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The aging population in the United States is growing rapidly and expected to double in size to approximately 90 million by the year 2050 (U.S. Census Bureau, 2011). Similarly, ethnically diverse and vulnerable populations will also increase, including those living with disabilities and chronic health conditions (He, Sengupta, Welkoff, & Debarros, 2005). The World Health Organization (WHO; 2007) suggests that as the population grows older, so do cities. It is estimated that the number and proportion of urban dwellers will continue to rise in the next decade. The aging environment and changing demographics present both challenges and opportunities for public health researchers and clinicians focused on creating communities. For example, the Blue Zones project uses a broad systems approach, including civic engagement to promote healthy communities. The Centers for Disease Control and Prevention Healthy Aging Network (CDC-HAN) has more than one decade of work to better understand place-based determinants of health and translate that knowledge to real-world practice, with a focus on environmental strategies. The interaction between older adults and the built environment is especially important, as a growing body of research suggests that a community's physical characteristics can play a major role in promoting or discouraging physical activity (Li, Fisher, Brownson, & Bosworth, 2005), mobility (Rosso, Auchincloss, & Michael, 2011), safety, and ultimately health (Yen, Michael, & Perdue, 2009).
For the past 20 years, physical activity has remained a top leading health indicator for the nation, as noted in the Healthy People 2020 report by the Centers for Disease Control and Prevention (CDC; 2011). The benefits of moderate intensity physical activity, including brief 10-minute episodes, have been well documented. Older adults, especially those living with chronic disease or those with disabilities, can experience significant health benefits with a moderate amount of daily physical activity. Programs that promote walking among older adults have shown a significant reduction in falls in this population (Gillespie, Gillespie, Cumming, Lamb, & Rowe, 2000). Older adults are sensitive to the effects of physical activity, and even small amounts of activity are healthier than the alternative. Public health strategies to promote physical activity across generations must include multilevel approaches that consider the built environment. Research suggests that the level and type of physical activity, in which older adults engage, is affected...