Individual and community health often are a function of larger social and economic factors such as income, education and social engagement.

Obesity’s a problem for Polk County just as it is throughout Florida and America. In 2012, civic leaders got a wakeup call when a national study ranked the Lakeland-Winter Haven metro area seventh in the nation in obesity. Polk ranks worse than the state average for obesity, access to exercise and physical inactivity and sits in the bottom half of Florida counties overall for healthy behaviors and health outcomes.

“There are things we need to improve,” says Dr. Joy Jackson, director of the Florida Department of Health in Polk.

Something as simple as more kids walking to school would help. But 27.5% of the road network leading to schools lacks sidewalks.

That’s changing. In 2012, Polk and its 17 municipalities became a state leader in the countywide adoption of what’s called a Complete Streets policy, a national movement toward designing roads for pedestrians and cyclists as well as drivers. The Polk Transportation Planning Organization has set aside $6 million annually from road funds to create sidewalks, cycling lanes and even trails. Last year, the money funded a pedestrian bridge over U.S. 17/92 to connect two trail systems in Polk County, says county assistant manager for planning and development Tom Deardorff. Efforts also have been undertaken to educate students and adults on safety. “It’s really behavior and education,” Deardorff says.

The Complete Streets policy dovetails with an even more comprehensive approach county leaders are pursuing called Health in All Policies. That’s an attempt to advance community health — whether curbing obesity or infant mortality or promoting exercise — by having government agencies and civic organizations cooperate to promote health far beyond the individual power of the Florida Department of Health county offices, doctors and hospitals.

Health in All Policies encompasses building and community design, air quality, affordable housing, recreation, crime and safety, education and other fields.

“We talk about health now the way we talk about economic development,” says Colleen Mangan, community health program manager in Polk. “We talk about healthy design the way we talk about economic vitality.”

Behind the effort lies a three-fold recognition. A fifth of cancers stem from a person being overweight while a lack of exercise and poor nutrition contribute to other preventable, chronic diseases. It’s unreasonable to expect people to choose healthy behaviors — say, walking more — if infrastructure, public policy and the resulting societal factors work against it.

Complete Streets policies are no longer rare in Florida communities. The state itself adopted it for state roads in 2014. But Health in All Policies is advancing slowly. This spring in St. Petersburg, Mayor Rick Kriseman signed a resolution establishing that the Pinellas County health department, with a grant from the Foundation for a Healthy St. Petersburg, would designate a full-time planner who will make recommendations that integrate health considerations as part of “city interdepartmental policy and projects.” In July, the county health department and the foundation formally launched the Health in All Policies effort.

It takes time. The health department in Polk and community advancement organization Polk Vision have been moving for several years to build partnerships between disparate government agencies and civic groups to jointly address health. One area being looked at is community schools, schools that would double as access points for health care and social support for students and their families.

The county’s comprehensive land-use plan now, through development and redevelopment, encourages construction that leads to exercise and a healthy lifestyle. Obesity is taken on through myriad other directions: Workforce education, visits to the doctor, local hospitals or clinics, school physical education classes, yoga instructors and others.

“It’s a work in progress,” says Jackson, the Polk health director. “It’s very, very important work.”

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