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Comprehensive Planning for Healthy Cities and Communities Presentation by Marya Morris, AICP 2006 design for Health Speaker Series Sponsored by Blue Cross/Blue Shield of Minnesota A Convergence of Priorities Public Health Comp Planning, Plan Implementation Healthy, Active Communities APA’s Five Strategic Points of Intervention 1. Visioning and goal setting 2. Rethinking planning in all contexts 3. Local implementation tools 4. Site Design and Development 5. Siting Public Facilities and Capital Spending Visioning and Goal Setting • Begins with a discussion of shared values • Results in a shared image of a community imagines most desired future • Provides a broad context within which goals are set and plans are developed • Majority of planning efforts now launched with a visioning exercise (reflective of more citizen participation) Where Health and Physical Activity Fit in the Visioning and Goal Setting Process • Residents’ shared desire for healthy communities • Enhancement and improvement of quality of life • It is government’s responsibility to protect the public’s health, safety and general welfare • Environmental justice (and the removal of health disparities) is a land-use issue Attitudes About the Planning / Public Health Connection self vs. elected/appointed officials NACCHO members important policy issue 33% emerging policy issue not an important issue 63% 20% 1% 2% unsure 42% 27% 11% APA members important policy issue 54% 20% 38% 39% emerging policy issue not an important issue 4% unsure 4% 0% 24% self 17% 20% officials 40% 60% base: jurisdiction employees (368 NACCHO members, 355 APA members) 80% Barriers to Planning/Public Health Collaboration PRACTICAL BARRIERS* lack staff resources 64% lack funding 54% 78% 76% 40% 41% lack qualified staff 21% 19% statutory restrictions operate in "crisis" mode 14% lack interdepartmental flexibility 13% 15% 26% SUBSTANTIVE BARRIERS citizens not interested 40% 48% 29% 35% public health regarded solely as medical issue regarded as barrier to local growth 14% other 12% 0% 33% NACCHO APA 20% 20% 40% 60% 80% base: jurisdiction employees (368 NACCHO members, 355 APA members) (multiple answers) *top mentions 100% Plans Prepared/Updated (1999-2004) 52% comprehensive (or master) 75% 42% transportation 41% trail and/or greenway 61% 42% parks and recreation 70% 61% 31% bicycle and pedestrian 64% 39% downtown 27% housing 47% growth management 30% redevelopment 30% 20% community facilities human services 11% 0% 20% 40% 40% 41% 14% neighborhood 47% 43% 27% 40% NACCHO APA 60% base: jurisdiction employees (368 NACCHO members, 355 APA members) (multiple answers) 80% Plans Explicitly Addressing Public Health 24% comprehensive (or master) 14% parks and recreation 23% 11% bicycle and pedestrian 25% 13% trail and/or greenway 11% transportation human services 7% 9% housing 36% 22% 22% 23% 16% 10% 12% 8% 11% growth management community facilities 4% neighborhood 5% redevelopment 4% downtown 12% 10% NACCHO APA 10% 5% 6% other 0% 20% 40% 60% base: jurisdiction employees (368 NACCHO members, 355 APA members) (multiple answers) 80% Health and Environmental Data Provided (from public health to planning department) incidence of providing 53% 22% TYPES PROVIDED environmental quality 41% 17% Behavioral Risk Factor Surveillance System 23% 2% obesity 4% exercise 4% routine physical activity 20% 18% 16% 5% pedestrian or bicyclist injuries/fatalities 14% 6% housing conditions 7% industrial pollutants 6% asthma 11% 11% 14% 3% other 4% 0% NACCHO APA 10% 10% 20% 30% 40% 50% base: jurisdiction employees (368 NACCHO members, 355 APA members) (multiple answers) 60% 2. Rethinking State and Local Planning • Comprehensive plans • Neighborhood plans • Redevelopment plans …2. Functional Plans • Functional Plans – – – – – – – – – Health services Bicycle and pedestrian Transit Streets and circulation Trails Parks Housing Economic development Schools and campuses Local Implementation Tools • Zoning, subdivision, and land development regulations – Rethink development density – Mix land uses – Connect streets and routes – Require sidewalks – Open space • Transit-oriented development • Traditional neighborhood development Putting Health and Physical Activity into Comprehensive Planning Good planning and smart growth is are inherently supportive of physical activity and health: • Walkable communities, increased transportation options: – Create opportunities for PA – Reduce VMT – Improve air quality – Provide open space, trails, bike/ped • Managing the pace and direction of local and regional growth: – Supports contiguous, compact development – Creates high-quality neighborhoods – Ties to public infrastructure spending Putting Health in Plans: Specific Interventions • Narrative description of rationale for including health in the plan • Explain relationship of existing plans, e.g., smart growth to health • Develop goals and objectives that connect heart health, safety, physical activity, and obesity to planning, community design, and land use • Develop specific health goals for relevant plan elements • Create an implementation schedule for the health objectives Riverside County, California • 7,100 square miles (size of New Hampshire) • 1.8M population • 24 cities • 1/3 of residents live in unincorporated areas • Auto-dependent development patterns • Ranked 4th in US for unhealthy air • High rate of CVD • Low public transit use How Riverside Co. DPH Got Involved in Livable Communities Activities • County DPH invited to take part in City of Riverside’s Healthy Cities project in 2000 • “Get Movin’ Riverside” walking program: identified safe walking routes • DPH staff attended conferences and meetings to learn the language of transportation, planning and development • Riverside County completed its Integrated Plan for unincorporated areas – Emphasizes habitat protection – Focuses on creating pedestrian-friendly neighborhoods and smart growth in general City of Riverside Project Mayor invited County DPH to sit on 38-member Walkable Communities Task Force to prepare a Pedestrian Walkability Plan County conducted 1 walkable community workshop and 5 Walk Audits to identify areas for change Drafted a pedestrian plan Reviewed policies that promote walkability, recommend design guidelines, capital improvements, prioritize recommendations, and provide action steps Presented report/plan to City Council Riverside County DPH Participation Conducted Walkability Assessments Identified 38 Walking Routes Riverside Co. DPH Conducted Walk Audits at Highest Pedestrian Crash Zones . . . Riverside Co. DPH Recent Interagency Activities • Providing funding and content for a “Smart Growth Guide” for developers • Jointly submitted w/ planners, transportation depts. 2 Caltrans grant apps. to conduct visioning plans in two unincorporated areas • Collaborating w/ 9 county agencies and 6 developers on a Planning Community Facilities Strategy for a massive new development • Awarded California State Association of Counties’ 2005 Challenge Award for its Livable Communities Project More Riverside Co. DPH Recent Interagency Activities • Hosting workshops for planning, transportation, fire departments on Context Sensitive Road and Street Standards for Riverside County. • Riverside City Council adopted Walkable Communities Task Force Report and Pedestrian Master Plan in June 2005 • Will conduct safe routes to school trainings in spring 2006 for two Riverside school districts. Seattle/King County, Washington • 2,130 sq. mi. (size of Delaware) • 1.7M population • 39 cities • Pop doubled between 1960 – 2000 (1.5 to 3.3 M) • Air quality still better than federal standards • Top 3 health issues – Asthma – Overweight/Obesity – Physical inactivity (45% of adult residents are inactive) Seattle/King County Initiative Environmental Health Community Assessment Team (EHCAT) • Interagency/cross divisional team formed in 2001 • Raised awareness, provided recommendations on environmental health issues and how they relate to planning policies • Built Environment and Health became a cross-cutting team priority Public Health – Seattle/King County Initiative • Seattle/King Co. Public Health Dept. Strategic Plan (2004): – Identified Land Use, Built Environment, and Health was named 1 of 3 strategic priorities for the Department • Capacity Building Actions: – Seattle Planner and King Co. Health Director participated in NACCHO/APA collaborative training – Hosted presentations and forums for state and local health officials – Formed stakeholder group for LUTAQH – December 2005 – Two new positions created to implement interagency recommendations Partnership and Input on Planning, Transportation & Land Use Policies • Providing input on the Puget Sound Regional Council Vision 2020 Update – Participated in Scoping Sessions – Convened Environmental Health directors in the region to gather input – Drafted white paper: “What’s Health Got to Do With Growth Management, Economic Development, and Transportation?” – Drafted policies and actions for inclusion in the final plan Excerpts of Puget Sound Regional Council that Direct Health Issues in Multi-County Policies • A-6 Address safety improvements for transportation with an emphasis on pedestrian and bicycle safety • A-7 Direct transit agencies/local govts to make ped/bike investments coincident with improved transit service • A-8 Incorporate provisions addressing health and well being into local comprehensive plans in the 4-county region • A-9 Improve access to health facilities for all community sectors Regional Plan Excerpts: Health-Related Implementation Actions • B-1:Develop model health provisions for local comp plans • B-2: Encourage local funding of pedestrian and nonmotorized improvements • B-3: Assess sidewalk connectivity through the urbanized areas of the region • B-4: Establish performance criteria or other level of service for all modes of transportation • B-7: Add a public health representative to the Regional Council’s Transportation Policy Board • B- 9: Advocate inclusion of health considerations in State Environmental Policy Act/EIS review Regional Plan Excerpts: Measurable Objectives to Monitor Health Conditions % meeting 30 min/day guideline • C-1: Work with health agencies and the academic community and with local jurisdictions to identify measures for assessing environmental and public health related to: – Land use, including soil contamination, noxious uses, etc. – Water quality – Air quality • C- 2: Work with partner agencies to develop measures for assessing the walkability and bikability of urban environments BMI and Walkability Ingham County, Michigan • 36 sq. mi. (size of Delaware) • 400K population • Pop declining, aging, suburbanizing • Air quality still better than federal standards • Top 3 health issues – Overweight/Obesity – CVD – Physical inactivity (45% of adult residents are inactive) Ingham County (Mich.) Health Department • Formed the Land Use and Health Team (2001) • Made public health a priority in the Regional Growth Strategy • Developed Health Impact Assessment (HIA) matrix – Checklist format for reviews with developers – Matrix for greater level of detail or thoroughness – HIA: Mapping results w/ GIS • Hired a Land Use/Health Liaison Regional Growth: Choices for Our Future Jobs, Economic Development, and Work Force Goal Jobs, economic expansion and workforce development should be emphasized consistent with the preferred Regional Vision to keep the region competitive in a global economy, but not at the expense of environmental health. Greenways & Walkability Goal Pathways, sidewalks, trails and onstreet bike facilities should be developed and enhanced to provide alternatives to motorized transportation, improve linkages to recreational opportunities for regional residents and provide public health benefits by offering opportunities for physical activity. Ingham County, Michigan Factors in the Health Impact Assessment Matrix • Water • Interaction between neighbors • Air Quality • Diversity of housing types and affordability • Noise • Resident involvement in planning • Physical Activity • Compatibility with adjacent uses • Injury Prevention • Sidewalks and pathways and mobility options • Health Equity • Nuisance Noises • Impacts on Traffic Volume • Groundwater Recharge • Children walking to school Delaware County, Ohio • Started w/PACE-EH, community-based environmental health assessment • Public raised land use as the key issue Lessons learned to date: • Role of public health official should be clearly defined and abided by • Get health to the table, continue make the connections • Health assessments lay groundwork for collaboration that addresses local land use and planning policies • Assessments highlight community values and concerns that help build community support and support of elected officials Tri-County Colo. Health Department • Developed community-based environmental health assessment checklist • Available at naccho.org Sky Ranch Subdivision Developer proposed a cookie cutter subdivision Planning Dept. rejected proposal; sent 20-page letter of conditions Health Dept. worked w/planners and the developer to improve the site design and the active living features Used the County’s own development regulations to push the envelope Existing Zoning, PUD Reg. Used to Create a ActivitySupportive Community at Sky Ranch Zoning code Planned Unit Development criteria Walkability – “…thoroughly examining…capability of … transportation system to serve present and future land uses.” Trails along drainage – “Assure compatibility between the proposed development, surrounding land uses and the natural environment.” Integrated mixed uses – “Enhance convenience for …residents…by ensuring that appropriate supporting activities … are in close proximity to one another.” Zoning code Planned Unit Development criteria Safe bike/ped paths, connectivity – “Provide for accessibility within the development, and between the development and… adjacent uses. (e.g., traffic circulation, transit, pedestrian avenues, parking and road connections). Open spaces – “Minimize disruption to … physiographic features…” Two criteria specify creation of open space. Preliminary Development Plan Summary: Commonalities Among Planning/Public Health Collaborations • Advocate for local public health policy making in multiple contexts e.g., plans, transportation, zoning • Participate in comprehensive plan updates and code revisions • Brief planners on DPH activities relevant to planning • Provide health data to support planning policies and actions • Assume responsibility for health related assessments • Become a regular stakeholder in land use & transportation planning process • Attend planning meetings, engage in policy-making process, be proactive rather than reactive Summary: Commonalities Among Local Public Health Agency Roles • Make presentations to civic groups e.g., League of Women Voters, who can monitor process & provide input. • Provide training for boards of health; encourage passage of resolutions • Collaborate with & mobilize elder network • Expand role of LPHAs in commenting on development plans with regard to health impacts. • Conduct a health impact assessment • Make planning/public health collaboration a matter of standard procedure Thank You Marya Morris, AICP American Planning Association [email protected] 312-786-6375