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Place Matters. Martha Halko, MS, RD, LD Healthy Kids, Homes, and Places June 11 th , 2010. Objectives. Provide an increased understanding of the link between the conditions in which one lives, learns, works and plays and health outcomes
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Place Matters Martha Halko, MS, RD, LD Healthy Kids, Homes, and Places June 11th, 2010
Objectives • Provide an increased understanding of the link between the conditions in which one lives, learns, works and plays and health outcomes • Understand the impact of neighborhood planning on health • Explore approaches to advancing health equity and healthy land use planning through the “Cuyahoga County Place Matters Initiative”
Why Does Place Matter? • Where we work, live, learn and play impacts health • Residents in low-income areas live far fewer years in comparison to higher-income areas – “Place-based” disparity • These disparities are seen for chronic disease, low birth weight births, environmental issues etc. • Big gap in life expectancy
Urban Dynamic • Inner-city residents are more overweight, less physically active, & less healthy overall than general population • Diabetes & cardiovascular disease are more prevalent • Major inequities in life expectancy and mortality driven by chronic diseases
Why the disparity? • Research indicates much of disparity is associated with: social and environmental issues such as stress of poverty, racism, violence, discrimination in health services, food insecurity Social Determinants of Health
How Much Does Place Matter? A look at Alameda County’s Place-Based Data
High school grads: 90% Unemployment: 4% Poverty: 7% Home ownership: 64% Non-White: 49%
High school grads: 81% Unemployment: 6% Poverty: 10% Home ownership: 52% Non-White: 59%
High school grads: 65% Unemployment: 12% Poverty: 25% Home ownership: 38% Non-White: 89%
89% of all housing in East Cleveland contains lead based paint
When the external becomes internal: How we internalize our environment Allostatic Load High Demand-Low Control Jobs Stress Inadequate TransportationLong Commutes Stress Lack of access to stores, jobs, services Stress Housing Stress Stress Lack of social capital Stress Crime
Decades of disjointed state, local and federal policies have caused social and structural problems that impact urban community health
Social Inequities Health Inequities Segregation Income & Employment Education Housing Transportation Air Quality Food Access & Liquor Stores Physical Activity & Neighborhood Conditions Criminal Justice Access to Healthcare Social Relationships & Community Capacity Social Inequities
Cuyahoga County Place Matters Team: Establishing Partnerships and Building a movement to improve health outcomes and address health inequities through “place-based” strategies
Place Matters: Nationwide Initiative of the Joint Center for Political & Economic Studies, Health Policy Institute A National Learning Community Focused on improving the health of participating communities by addressing social conditions that lead to poor health. www.jointcenter.org
Cuyahoga County Team • Selected by National Association of City and County Health Officials (NACCHO) • Cuyahoga County is 1 of 16 teams, across the US participating in the pilot national learning community
Place Matters Team Members • Cuyahoga County Board of Health • Najeebah Shine • Martha Halko • Saint Luke’s Foundation • Sandra Byrd Chappelle • Cuyahoga County Office of Health and Human Services • Sabrina Roberts • Center for Community Solutions • Ken Slenkovich • Cuyahoga County Planning Commission • Paul Alsenas
Place Matters - Cuyahoga County Vision – Cuyahoga County is a place where people can thrive because there is equitable access to resources & opportunities, whether, economic, social or environmental, that are necessary to attain the highest quality of life
Place Matters - Cuyahoga County Purpose – The Cuyahoga County Place Matters Team will inform, influence & engage policy makers & community members to use an overarching health equity lens for the development of policies that create conditions for optimal health
What we intend to accomplish… • Urban communities will have more choices regarding, housing, food access, access to healthcare and education • Allow urban communities to thrive because they’ll have equal access to economic, social and environmental resources
Next Steps for the Team • Education of Key Stakeholders • Health and Land Use Summit II • MAPP • Health Impact Assessment • Policy Agenda
MAPP stands for: • Mobilizing – community engagement • Action – implementation of a Health Improvement Plan • Planning – built on strategic planning concepts • Partnerships – the public’s health is more than the concern of the health department
Connecting Planning & Health Seeking to answer the question: “How are existing or planned land use, community design and transportation policies, projects, or programs affecting or likely to affect public’s health?
The Health Impacts of Land Use Planning • Air pollution • Car crashes • Pedestrian injuries • Water quality • Mental health • Social capital • Physical activity Credit: Dr. Richard Jackson
Opportunities to Address Health Through Planning • Comprehensive Planning/Master Planning • Plan Implementation can further address health • Zoning ordinances • Design Guidelines • Capital Improvements • Health Impact Assessment (HIA)
What is HIA? • Used by local health dept. staff, planning staff, academicians, policy makers etc. • It is a decision support tool for determining or evaluating potential health impacts of a project, policy or program. • HIA process engages and empowers communities
HIA Example • Utilizing HIA to evaluate the health and equity impacts (positive and negative) of a city’s existing land use and zoning policies. • HIA can help planners, developers and other decision makers better recognize the health and equity consequences of the decisions they make.
Place Matters: Health & Land Use Summit II • Purpose is to advance health equity through land use planning and building local capacity for creating: Healthy, Hopeful and Prosperous Communities • Thursday, August 19th, 2010
Questions? For More Information Contact : Martha Halko, MS, RD, LD (216) 201-2001 ext. 1535 mhalko@ccbh.net