Comprehensive Planning for Healthy Cities and Communities

1
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

2
A Convergence of Priorities
Public Health
Comp Planning, Plan Implementation
Healthy, Active Communities
3
APAs 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

4
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)

5
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 governments responsibility to protect the
  publics health, safety and general welfare
• Environmental justice (and the removal of health
  disparities) is a land-use issue

6
Attitudes About the Planning / Public Health
Connectionself vs. elected/appointed officials
base jurisdiction employees (368 NACCHO members,
355 APA members)
7
Barriers to Planning/Public Health Collaboration
base jurisdiction employees (368 NACCHO members,
355 APA members) (multiple answers) top mentions
8
Plans Prepared/Updated (1999-2004)
base jurisdiction employees (368 NACCHO members,
355 APA members) (multiple answers)
9
Plans Explicitly Addressing Public Health
base jurisdiction employees (368 NACCHO members,
355 APA members) (multiple answers)
10
Health and Environmental Data Provided(from
public health to planning department)
base jurisdiction employees (368 NACCHO members,
355 APA members) (multiple answers)
11
2. Rethinking State and Local Planning

• Comprehensive plans
• Neighborhood plans
• Redevelopment plans

12
2. Functional Plans

• Functional Plans
• Health services
• Bicycle and pedestrian
• Transit
• Streets and circulation
• Trails
• Parks
• Housing
• Economic development
• Schools and campuses

13
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

14
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

15
Putting Health in PlansSpecific 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

16
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

17
How Riverside Co. DPH Got Involved inLivable
Communities Activities

• County DPH invited to take part in City of
  Riversides 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

18
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

19
Identified 38 Walking Routes
Riverside County DPH Participation
Conducted Walkability Assessments
20
Riverside Co. DPH Conducted Walk Audits at
Highest Pedestrian Crash Zones
21
. . . 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

22
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. 

23
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)

24
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

25
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

26
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 Whats Health Got to Do
  With Growth Management, Economic Development, and
  Transportation?
• Drafted policies and actions for inclusion in the
  final plan

27
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

28
Regional Plan ExcerptsHealth-Related
Implementation Actions

• B-1 Develop model health provisions for local
  comp plans
• B-2 Encourage local funding of pedestrian and
  non-motorized 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 Councils Transportation Policy Board
• B- 9 Advocate inclusion of health considerations
  in State Environmental Policy Act/EIS review

29
Regional Plan Excerpts Measurable Objectives to
Monitor Health Conditions

• 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

meeting 30 min/day guideline
BMI and Walkability
30
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)

 
31
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

32
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 on-street 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.
33
Ingham County, Michigan Factors in the Health
Impact Assessment Matrix

• Water
• Air Quality
• Noise
• Physical Activity
• Injury Prevention
• Health Equity
• Impacts on Traffic Volume
• Children walking to school

• Interaction between neighbors
• Diversity of housing types and affordability
• Resident involvement in planning
• Compatibility with adjacent uses
• Sidewalks and pathways and mobility options
• Nuisance Noises
• Groundwater Recharge

34
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

35
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 Countys own
development regulations to push the envelope
36
Existing Zoning, PUD Reg. Used to Create a
Activity-Supportive Community at Sky Ranch

• Zoning code Planned Unit Development criteria
• Walkability thoroughly examiningcapability
  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
  residentsby 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.

37
Preliminary Development Plan
38
Summary Commonalities AmongPlanning/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

39
Summary Commonalities AmongLocal 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

40
Thank You
Marya Morris, AICP American Planning
Association Mmorris_at_planning.org 312-786-6375