Surgeon General’s Prescription for Health: Walk More An Action Guide About How to Get America Back on Its Feet

| September 16, 2015


By Jay Walljasper,


We’ve always known walking is good for us— it burns calories, reduces stress and helps the environment.

But we never knew how really great it is for us until the just released Call to Action on Walking from US Surgeon General Vivek H. Murthy, who explains, “An average of 22 minutes a day of physical activity – such as brisk walking – can significantly reduce the risk of heart disease and diabetes. The key is to get started because even a small first effort can make a big difference in improving the personal health of an individual and the public health of the nation.”

Surgeon General Murthy announced a national campaign to encourage Americans to walk more and make all communities safer and easier for walking. His office will partner with schools, citizens groups and businesses to meet these goals.

“Walking is a simple, effective and affordable way to build physical activity into our lives,” Murthy adds. “That is why we need to step it up as a country ensuring that everyone can choose to walk in their own communities.”

The landmark report—which is being compared to the Surgeon General’s 1964 warning on the dangers of smoking—is based on definitive medical evidence that moderate physical exercise boosts your health cuts your chances of diabetes, dementia, depression, colon cancer, cardiovascular disease, anxiety and high blood pressure by 40 percent or more.

A major study released this year shows that lack of exercise is twice as deadly as obesity, according to Cambridge University researchers who studied more than 300,000 people over 12 years.  Their findings match another comprehensive study that found sitting for long periods is linked to higher death rates.

This explains why the Surgeon General and a growing chorus of health care experts are singing the praises of walking.

The federal Centers for Disease Control and Protection (CDC) recommends Americans walk at least 30 minutes a day five days a week—or bike, run, swim, dance, garden do aerobics and play sports.  (For kids, it’s 60 minutes a day seven days a week.)  Taking a walk is the exercise that people stick with most over time, according to the American Heart Association.

“Walking is like medicine for my patients. If walking was a pill or surgical procedure,” it would be all over the news, says Dr. Bob Sallis , a family practitioner in Fontana, California.

“You don’t have to be an athlete to be physically active, just walk, walk, walk!” says the Bernard J. Tyson, president of Kaiser Permanente, one of America’s largest health care providers that powers the Every Body Walk! Collaborative (involving more than a hundred other organizations from the National PTA to AARP to the National Association of Realtors) to get more Americans walking.

Walking stands out as Americans’ favorite aerobic activity because it’s free, easy, available anywhere—and, most of all—it’s fun.  Six in ten Americans take a walk at least once a week, according to the Centers for Disease Control and Prevention (CDC), and the number of Americans walking has risen six percent since 2005. That adds up to 20 million more people on their feet.

The U.S. Department of Transportation reports that eleven percent of the nation’s trips are now made by walking.  That rises to 28 percent for all trips under one mile, including 35 percent to work, 40 percent to shopping and 46 percent to religious services.


Good For Your Health—But Also For Your Pocketbook and the Local Economy

The rising tide of walkers across America brings us other benefits too.

Lower health care costsPhysical inactivity costs Americans an estimated $177 billion a year for medical costs, and accounts for 16 percent of all deaths, according to the American Public Health Association.

More social connections: Strong social connections improve both our physical and mental health, and walking is one of the best ways to meet neighbors and deepen ties with friends.

Stronger communities: “Exercise is medicine.  It’s also good for the social fabric of our communities,” says former Dr. Regina Benjamin, US Surgeon General from 2009 to 2013, explaining why she added a walking path to the grounds of her health clinic in rural Alabama. “Health does not just happen in doctors’ offices and clinics — it happens where we work, live, play and pray,” she says.

“What makes people walk is what makes great places to live,” adds Harriet Tregoning, head of the Office of Community Planning at the US Department of Housing and Urban Development (HUD). “Walkability is the secret sauce that improves the performance of many other things ” in our communities.

Improved school performance. Walking to school boosts “cognitive performance” in students, according to Mary Pat King, the National PTA’s Director of Programs and Projects.  Dr. Richard Jackson, a pediatrician and former Environmental Health Director at the US Centers for Disease Control finds that walking to school is good for children’s learning ability, concentration, moods and creativity.

Improved creativity and reduced anxiety: Eighty five percent of Americans believe that walking helps reduce anxiety and feelings of depression, and two-thirds of Americans report that walking “stimulates their thinking” according to a national survey.

Putting one foot in front of the other is intrinsically tied to our minds as well as our bodies. “To solve a problem, walk around,” advised St. Jerome in the 4th Century.  Fifteen hundred years later, Henry David Thoreau agreed: “The moment my legs begin to move, my thoughts begin to flow.” The Buddhist philosopher Thich Nhat Hanh observes, “Every time we take a step on this Earth, we can appreciate the solid ground underneath us.” The Bible counsels, “ask for the ancient paths, where the good way is; and walk in it, and find rest for your souls.” [Jeremiah 6:16]

A stronger economy: “Walking is a business issue.  A healthy workforce means a more successful workforce,” says Karen Marlo vice-president of the National Business Group on Health, a consortium of leading companies across many fields. Indeed, communities with many walkable neighborhoods do better economically than those with just a few, according to a report from the George Washington University School of Business.

Lower cost of living: Transportation costs rival housing costs for many American families today, especially those living in places where it is hard get around without a car (25 percent of  household expenses) compared to walkable communities (9 percent), according to the Federal Highway Administration. The yearly costs of a owning and operating a car at $8698, which means that figuring out how to walk more and drive less makes economic sense, according to the  American Automobile Association

Higher quality of life: Walk with a Doc, a group of more than 200 doctors in 29 states, documents 100 “Benefits of Walking”, including many medical advantages but also increased physical energy, clearer skin, improved athletic performance, reduced anger, increased self-control, longer lives and a greater sense of well-being.


Getting America Back on Its Feet

In light of all this evidence, it’s clear that walking is a healthy, economical, sociable, pleasurable thing to do. Yet less thanhalf of us meet the CDC’s weekly minimum for walking or any other physical activity–30 minutes a day five days a week.

Americans walk less than people in most other countries. In fact, Australians walk almost twice as many steps each day as we do, a surprise in a country that is similar to the US with high rates of car ownership and spread-out suburban development.

While ninety four percent of Americans participating in a national survey said that walking is “good for their health,” 79 percent admitted they “should walk more.”

So what’s stopping them?

40 percent of people said their “neighborhood is not very walkable”

40 percent said there are “few places within walking distance of my home”

39 percent said “they don’t have time”

25 percent cited a “lack of sidewalks or speeding traffic”

25 percent cited “no one to walk with”

13 percent cited “crime in my neighborhood”

“Everyone deserves to have a safe place to walk or wheelchair roll,” Surgeon General Murthy . “But in too many of our communities, that is not the reality.”

To get Americans back on their feet —to enjoy better health and other rewards— we need to make strolling and striding a natural part of daily life again. This can be accomplished by removing the personal and physical barriers that discourage us from walking for recreation, relaxation, and transportation.

Most Americans support significant changes in our communities to promote this goal, according to the survey sponsored by Kaiser Permanente.  Eighty percent “want to design streets to make walking safer” (even if it means driving slower); 71 percent “want better enforcement of speed limits” (even if it means driving slower), and 54 percent “want communities where destinations are within walk distance” (even if it means building homes closer together).

These steps are popular because they are not some radical upheaval of our way of life, but a common-sense readjustment. Walking has always been one of the most elemental human acts, central to our lives the same as breathing, eating and sleeping. Making streets and neighborhoods more safe, convenient, comfortable and interesting for people traveling on foot (or rolling in wheelchairs) is a sensible return to traditional values.  It not only enhance our health, but enriches our lives by better connecting us to people and places in our communities.


Easy Steps to Walking More

Find your natural rhythm

Figure out the best times to walk for your schedule. Maybe it’s first thing in the morning. Or with your kids on the way to school. After lunch. Taking the dog out. After dinner.  Before bedtime. With friends or family on the weekends.  There’s a national effort to get people walking every Wednesday .

Seize the opportunity whenever you can

Take the stairs instead of an elevator.  Park a few blocks from your destinations. Ride transit (which usually involves a short walk on both ends of the trip). Swap the drive to the gym for a hike around the neighborhood.  Run errands on foot. It all adds up.

Pay attention to other ways you can incorporate walking into your daily life, rather one more thing added to your schedule.  Studies show we stick with exercise more when it is a regular part of our day more than when it’s a leisure time activity.

Start small but think big

Be realistic in your goals. The CDC’s recommended minimum–30 minutes a day–makes a good beginning.  Do it in two or three separate trips if you need to. Then yo might work your way up to the increasingly popular walk marathons or half-marathons.  (Three out of eight finishers of the Portland marathon now walk, and there are increasing numbers of walk-only marathons.)

Keep track of your progress

A pedometer, phone app or other device that keeps tabs on how much you walk each day can be a handy tool. Fitness experts recommend 10,000 steps a day, but that can vary depending on personal factors. Americans on average walk about 5,110 steps a day.

Identify as a walker

Walkers are athletes too. It’s a good exercise and an enjoyable pastime the same as biking, running, or basketball.  Claim it as your sport, and you’ll do it more often.  Solidify your commitment by taking the walking pledge.

Make sure your walk is enjoyable

Find a route that is interesting, perhaps with a favorite destination like a coffee shop, park or a great view.  Wear walking gear that is comfortable and that you feel good in. Don’t set overly tough goals at first. “If you’re slogging through somethingyou don’t enjoy, you won’t stick with it,” says David W. Brock, PhD, assistant professor of exercise and movement science at the University of Vermont.

Invigorate your social life

Suggest a walking “date” with your partner, friends or family.  Invite dinner guests to stroll around the block after a hearty meal.  Instead of meeting someone for lunch, a drink, or a movie —begin the occasion with a walk before you sit down together.

In New York City, for instance, it’s a longstanding tradition for folks to walk together through Central Park or along the Brooklyn Promenade. In San Antonio, it’s the Riverwalk. What would be the equivalent activity in your town?

Most people’s vacations are built around walks–hiking in the woods or mountains, ambling on the beach, strolling through historic neighborhoods, wandering all over theme parks or the State Fair. Why not maintain that vacation spirit all year by regularly walking with family and friends.

Try a walking meeting

Instead of gathering around a table, walk around the block. You’ll likely see a spike in people’s creativity and attention. Facebook founder Mark Zuckerberg and Twitter co-founder Jack Dorsey both favor walking meetings, as did Steve Jobs, Sigmund Freud, Charles Dickens and Aristotle. Prominent corporate consultant Nilofer Merchant explains how it works in this TED Talk.

Since 80 percent of Americans get virtually no physical activity in their jobs, this could be a giant boost for the nation’s health.  Also, walk around while talking on the phone.

Organize a walking group

“If you want to go fast, walk alone; if you want to go far, walk together,” says an African proverb. Round up co-workers for a lunchtime hike. Grab the neighbors for an evening stroll. You’ll walk more often and more merrily when you share the journey.  Think of it as a book club with no homework.

Thirty walking groups were launched in Albert Lea, Minnesota in 2009 as part of a community-wide campaign to improve health. Six years later, more than half are still going, with four to ten people meeting to walk three to seven times a week.  Girl Trek, a growing organization dedicated to help African-American women stay in shape, has launched walking groups from Oakland to Jackson, Mississippi to Philadelphia involving more than 10,000 women.

Get more information

To learn more about walking, see the free 30-minutes on-line movie The Walking Revolution, and enjoy the a recent reunion of The West Wing cast in a 2-minute sketch extolling the benefits of walking.

Join the walking movement

Americans’ growing interest in walking has sparked a national movement to encourage people to walk more and to make our communities more walkable.  More than 230 organizations from 41 states were represented at the first ever Walking Summit in 2013, including the PTA, YMCA, AARP, NAACP and CDC.  Another summit will be held October 28-30 this year in Washington, DC.

America Walks, a coalition of more than 530 walking advocacy organizations that covers all 50 states, can connect youwith a walking group in your area.

How to Make Every Place Good to Walk

Almost everyone moves on foot throughout the day (or rolls in a wheelchair) but a lot of us don’t see ourselves as walkers.  That’s only for people who are in great shape. Or those too poor to own a car. Or folks who live in big cities. Or young hipsters. Or people in places where the weather is warm year-round.

Definitely not! Every one benefits from walking, and communities of all kinds—from from Los Angeles to Newark, Muscatine, Iowa to Greenville, South Carolina—are pitching in to encourage people to walk more by improving walking conditions. Here’s how:


Making inner city streets safer

In some places, fear of crime keeps people shut up indoors. There’s safety in numbers, as the old saying goes, and walking groups help everyone feel more at ease. In DC’s Anacostia neighborhood, the Just Walk group sponsors Saturday morning hikes and works with city officials to fix broken sidewalks and streetlights, and reduce crime.

“If you look at the statistics, the neighborhood is safer now than it’s been in many years,” says Khadijah Tribble, one of the group’s leaders. “So part of the problem is perception. We help change that by getting people out.  People on the street create greater levels of safety.”


Addressing social justice

Civil rights activist Lexer Quamie advocates “equal activity in mobility,” noting that African-Americans and Latinos are killed walking at nearly twice the rate of whites.  And people walking in low-income neighborhoods are four times more likely to be struck by motorists–which cannot be explained by the age, education or English proficiency of residents, or by the population density of the community.


Getting suburbs back on their feet

After World War II, most new communities were designed exclusively for drivers. Sidewalks were forgotten and traffic was channeled into wide, busy, high-speed roads that few people dared to cross on foot. But that’s changing now that the upcoming Millennial Generation (and many baby boomers too) show a decided preference for strolling to cafes, stores and other gathering places.  A new wave of suburban leaders believe their communities’ futures depend on becoming more walkable so they can attract young people, families and businesses–as well keep current residents who don’t wan to drive everywhere all the time.

The best place to see this transformation in action is Arlington County, Virginia, right outside Washington, DC.  Built up after autos came to dominate American life, it’s a classic suburb full of freestanding homes with driveways and green lawns.  Nonetheless, it’s been named one of the 14 best “Walk Friendly” communities in America by the Pedestrian and Bicycle Information Center at the University of North Carolina. It achieved this distinction through an “urban village” approach to development, which encourages shopping, schools and services to locate within walking distance of people’s homes.  Today 90 percent of the county’s streets now have sidewalks.


Rejuvenating small towns

Many folks think walking is a city thing.  In rural America, people only walk between their pickup truck and the Walmart entrance, right? The truth is that in towns of 10,000-50,000, 8.5 percent of all trips are made on foot, second only to “urban core” communities, according to the US Department of Transportation. In smaller towns of 2500 to 10,000, walking accounts for 7.2 percent of trips–higher than in most suburban communities.

In Albert Lea, Minnesota–a farm town of 18,000– walking has increased 70 percent in the last five years, thanks to a community-wide push. Downtown has been improved by widening sidewalks, narrowing streets and adding traffic calming features that make pedestrians feel more at home. Six-and-a-half miles of new sidewalks have been added near schools, senior centers and businesses.   The goal is to create a healthier community for residents and to boost the local economy, says city manager Chad Adams.


Walking in All Seasons and Weather

You’d expect that people walk the most where it’s sunny and warm. Not so, according to recent census data.  In rainy, chilly Seattle, 9.1 percent of commuters travel on foot compared to 2.9 percent in San Diego, which has 100 fewer days of rain each year.  In snowy Syracuse, NY, 10.4 percent walk to work compared to 1.8 percent in mild, dry San Jose.  In frigid Minneapolis, it’s 6.4 percent compared to 1.8 percent in Dallas, where the January high averages 57 degrees.


Indeed, Minnesota ranks second in the nation for walking during the summer, and a surprising fifth in the winter.  Their secret: dress warm, and walk indoors when it’s bitter cold.  The same advice applies to hot weather places, only in reverse: dress cool, and walk indoors when it’s scorching. And for rainy places: dress dry, and walk indoors when it’s pouring.


A Vision of Safe Streets for All

Over 4500 people on foot are killed by motor vehicles every year—a death toll surpassing all natural and man-madedisasters of the last century, including 9/11.  The victims are disproportionately children, older people and people of color.

Unfortunately, these pedestrian deaths (and another 33,000 people killed in vehicles and bike collisions) are viewed as an inevitable side effect of modern life. Yet recent history offers genuine hope for safer streets. A generation ago domestic abuse and drunk driving were seen as sad, unalterable facts of human nature. But vigorous public campaigns to prevent these tragedies have shown big results, offering evidence that destructive human behavior can be curbed when we put our minds to it.

U.S. Secretary of Transportation Anthony Foxx (the former mayor of Charlotte) is making safe streets for everyone a major mission with his Safer People, Safer Streets initiative. “This is the safest time for transportation in history, except for pedestrians and bicyclists,” he said, adding that walking and biking are “as important as any other form of transportation.”

A number of places such New York, San Francisco, Pittsburgh, Chicago, Los Angeles, Portland and Boston are already at work to eliminate all traffic deaths (on foot, on bike, in cars) through street improvements, law enforcement and public education.

This Vision Zero safety strategy is modeled on successful efforts in Sweden, where overall traffic deaths have been cut in half since 2000–making Swedish streets the safest in the world according to a front page story in the New York Times. Pedestrian deaths in the country have also plunged 50 percent since 2009. After adopting Vision Zero policies in 2014, New York City saw an immediate 27 percent reduction in people killed while walking –the lowest in more than a century.


How to Make Walking Safer, Easier & More Fun

Here are a few practical steps to slow speeds, deter distracted driving, enforce traffic laws and help make walking safe, comfortable, and enjoyable for everyone. This is where Vision Zero hits the road—a series of road improvements that make travel safer for everyone in or out of motor vehicles.

View walking as a basic human right: Walking has been shown to optimize our health and strengthen our communities, which means everyone should have equal opportunity to do it.  But low-income people often find it difficult or dangerous to take a walk in their neighborhoods, which often lack sidewalks and other basic infrastructure. Latinos suffer a pedestrian death rate that is 43 percent higher than whites, while for African-Americans it is 60 percent higher.

Create Safe Routes to Schools: Half of kids under 14 walked or biked to school in 1969.  Now it’s less than 15 percent. That’s why families, schools and community officials are launcing campaigns in many towns to identify and eliminate barriers that block kids from getting to school under their own power.

“We’re finding that the best interventions include both infrastructure improvements and programming.  You put the sidewalks in but also get parents involved,” explains Margo Pedroso, deputy director of the Safe Routes to Schools National Partnership.  A five-yearstudy of 800 schools in Texas, Florida, Oregon and DC found a 43 percent rise in walking and biking by using this strategy. (This success also spawned Safe Routes for Seniors programs in Chicago, San Francisco.)


Build communities for people of all ages:  The mark of a great community is whether you’d feel calm about letting your 80-year-old grandmother or 8-year-old son walk to a nearby park or business district, says Gil Penalosa, founder of the international organization 8 80 Cities. Actually, one third of all Americans are unable to drive because they are too young, too poor, too old or disabled. “Most of us are going to outlive our ability to drive by 10-12 years,” warns Kelly Morphy, executive director of Walkable and Livable Communities Institute.


Join or initiate a pedestrian advisory council

Almost all of us walk every day, but too often we are silent on the problems we face, unlike bicyclists, motorists and other groups. That’s why towns and cities from Flagstaff to Milwaukee to Frederick, Maryland have created pedestrian advisory councils to help lawmakers, planners and street engineers do their jobs better.


Conduct walk audits:  A deceptively simple idea, walk audits bring citizens and public officials together to assess the safety and convenience of walking in a particular locale. “They can really change how people look at a place,” says Dan Burden of Blue Zones, who in 1984 organized the first walk audit at a treacherous Florida intersection.  This is a crucial tool to create what Burden calls “community-driven planning”, where the people living in a neighborhood have a big say in what happens there. (Walk Audits will become even more important to help us safely incorporate new technologies such as driverless cars, which could hit the streets as early as 2020.)


Take a walk on the Jane side: Jane Jacobs, a woman who in the 1960s stood up to stop a highway planned for her neighborhood, is the godmother of the movement to improve life in our communities.  She died in 2006 but her legacy lives on in Jane’s Walks, where folks in neighborhoods from Regina, Saskatchewan to Carthage, Mississippi organize walking tours to highlight the attractions and history of their community.


Enact Complete Streets policies: The simple idea here is that all streets should offer safe, convenient and comfortable travel for everyone–those on foot, on bike, on transit, in wheelchairs, young, old or disabled.  Twenty seven states and 625 local communities across the US have adopted Complete Streets policies in some form. The aim is to provide protection for everyone by curtailing speeding and other dangerous  behavior on streets and making people on foot or bikes more visible to drivers.


How to Make The Streets Safe for Everyone

Share the street: Streets can take up 30 percent or more of the space in a city or suburb, and this should not be the exclusive property of motor vehicles.  We all need to cross streets, of course, but they can also be used for other purposes too.  Open Streets events, which turn roads into lively linear parks for a day, have been a hit everywhere from Fargo, North Dakota to Pensacola, Florida.  New York City (where 36 percent of the entire city is taken up by roads) has expanded this idea with Play Streets, when roads are closed to traffic and opened to kids at regularly scheduled hours.

Reduce the number of travel lanes on wide streets: Downsizing four-lane streets to two travel lanes with an alternating turn lane in the middle has become a popular trend across the country. When this “road diet” approach was used on a stretch of Edgewater Boulevard in Orlando, crashes declined 34 percent and injuries 68 percent, property values rose 8-10 percent, and drivers’ travel times actually decreased. All this explains why the Federal Highway Administration designates road diets as “Proven Safety Countermeasures,” which they urge traffic engineers to use to reduce collisions at intersections.

Reduce the width of travel lanes: “Many communities created 12 foot travel lanes for  cars simply because it was  a recommended standard.  Increasingly they’ve realized  wide lanes invite speed,  and  in  neighborhoods,  retail  districts and near schools, narrower lanes  send a better  message to  drivers,” says walkable communities expert  Mark Fenton, a former member the US national racewalking team.

Reduce the length of crosswalks: A shorter walk across the street is a safer one. Extending the sidewalk out a few feet into the intersection also improves safety for all road users by making pedestrians more visible and slowing the speed of turning traffic.  A study in Albany, Oregon found that curb extensions significantly reduced the number of drivers refusing to yield to people walking across the street .

Make crosswalks more visible: Mark them with bright swaths of paint or, better yet, elevate them to curb level, which has worked everywhere from San Francisco to Boulder to rural Harrisonburg, Virginia.

Add medians or pedestrian crossing islands in the middle of busy streets: This has been shown to reduce traffic accidents by 46 percent, and it provides a refuge for people crossing the street.  The Federal Highway Administration (FHWA) deems this one of its nine “proven safety countermeasures”.

Give people walking a head start at traffic lights: a three-to -even second head start allows pedestrians to enter the crosswalk first and be far more visible to motorists, resulting in up to 60 percent fewer pedestrian-vehicles collisions, according to the National Association of City Transportation Officials.

Ban right on red turns at busy intersections: Drivers, busy watching out for other cars, often don’t see people crossing the street on green lights.

Install roundabouts, speed humps and other traffic calming measures: These are valuable for reminding motorists to drive slower and to keep an eye out for people on foot and bikes. A traffic calming project in West Palm Beach, Floridaresulted in safer streets, less crime, increased property values and $300 million in business investment. Roundabouts (another FHWA safety countermeasure) added to La Jolla Boulevard in San Diego led to more people walking, new businesses, more on-street parking and shorter travel times for motorists.

Convert one-way streets to two-way: This encourages safer, slower driving and less noise for local residents.  Tampa, Dallas, Louisville and San Jose are among the cities changing streets back to two-way.

Install red light cameras and other of means high-tech law enforcement:  It’s expensive to station a police car at every unsafe intersection, but cameras can nab lawbreakers who speed, run red lights or do not yield right-of-way to people walking. More than 550 communities from Sacramento to Charlotte use them.

Stricter enforcement of traffic laws: Killing or Injuring people with a car is no less tragic than doing it with a weapon. Seattle won top honors as a Walk Friendly Community , in part, for their Aggressive Driver Response Team, where neighborhoods work with police to curb dangerous drivers, and the 2012 Vulnerable User Law, which zeroes in on negligent but not criminal traffic errors that injure or kill people walking.

“These pedestrian improvements also typically improve motorists’ and bicyclists’ safety,” says Charlie Zegeer, Director of the Pedestrian and Bicycle Information Center.  “It’s a win-win-win.  Everyone’s safer.”


Jay Walljasper is a writer, speaker and consultant on making our communities great places for everyone and author of the Great Neighborhood Book.  He is the Urban Writer in Residence at Augsburg College in Minneapolis and a Senior Fellow at Project for Public Spaces. Contact him at

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