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Design For Health

Plan Evaluations from the American Planning Association

The American Planning Association recently released a report, Healthy Planning, evaluating 22 comprehensive and sustainability plans in terms of health issues. Funded by the CDC this report looks at 22 plan documents. As the APA’s web site web site states: “The evaluation assessed the extent to which these plans addressed public health through six broad health-related planning topics:

  • Active Living
  • Emergency Preparedness
  • Environmental Exposures
  • Food and Nutrition
  • Health and Human Services
  • Social Cohesion and Mental Health”

Its an interesting report downloadable at http://www.planning.org/research/publichealth/pdf/evaluationreport.pdf. Anna Ricklin, the current manager of APA’s Planning and Community Health Research Center led the team creating the report. The plans were selected from a 2012 survey that had identified 890 plans using mentioning public health and 45 additional plans identified by the CDC. Plans were selected because they covered a wide range of health topics and also geographical diversity (urban, rural, county, city, etc). The report doesn’t present evaluations of individual plans but examines how many of the plans covered particular topics and issues. It does, however, identify lists of top plan e.g. for active living  top jurisdictions included Baltimore County, Washington, DC, and Fort Worth and for food and nutrition the top places where Alachua County (FL), the Oneida Nation, and Baltimore County.  A next phase of the project will look in greater depth at some specific case studies.

 

A number of my Cornell students worked on the report with APA (acknowledged on page 4).

American Planning Association’s Planning and Community Health Research Center

APA

APA’s Planning and Community Health Research Center

For those interested in how to connect health and urban planning, the APAs Planning and Community Health Research Center is a good place to start. Resources include links to a number of health-related interest groups, links to educational programs, and a useful listing of APA’s health-related publications. A companion resource is the Planning and University Research Registry (PURR) where researchers can list projects both in progress and completed. A number are related to health and planning.

Planning for Healthy Places with Health Impact Assessments

 

A screenshot of the online slide show
A few years back the American Planning Association in association with the National Association of County and City Health Officials created the online course Planning for Healthy Places with Health Impact Assessments at http://advance.captus.com/planning/hia2/home.aspx. Don’t be put off by the initial survey that you have to fill in to get into the site—it’s short and you don’t need to be an APA member to access it! Sponsored by the Centers for Disease control and Prevention the initial course was developed by Rajiv Bhatia, Laura Biazzo, MPH, Division of Nutrition and Physical Activity of the Centers for Disease Control and Prevention, Brian Cole, Andrew Dannenberg, Carrie Fesperman, and Candace Rutt.


With Christine Green
from APA and Nisha Bochwey from the University of Virginia I’ve worked to update the program (without changing the voiceover except for one short additional module!)—Christine is the maven of resources and Nisha did a stellar job on quizzes. There are a lot of new examples. The computer generated voice is a bit weird but the content is a good introduction to HIA—and thanks to the CDC it’s free.

Food Resources

 

Food stall in Stockholm. Photo: Ann Forsyth

How people get access to healthy food is a concern to many. I’ve recently had some requests for information. Design for Health resources include an “issues sheet” with ideas for incorporating food into planning and a research summary. Links include a food security assessment, also featured on an earlier blog http://healthymetropolis.blogspot.com/2010/11/tools-food-security-assessments.html

The APA’s national healthy communities center has a food interest group is also a terrific resource as are its numerous publications on this issue: http://www.planning.org/nationalcenters/health/food.htm

Resources: Planning and Active Living

Active living, the idea that it’s good to build exercise into daily life, has been big news in planning for a while but I still get questions about how to incorporate active living into plans. A decade ago, when it was a fairly new idea, there was the hope that if we built places where people were more prone to do activities like travel walking, that they’d keep exercising as well, increase their total activity, and reduce weight. It turns out to be a bit more complicated than this as I noted in my blog on high density and overweight adolescents in China. Research is quite mixed in its findings—there’s a lot of variation in how people respond to environments. Programs, policies, prices, education, and attitudes all shape how people use environments. But as a bottom line it is useful to provide options for people to be active in different ways so that when they want to do so they can. 

So how can you help provide options? Several web sites provide case studies of communities have done this work.
Mexico City Cycle Day, 2011. Photo: Ann Forsyth
  • Active Living by Design has been around since 2001 and has a useful web site. The group has worked with a number of cities and countied and provides case studies linked to an onsite map: http://www.activelivingbydesign.org/communities.
  • The APA has a webinar with some practice examples: http://www.planning.org/nationalcenters/health/education/webinars/activecommunity.htm
  • Design for Health also highlights some alternative transportation plans including ones by Bloomongton and St. Louis Park. Some of the questions in the DFH Comprehensive Plan Review checklists also target active living—noted in a column: http://www.designforhealth.net/resources/checklists.html

Tools for Conducting an HIA on a Comprehensive Plan

I’ve recently had a number of queries about how to conduct a health impact assessment on an existing comprehensive plan. This is a great thing to do because it can help prioritize changes in an update. How to conduct an HIA is a big topic, but fortunately there are a lot of resources available with more coming online over the next year.

One place to start is the set of Comprehensive Planning Checklists on the Design for Health web site: http://designforhealth.net/resources/legacy/checklists/. They are based on evidence–though there is stronger evidence for the “essential for health” sections than the “good for health” ones. Each question has a column that explicitly states which area of research it is based on and these are described more fully in online research summaries (see next point). These checklist are also broken into standard categories for comprehensive or general plans in the United States. Two other resources, highlighted in an earlier blog, may be useful: the Australian Healthy Urban Development Checklist and British Delivering Healthier Communities in London.

Research Summaries that form the basis of the DFH checklists that are available for free: http://designforhealth.net/resources/researchsummaries/. The current versions reperesent work up to about 2007 or 2008 and in fast developing areas–such as food–we’ll be preparing updates in the next year. For extra information in the interim you might look at the “pathways” section of HIA-CLIC http://www.hiaguide.org/sectors-and-causal-pathways/pathways.
Model of Downtown Tianjin in the
Tianjin planning museum.
Photo: Ann Forsyth.

For advice about what to do after you have used the checklist and done your evaluation, the Design for Health web site has Information Sheets linked to the research summary topics that have examples and cases:
http://designforhealth.net/resources/planningissues/

In addition, a course on Planning for Healthy Places with Health Impact Assessments by the American Planning Association in association with the National Association of County and City Health Officials, is also a good place to start: http://professional.captus.com/Planning/hia/default.aspx. It is currently being updated by a team including Christine Green and Kimberly Hodgson at APA, Nisha Botchwey from the University of Virginia, and myself, with advice from Dee Merriam of the CDC. The update will substantially expand the resources section so there will be lots more information than this brief note can provide.


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