Supporting Health Equity in Arizona by Assessing Physical Activity Resources in Lower-Income Census Tracts
Abstract
In Arizona, the Supplemental Nutrition Assistance Program-Education (SNAP-Ed), known as the AZ Health Zone, addresses health inequities among lower income groups. These inequities extend to the condition of physical activity resources in lower-income census tracts. In federal fiscal year (FFY) 2017, the AZ Health Zone began to gather baseline data on physical activity (PA) resources in lower income census tracts to inform organizational and community level active living work focused on PA resources. AZ Health Zone staff assessed the condition of 71 PA resources in 10 of Arizona’s 15 counties using the Physical Activity Resource Assessment (PARA). While accessibility of PA resources (cost, hours open) was good, the condition of resources varied by site type and location. The number of incivilities—items which make it less desirable to be active at a location—was negatively correlated with the condition of features and amenities. A multiple linear regression was performed and showed two significant predictors of total PARA scores: amenity quality and incivility severity. Baseline assessment of PA resources in lower income census tracts in Arizona revealed relationships among the presence and condition of features, amenities and incivilities. Across the state, as the number of incivilities rose, the condition of features and amenities at that PA resource declined.
Background
Methods
Health equity means that everyone has an equal opportunity to be as healthy as possible. There are many barriers that create health inequities between population groups; poverty and neighborhood factors are known to play an outsized role. The AZ Health Zone, addresses health inequities among lower income groups by working at multiple levels of the socio-ecological model –providing individual education, working with sites such as schools and parks, and working at the community level with active living coalitions and other community groups.
The Physical Activity Resource Assessment (PARA)1 was administered by trained staff and submitted to the state evaluation team (SET). It captured information on features (e.g., basketball courts), amenities (e.g., drinking fountains) and incivilities (e.g., litter). Staff also noted resource size, hours open, cost, and type (e.g., park). Data were entered into Qualtrics and analyzed using descriptive statistics, Spearman correlations, and multiple regression to predict total PARA scores.
Feature: Basketball Court, Nogales AZ
Amenity: Drinking Fountain, Casa Grande AZ
Incivility: Litter, Tucson AZ
Results
Conclusion & Implications
These baseline assessments suggest two pathways to improve the condition of PA resources: 1) Attend to the removal of incivilities and/or 2) Increase maintenance of the features and amenities. These two pathways may be mutually reinforcing, and changes may increase equity by producing a more appealing environment for being physically active in lower-income census tracts in Arizona.
1. Lee RE, Booth KM, Reese-Smith JY, Regan G, Howard HH. The Physical Activity Resource Assessment (PARA) instrument: evaluating features, amenities and incivilities of physical activity resources in urban neighborhoods. Int J Behav Nutr Phys Act. 2005;2:13. doi:10.1186/1479-5868-2-13
Kathryn M. Orzech PhD
Theresa A. LeGros MA
Gregory Goodman MS
Laurel Jacobs DrPH
Ryan Lang, BS
Kathryn and her co-authors are part of the AZ Health Zone state evaluation team in Arizona, which is located within the Department of Nutritional Sciences. Kathryn specializes in evaluation of Active Living policy, systems, and environment changes. Ryan is the is the AZ Health Zone Active Living program coordinator, based at the Arizona Department of Health Services.
This work was supported by the USDA SNAP-Ed in collaboration with the Arizona Department of Health Services (AGREEMENT NO: ADHS16-099661) and the Arizona Department of Economic Security.
The USDA is an equal opportunity employer.