Before You Go - February 2013
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Playgrounds: Who Has Access?

By Deborah L. Vence

Access to high-quality playgrounds varies by neighborhood, according to a new study that will be published in the February issue of Pediatrics, the publication of the American Academy of Pediatrics.

The study, titled "Playground Safety and Quality in Chicago," took place from 2009 to 2011, and evaluated about 500 playgrounds in Chicago for age-appropriate design, ground surfacing, equipment maintenance and physical environment. A cross-sectional survey of public park playgrounds in Chicago was conducted in 2009, 2010 and 2011 using the National Program for Playground Safety Standardized Survey. (All playgrounds were surveyed in 2009 and 2010; and those that failed in 2010 were resurveyed in 2011.)

The idea for the study came out of the Chicago Park District's concern over quality and safety of its playgrounds.

"I think as a pediatrician, play is really important—both for developmental and fine motor skills, and also for obesity prevention," said Karen Sheehan, M.D., MPH, an emergency medicine physician at Ann & Robert H. Lurie Children's Hospital of Chicago and Professor of Pediatrics and Preventive Medicine at Northwestern University's Feinberg School of Medicine, who was one of the study's authors.

"Kids need physical activity to be healthy," she said, adding that in Chicago, where many people don't have backyards to play in, they often turn to neighborhood parks for outdoor play.

This makes ensuring playground safety all the more important.

Many of the playgrounds were constructed from 1988 to 1993, when all of the asphalt playgrounds were converted into enclosed loose-fill, soft-surface areas. Between 2004 and 2012, 45 new playgrounds were constructed.

Among the study's findings, Sheehan pointed out that surfacing was the biggest challenge, from an injury perspective.

"The most severe injuries are due to falls. We did see that there was not enough wood chips [in some playgrounds]. The caveat is that wood chips ebb and flow through the season. We randomly picked [some playgrounds], and saw that they were low," Sheehan said.

Also, many of the playgrounds evaluated were replaced years ago, as far back as the 1980s, and had broken equipment.

"We were able to take pictures. And, [equipment was able to be] fixed within a day or two," she said, adding that many of the parks don't have a park district building associated with them. So, the parks rely on the public to report any damage to the playgrounds.

Besides surfacing issues, overall results of the study indicated that most Chicago playgrounds are in fair condition, although there is a disparity in geographical distribution of both playgrounds and safe playgrounds. Playgrounds systematically met safety standards for the age-appropriate design and physical environment criteria. They were more likely to fail because of problems with fall surfacing and equipment maintenance.

Moreover, of the 500 playgrounds, 467 were assessed in 2009, and 459 were assessed in 2010. In 2009, half of all playgrounds (55 percent) and in 2010, nearly two-thirds (61 percent) earned scores consistent with safe playgrounds. Geographic information system mapping showed neighborhoods with a higher percentage of children and impoverished families had fewer playgrounds and more failing playgrounds.

In 2011, 154 (85 percent) of the playgrounds that failed in 2010 were surveyed. Throughout the course of the study, when a playground was found to have problems, the appropriate authorities were notified, leading to more playgrounds receiving a passing grade at the end of the study period.

"We, with the [Chicago Park District's] permission, gave the information back to them about safety scores and they were able to target their interventions," she said.

"We went through the whole city. The majority [of the playgrounds] are old wooden playgrounds. It's costly to replace them. They are trying to develop a plan to replace them more quickly, but that's in the works," Sheehan said.

In terms of finding better ways to maintain playgrounds throughout Chicago in the future, Sheehan said that one way that might be helpful is Friends of the Park, which helps organize park advisory groups.

"That would be a great way community people could keep an eye on the playground. Know what to do if they notice a problem. Parks are a good way for building social cohesion," she said, adding that around Earth Day, many corporations often will donate services to help refill wood chips at Chicago parks.

The study was supported by the Kohl's Care for Kids Safety Network and Northwestern University's Community-Engaged Research Center Geospatial Analysis Mini-Grant. Lurie Children's is considered one of the top pediatric hospitals in the country, according to U.S. News & World Report. Its physicians are on staff at Northwestern University Feinberg School of Medicine.

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