Safe access to community establishments encourages active transportation like walking and biking, reduces vehicle use and environmental emissions and ensures a variety of needs of are met. When residents of all ages have desirable destinations to walk to, have access to sidewalks and face fewer traffic hazards, they are more mobile (read more about transportation and health here). Additionally, public spaces promote more community interactions and neighborhood cohesion (read more about the social environment here). In a livable community, outdoor spaces and buildings allow people to visit museums and shows, explore local landmarks, play sports at a recreation center, trek parks and open spaces, or participate in community events. Altogether, these neighborhood facets contribute to improved cardiovascular and respiratory health, including reducing the risk of hypertension and obesity.

Proximity to some establishments, such as fast food chains, tobacco retailers, and liquor stores can have the effect of promoting unhealthy behaviors. Minimizing their presence, especially near youth, is key to public health. 

The location and density of retail and other establishments influences health behaviors, such as nutrition (e.g., presence of supermarkets predicts higher fruit and vegetable consumption), opportunities for physical and social activities (e.g., gyms, parks, recreation and civic centers), health care utilization (e.g., availability of specialized types of care like mental health) and ease of communication (e.g., event outreach, alerts and emergency response). For more information on the importance of food security and local services to health, please visit the Emergency Food System Study and Community Health Environment pages.

Accordingly, examining a neighborhood’s “completeness,” or diversity of nearby amenities, can be used to rate its environment and how well it meets the needs of its residents. The Neighborhood Completeness Index (NCI) in the map below is a percentage of categories of available resources for each residential census block in Napa County. Twenty categories were included (graphic below to the right of the map) and possible scores range from 0% (0/20 categories) to 100% (20/20 categories) with higher percentages representing more completeness. Scores in Napa County ranged from 0% to 95% with an average of about 38% and median of 35%. The score is most meaningful when applied to urban and suburban areas; rural areas often have limitations on development due to agriculture and open space assets that are not included in the index.

Click on the census blocks of interest to bring up a pop-up and learn about an area's available amenities. Block characteristics use US Census data from 2010 and neighborhood attributes come from searches conducted in spring 2018.

NCI was adopted and modified from San Francisco Department of Public Health's experiences. 

Learn more in the following link SF Indicator Project

From The Trust for Public Land (TPL), adequate and equitable access to parks and open spaces helps communities to be fit and healthy by encouraging exercise and active transportation. In fact, the Centers for Disease Control and Prevention has called for more parks and playgrounds nationwide to combat the increased incidence of obesity and prevent other chronic diseases. However, the benefits of green spaces extend beyond physical health – they also have therapeutic effects, support children in their development and build “social capital” or networks of strong relationships in the community. Indeed, a study found that impoverished residents living in public housing with views of trees or grass reported less overall mental fatigue and the ability to better cope with life's hardships than their counterparts. Additionally, parks provide opportunities for children to play, which is critical in the “development of muscle strength and coordination, language, and cognitive abilities.” Lastly, parks and open spaces help build stable, interconnected communities as people engage in outdoor activities and community events together, are more likely to interact or connect with others in the area, and even share projects like community gardens and tree-planting where they can develop a valued role and/or deeper sense of belonging in their neighborhood (read more about respect and social inclusion here).

TPL’s ParkScore is an index that measures how well the nation’s largest 100 cities are meeting park needs. Using ParkServe (a compliment to ParkScore that provides suggestions for cities to improve park access) and local data, a ParkScore was recreated for Napa County’s five cities. The definition for urban parks (or a public outdoor area that serves the broader community, typically managed for recreation activities and special events) was used (refer to graphic to the right for examples of what was included and excluded). Only parks that fell within city jurisdictions were incorporated into the index. ParkScores range from 0 to 100 with higher scores indicating better availability and access to quality parks. ParkScores for Napa County's cities ranged from 36 to 63. Common positives across the cities were high park spending and number of facilities per resident; common negatives were small park sizes and limited park access Up Valley or in the northern half of the County.

In the graphic to the left, we highlight the walkability component of the ParkScore. American Canyon, the City of Napa and Yountville had a larger percentage of their residents within a 10-minute walk to any park compared to the national average (54%), while Calistoga and St. Helena fell below this average. To see how park walkability varied among age, racial/ ethnic and income groups as well as additional information on local parks, please visit the following ParkServe pages  American Canyon, the City of Napa, Yountville, St. Helena & Calistoga.

A general walkability score for a city's amenities is also available through Walk Score® (read about active transportation here). To learn more about parks and outdoor spaces countywide that were not captured by the city-centered ParkScore, please visit the following Napa County Regional Park and Open Space District & Land Trust of Napa County.

Napa County Public Health surveyed youth and their families about healthy living and safety in their communities. The Neighborhood Perception Survey was collected from families of students from four schools (Napa Junction Elementary, Phillips Elementary and Calistoga Elementary and Junior-Senior High) in areas targeted by Napa County's Health and Human Services Agency for place-based services (American Canyon, Napa and Calistoga respectively). The survey was administered in late 2017 in both English and Spanish. A total of 556 surveys were completed; participants included families of children in transitional kindergarten (TK) through fifth grade for elementary schools and sixth through eighth grade for the junior-senior high school. The common sentiment among families across all sites was that their neighborhoods had access to healthy foods and outdoor areas, but were not as safe as they could be for pedestrians or people on bikes.

Regular physical activity provides many benefits to the development and long-term health of children. Exercise helps young people develop healthy musculoskeletal (i.e., bones, muscles and joints) and cardiovascular systems (i.e., heart and lungs), improve their neuromuscular awareness (i.e., coordination and movement control) and maintain a healthy body weight. Habitually engaging in physical activity as they age also reduces the risk of developing many chronic health conditions, such as heart disease, cancer, type 2 diabetes, obesity and osteoporosis. The benefits of being active extend beyond the physical and improves psychological health as well, such as fostering resilience (e.g., handling stress and anxiety, overcoming obstacles) and social connections (e.g., opportunities for self-expression, building self-confidence and developing relationships). Additionally, research suggests that physical activity among youth promotes other healthy behaviors (e.g., nutritious diet, avoidance of tobacco and alcohol) and better academic performance at school. 

The following results came from custom questions specific to Napa County so data is not available statewide. Subgroup breakdown (e.g., by race/ethnicity) is also not readily available.

The US Physical Activity Guidelines for Americans recommend that youth ages 6 to 17 should have at least one hour of daily physical activity. For example, this can come from physical education classes at school, sports programs after school and visits to the park with peers and family. However, many young people do not meet these recommendations. In 2017 for Napa County, about two-thirds of all secondary school students surveyed reported being active 4 or more days a week for at least an hour, but only about a quarter exercised for at least an hour every day of the week.

Click on Change Filter to view the percentages for non-traditional students and/or the total surveyed.

Physical activities after school such as team sports provide additional opportunities to be active and can further consolidate healthy habits. Other physical activities after school include going to the gym, hiking a trail and walking at the park. Among Napa County's 7th, 9th and 11th graders in 2017, over 40% participated in teams sports after school and over half participated in other physical activities. A lower portion of non-traditional (i.e., those in alternative public education settings/pathways, who frequently do not fall into clearly designated grade levels) students were active after school  17% were in team sports and over 41% did other activities. 

Fitness testing evaluates the current and future health of youth through their performance on certain physical tasks or activities. In California, all 5th, 7th and 9th graders from public schools are required to take the test. The State uses FITNESSGRAM®, which has six measures: abdominal strength, aerobic capacity, body composition, flexibility, trunk extension strength and upper body strength. This test uses the Healthy Fitness Zone® (HFZ) based on scientifically-supported standards to grade students. Physically fit children are those who are in the HFZ for all six measures. In 2017, about 30% of students both in California and Napa County met this criteria.

In the graph on the lower right, two specific measures are highlighted. Body composition looks at both students' percent body fat and body mass index (i.e., ratio of height to weight); standards vary by age. In 2017, about 62% of Napa County students are in the HFZ for body composition, meaning they would not be classified as overweight or obese. This was slightly more than the State's 61%. VO2 max, or the maximum amount of oxygen a person can utilize during intense physical activity, is a marker for endurance and overall health and is used to determine aerobic capacity; standards vary by age and sex. In 2017, Napa County had more students in the HFZ for aerobic capacity than California — 65% vs. the State's 63%.

You can explore additional data by clicking on Change Filter on either graph.

Research suggests that disparities in fitness and physical activity among youth can arise from the lack of resources (e.g., inadequate space and facilities at school, unsafe or little access to recreation, limited transportation and/or means to afford equipment), support (e.g., minimal encouragement from teachers or family, no role models) and time (e.g., obligations at home, working around others' schedules). Here, we display two FITNESSGRAM® measures and differences across racial/ethnic groups in Napa County. American Indian or Alaska Native and Native Hawaiian or Pacific Islander students were not included as their counts were too low to be statistically stable. Hispanic students were less likely to be in the Healthy Fitness Zone for aerobic capacity and body composition compared to other groups. 

Read more about FITNESSGRAM®, its metrics and the State's data in the following links The Cooper Institute & California Department of Education

Air pollution can cause immediate health problems, such as aggravated respiratory and cardiovascular illness, and chronic health conditions, such as the development of asthma and lung disease.

The location and density of alcohol and tobacco retailers can influence drinking, smoking and vaping behaviors, especially for susceptible youth. Excessive alcohol consumption can bring about accidents or injuries and acts of violence. Ultimately, tobacco use and alcohol abuse lead to many negative long-term health outcomes.



Bauman, A. E., & Bull, F. C. (2007). Environmental correlates of physical activity and walking in adults and children: A review of reviews. London: National Institute of Health and Clinical Excellence.

Child, S. T., Schoffman, D. E., Kaczynski, A. T., Forthofer, M., Wilcox, S., & Baruth, M. (2016). Neighborhood attributes associated with the social environment. American Journal of Health Promotion, 30(8), 634-637. DOI:

Ding, D., & Gebel, K. (2012). Built environment, physical activity, and obesity: what have we learned from reviewing the literature?. Health & Place, 18(1), 100-105.

Rosso, A. L., Grubesic, T. H., Auchincloss, A. H., Tabb, L. P., & Michael, Y. L. (2013). Neighborhood amenities and mobility in older adults. American Journal of Epidemiology, 178(5), 761-769.

Sallis, J. F., Saelens, B. E., Frank, L. D., Conway, T. L., Slymen, D. J., Cain, K. L., ... & Kerr, J. (2009). Neighborhood built environment and income: examining multiple health outcomes. Social Science & Medicine, 68(7), 1285-1293.

Neighborhood Completeness & Parks

Bendell, T. (2013). Human Health and The Built Environment (Masters dissertation, De Montfort University).

City of Portland. (2018). Portland Plan. Retrieved from

Dartmouth Atlas of Health Care (1996). Appendix on the Geography of Health Care in the United States. Hanover, NH: Dartmouth University.

Frumkin, H. (2001). Beyond toxicity: Human health and the natural environment. American Journal of Preventive Medicine, 20(3), 234-240.

Gies, E. (2006). The health benefits of parks. The Trust for Public Land, 1-24.

Inagami, S., Cohen, D. A., Finch, B. K., & Asch, S. M. (2006). You are where you shop: grocery store locations, weight, and neighborhoods. American Journal of Preventive Medicine, 31(1), 10-17.

Kuo, F. E. (2001). Coping with poverty: Impacts of environment and attention in the inner city. Environment and Behavior, 33(1), 5-34.

Morland, K., Roux, A. V. D., & Wing, S. (2006). Supermarkets, other food stores, and obesity: the atherosclerosis risk in communities study. American Journal of Preventive Medicine, 30(4), 333-339.

Tzoulas, K., Korpela, K., Venn, S., Yli-Pelkonen, V., Kaźmierczak, A., Niemela, J., & James, P. (2007). Promoting ecosystem and human health in urban areas using Green Infrastructure: A literature review. Landscape and Urban Planning, 81(3), 167-178.

Youth Physical Activity

Babey, S. H., Wolstein, J., & Diamant, A. L. (2016). Adolescent physical activity: Role of school support, role models, and social participation in racial and income disparities. Environment and Behavior, 48(1), 172-191.

California Department of Education. (2017). Physical Fitness Testing (PFT). Retrieved January 15, 2019 from

Cooper Institute. (2014). About FitnessGram®. Retrieved January 15, 2019 from

Centers for Disease Control and Prevention. (2018). Physical Activity Before and After School. Retrieved January 15, 2019 from

Centers for Disease Control and Prevention. (2018). Physical Activity Facts. Retrieved January 15, 2019 from

Johnston, L. D., Delva, J., & O’Malley, P. M. (2007). Sports participation and physical education in American secondary schools: Current levels and racial/ethnic and socioeconomic disparities. American Journal of Preventive Medicine, 33(4), S195-S208.

Martinek, T. J., & Hellison, D. R. (1997). Fostering resiliency in underserved youth through physical activity. Quest, 49(1), 34-49.

US Office of Disease Prevention and Health Promotion. (2015). Physical Activity Guidelines for Americans. Retrieved January 15, 2019 from

Whitt-Glover, M. C., Taylor, W. C., Floyd, M. F., Yore, M. M., Yancey, A. K., & Matthews, C. E. (2009). Disparities in physical activity and sedentary behaviors among US children and adolescents: Prevalence, correlates, and intervention implications. Journal of Public Health Policy, 30(1), S309-S334.