How to Learn About the Basics of Healthy Community Planning

Linking health and planning requires learning about (at least) two areas. Public health folks are often confused about planning and planners have a lot to learn about health. There are a number of useful web sites and below I list just a few free guides that can lead you through the maze.

Healthy Urban Development Checklist
  • The Healthy Urban Development Checklist: A Guide for Health Services when Commenting on Development Policies, Plans and Proposals introduces public health folks to planning. Developed by the NSW Department of Health in Australia, it will be useful in many other locations. It takes a little while to load but once it’s on screen it provides a useful introduction to health issues and the planning system. It covers a typical range of issues including food, physical activity, housing, transport employment, community safety, open space, social infrastructure, social cohesion, environment, and specific development contexts such as infill.
  • Delivering Healthier Communities in London  was developed for the National Health Service London Healthy Development Unit in 2007. Also a bit slow to load, it is organized around key health issues–mental health, cardiovascular disease, respiratory disease, excessive heat and cold, and injuries. It links each of these the environmental factors.
  • The Design for Health web site comes from the other direction, aimed at informing planners about health. Its health impact assessment tools draw on research summaries and can feed into planning actions. Topics are rather similar to the Healthy Urban Development Checklist (above).

When in the Planning or Policy Process Does a Health Impact Assessment Fit?

Many people are interested in when to do an HIA. The simple answer is, it depends. There are a lot of different formats that may be used alone or in combination.

  1. Screening tools to see if an HIA is worth it
  2. Scoping tools to investigate the topics and dimensions worth exploring more
  3. Desktop or mini HIAs that can be done quickly in an office
  4. Rapid assessments or appraisals that re more participatory, drawing on expert and local knowledge (see an earlier post for some examples)
  5. Intermediate HIAs that are more comprehensive or multi-dimensional but not yet on a par with a full environmental impact assessment
  6. Full HIAs—a lot of work
  7. Integrated HIA that are plugged in to other processes
They may also be done prospectively—to figure out what may happen—or retrospectively to assess what did happen. This latter version is often looked down upon as not sufficiently proactive. However, it can be a great way to start a new planning process—looking at the current state of affairs to figure out what to do next. This can be a lot less threatening than assessing a draft plan or policy that people already invested in.
The attached diagram from a Design for Health training captures some of this variety.

Technical Resource 3: People and Participation.net (now Participation Compass)

 

Workshop on housing options.
(Joanne Richardson in center,
Ann Forsyth photographer)
Expert-driven tools can be very helpful for assessing community health. However, in all but the smallest assessments, it’s important to combine such expert methods with more participatory approaches. Local people know their own communities and that local knowledge can be very helpful. They may also have fears that need to be investigated—some may be appropriate and some may not but in either case it is important to know about them.
Public health, urban planning, and related fields have different cultures of participation and this also varies by country, region, setting, and project type. However, one terrific resource for giving most people good ideas is the British web site People and Participation.net (now Participation Compass): http://participationcompass.org/
Register for free to gain access to the site and some really terrific tools including:

  1. A process planner that quizzes the user on everything from money and time available to political support and shoots out a set of participation options–click on methods then planning. Using this planner is a way of getting out of the rut of doing the same old thing. It can also just give you a place to start that is relevant to your situation.
  2. If you want to see all the methods they are also listed alphabetically.
  3. Their library is particularly good and with a keyword cloud and lists of recommended webs sites, practical guides, and web tools:http://participationcompass.org/article/index/qa
  4. Users can also upload case studies: http://participationcompass.org/article/index/study

The Design for Health project has a short information sheet on how to use participatory methods to integrate health into the planning process: http://www.designforhealth.net/resources/participation.html. I have reviewed some other participation tools on my Planetizen blog at: http://www.planetizen.com/node/46672.

Tools: Food Security Assessments

 

Oakland, California (Photo by Ann Forsyth)
The topic of food and planning is one of great interest—particularly promoting healthy food options. Of course what people eat is a complicated result of their personal preferences, financial resources, and social context. Food availability depends on climate, the time of year, whether people grow their own food, how much it costs, home food storage options, and the kinds of stores in the local area.
However, a number of tools can help larger communities plan for their food access.
  • One such tool is the Food Security Assessment. In 2002, the USDA Economic Research Service published a well-known Community Food Security Toolkit: http://www.ers.usda.gov/Publications/EFAN02013/ with the entire toolkit at http://www.ers.usda.gov/publications/efan02013/efan02013.pdf. There are other toolkits around, with many good tools developed for use internationally in areas likely to suffer substantial food shortages, but this one by aU.S. government agency may be a good place for others to start.
  • The USDA web site provides helpful information about food security in the U.S.: http://www.ers.usda.gov/Briefing/FoodSecurity/. A 2007 USDA Food Security Assessment provides an example at the international level: http://www.ers.usda.gov/Publications/GFA19/. However, using the methods in the toolkit, local communities can do this as well.
The food security assessment and other food related tools are discussed in the DFH Food Issues Sheet at http://designforhealth.net/wp-content/uploads/2012/12/Information_Sheet/BCBS_ISFood_090107.pdf based on research outlined in the Food Key Questions research summary http://designforhealth.net/wp-content/uploads/2012/12/Key_Questions/BCBS_KQFood_082207.pdf.

Technical Resource 2: InformeDesign

InformeDesign (http://www.informedesign.org/) is an online database of research on people and environments. With substantial funding from the American Society of Interior Designers, and based in the University of Minnesota Department of Design, Housing, and Apparel, the database emphasizes research at the building and component level. However, there is enough other work to make it worth a visit, even for urban planning scale investigations.

The site is basically a database of research summaries in a standard format: introduction, design issue or topic, design criteria or implications, key concepts or central ideas, research methods, limitations identified by the authors of the piece, commentaries on limitations noticed by the InformeDesign reviewers as well as additional information, and a full citation.
The site offers several navigation and search options though not all are obvious. A simple search window is on the home page. There is also an advanced search engine that I found to be well designed though results are listed by URL only and one has to click on the link to the summary to get more information such as titles. Also on the home page are buttons titled “space,” “issues,” and “occupants” that link to lists of subtopics that are further subdivided on later pages. When a user clicks on a subtopic, or a sub-subtopic, articles are listed by name and author and have check boxes to add to a personalized list.
For those interested in more general information about the project, a main menu links to useful information about the site, its sponsors, and the database. An online tutorial on Research 101 provides a refresher on research vocabulary and concepts.

How to Do a Rapid Health Impact Assessment: Useful Reports

The Rapid Health Impact Assessment—the kind of HIA that takes the form of a structured workshop with substantial preparation and reporting—boasts a number of detailed manuals, such as the classic by Erica Ison: http://www.apho.org.uk/resource/item.aspx?RID=44890.

Arden Hills Healthy City Planning Workshop
Photo: Ann Forsyth
However, moving beyond such general guidance it can be hard to find out how others have conducted their HIAs. Some people provide extensive background reports but not much about what actually happened at the workshops. Others focus on the outcomes of the HIA and not the inputs and process. An increasing number of practitioners are, however, reporting on HIAs in straightforward ways that provide transferrable tools for others. This entry highlights several of these, all containing useful examples of worksheets, maps, and recommendation checklists or tables.
  • The London Olympics HIA, completed in 2004 is an example of a health impact assessment conducted on a major employment and housing development. Prepared by consultant for the London Health Commission and the London Development Agency, the HIA had two parts: a desktop assessment using many existing reports and a workshop with 21 key participants (including advocates, government representatives, academic and academics). The HIA looked at construction, operation, and post games time periods and the consultant produced a 155 page report, available online: http://www.apho.org.uk/resource/view.aspx?RID=61057. This comprehensive report contains substantial background information, results from exercises in the workshop including some interesting voting activities, and clear recommendations.
  • The Lowry Corridor HIA of 2007, while an internally conduced assessment rather than a true participatory HIA, is a terrific resource. Focusing on the redevelopment of a major road in Minneapolis, the report contains several well thought-out worksheets and a number of interesting maps: http://www.apho.org.uk/resource/item.aspx?RID=60512. It is a very accessible document.
  • Commerce City, Derby Redevelopment Area HIA is also not a traditional rapid HIA but it is included here for its imaginative use of participation and analysis tools. These range from computer mapping and proposals for street redesign to photos taken by residents and stills from a video produced by local high school students. Located in a lower income, majority Latino area of suburban Denver the HIA was conducted by the Tri-County Health Department who in turn employed short-term consultants on special topics. With a focus on physical activity and nutrition, recommendations from the 65- page report (http://www.tchd.org/pdfs/hia_final.pdf) fed into a master plan.
  • The Arden Hills Healthy City Planning Workshop of 2010 assessed options for reusing a military facility in a suburb of the Twin Cities. The state Department of Health sponsored this HIA collaborated with the City of Arden Hills, hiring a consultant to actually conduct it (Design for Health). This is one of the very few HIA reports that includes basically all the information used to run and report on the HIA workshop–the actual information packet provided to participants in advance; the agenda of the meeting, copies of handouts, worksheets, and presentations from the workshops; a series of photos keyed to parts of the agenda; and the workshop’s summary report. The summary report and appendices, along with a description of the workshop, are online: http://designforhealth.net/cases/arden-hills-2010-workshop/.
  • More information about HIA in general can be found at http://designforhealth.net/hia/.

Finding Information about HIA: Design for Health Blog

>How health impact assessment can make a difference is an issue of some interest at present. For those wanting to explore HIA online, several major clearinghouses provide a wealth of information from legislative updates to workbooks.



For more information about HIA go to the Design for Health web site at http://www.designforhealth.net/ resources/healthimpact.html.

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