CDC-JUA Health Equity – Centers for Disease Control and Prevention (CDC). Joint Operating Agreements (JUA): Why is this a question of health equity? „Sharing“ – also known as „shared use“ or „community use“ – occurs when public organizations or sometimes private non-profit organizations agree to open or expand access to their institutions for collective uses. Sharing can be done on a formal basis (on the basis of a written legal document) or on an informal basis (on the basis of historical practices). Being physically active is one of the most important steps people of all ages can take to improve their health (U.S. Department of Health and Human Services, 2008). Despite the many benefits of physical activity, only half of adults in the United States and about a quarter of high school students comply with the current aerobic physical activity directive (Blackwell et al., 2014; Centers for Disease Control and Prevention, 2014). A known barrier to physical activity is lack of access to facilities and places where physical activity can take place (Bauman et al., 2012; Sallis et al., 2000; Consolation et al., 2002). Public schools are located in almost all municipalities and often have appropriate recreational facilities that can be shared with community members (Evenson et al., 2010; Vincent, 2010). Sharing agreements are guidelines that allow the public use of schools during extracurricular periods.
The sharing agreement is a widely held concept, which can also be described as a sharing agreement, a Community use agreement or a partnership for sharing (Vincent, 2014); Spengler, 2012). While the importance of such terminology may vary particularly depending on discipline (Vincent, 2014), we use these terms interchangeably with respect to out-of-school institutions that use schools and school places. These measures use existing infrastructure (Vincent, 2010; Young et al., 2014; Filardo et al., 2010) and are known to increase physical activity of children and adolescents in these communities (Durant et al., 2009; Farley et al., 2007; Lafleur et al., 2013; Slater et al., 2013). In addition, sharing agreements can help eliminate inequalities in access to recreational facilities (Taylor and Lou, 2011). This is particularly important because children from racial and ethnic minorities and low-income groups are more likely to be overweight or obese (Miech et al., 2006; Centers for Disease Control and Prevention, 2009) and live in communities where physical activity support functions are lacking (Babey et al., 2008; Gordon-Larsen et al., 2006; Moore et al., 2008). Beyond the simple acceptance of a sharing agreement, the types of institutions covered by an agreement differ. On their most basic shared use agreements can allow the public use of outdoor facilities. This is consistent with our finding that >95% of notified agreements on outdoor facilities. Wider agreements also include interior fittings, increasing the number and type of equipment available for public use. It can be an important resource for communities in adverse weather conditions or in areas where few public institutions are available. In addition, sharing can be an important consideration for stationary projects in school infrastructure planning, which is more conducive to sharing (Vincent, 2014).
Given that fewer municipalities have notified a sharing agreement covering interior developments in relation to outdoor facilities, it is likely that the inclusion of indoor facilities in sharing agreements faces additional barriers compared to outdoor facilities alone. For example, additional issues such as costs, monitoring and security may be associated with the sharing of indoor facilities, unlike outdoor facilities. Compared to municipalities that do not agree on shared use, the chances of an agreement and an agreement including interior accommodations were for municipalities with a smaller population, a lower average level of education and in the south.