Published online by Cambridge University Press: 06 January 2021
Obesity is the number one health problem facing America today. The connection to physical inactivity and a sedentary lifestyle has long been recognized, but only recently has it become a focal point for physicians worldwide. Surprisingly, the answer may be as close as America's backyardthe public lands and waters under the management of the U.S. Department of the Interior (Interior), as well as other federal, state, and local agencies. While traditional efforts to increase physical activity among Americans have focused on exercise-related activities such as calisthenics, treadmills, or stair machines, more recently leisuretime activities like gardening and housework have emerged as additions to the physical activity arsenal. These activities in turn have shifted attention away from individual obstacles and toward barriers to human movement in the built environment.
1 See e.g., CDC CHIEF: OBESITY TOP HEALTH THREAT, at http://www.cnn.com/2003/HEALTH/diet.fitness/10/29/obesity.threat.reut/ (Oct. 29, 2003).
2 JoAnn, E. Manson et al., The Escalating Pandemics of Obesity and Sedentary Lifestyle: A Call to Action for Clinicians. 164 ARCHIVES INTERNAL MED. 249 (2004); see also, Brian Vastag. Obesity is Now on Everybody's Plate, 291 JAMA 1186 (2004)Google Scholar.
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4 The built environment refers to the urban environment consisting of buildings, roads, fixtures, parks, and all other improvements that form the physical character of a city. See SEBASTIAN TOMBS, THE BUILT ENVIRONMENT, at http://www.scottisharchitecture.net/be-home-more.html (June 2002).
5 Cynthia, L. Ogden et al., Prevalence and Trends in Overweight Among US Children and Adolescents, 1999-2000, 288 JAMA 1728 (2002)Google Scholar.
6 Katherine, M. Flegal et al., Prevalence and Trends in Obesity Among US Adults, 1999-2000, 288 JAMA 1723 (2002)Google Scholar.
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8 The cost of this epidemic to society is enormous. Nationally it is estimated that obesity and physical inactivity cost society about 117 billion dollars in 2000. OFFICE OF THE SURGEON GENERAL, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, OVERWEIGHT AND OBESITY: AT A GLANCE, at http://www.surgeongeneral.gov/topics/obesity/calltoaction/fact_glance.htm (last visited July 13, 2004). Being overweight increases yearly per-person healthcare costs by 125, while obesity increases costs by 395. NATIONAL CENTER FOR POLICY ANALYSIS, COSTS OF OBESITY, DRINKING, SMOKING AND GROWING OLDER, at http://www.ncpa.org/iss/hea/2002/pd041902e.html (Apr. 19, 2002). In addition, a comparison of individuals fifteen years and older found a significant difference in annual direct medical costs between those who were regularly physically active and those who were not. Michael, Pratt et al., Higher Direct Medical Costs Associated with Physical Inactivity, 28 PHYSICIAN & SPORTSMEDICINE 63, 66-67 (2000)Google Scholar.
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10 Kevin, R. Fontaine et al., Years of Life Lost Due to Obesity, 289 JAMA 187 (2003)Google Scholar; National Task Force on the Prevention and Treatment of Obesity, Overweight, Obesity, and Health Risk, 160 ARCHIVES INTERNAL MED. 898 (2000).
11 See Must et al., supra note 7.
12 CENTERS FOR DISEASE CONTROL AND PREVENTION, supra note 7, at 2.
13 NATIONAL CENTER FOR HEALTH STATISTICS, CDC, PREVALENCE OF OVERWEIGHT AND OBESITY AMONG ADULTS: UNITED STATES, 1999-2000, at http://www.cdc.gov/nchs/products/pubs/pubd/hestats/obese/obse99.htm (last reviewed May 4, 2004).
14 Ogden, supra note 5, at 1731. Equally troubling is the fact that diseases once seen only in adults, such as Type 2 Diabetes, are now diagnosed in children. Furthermore, overweight children are far more likely to become overweight adults who as they age face serious health problems, such as cardiovascular disease, certain cancers, osteoarthritis, depression, and other complications. OFFICE OF THE SURGEON GENERAL, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, OVERWEIGHT IN CHILDREN AND ADOLESCENTS, at http://www.surgeongeneral.gov/topics/obsesity/calltoaction/fact_adolescents.htm (last visited July 13, 2004).
15 DHHS, HEALTHY PEOPLE 2010: UNDERSTANDING AND IMPROVING HEALTH (2d ed. 2000), available at http://www.healthypeople.gov/document/pdf/uih/2010uih.pdf.
16 Id.
17 See David, B. Allison et al., Annual Deaths Attributable to Obesity in the United States, 282 JAMA 1530 (1999)Google Scholar; Ali, H. Mokdad et al., Actual Causes of Death in the United States, 2000, 291 JAMA 1238 (2004)Google Scholar.
18 See Thomas, N. Robinson, Reducing Children's Television Viewing to Prevent Obesity: A Randomized Controlled Trial, 282 JAMA 1561 (1999)Google Scholar.
19 Richard Lowry et al., Recent Trends in Participation in Physical Education among US High School Students, J. SCH. HEALTH, Apr. 1, 2001. In addition, children who watched more television were also less likely to participate in vigorous activity and tended to have a higher body mass index. Ross, E. Andersen et al., Relationship of Physical Activity and Television Watching with Body Weight and Level of Fatness among Children: Results from the Third National Health and Nutrition Examination Survey, 279 JAMA 938 (1998)Google Scholar.
20 OFFICE OF THE SURGEON GENERAL, supra note 14, at 24.
21 Id.
22 Id. at 2.
23 GEOFFREY GODBEY ET AL., INCREASING PHYSICAL ACTIVITY AMONG OLDER ADULTS 8, at http://www.ncppa.org/Godbey-Congress_final.pdf (last visited July 21, 2004).
24 Id. at 8-9.
25 Karla, A. Henderson. Enjoyment as the Link Between Leisure and Physical Activity, 74 J. PHYSICAL ED. RECREATION & DANCE 6, 7 (2003)Google Scholar.
26 Id. at 6-7.
27 GODBEY ET AL., supra note 22, at 2.
28 Outdoor recreation is important to the mental, physical, and spiritual well-being of individuals. Almost 90% of Americans age sixteen and older feel that getting outdoors reduces their stress levels and leaves them with a sense of accomplishment. Furthermore, nearly 80% of Americans feel that experiencing outdoor recreational activities strengthens their family relationships. OUTDOOR INDUSTRY ASSOCIATION, NEW HARRIS INTERACTIVE STUDY FINDS THAT PARTICIPATING IN OUTDOOR ACTIVITIES IMPROVES MENTAL AND PHYSICAL HEALTH, at http://www.outdoorindustry.org/press.oia.php?news_id=393&sort_year=2004 (Jan. 30, 2004).
29 The key to being a life long active outdoor participant is to start young. Nearly 90% of current outdoor enthusiasts have been participating since they were young. Starting at a young age teaches children to love and appreciate the outdoors while the personal challenge and health benefits are what keeps them participating throughout their lives. Id.
30 The National Park Service Organic Act directs the bureau to conserve the scenery and the natural and historic objects and the wildlife therein and to provide for the enjoyment of the same in such manner and by such means as will leave them unimpaired for the enjoyment of future generations. 16 U.S.C. 1 (2000).
31 U.S. DEPARTMENT OF THE INTERIOR, DOI QUICK FACTS, at http://www.doi.gov/facts.html (last updated Mar. 12, 2004).
32 Id.
33 See generally, U.S. DEPARTMENT OF THE INTERIOR, FISCAL YEAR 2005: THE INTERIOR BUDGET IN BRIEF (2004), available at http://www.doi.gov/budget/2005/05Hilites/toc.html [hereinafter DOI BUDGET IN BRIEF].
34 Richard A. Goodman & Marc L Miller, Public Lands for the Public's Health: Could Georgia Use Its Parks for the Public Health?, ENVIRONMENTAL LAW INSTITUTE, available at http://www.americantrails.org/resources/health/resource.html (last visited July 13, 2004).
35 DOI BUDGET IN BRIEF, supra note 33, at 32.
36 The Department of the Interior's (Interior) 2005 budget request provides 900 million toward the recreation mission. The budget proposes to: [f]ulfill the President's commitment to a Healthier US through the promotion of recreational physical activity and volunteerism on its lands. Id.
37 Id. One important aspect of encouraging people to engage in outdoor recreation is making information available about recreational opportunities. The Department of the Interior, in conjunction with other federal agencies, provides information on federal recreational opportunities indexed both by location and by activity. RECREATION.GOV, at http://www.recreation.gov (last revised May 27, 2004).
38 For information on national parks, see NATIONAL PARK SERVICE, U.S. DEPARTMENT OF THE INTERIOR, at http://www.nps.gov (last visited July 13, 2004).
39 For information on Interior's wilderness areas, covering more than 70 million acres, see DOI, DOI INITIATIVES, at http://www.doi.gov/initiatives/wilderness.html (last updated Oct. 9, 2003).
40 U.S. FISH & WILDLIFE SERVICE, AMERICA's NATIONAL WILDLIFE REFUGE SYSTEM, at http://refuges.fws.gov (last updated July 8, 2004).
41 NATIONAL PARK SERVICE, DOI, NATIONAL TRAILS SYSTEM, at http://www.nps.gov/ncrc/programs/nts/nrt.html (last modified May 25, 2004).
42 A volksmarch is an organized hike or walk which usually covers a distance of 10 or 20 kilometers (6 or 12 miles). It may be conducted in either a rural or urban setting and generally highlights a scenic or historical area. It is designed to appeal to everyone, and is not a contest of speed or endurance. Volksmarching is good exercise and encourages outdoor physical activity for people of all ages and physical conditions. F.S. FAMILY WANDERERS, VOLKSMARCHING, at http://www.seattlevolkssport.org/Pages/volksmarching.htm (last modified July 3, 2004).
43 TAKE PRIDE IN AMERICA, at http://www.takepride.gov (last visited July 13, 2004); VOLUNTEER.GOV/GOV, at http://www.volunteer.gov/gov (last visited July 13, 2004).
44 In June 2002, President Bush launched the HealthierUS Initiative, which is based on the premise that increasing personal fitness and becoming healthier is critical to achieving a better and longer life. Activities to Promote Personal Fitness, Exec.Order No. 13266, 3 C.F.R. 237 (2003). The President's HealthierUS Initiative uses the resources of the federal government to alert Americans to the vital health benefits of simple and modest improvements in physical activity, nutrition, and behavior. In support of HealthierUS, a Memorandum of Understanding was signed by the Secretaries of the Department of the Interior, Department of Agriculture, Department of Health and Human Services, and the U.S. Army. Memorandum of Understanding, To Promote Public Health and Recreation (June 19, 2002), available at http://corpslakes.usace.army.mil/employees/cecwon/pdfs/mou/cdc.pdf.
In November 2003, the heads of the seven federal land and water management agencies further pledged to explore the possibilities of collaboration in the creation of a seamless system of services. See Joint Ventures Partners in Stewardship, Joint Ventures Conference Attendees Urged to Serve as Ambassadors for Partnerships, CONFERENCE DAILY NEWSLETTER, Nov. 19, 2003, available at http://www.partnerships2003.org/home.html.
45 Contra Jay, D. Wexler, Parks as Gyms? Recreational Paradigms and Public Health in the National Parks, 30 AM. J.L. & MED. 155 (2004)Google Scholar.