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Assessing and Addressing Detriments to Health in Nashville


Nashville is on the move ... in more ways than one.

Efforts to address social detriments and improve livability are happening citywide, with hopes of producing a healthier Nashville for years to come.

Nashville WalknBike

There's an unmistakable correlation between obesity rates and miles traveled in a vehicle, but the city of Nashville is working to change that.

Nashville WalknBike was established in 2015 to kick start conversations and actions needed to encourage healthier means of transportation. The result was a long-term Metro Public Works strategic plan for sidewalks and bikeways to improve outcomes in a city with higher-than-average fatalities for walkers and bikers.

Mary Beth Ikard

"We have the highest concentrations of healthcare companies and workers in the U.S., but extremely poor health overall," said Transportation and Sustainability Manager Mary Beth Ikard with the Nashville Mayor's Office. "We felt like we needed to take a look at that and make sure it's on par with best practices and consistent with the transit plan the city recently adopted."

The commitment is a sizeable one, with $30 million earmarked for sidewalks and bikeways in Mayor Megan Barry's first year in office. Since then, an additional $5 million has been set aside for the project, and full implementation will require roughly $41 million. On May 1, Mayor Barry is seeking voters' approval of a transit funding referendum touted as making the city even more conducive to pedestrians and bikes.

Priority Sidewalk Network

The multi-faceted WalknBike strategic plan was finalized in 2017 and includes changes ranging from new sidewalks and sidewalk repairs to safer bikes lanes and repurposed public space. City leaders are now meeting with council members to establish a Priority Sidewalk Network (PSN). The PSN will serve as the foundation for the development of the five-year strategic project list. A scoring card helps officials look at each neighborhood objectively based on social detriments such as obesity, safety, health disparities and chronic disease.

"We look more strongly at investing in an area where we know we can achieve health goals," Ikard said, noting the number of carless households also factors into the equation. "Walking is free, and the annual transportation cost for a biker is $700 a year instead of $9,000 or more for a vehicle," she continued. "For people on limited incomes, walking, biking, and mass transit are the most affordable modes."

Linking Transportation & Lifestyle

"We're trying to have really informed discussions and engage the community in conversations about these trade-offs ... with an understanding that as a growing city, we'll have to think about how to accommodate transportation means that take up less space than cars and give people health, affordability, and better quality of life," Ikard said.


Senator Bill Frist, MD

In 2015, NashvilleHealth was launched as a citywide effort to support a cross-sector of activities surrounding the improvement of overall well being. Three years later, the group is hard at work addressing a variety of social determinants impacting Nashvillians.

"Our city is rich in healthcare capital and experience, but we suffer from serious health inequities among our citizens," said former U.S. Senator Bill Frist, MD, who helped launch the initiative. "NashvilleHealth is bringing together public health, business, government and academia to align resources and move the needle on the shared goal of better population health."

Infant Mortality

NashvilleHealth has joined forces with more than 70 groups to address infant mortality in Nashville. The Nashville Infant Vitality Collaborative (NIVC) is led by Metro Health Department and Meharry with a goal of making Nashville the best place for babies to be born.

Caroline Young

"We're excited to be a part of the NIVC effort, where we seek to address key influencers on infant health," said NashvilleHealth Executive Director Caroline Young, who serves on the NIVC leadership committee.

Because 25 percent of infant deaths are sleep related and considered preventable, NashvilleHealth is launching an infant safe sleep public awareness campaign for parents and caregivers. "Nashville partners are working hard to educate about safe sleep, and we're excited to help amplify that message," added Young.

Tobacco Reduction

According to the Centers for Disease Control and Prevention, the current rate of tobacco use among adults in Tennessee is 22.1 percent, noticeably higher than the U.S. rate of 15.1 percent. With a national ranking of 43, Tennessee is among the states with the highest prevalence of smoking adults. Cigarette smoking and exposure to secondhand smoke account for deaths of 11,400 Tennesseans annually, while productivity losses caused by smoking each year equal an estimated $3.6 billion in Tennessee, according to the Campaign for Tobacco Free Kids. Additionally, the organization estimates another $2.67 billion in annual healthcare cost in Tennessee directly caused by smoking.

As administrator of the Tobacco-Free Tennessee Coalition, NashvilleHealth is convening more than 25 organizations across the state to strengthen tobacco policies. They also recently supported media efforts related to the state's "Quittin' Time" smoking cessation campaign.

"If the Tennessee smoking rate dropped to the national smoking rate, then there would be 365,000 fewer people smoking in the state ... ultimately giving those people about two million additional years of life," Frist stated.

Conversations on Health

At the beginning of March, the group partnered with the Metro Public Health Department to launch a speaker series called All In: Conversations on Health in Nashville. The March 2 presentation - which was open to business, community and health leaders - highlighted the correlation between zip codes and overall health. A more detailed report on the inaugural meeting will be featured in the April edition of Nashville Medical News.

Young said each presentation would be followed up by small group discussions to continue conversations sparked at the lectureship. A second event is being planned for fall 2018.

"We want to bridge Nashville's health and business worlds so there's greater networking and awareness of resources we can put toward making our city a great place to live and work," Young said.



Nashville WalknBike

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Baby University, Caroline Young, Mary Beth Ikard, Mayor Megan Barry, Metro Public Health, Nashville Transportation Plan, Nashville WalknBike, NashvilleHealth, Senator Bill Frist MD
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