Supporting Healthy Communities Through Planning

1. Supporting Healthy Communities Through Planning William Anderson, FAICP President, American Planning Association Principal/Vice-President, AECOM william.anderson3@aecom.com

3. Planners: Five Strategic Points of Intervention • Long-range community visioning and goal setting • Plan making • Standards, policies, and incentives • Development work • Public investments

4. Planning and Community Health Research Center (with the CDC) • Active living and physical activity • Healthy eating and nutrition • Transportation safety • Access to health and social services • Aging and people with disabilities • Educating future planners and health professionals • Environmental exposures • Environmental justice and equity • Social cohesion and mental health

5. Products: Fact sheets for planners and public health professionals • “Public Health Terms for Planners and Planning Terms for Public Health Professionals” • "Working with Elected Officials to Promote Healthy Land Use Planning and Community Design" http://www.planning.org/research/healthy/ pdf/jargonfactsheet.pdf

6. Healthy Planning Phase 1: Survey Results • 890 valid responses –plan officially adopted AND local gov’t (1162 total) • All states except ND/SD • Majority from planners in medium-size places • 27% reported plan addresses public health Health topics included in: • Land Use, Transportation, Recreation/Open Space, Bike/Ped Elements • 23 comp, 5 sustainability plans had stand alone Health Element

7. Healthy Planning Phase 1: Survey • Active Living • Active Transportation • Chronic Disease Prevention • Clean Air • Clean Water • Clinical Services • Emergency Preparedness • Environmental Justice • Environmental Health • Food Access • Food Safety • Food Security • Health Disparities • Healthy Eating • Healthy Homes • Health and Human Services • Mental Health • Nutrition • Obesity Prevention • Physical Activity • Public Safety • Recreation • Social Capital • Social Equity • Toxic Exposures • Other, please specify • Does the comprehensive plan contain a stand alonehealth element?

8. Healthy Planning Phase 2: Plan Evaluation • Develop a framework for key public health topics • Identify common goals and policies • Identify subjects not included • Assess if health policies are supported by implementation mechanisms, indicators, time lines, funding, responsible parties,

9. Evaluated Plans *Plan includes a Health Element or Chapter ^Plan suggested for inclusion by CDC

11. Plan Strengths • Active Living: most strongly represented across plans; addressed in Parks & Open Space, Urban Design, Transportation/Circulation, and Health/ Healthy Communities plan elements. • Environmental Exposures: second most represented, particularly regarding water and tree planting. • Emergency Preparedness policies, when included, tended to be strong and specific with associated implementation mechanisms.

12. Plan Strengths • When plans addressed food issues, they did so relatively comprehensively and with attention to equity and access for vulnerable populations. • The plans that had a standalone Public Health Element emphasized health to a greater extent throughout the plan than those that did not. • Most plans were written in accessible, easy-to-follow language and format.

13. Plan Weaknesses • Relatively weak coverage of Food and Nutrition and Emergency Preparedness. • Very weak in coverage of Health and Human Services and Social Cohesion and Mental Health. • Most plans did not use images, such as maps, to convey information about the distribution of resources, other community assets, SES or health status of populations across the jurisdiction.

14. Plan Weaknesses • Even plans with strong public health-oriented policies did not utilize public health data (e.g., crash or injury rates, chronic disease rates, crime) or include information on the current distribution and accessibility of services (e.g., clinical, grocery, parks or transit). • Even plans with strong public health-oriented policies did not identify metrics by which to measure or track success for goals and policies. • Most plans lacked implementation strategies, including benchmarks, responsible parties, time lines, etc.

15. Phase 3: Case Study Analysis – 7 communities • Methods/who/where Source: 2007-2011 ACS 5-year estimates

16. Phase 3: Case Study Analysis Incorporating Health Priorities • Champions/Drivers • Funding • Outreach/Communication • Health Priorities Implementation • Collaboration • Funding • Mechanisms/Achievements • Evaluation/Monitoring Who was involved? What kinds of code changes or other mechanisms are being used to institutionalize health? What kind of funding is available? Are they tracking progress?

17. Phase 3: Implementation mechanisms

18. Phase 3: Implementation mechanisms

19. Lessons Learned • Planners are the conveners • Solicit meaningful input from cross-agency working groups – best if have support at high level • Approach health through language of Quality of Life, Community Character – meet people where they are • Equity and Access are core public health issues for planning • Include health goals in multiple plans – comp, area, community • Include capital projects as implementation measures in plan – a great way to show success • Accountability: If possible, write plan implementation responsibilities into departmental evaluations • Enforce plan policies through code changes

20. Potential Partners for Healthy Planning Government – • Local, County, and State Health Departments • Parks and Recreation • Transportation • Councils of Governments • Schools • Offices of Sustainability • Mayor’s Special Councils (egUrban Forestry) Non-government – • Local foundations & chapters of national NGOs • Friends of Parks groups, environmental orgs • Community coalitions: bike/ped, trees, seniors • Local food/community gardening organizations • Hospitals & med/public health professionals • Universities & school districts • Development Community

21. Other projects in partnership with CDC • Free online Health Impact Assessments (HIA) training course • APA’s most popular online course • Course report data • Healthy Planning Toolkit and Resource Guides www.planning.org/ nationalcenters/health/ education

22. Topics for future collaboration • Develop educational materials & curriculum related to this research • Outline model ordinances/best practices for health-promoting city codes • Develop Metrics and Indicators for Healthy Communities • Provide technical assistance for planning-related HIA • Partner with NACCHO and APHA for nationwide campaign • Access to parks and recreation facilities • Healthy Aging and Aging in Place • Community-centered schools • Walking, Sidewalks & “Safe Routes to Transit” • Disaster planning to protect public health

23. Thank you! For more information: aricklin@planning.org planning.org/nationalcenters/health