I have practiced my medical specialties of family and preventive medicine in rural New Mexico for 40 years. One would think that a surrounding landscape of mountains, mesas and endless vistas would lead almost everybody in my community of Cuba to an active outdoor lifestyle. But sadly this is often not the case. Our town – like many others – has become a place for motor vehicles rather than pedestrians. Our trails often connect natural places to each other rather than to places where people live. Success in our schools and workplaces often deprives us of the time we need to restore our minds and bodies through outdoor activity. Increasingly our recreation depends upon “screen time,” rather than time with others. We become heavier, and develop diabetes, high cholesterol, and cardiovascular diseases at younger ages.
About five years ago I decided to take my practice out of the exam room and into my community. I organized a group of leaders that shared my vision for a healthier Cuba, developed a broad local and external partnership, and created a program of outdoor physical activity – Step Into Cuba. We soon became aware that solid research paves the way for communities such as ours to successfully promote active living, but implementing the recommendations in a rural New Mexico community of under 2000 people is a challenge. But we have been creative and persistent and mutually supporting, and many of our ambitious goals are now in sight.
One initial effort was to create an environment for walking by developing one short nature trail in our village park. Who could have imagined that four years later we would have acquired a mile-long strip of open space land, and built a trail from our village to the nearest corner of National Forest! Or – through the partnership with our Village, regional planning agency and Department of Transportation – have completed the first phase of a plan for new sidewalks and pedestrian walkways throughout our town!
Who could have imagined the numerous volunteers – including local youth – who are planting trees and shrubs, constructing kiosks, building and maintaining trails, and encouraging others to go places where they have! We have received critical assistance through the National Park Service Rivers, Trails and Conservation Assistance program. We, in turn, assist the US Bureau of Land Management and US Forest Service plan a new segment of Continental Divide National Scenic Trail that will come right through Cuba.
And with our strong academic partnership with the University of New Mexico Prevention Research Center, we have been able to follow evidence-based strategies; maintain a website; perform walkability audits, a walkability workshop, and a health impact assessment; learn from interviews and pedestrian counts; and begin to share what we have learned with other communities.
I can think of no better way to develop a sense of place and connect to your community than committing to a physical activity project. In fact, let me prescribe it for you!
Learn more: www.stepintocuba.org.
Richard Kozoll, MD, MPH has practiced family and preventive medicine in the small community of Cuba, New Mexico since 1975. In addition to his medical work, Richard helps lead Step Into Cuba, a program to promote healthy physical activity through development of sidewalks, paths, trails, social support, and opportunities for lifestyle change.