costs than normal weight; moderate obesity increases health care costs by 18%(men) to 31% (women). Averaging across these four groups (men/women <strong>and</strong>moderate/severe obesity), there was a 44% increase in health care costs comparedwith people <strong>of</strong> normal weight (Sturm, 2004).Obesity may account for as much as a 36% increase in costs for inpatient <strong>and</strong>ambulatory care for individuals-a greater increase than that attributed to aging 20years, smoking, or problem drinking (Sturm, 2002).One report suggests that being active saves almost twice as much per person asbeing a non-smoker (Craig, 1994).Costs <strong>of</strong> obesity-related lost productivity in 1994 included 39 million lost workdays, 239 million restricted-activity days, 90 million bed days <strong>and</strong> 63 millionphysician visits (Wolf, 1998).Determining the total medical costs <strong>of</strong> obesity using claims data may underestimatecosts because claims are not always coded with an obesity diagnosis. However, datastill show that per-person claim costs for obese patients are about triple those for theaverage person, <strong>and</strong> the hospital admission rate is roughly 350 per 1,000 comparedto about 50 per 1,000 for an average commercial population (Fitch, 2004).The Wall Street Journal reports that by 2020, the treatment <strong>of</strong> medical problemsrelated to being overweight will comprise 20% <strong>of</strong> health-care dollars spent forpeople aged 50- 69. Severely obese older people, in particular, have about twice asmany chronic medical conditions (Rundle, 2004).People with diabetes had per capita medical expenditures <strong>of</strong> $13,243 while thosewithout diabetes spent only $2,560. After accounting for differences in age, sex, <strong>and</strong>race/ethnicity, diabetics had medical expenditures that were 2.4 times greater than ifthey had not had diabetes (USDHHS).Ferries in Puget Sound, Washington have widened their seats from 18 to 20 inches,<strong>and</strong> an ambulance company in Colorado retr<strong>of</strong>itted its vehicles with a winch a largecompartment to h<strong>and</strong>le patients who weight up to half a ton (Newman, 2004).In Louisiana, which is in particularly known for its food, statewide obesityattributableexpenditures total $1.37 billion (White, 2004).Americans are estimated to spend a total $44.5 billion in 2004 on diet services <strong>and</strong>products (Tahmincioglu, 2004), <strong>and</strong> they already spend $1 billion a year onprescription <strong>and</strong> over-the-counter weight-loss drugs (Park, 2004).Importance <strong>of</strong> Accessibility to <strong>Parks</strong> <strong>and</strong> <strong>Trails</strong> In one study, people with the best access to a variety <strong>of</strong> built <strong>and</strong> natural facilitieswere 43% more likely to exercise 30 minutes most days than those with poor access(Giles-Corti, 2002). Proximity to parks <strong>and</strong> trails is important for attracting certain segments <strong>of</strong> thepopulation. For example, older women who lived within walking distance <strong>of</strong> trails,parks or stores recorded significantly higher pedometer readings in one study thanwomen who did not, <strong>and</strong> the closer the destinations were, the more they walked(King, 2003). Similarly, children <strong>and</strong> adolescents are more active if they haveconvenient access to facilities or activity programs (Sallis, 2000). Longer distances to bikeways were associated with non-use <strong>of</strong> the MinutemanBikeway in Arlington, MA (Troped, 2001).113
Evidence is accumulating that demonstrates that accessibility <strong>of</strong> facilities isimportant in encouraging physical activity (Humpel, 2002).An Outdoor Industry Association survey showed that lack <strong>of</strong> nearby parks or areasto recreate is the number five challenge for participation in outdoor activities, <strong>and</strong> agreater number <strong>of</strong> local parks or nearby recreation areas was cited as the sixth <strong>and</strong>fifth best action for encouraging youth <strong>and</strong> adults, respectively, to experienceoutdoor activities (Outdoor Industry Foundation, 2004).A study on the recreation impact <strong>of</strong> the designation <strong>of</strong> additional wilderness wasconducted to determine whether designation leads to additional recreational use orwhether users are just spreads across a greater range. Designation <strong>of</strong> additionalwilderness areas resulted in an overall increase in wilderness recreation use. Therate <strong>of</strong> increases use was such that a 10% increase in designated wilderness wouldresult in an average increase in visitor use <strong>of</strong> 8.9% (Loomis, 1999).Impact on Employers In 1994, the costs that U.S. businesses bore for obesity-related health problemsreached $13 billion, broken down by:o health insurance expenditures: $8 billiono sick leave: $2.4 billiono life insurance: $1.8 billiono disability insurance: $1 billion (Thompson, 1998) Limited physical inactivity has been linked to increased costs for time awayfrom work. The high risk category, meaning people participated in physicalactivity less than once a week, had a time away from work costs <strong>of</strong> $1,088compared to low risk groups which only had costs <strong>of</strong> $1,005 (Wright, 2002). Examples <strong>of</strong> Employee Fitness Programs:o HealthPartners, a Minneapolis-based health insurer, <strong>of</strong>fers $25 gift cardsto employees who start a walking program or join an on-site WeightWatchers group (Tahmincioglu, 2004).o Blue Cross Blue Shield <strong>of</strong> Western New York, based in Buffalo, givesradios <strong>and</strong> binoculars to employees who participate in company walks<strong>and</strong> wellness programs (Tahmincioglu, 2004).o Colonial Life <strong>and</strong> Accident Insurance in Columbia, SC implemented acomprehensive wellness program <strong>and</strong> invited <strong>of</strong>ficers from the localArmy recruiting battalion to administer a fitness test. It was runaccording to the Army’s active duty personnel st<strong>and</strong>ards, for example, bylaying out a 2-mile course that met the Army’s st<strong>and</strong>ards for maximumelevation. Those who passed received gift certificates to a local sportinggoods store (Patton, 2004).114
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ECONOMIC IMPACTS OF PARKS, RIVERS,
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AcknowledgementsI am grateful to ma
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3.5.5 Sources of Information.......
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Table 28. Hiking/Walking Organizati
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1 IntroductionParks, rivers, trails
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Table 1.SectionAgency ExpendituresC
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provide communities with economic,
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the most current information on the
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3.1 Agency ExpendituresThis section
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grants. About 25% of capital expend
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The Marin Conservation Corps (MCC)
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already been implemented and is ope
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Table 5.Net Benefit Per Participant
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WEST VIRGINIAWISCONSINEarthCorpsFed
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contracts that gross over $800 mill
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3.2.2 Special EventsRevenue enhanci
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park experience to an audience who
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you have the opportunity to determi
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Use good survey methods. The better
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California. A Report to The Sierra
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powered activities 3 , a participan
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Table 11. 2003 Sport Footwear Purch
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3.3.4 Fish and Wildlife-Related Rec
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EQUIPMENT AND OTHER EXPENSESTotal $
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Table 17. Estimates of Retail Expen
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Table 19. U.S. Ski & Snowboard Indu
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and from services related to the Pa
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o $60 million in Harris County, TX,
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League ofAmericanBicyclistsNational
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SportingGoodsManufacturersAssociati
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necessarily better, especially in s
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Perspective. Available at http://ww
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o Washington: $209 milliono West Vi
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Economic Output Retail Sales Salari
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Economic Output Retail Sales Salari
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