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The Healthy Development Measurement Tool. Rajiv Bhatia, MD, MPH San Francisco Department of Public Health. Presentation Objectives. Understand the background and structure of the Healthy Development Measurement Tool Review an HDMT “application”
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The Healthy Development Measurement Tool Rajiv Bhatia, MD, MPH San Francisco Department of Public Health
Presentation Objectives • Understand the background and structure of the Healthy Development Measurement Tool • Review an HDMT “application” • Consider How the HDMT can serve as a template for indicator systems for HIA in other contexts
Eastern Neighborhoods Rezoning = SFDPH HIA Policy Opportunity • City implements a rezoning and community planning process in the Eastern Neighborhoods responding to demand for housing and concerns about gentrification and displacement of low-income and minority communities • Community places demands on planning department to analyze plans impacts on social and health needs • SFDPH agrees to facilitate a health impact assessment of the Eastern Neighborhoods rezoning as an alternative, parallel process that considers community impacts • Researched and adopted best practices in community participation in planning and decision-making processes
SFDPH Land Use Planning Objectives • Identify and analyze the likely impacts of land use plans and zoning controls on health determinants. • Provide recommendations for land use policies and zoning controls that promoted community priorities. • Develop capacity for inter-agency working relationships. • Demonstrate the feasibility of health impact assessment methods. • Promote meaningful public involvement in land use policy-making by making explicit competing interests and facilitating consensus.
Known Public Health Impacts of the Built Environment • Physical activity • Pedestrian injuries • Asthma and respiratory disease • Obesity and chronic disease • Crime and violence • Social capital and cohesion • Child psychosocial development • Elder health and mobility • Water quality and quantity • Depression and isolation • Health disparities
Eastern Neighborhoods Community Health Impact Assessment • Collaborative, consensus-based health impact assessment to analyze how development in three SF neighborhoods affected health • Facilitated by SFDPH & Guided by a Community Council Comprised of >20 organizations and government stakeholders • 18-month process culminated in the development of the “Healthy Development Measurement Tool”
ENCHIA - Process • Phase 1. Created Healthy City Vision • Phase 2. Developed Community Health Objectives to reflect Healthy City Vision • Phase 3. Identified Community Health Indicators to measure Vision and Objectives • Phase 4. Generated Data Profiles on selected indicators to assess neighborhood conditions • Phase 5. Developed a menu of Policy/Strategy Briefs to advance Objectives • Phase 6. Created the Healthy DevelopmentMeasurement Tool (HDMT)
From Vision to Indicators: Creating a local framework for healthy built environment • Built Environment Elements that affect health: • Land use and zoning • Transportation systems • Community design • Housing • Public infrastructure
Modeled Vehicle Source PM 2.5 Concentrations At Streets – Southeastern San Francisco, CA
Healthy Development Measurement Tool (HDMT) – Overview • Goal: To support comprehensive and health-responsive planning using a systematic and objective method • Method:Multi-objective, voluntary evaluation metric and checklist that incorporates measurable community health indicators and development targets
HDMT – Components • Six elements of a healthy city • Community health objectives • Measurable indicators and baseline data • Action Targets for Land Use Development • Health-based rationales • Policy and strategy recommendations
Objective pages include: • Indicator pages with associated data to advance the Objectives • Development Targets that provide criteria to evaluate the healthiness of a Plan • Health Based Rationales linking the Objectives to public health • Established Standards (City, State, and/or Federal) that relate to the Objective • Policy and Design Strategies that can be applied to improve a plan or project
Indicator pages include: • Indicator data in the forms of maps and tables often disaggregated by neighborhood • Explanations and Limitations of the data • Research connecting the indicator to health
HDMT Application Example: Executive Park SubArea Plan (EPSP)
Application Process • Does a place have healthy living and working conditions? • Use HDMT indicator data to assess and record baseline conditions • Does a plan or project advance health-related conditions? • Review plan or project documents to assess the extent to which it meets HDMT development target? • What recommendations for planning policies, implementing actions, or project design would advance community health objectives? • Identify or develop concrete and specific recommendations for plan/project improvements
Gathering Existing Data • Project/plan Documents: • Newspaper articles • Conducted 4 site visits / assessments • Attended 3 community planning meetings • Conducted 5 key informant interviews (in-person and phone)
EPSP Application Example (Step 1) Does a place have healthy living and working conditions? • Step 1: Use HDMT indicator data to assess baseline conditions • Indicator PI.6.a: Proportion of population within 1/2 mile from full-service grocery store/supermarket
EP SubArea Plan Example (Step 1) • Indicator PI.6.a: Proportion of population within 1/2 mile from full-service grocery store/supermarket
EPSP Application Example (Step 2) Does a plan or project advance health-related conditions? • Step 2: Review plan or project documents to assess the extent to which it meets HDMT development targets
EPSP Application Example (Step 3) • What recommendations for planning policies, implementing actions, or project design would advance community health objectives? • Step 3:Identify or develop concrete and specific recommendations for plan/project improvements
HDMT – Applications • San Francisco • Executive Park Sub Area Plan • Eastern Neighborhoods Area Plans • Bernal Height Preschool Planning • Western SOMA Community Plans • Daggett Place Project • Beyond San Francisco • Humboldt County General Plan Scenarios • Richmond California General Plan • Oakland Estuary Plan • Geneva Agglomeration Plan
HDMT – Limits • Does not regulate actions or force compliance • Does not provide for in-depth or scientific forecasting of impacts • Action targets and mitigation strategies oriented to Urban mixed-use development
What the HDMT Contributes • Responds to a lack of formal mandates to consider health in planning • Provides a “systems view” for analyzing policy and projects on the inter-related issues of sustainability, economy, community, population and health • Provides indicators for existing conditions, impact analysis and monitoring • Helps to reveal relationships among issues and make explicit trade-offs • Build inter-agency relationships and increases transparency of decision-making processes • Template for tool for other contexts and policy domains
HDMT and Alaska HIA • Process for developing consensus vision and objectives for healthy development of natural resources • Template for indictor system for assessing existing conditions • Consolidated public resource for HIA with health conditions data, project information, mitigation strategies, etc