Here's to Your Health

From PCJ Editor Wayne Senville:

One of the fascinating themes at this February's national Smart Growth Conference in Washington, D.C., was the connection between public health and planning. Health professionals, as well as planners, are increasingly recognizing the benefits of collaboration.

Richard Mitchell, Planning Director of Richmond, California (on right), Tracy Rattray of the Contra Costa County Health Service Department (left below), and planning consultant Daniel Iacofano spoke about work recently completed on adding a "health element" to the City's general plan.

Richmond is a city of 102,000 on the East Bay, north of Oakland. It faces some pressing public health issues, from the impacts of crime, to injuries to bicyclists and pedstrians caused by motorists, to concerns about industrial contaminants, to concerns about sedentary lifestyles leading to poor health.

In fact, in hearing what's in their plan's new health element, I was amazed by its breadth. Beyond issues such as access to medical services and to healthy foods, the plan also covers concerns as diverse as promoting "green and sustainable" development, providing improved access to public transit, and ensuring quality affordable housing.

The health element also contains a wealth of data, some of which was displayed during the Conference session. One example: maps showing "hot spots" where there have been a number of accidents involving bicyclists or pedestrians. As Rattray explained, this kind of mapped data will be valuable for the city in prioritizing where to make streetscape safety improvements.

Rattray made another quite interesting observation -- one I heard echoed by others at the Conference -- public health professionals add credibility to discussions about development, placing, as she put it, "environmental justice front and center."

One of the issues facing Richmond is alcohol use and its impact on neighborhoods. Background reserach for the health element indicated that: "The density of alcohol outlets correlates with density of ...

physical assaults and is closely related to crime and violence. Alcohol slows reaction time and its use by pedestrians and drivers contributes to traffic injuries. ... Liquor stores are concentrated in low-income neighborhoods. ... (17%) of Richmond’s 35 neighborhoods, which together account for 41% of Richmond’s population, have 62% (39) of the 63 liquor stores in the city. These neighborhoods have high poverty rates ..."

The distribution of liquor stores can be seen mapped against the income level of neighborhoods in this slide presented at the Conference (the darker the color on the map, the lower the income level; click on image to view it at larger size).

Another important element of the Richmond planning process was the use of "Photovoice" -- a method for engaging residents, with cameras and words, to document key health-related issues facing their community. The photo of the liquor store and accompanying caption were part of Richmond's use of Photovoice.

During questioning at the Conference session, planning consultant Daniel Iacofano noted that the level of detail in putting together the Richmond health element was possible because of a generous grant from the California Endowment. But even with more limited funding, the idea of preparing a basic health element makes sense. Health is something everyone can relate to. A focus on health also makes planning seem less abstract. And, as the Richmond health element shows, public health concerns are interwoven into many of the issues planners and planning commissioners are dealing with.

Some of you might also recall that the American city planning movement's roots lie, in large part, in the early 20th century public health movement. Here's what planning historian Laurecne C. Gerckens, FAICP, wrote several years ago in the Planning Commissioners Journal (in P is for Public Health & Safety):

"The belief that health and quality of life are shaped by the physical environment brought together public sanitation advocates, settlement house workers, architects, and landscape architects at the first American national conferences on city planning in 1909 and 1910. Public health advocates focused on improving waste disposal, assuring light and air to homes, providing clean food and water, and making available safe play areas. ... Common ground was found on key issues such as limiting building height. Public health advocates saw this as a way of assuring light and air to buildings and to the streets below, while City Beautiful proponents viewed height limits as a way of lending visual unity and human scale to the city."

See also Gerckens' Ten Successes that Shaped the 20th Century American City (including among his Ten Successes, the Provision of Pure Water and Effective Sewage Treatment; and the Isolation of Dangerous and Disharmonious Land Uses).

Interestingly, public health is finally returning to the planning arena as a key issue.

more on planning and public health on Wednesday