Movement, Health, and “The New Local”: A Conversation with Jim Sallis
This interview series is part of First Mile Health, a collaboration between IDEO, Robert Wood Johnson Foundation, and Building H to imagine how we might design health into everyday life.
The pandemic has completely transformed how we move around. Since life became more local, we’re rediscovering what’s close to home. Could these new patterns, behaviors, and rituals permanently shape our movements? Or will we revert back to our comfort zones?
In this interview, Steve Downs (Co-Founder of Building H) and I speak with Jim Sallis, Distinguished Professor in the Department of Family Medicine and Public Health at University of California, San Diego and the Director of Active Living Research, to learn about the relationship between physical movement and health and how to create the conditions to enable everyone to lead actives lives.
The New Local
Joanne: We’re in a moment where people are forced to exist in new and different ways. We’re taking stock of what our lives are like, shifting our personal values, and thinking about what’s worth keeping.
From your perspective, what are some shifts you’re seeing in society? Will they last?
Jim: I’m on the board of Rails to Trails Conservancy, and they noticed that almost immediately after the shutdown started, trail traffic picked up 100 to 200%. When people were prohibited from going to parks, I think they started valuing parks more.
When you’re cooped up, of course, the first thing you want is to be outside. I think there’s potential for people valuing being outdoors more highly. I think that value is pretty important because in the prior decades, people would walk out of their home, get in their car, go to their office, get back in the car, come home, and go to a shop on the way. I think being deprived of the outdoors has the potential to transform things. But I don’t think that transformation is going to be automatic. Unless there’s some way of acting on this moment of a different value, then it’ll just go back to the way it was.
Another change is staying local. That’s been one of my summary words for how this has changed life: It’s made life more local. One of my fantasies is that people will be more likely to consider what it would be like if they had a store in their neighborhood and be more open to mixed-use areas, which is kind of anathema in the suburbs. Also, not being stuck in rush-hour traffic for an hour and a half every day might make some people rethink how their commute contributes to their quality of life. If we can get people to reflect on how to make things better and advocate for things like better parks, wider sidewalks, or putting essential stores in their neighborhood, we may actually see some more permanent changes.
Joanne: There are systemic barriers in place, be they financial incentives or cultural or social norms, that lead to behaviors rebounding back to normal. Do you think systemic barriers might also be shifting as a result of COVID?
Jim: I think we’re at a time of disequilibrium. People are out of their comfort zones and routines, and they’re discovering new things, but what’s going to happen afterwards? If we don’t have some push in one direction or another, then the old patterns will just return. For example, car traffic has returned quickly after the national stay-at-home orders.
I don’t think I see this happening in a natural way. If somebody were to actually invest in finding ways to encourage less driving, putting more shops or a weekly farmers market in everybody’s neighborhood, making the sidewalks wider, putting bike paths in safe places to bike, those are potentially transformative things. If there’s not some force pushing in a healthier direction, we won’t see permanent change. What is that missing ingredient to encourage change?
Physical Opportunity Deficit
Steve: I wonder if it’s leadership. I’ve been looking with great envy at Paris lately. The mayor there has been running her reelection campaign on the idea of the “15-minute city,” that everybody should be within 15 minutes of everything they need.
Jim: I would completely agree with that — leadership is absolutely essential. When we look at cities that are really doing well with active living, low childhood obesity, better food supplies, and that sort of thing, I can’t think of any examples where that happened in a city that didn’t include leadership. It has to be at least supported by the top, if not initiated and driven from the top.
But I also think politicians are notable for being followers. If public opinion is going one way, they will find a way to jump on that. Most people want to be more active, but most people don’t do it.
That’s not an information deficit, it’s an opportunity deficit.
That’s why I think we need more ways for the public to become advocates for better ways of living, better neighborhoods, and better ways of doing things. I think that continues to be a missing ingredient.
So, what are the mechanisms of culture change? Well, I think part of it is some type of promotion of engagement. I started thinking about this during the big focus on childhood obesity. We had the whole federal government on our side, and we had businesses wanting to get involved, but what we didn’t have was the equivalent of grassroots movements like the Million Mom March to demand changes in schools, changes with restaurants, better parks, etc.
Joanne: What contributes to this physical activity deficit?
Jim: Well, that’s kind of everything — all of society. Think about how many of the world’s biggest industries only make money when you are inactive: cars, petroleum, virtually the whole entertainment industry, the technology industry, even restaurants. We’ve just structured our whole life and all of these industries around not being active.
Steve: And that desire to be inactive probably derives from our evolutionary history, right?
Jim: Yeah, exactly.
We have mastered evolution.
What have we wanted all throughout evolution? We wanted all the food we could possibly have — check. We wanted to just sit around and not have to move — check. Those options used to be only available to kings and queens. We’re now living the life of royalty. We should be perfectly happy with it — and in a lot of ways, we are, because people resist changing those things. But the problem is, these behaviors, plus smoking, are what’s killing us 80% of the time.
Happiness Measures Health
Joanne: What are some of the most important conditions that need to be in place for people to lead active lifestyles?
Jim: The social dimension of physical activity is very important. There’s certainly something valuable about being active together, though it’s not necessary. But having other people encourage you — somebody you can talk about your activity with — is very good. It could be somebody in your household, it could be a coworker, it could be an old college friend who lives across the country — it doesn’t really matter. That social aspect is really important. If everybody you hang out with hates exercise, so will you.
Steve: Is there data on what modes people tend to get their physical activity from? For example, commuting vs. discrete workout vs. running errands or walking the dog?
Jim: The bottom line is simple. Throughout the lifespan, except for small children, walking is the most common activity. So a message to walk more, or roll if you can’t walk, works for most everybody. But it’s also useful to look closely at activity for various purposes. The more occupational activity you do, the less leisure activity you tend to do. Throughout history, people were active because they had to be, so there was no reason for them to go out for a run. Transportation activity tends not to be related to either of those; it’s basically related to where you live. In a walkable neighborhood, you’re going to walk places because it’s easier or nicer. You may or may not do leisure activity in addition. Transportation activity is really not as motivationally driven as exercise — it’s environmentally driven.
You see dramatic differences worldwide.
In our international studies, we see places where they’re doing no leisure activities and tons more transportation activities than the U.S. In the U.S., almost all of our activity is leisure.
Joanne: It’s easy to know when we’re sick, but how do we know when we’re healthy? How would you define health in a positive way — as in, not the absence of disease, but rather the presence of something?
Jim: How about happiness? Most people have a pretty positive conception of happiness, and physical activity will reliably take you there. Physical activity has so many beneficial mental health effects. I always say that teachers and parents should be super motivated to make sure their kids are active because those kids are going to be in a better mood. It’s to everyone’s benefit.
Joanne: That reminds me of one of my favorite poems by Mary Oliver, “Lingering In Happiness”, from her book Why I Wake Early. I’d like to read it to you to conclude our interview:
Lingering In Happiness
After rain after many days without rain,
it stays cool, private and cleansed, under the trees,
and the dampness there, married now to gravity,
falls branch to branch, leaf to leaf, down to the ground
where it will disappear–but not, of course, vanish
except to our eyes. The roots of the oaks will have their share,
and the white threads of the grasses, and the cushion of moss;
a few drops, round as pearls, will enter the mole’s tunnel;
and soon so many small stones, buried for a thousand years,
will feel themselves being touched.