title: Barriers to optimizing investments in the built environment to reduce youth obesity: policy-maker perspectives.
abstract: OBJECTIVE
  To identify factors which limit the ability of local governments to make appropriate investments in the built environment to promote youth health and reduce obesity outcomes in Atlantic Canada.
  
  
  METHODS
  Policy-makers and professionals participated in focus groups to discuss the receptiveness of local governments to introducing health considerations into decision-making. Seven facilitated focus groups involved 44 participants from Atlantic Canada. Thematic discourse analysis of the meeting transcripts identified systemic barriers to creating a built environment that fosters health for youth aged 12-15 years.
  
  
  RESULTS
  Participants consistently identified four categories of barriers. Financial barriers limit the capacities of local government to build, maintain and operate appropriate facilities. Legacy issues mean that communities inherit a built environment designed to facilitate car use, with inadequate zoning authority to control fast food outlets, and without the means to determine where schools are built or how they are used. Governance barriers derive from government departments with distinct and competing mandates, with a professional structure that privileges engineering, and with funding programs that encourage competition between municipalities. Cultural factors and values affect outcomes: people have adapted to car-oriented living; poverty reduces options for many families; parental fears limit children's mobility; youth receive limited priority in built environment investments.
  
  
  CONCLUSIONS
  Participants indicated that health issues have increasing profile within local government, making this an opportune time to discuss strategies for optimizing investments in the built environment. The focus group method can foster mutual learning among professionals within government in ways that could advance health promotion.
authors.affiliation: School of Planning, Dalhousie University, Box 1000, Halifax, NS B3J 2X4. jill.grant@dal.ca
authors.forename: Jill L
authors.initials: JL
authors.lastname: Grant
authors.forename: Kathryn C
authors.initials: KC
authors.lastname: MacKay
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Manuel
authors.forename: Tara-Leigh F
authors.initials: TL
authors.lastname: McHugh
mesh_terms: D000293:Adolescent; D001334:Automobile Driving; D002170:Canada / Q000453:epidemiology; D002648:Child; D003466:Cultural Characteristics; D004032:Diet; D004777:Environment; D005260:Female; D017144:Focus Groups; D006291:Health Policy; D006801:Humans; D008019:Life Style; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control*; D012111:Residence Characteristics; D012959:Socioeconomic Factors