February 6, 2012

Many strategies to increase physical activity for kids lack injury prevention measures, study finds

A new study by researchers at the Johns Hopkins Center for Injury Research and Policy and at the Centers for Disease Control and Prevention documents a need for increased injury-prevention efforts in many of the most popular activities for kids—walking, bicycling, swimming, sports and playground use—in the United States.

Injury is the leading cause of death for young people in this country, yet many public health efforts to promote physical activity in kids do not consider the numerous available strategies to incorporate injury prevention.

The report, published online in the journal Health and Place, outlines how injury prevention and child obesity professionals can work together to prevent injury while promoting active lifestyles in kids.

“Many of the activities currently recommended to reduce obesity in kids are also the leading causes of activity-related injury,” said lead study author Keshia Pollack, an assistant professor with the Johns Hopkins Center for Injury Research and Policy, part of the Johns Hopkins Bloomberg School of Public Health. “There are many behavioral, environmental and policy approaches proven to make exercise activities safer for kids, which we outline in our study.”

For example, she said, efforts are under way at the federal, state and local levels to increase the number of kids who walk to and from school. Those who walk each day are more likely to meet their daily recommended level of physical activity, and, over time, walking or biking to school helps children develop an early habit of engaging in physical activity. The researchers note, however, that while pedestrian injury is the second-leading cause of unintentional injury–related death among U.S. children ages 5 to 14, many effective interventions exist to improve pedestrian safety, particularly changes to the built environment, such as traffic-calming measures (i.e., speed humps, traffic circles), and enforcement of traffic laws.

“The key is breaking down the silos so injury prevention is incorporated into strategies to increase physical activity,” Pollack said. “The goal should be to maximize the benefits of physical activity programs and avoid the possible unintended consequences of increased injury.”

As an example of such integration, the researchers cite Sweden, where in 1954 a national program for child safety was established. The program, which involved representatives from the government and private sectors, used policy to promote environmental and behavioral changes to reduce pedestrian, play, cycling and swimming injuries, and the results were dramatic. Between 1966 and 2001, the child injury death rate in Sweden fell more than 50 percent. Sweden continued its commitment to childhood injury prevention with its Vision Zero initiative, which began in the late 1990s and sought to redesign many roadways in communities throughout the country to encourage pedestrian and bicycle safety.

“Biking and walking provide great exercise and health benefits. We also know that wearing helmets while biking, and building safe pedestrian paths, can help prevent injuries,” said David Sleet, associate director of science in the CDC Injury Center’s Division of Unintentional Injury Prevention. “It’s taking that one extra step to build safety into physical activity that helps reduce injury risks.”

Additional authors of the study are Cassandra Kercher and Shannon Frattaroli, both of Johns Hopkins; Corinne Peek-Asa, of the University of Iowa; and Frederick P. Rivara, of the University of Washington.

This research was supported by a grant from the Robert Wood Johnson Foundation Active Living Research program to the San Diego State University Foundation. This work was also supported in part by a CDC/NCIPC contract to the Society for the Advancement of Injury and Violence Research.