federal agencies to promote the Call to Action have continued since its release

Following the release of the Call to Action, then Surgeon General, Dr. Murthy, participated in more than 30 events, webinars, and walks that reached almost 22,000 adults and youth with messaging about the importance of walking. In addition, federal agencies are building interagency partnerships to promote smart growth development⁶ and more walkable communities⁷ modeled after the Partnership for Sustainable Communities, which was formed in 2009 by the U.S. Environmental Protection Agency, the U.S. Department of Housing and Urban Development, and the U.S. Department of Transportation.⁸

Federal agencies are also working with other nonfederal partners to support initiatives. For example, with Centers for Disease Control and Prevention support, the National Association of Chronic Disease Directors is conducting annual Walkability Action Institutes to train local and state multidisciplinary teams, which includes members from different sectors, such as health and transportation, to create plans to improve walkability in their states and municipalities.² The U.S. Department of Transportation works with states and communities to promote the Safer People, Safer Streets Initiative to improve safety for walking and bicycling.⁹

1.4. The goals of the Call to Action are being advanced

Partners, organizations, and communities are advancing the Call to Action goals (Table 1). The Every Body Walk! Collaborative is a partnership of national, state, and local organizations, federal agencies, businesses, and associations committed to building a national walking movement (Goal 1).¹⁰ Complete Streets policies and pedestrian master plans are examples of community and street design policies that can help create more walkable communities (Goal 2).11, 12 As of December 2015, 31 states and the District of Columbia adopted Complete Streets policies, and 851 policies have been adopted at local and regional levels.¹³ Even before the release, groups across sectors of society at local, state, and national levels were taking actions to support walking and walkable communities. For example, of 41 states reporting data during 2011–2012, the average percentage of schools participating in Safe Routes to School programs was 17.1% (range: 1% in Arkansas and South Dakota to 60% in Maine) (Goal 3).¹⁴

To help people learn about the importance and benefits of physical activity and walking (Goal 4), the American College of Sports Medicine distributed over 3000 free walking prescription pads upon request to health care professionals across the country.² The Centers for Disease Control and Prevention and American College of Sports Medicine also published proceedings from a 2014 roundtable meeting convened to identify physical activity surveillance gaps and challenges (Goal 5).¹⁵ The Status Report includes baseline measures for monitoring progress in achieving Call to Action goals (Goal 5).

1.5. States, communities, and organizations are successfully implementing activities that build on the Call to Action

Success stories from Delaware, Nebraska, North Carolina, Michigan, and Ohio are included in the Status Report, which illustrate new or expanded activities related to walking or walkable communities. For example, Ottawa County in Michigan hosted a free Step It Up! walking challenge (Goal 3) that lead to about 850 residents walking over 100,000 miles in 3 months.²

2. Summary and the future

The Status Report highlights the state of walking and walkability when the Call to Action was released. Organizations and communities across the country have initiated new activities, or amplified their walking or walkability initiatives. However, more engagement is needed to increase the reach and impact of efforts to improve physical activity in the USA. Moving forward, significant progress may be achieved by pursuing a broad, coordinated effort to improve walking, walkability, and physical activity among U.S. youth and adults. The Call to Action and other important documents, such as The National Physical Activity Plan,¹⁶ provide a road map for partners to step up and take action to improve the health of the nation.

Authors' contributions

DRB conceived of the article ideas and drafted and revised the manuscript; SAC, GSK, and JEF revised and edited the article. All authors have read and approved the final version of the manuscript, and agree with the order of presentation of the authors.

Competing interests

The authors declare that they have no competing interests.