Healthy General Plans

Alameda County Planning for Healthy Communities20 May 09

Improving Health

“Many would be surprised to learn that the y pgreatest contribution to the health of the nation over the past 150 years was made, not by

”doctors or hospitals, but by local government.”

Dr. Jessie Parfitt,

P bli H lth Ph i iPublic Health Physician

About Raimi + AssociatesComprehensive Planning

Sustainable Developmentp

Public Health and PlanningLEED ND Public Health Criteria Study USGBC- LEED-ND Public Health Criteria Study, USGBC

- How to Create and Implement Healthy General Plans, Public Health Law & Policy

- Design for Healthy Living, Coachella Valley Assoc. of Govts

- South Gate General Plan, South Gate CA

-Riverside County Public Health Element, Riverside County, CA

-El Monte Health and Wellness Element

How Healthy Are Our Communities?

Source: CDC

Public Health and the Built Environment

Data Sources: 2000 BRFSS, 2002 NHANES, Powell 1994, Pratt et. al. 2000; CDC

Public Health Issues

What makes a healthy ycommunity?y

Regional Location

Locate development in appropriate locations

T it i t d l tiTransit-oriented locations

Downtowns

Corridors

Mixed use centersMixed use centers

Density / Intensity

Mix of Land UsesMore types of uses

More retail usesMore retail uses

• Neighborhood retail uses

R t t & t• Restaurants & taverns

• Grocery stores

Employment destinations

Civic uses

Urban Form and Character

Building relationship to street

B ildi l ti hi t thBuilding relationship to other buildings

B ildi d iBuilding design

Overall character and attractiveness of environment

Transit Access and AvailabilityProximity

FrequencyFrequency

Density of Destinations

Pedestrian environment and amenities

Roadway Design

Connectivity

St t idthStreet width

Lane width

Speed

On Street parkingOn-Street parking

Street Trees

Bicycle and Pedestrian Facilities

Bicycle

ProximityProximity

Design

C l t f t kCompleteness of network

Pedestrian

Sidewalk presence and completeness

Pedestrian facilities

Pedestrian crossings

Access to Parks and Open Space

Proximity

A th ti A lAesthetic Appeal

Real and Perceived Safety Source: Dan Burden

Presence of others exercising

Access to Healthy Foods

Supermarkets

F M k tFarmers Markets

Locally grown foods

As Walking Increases

The tendency to be overweight or obese decreases

The tendency to be physically active increases

Per capita air pollution decreases

Transit use increases

As Driving IncreasesTendency to be overweight increases

Occurrence of traffic crashes increases

Exposure to air pollution increases

Driving related stress (road rage)Driving related stress (road rage) increases

Water quality decreasesWater quality decreases

Civic participation declines

A National Evidence Base

People who live in walkable neighborhoods report 30 min more walking than less walkable areas (Saelens, 2003)

Residents of more urban neighborhoods walk 3x more than suburban neighborhoods (Lawton, 2001)

SMARTRAQ (Frank, 2005)- Residents of most walkable areas of Atlanta were found to be 2.4

ftimes more likely to get recommended amount of physical activity.

- Each additional hour spend per day driving is associated with a 6% increase in the odds of obesity.y

- Each additional kilometer walked per day was associated with a 4.8% reduction in the odds of obesity.

A National Evidence Base

A 5% increase in walkability is associated with:

32 % increase in minutes of walking and biking32 % increase in minutes of walking and biking

A ¼ pt reduction in BMI (about ½ kilogram)A 6.5 % reduction in per capita vehicle kilometers traveled

A 5.5 percent reduction in ozone precursors (NOx, VOCs)

SOURCE: Frank, L.D. Sallis, J.F., Conway, T., Chapman, J., Saelens, B. Bachman, W. (Winter 2006). Many Pathways from Land Use to Health: Walkability Associations With Active Transportation, Body Mass Index, and Air Quality. Journal of the American Planning Association.

A Note on Health DisparitiesAsthma: Death rates from asthma are almost three times higher for African Americans than for white Americans (US EPA 2003)

Traffic injuries: jAfrican Americans represent only 12% of the US population, but more than 20% of pedestrian deaths (STPP 2002)

Opportunities for Physical Activity: Low-income communities have less access to parks, recreational f ili i ll f d d h l d l d iblfacilities, well-funded schools and playground structures, possibly contributing to disparities in physical activity rates (PolicyLink, 2002)

Policy DecisionsUrban Form,

Transportation System, andLand Use

Built EnvironmentA t G d d S iAccess to Goods and Services

Travel ChoicesStreet Design

Health IndicatorsPhysical Activity Levels, Time spent driving,

Access to Nutrition and HealthcarePollution, Stress

Health OutcomesHealth OutcomesDiabetes, Obesity

Traffic Accidents, Respiratory IllnessCrime Mental Health Issues

Making the ConnectionCrime, Mental Health Issues

A PRESCRIPTION FOR A HEALTHY PLAN

What is a General Plan?

Vision for the County’s future

L t li id fLong-term policy guide for:

Physical Changes

Economic Development

Preservation of Open Space

All land use decisions must derive from the GP

Covers 20 30 year time periodCovers 20-30 year time period

South Gate: An Overview

8 miles southeast of downtown LA

Population: 115 000 to 125 000Population: 115,000 to 125,000

7.5 square miles

> 95% Latino

Median age 26 years of ageg y g

Working class

Regional Location

Process

1. Create partnerships

2. Existing conditions analysis

3 Public workshops3. Public workshops

4. Healthy City Element and General Plan Policies

5 Implementation5. Implementation

P t hiPartnerships

Partnerships and Outreach

Informally disseminate information

S t t hi ith th d t tSet up partnerships with other departments

Pass Board/Council Resolution on Health

Create a Healthy Community Committee/Coalition

Public Workshops

W lk A ditWalk Audit

Healthy Community Partnership

1. City of South Gate

2. Los Angeles County Department of Public Health

3. Transportation and Land Use Collaborative

4. Raimi + Associates

5 Kaiser Foundation (funder)5. Kaiser Foundation (funder)

E i ti C ditiExisting Conditions

Rank South Gate LA CountyRank South Gate LA County1 Heart Disease Heart Disease

2 Stroke Stroke2 Stroke Stroke

3 Diabetes Lung Cancer

4 Emphysema/COPD Emphysema/COPD

5 Lung Cancer Pneumonia/Influenza

Leading Causes of Death

26.4%30

20.6%

20

25

%

15

20

10LA County South Gate &LA County South Gate &

sourrounding cities

Adults with Fair or Poor Health

LA County South Gate & Surrounding Citiesg

Overweight35.5

Overweight39.5

Obese 20.9

Obese 33.1

Overweight and Obese Adults

Overweight and Obese Children

South Gate+

LA CountyLA County

Obese Children Over Time

Proximity to Parks

Food Sources (healthy, not so much)

Proximity to Freeways and Truck Routes

Traffic Accidents

Data Challenges

Creating connections between land use and health outcomes

Many data sources – difficult to get info

Obt i i t it l l d b itObtaining accurate city-level and sub-city level information (LA County is the exception)p )

C it W k hCommunity Workshops

Workshop #1: Connecting Planning and Health

Workshop #2: Healthy Eating 101

Workshop #3: A Walkable South Gate

P i th PlPreparing the Plan

A Healthy General Plan

Health informs vision

R l t L d d b fRegulates Land use and urban form

Requires “healthy” transportation and infrastructure tsystems

Layers health policies throughout

May includes a stand-alone “Healthy Community” Element

Elements of the Plan

Land Use

Ci l tiCirculation

Healthy Community

Public Facilities and Services

SafetySafety

Parks and Open Space

Conservation

Vision Statement

HEALTHY ENVIORNMENT: South Gate supportsHEALTHY ENVIORNMENT: South Gate supports public health through a healthy environment that includes and promotes walkable communities, safe neighborhoods enhanced recreational and culturalneighborhoods, enhanced recreational and cultural amenities, reduced noise and air pollution, water and energy conservation, and an attractive natural environment.

Community Design: (not only land use)

Map future patterns and structures to better represent

Desired character and function of different parts of the county

Mixed use

Transportation and land use integration

Relationship between urban and rural

Focus on 3 dimensional results of 2Focus on 3 dimensional results of 2 dimensional plan

Source: City of TracySource: City of Tracy

Typical Land Use Map

VS.

VS.

Land Use = Character

Source: WRT, City of Sacramento

Community Design: Land Use, Form & Character

Create “designations” that address:Land use

Density/Intensity

Street connectivity

Building frontage and placement

Pedestrian Access

Parking, Vehicle Access and Services

Designations should create places not land uses

Community Design: Apply Urban Form Designations

Community Design: Policies

Mixed use development

Higher density developmentHigher density development

Infill development (downtowns, community centers, along corridors)community centers, along corridors)

Manage outward growth

Build around transitBuild around transit

Include urban design considerations

Agricultural land preservation

Mobility Element

Streets as public space

Prioritize moving people not carsPrioritize moving people not cars

Integrate land use and transportation - context-sensitive roadwaycontext sensitive roadway classifications

Safety improvements in y pneighborhoods

Identified pedestrian and bicycle infrastructure

Promote transit improvements

Green City Element

Green streets and infrastructure

N k dNew parks and open spaces

Expanded trail network

Climate change/GHG emissions

Healthy Community ElementStand-alone Healthy Community “element”

- Overall health and well-being

- Land use patterns that support physical activityy

- Active and safe transportation

- Access to healthy foods

- Access to health care

- Air pollution

“T diti l” f t l t t i- “Traditional” safety element topics (seismic, emergency preparedness)

Overall Health

Take health into consideration in city’s decisions

M it h lth ditiMonitor health conditions

Focus on preventive care

Build and maintain partnerships

Land Use Patterns

Support land use patterns that promote physical activity –mixed use development, TOD, corridor development

Improve neighborhoods with pedestrian and bicycle facilities

Improve park and recreation facilitiesImprove park and recreation facilities

Reinforces policies in Community Design Element

Active and Safe Transportation

Promote transit service throughout the city

Improve bicycle and pedestrian connections

Monitor areas with high-frequency injuries and accidentsj

Promote safe routes to schools

Reinforces and references policies in Mobility Element

Access to Healthy Foods

Encouragement of healthy food stores

Promote and support farmers markets

Create community gardens and support “edible” school yardspp y

Avoid concentrations of unhealthy food, particularly around schools, p y

Respiratory Health

Siting of “sensitive receptors”

- Freeways (I 710)- Freeways (I-710)

- Truck routes

H i d t i l- Heavy industrial areas

Addresses tension between d it d i ll tidensity and air pollution

Promotes reduction of auto trips

Additional Topics

Access to health care

Partnerships with local health providersPartnerships with local health providers

Incentives for hospitals and clinics

F ll f h lth i l diFull range of health care, including mental health

Seismic safetySeismic safety

Emergency preparedness

Hazardous materials

Other Elements

Public Facilities and Services

S f tSafety

Conservation

Green Infrastructure

I l t tiImplementation

Reform Zoning

Focuses on separation of uses

S t th t h ld bSeparates uses that should be mixed to encourage active transportation

Is a blunt instrument

Associates form standards (lot coverage, setbacks, etc) with use not place typep yp

Functional Plans

Roadway Master Plan

P k d R tiParks and Recreation

Bicycle Master Plan

Pedestrian Master Plan

Review “Standards”Street design standards

Parking requirementsParking requirements

School siting

Building codes

Development ReviewDevelopment Project Checklist

Health Impact Assessment (HIA)Health Impact Assessment (HIA)

Healthy Development Measurement Tool

LEED-ND

CEQACEQA

Conclusions

Build partnerships – NGOs, Public Health Dept, community

Health should be integral part of all General PlansHealth should be integral part of all General Plans

Reinforce good land use and transportation decisions with healthhealth

Health policies will differ based on local conditions-Urbanized vs urbanizing

-Population demographics

-Existing local and regional land use patterns

Separate Element important but not essential

for additional information

Matt RaimiRaimi + Associates

510-666-1010matt@raimiassociates commatt@raimiassociates.com

Healthy General Plans Toolkit:ywww.healthyplanning.org/toolkit_healthygp.html