National Complete Streets Coalition


In Moses Lake, Washington, the community has adopted a Healthy Communities Action Plan, in direct response to a 127% increase in the adult obesity rate there. New zoning rules require wider sidewalks and other features that improve accessibility for pedestrians and cyclists.

Incomplete streets restrict physical activity

When streets are designed only for cars, they deny people the opportunity to choose more active ways to get around, such as walking and biking. Even where sidewalks exist, large intersections and speeding traffic may make walking unpleasant or even unsafe – discouraging any non-motorized travel.

Obesity in America has reached epidemic proportions in recent years. The latest data show that 32% of adults are obese , the number of overweight or obese American children nearly tripled between 1980 and 2004. Health experts agree that a big factor is inactivity – 55 percent of the U.S. adult population falls short of recommended activity guidelines, and approximately 25 percent report being completely inactive. Inactivity is a factor in many other diseases, including diabetes, heart disease, and stroke. Incomplete streets mean many people lack opportunities to be active as part of daily life.

Post World War II growth patterns and street designs tend to favor the automobile over walking and bicycling. The health impacts are clear — one study found that, on a daily basis, each additional hour spent driving is associated with a 6% increase in the likelihood of obesity, while each additional kilometer walked is associated with a 5% reduction in this likelihood.

Complete Streets make active living easy

Complete Streets provide opportunities for increased physical activity by incorporating features that promote regular walking, cycling and transit use into just about every street. A report prepared by the National Conference of State Legislators found that the most effective policy avenue for encouraging bicycling and walking is incorporating sidewalks and bike lanes into community design – essentially, creating Complete Streets. The continuous network of safe sidewalks and bikeways provided by a Complete Streets policy is important for encouraging active travel.

A recent comprehensive assessment by public health researchers of actions to encourage more physical activity recommended building more sidewalks, improving transit service, and shifting highway funds to create bike lanes.

One study found that 43% of people with safe places to walk within 10 minutes of home met recommended activity levels; among those without safe places to walk just 27% met the recommendation. Residents are 65% more likely to walk in a neighborhood with sidewalks.

Walkability has a direct and specific relation to the health of residents. A comprehensive study of walkability has found that people in walkable neighborhoods did about 35-45 more minutes of moderate intensity physical activity per week and were substantially less likely to be overweight or obese than similar people living in low-walkable neighborhoods.

Easy access to transit can also contribute to healthy physical activity. Nearly one third of transit users meet the Surgeon General’s recommendations for minimum daily exercise through their daily travels.

A community with a Complete Streets policy ensures streets are designed and altered to make it easy for people to get physical activity as part of their daily routine, helping them stay trim, avoid heart disease, and receive the many other benefits of physical activity. DuPage County, Illinois adopted its Complete Streets policy as a health measure, calling it their “Healthy Streets Initiative” and the Tacoma-Pierce County Board of Health (WA) adopted a resolution urging decision makers in all Pierce County municipalities to adopt and implement Complete Streets policies to promote healthy living.


[all fact sheet citations are available in the downloadable files]

Additional Resources:

Transportation Recommendations
Centers for Disease Control and Prevention, April 2010

U.S. National Physical Activity Plan
April 2010

Solving the Problem of Childhood Obesity Within a Generation
White House Task Force on Childhood Obesity Report to the President, May 2010

Complete Streets Fact Sheet
American Public Health Association, November 2011

Promoting Active Transportation: An Opportunity for Public Health
American Public Health Association and Safe Routes to School National Partnership, 2012

Physical Activity Access for Minority and Low Income Communities
Active Living Research, November 2011

Healthier Americans for A Healthier Economy
Trust for America’s Health, November 2011

Switch Some Trips to Bikes and Have Cleaner Air and Improved Health
University of Wisconsin/Environmental Health Perspectives, January 2012

2012 Benchmarking Report
Alliance for Biking and Walking, January 2012

Designing Healthy Communities with Richard Jackson
PBS, 2011/2012

Increasing Physical Activity in Low Income African American Neighborhoods
Prevention Research Center at Tulane University, February 2012

Evaluating Public Transportation Health Benefits (.pdf)
American Public Transportation Association, 2010

Walking and Cycling to Health: A Comparative Analysis of City, State, and International Data
Pucher et al., American Journal of Public Health, 2010

Public Support for Street-Scale Urban Design Practices and Policies to Increase Physical Activity
Susan A. Carlson et al., Journal of Physical Activity and Health, 2011

A Heavy Burden: The Individual Costs of Being Overweight and Obese in the United States
Avi Dor, Ph.D., George Washington University School of Pubic Health and Health Services, 2010

Advocacy and Public Health: Partners for Walkable, Bikeable Communities
Washington State case study, Pedestrian and Bicycle Information Center

Increasing Physical Activity Through Community Design (.pdf)
National Center for Bicycling & Walking, 2010

The Effect of Light Rail Transit on Body Mass Index and Physical Activity
John M. MacDonald, Robert J. Stokes, et al., American Journal of Preventative Medicine Vol 39, Issue 2

Health Equity and Prevention Primer
Prevention Institute, 2010

The Association Between Community Physical Activity Settings and Youth Physical Activity, Obesity, and Body Mass Index
Journal of Adolescent Health, June 2010

Healthy Community Design Expert Workshop Report
Center for Disease Control and Prevention, 2010

Getting Students Active Through Safe Routes to School (.pdf)
Safe Routes to School National Partnership, 2010

F as in Fat 2010: How Obesity Threatens America’s Future 2010
Trust for America’s Health, June 2010

The Hidden Health Costs of Transportation (.pdf)
American Public Health Association, March 2010

The Hidden Health Costs of Transportation (Backgrounder) (.pdf)
American Public Health Association, March 2010

Recommended Strategies and Measurements to Fight Obesity
Centers for Disease Control and Prevention, 2009

The Transportation Prescription: Bold New Ideas for Healthy, Equitable Transportation Reform in America
PolicyLink and Prevention Institute, 2009

Action Strategies for Healthy Communities Toolkit
Leadership for Healthy Communities

Active Transportation: Making the Link from Transportation to Physical Activity and Obesity Research Brief (.pdf)
Active Living Research, 2009

Local Government Actions to Prevent Childhood Obesity
Institutes of Medicine, 2009

Active Design Guidelines: Promoting Physical Activity and Health in Design
New York City Department of Design and Construction, et al., 2009

Quality of Residential Neighborhood: A Modifiable Risk Factor for Type 2 Diabetes?
Mitchell H. Katz, 2009

Active Travel: The Role of Self-Selection in Explaining the Effect of Built Environment on Active Travel Research Brief (.pdf)
Active Living Research, 2009

Public health benefits of strategies to reduce greenhouse-gas emissions: urban land transport
James Woodcock, Phil Edwards, Cathryn Tonne et al., 2009

The Regional Response to Federal Funding for Bicycle and Pedestrian Projects
Barbara McCann and Susan Handy, 2009

Who Owns the Roads? How Motorised Traffic Discourages Walking and Bicycling
Peter Jacobsen et al., 2009

NYC Vital Signs: Physical Activity in New York City (.pdf)
New York City Department of Health and Mental Hygiene

Walking, Cycling, and Obesity Rates in Europe, North America, and Australia (.pdf)
David Basset and John Pucher, 2008

Promising Strategies for Creating Healthy Eating and Active Living Environments (.pdf)
The Prevention Institute, 2008

Air Pollution Burden of Illness from Traffic in Toronto – Problems and Solutions (.pdf)
Toronto Public Health, 2007

Endangerment and Cause or Contribute Findings for Greenhouse Gases under the Clean Air Act
US Environmental Protection Agency

Exercise-based Transportation Reduces Oil Dependence, Carbon Emissions and Obesity
Environmental Conservation, 2005

Physical Activity and the Health of Young People
Centers for Disease Control and Prevention, 2004

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