Category Archives: Built Environment and Health

May 12 2014
Comments

Center for Community Health and Evaluation Releases First National Evaluation of HIAs: Q&A with Tatiana Lin

file

Health impact assessments (HIAs) are evidence-based analyses that estimate future health benefits and risks of proposed laws, regulations, programs and projects. They provide decision makers with an opportunity to minimize health risks and enhance health benefits. HIA practitioners say the tool allows for more informed—and potentially healthier—decisions related to land use, transportation, housing, education, energy and agriculture.

The Center for Community Health and Evaluation, a division of Group Health Research Institute, a nonprofit based in Seattle, recently published a national study on HIAs that looked at their utility and potential improvements.

The new study outlines how HIAs change decision making and highlights evidence that HIAs can also lead to stronger cross-sector relationships, greater attention to community voices and longer-term changes beyond the initial decision the HIA is focused on.

Key findings of the Center’s evaluation include:

  • HIAs can contribute directly to the decision-making process and help achieve policy outcomes that are better for health.
  • There are opportunities to advance the HIA field in the areas of stakeholder and decision-maker engagement, dissemination and follow-up.
  • Attention to specific elements can increase likelihood of HIA success.

A past HIA funded by a grant from the Health Impact Project, a program of the Robert Wood Johnson Foundation and the Pew Charitable Trusts, was conducted in 2012 by the Kansas Health Institute (KHI) and looked at the health impacts of building a casino in Southeast Kansas (a law that would move such a project forward was enacted last month).

NewPublicHealth recently spoke with Tatiana Lin, the author of the HIA and a senior analyst at KHI, about the recent HIA evaluation and lessons learned from the HIAs KHI has worked on so far. 

Read more

May 8 2014
Comments

Streetcars: Is Desire Enough?

file

This year, the County Health Rankings and Roadmaps, an annual report of the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, added some new measures, including transportation, to help track what communities can do to help improve population health. Researchers have found that more than three-quarters of workers drive to work alone and among them 33 percent drive longer than a half hour each way. Driving contributes to physical inactivity, obesity and air pollution.

One idea that has sprouted as an alternative to cars is actually a throwback: Streetcars. First introduced in the 1820s and drawn by horses on rails that let wagons move faster than they could on unpaved roads, many cities later added electricity by the 1920s to create early transit systems. They then added buses—and often faster underground rail lines—to transportation options as the 20th century continued, and then usually discontinuing the streetcar lines.

Planners say resurgence has come with plans to revitalize downtown areas as well as attract tourists, who often fly into town but then look for inexpensive and accessible ways to go from site to site. But funding, including grants from the U.S. Department of Transportation, is sometimes awarded for streetcars on the promise of using the lines as an inexpensive transit mode to get to and from work. An opinion piece in The New York Times last month proposed that idea for people who live in lower-income neighborhoods a mile or more from subway stations, which can be a deterrent to looking for higher-paying jobs outside of home neighborhoods.

But some researchers remain skeptical that streetcars will meet that and other promises made by some developers, including reducing car emissions and the need for parking spaces in cities. A study published last year in the Journal of Public Transportation by Jeffrey Brown, an associate professor in the Department of Urban and Regional Planning at Florida State University, said there is “a lack of information about how these investments [in streetcar lines] function as transportation modes as opposed to urban development tools.”

Brown said few streetcar rider surveys have been done, but where they have been ridership so far does not indicate they’re being used as a transportation option for work. A Memphis survey found that only 9 percent of streetcar rides transport workers between home and job, while 58 percent of bus rides are for transportation to work and back. And surveys of the Portland system, the heaviest used streetcar system in the United States, show that streetcar users tend to have higher incomes than users of the city’s other mass transit modes. 

Read more

Apr 30 2014
Comments

Place Matters: Eliminating Health Disparities in Jefferson County, Alabama

file

Place Matters is a national initiative of the Joint Center for Political and Economic Studies designed to build the capacity of local leaders around the country to identify and improve the social, economic and environmental conditions that shape health. “Addressing upstream causes of poor health, such as issues related to employment, education, poverty, and housing and environmental health risks through community action, policy development, and measuring the indicators associated with these determinants of health, are at the heart of our Place Matters work,” said the project’s program director, Autumn Saxton-Ross, PhD.

Nineteen Place Matters teams are currently working in 27 jurisdictions. This week NewPublicHealth will be highlighting six teams, chosen by Ross as representing both what needs to be fixed and what can be done.

file Jefferson County Place Matters team members take part in Food Day

Jefferson County, Alabama is the most populous county in the state. The Place Matters team, headquartered at the University of Alabama at Birmingham, found that the county leads the nation in chronic diseases and conditions linked to premature death, disability, decreased productivity and high health care costs. The leading causes of death in the county are heart disease, cancer and diabetes, and the county also exceeds state and national rates for obesity.

“At the heart of the Jefferson County Place Matters Team is a commitment to empowerment and civic engagement,” said team leader Monica Baskin, PhD, as associate professor of preventive medicine at the University of Alabama/Birmingham Nutrition and Obesity Research Center. The team works to improve the social determinants of health by:

  • Informing and illuminating public policy debates via research, analysis and information dissemination
  • Building capacity of community leaders
  • Facilitating community action planning and implementation.

Baskin, who has led the team for two and half years, said it has so far focused on improving access to healthy, affordable foods; physical activity opportunities; and obesity-related issues. The team also released a health equity report about the county, timed to coincide with the 50th anniversary of the Birmingham campaign, a touchstone moment in the U.S. civil rights movement.

Read more

Apr 28 2014
Comments

Place Matters: Q&A with Brian Smedley, Joint Center for Political and Economic Studies

file

Place Matters is a national initiative of the Joint Center for Political and Economic Studies, a non-profit organization based in Washington, D.C., whose mission it is to improve the lives of African Americans and other people of color through policy analysis and change. The Place Matters initiative was designed to build the capacity of local leaders around the country to identify and improve social, economic and environmental conditions that shape health. Nineteen teams are working in 27 jurisdictions.

NewPublicHealth recently spoke with seven Place Matters teams about their ongoing efforts. We will be showcasing their work in a series that begins today with a conversation with Brian Smedley, PHD, Vice President and Director of the Joint Center’s Health Policy Institute.

NPH: What are some initial steps that a community has to take when making changes in order to impact health?

Brian Smedley: Several things we believe are important, and these are principles that we employ in our Place Matters work. One is first and foremost to start with the very communities that are most affected by economic and political marginalization and that have suffered from disinvestment for years. These are often communities that have the leadership and sources of strength and resiliency to begin to tackle these problems. We believe that engaging with communities; identifying their key concerns; identifying the sources of strength and resiliency in the community; and finding out from the community what their vision is for a healthy and vibrant community are all important first steps for anyone engaged in this kind of work.

We also believe that there’s an important role for research to document the inequitable distribution of health risks and resources, and to show how that often correlates with patterns of residential segregation. We have worked with our Place Matters teams to produce what we call community health equity reports, where we document such issues as where people can buy healthy food; how close polluting industries are to neighborhoods and residential areas; sources of jobs; and neighborhoods that have high levels of poverty concentration. 

Read more

Mar 26 2014
Comments

County Health Rankings 2014: Western New York

file

The County Health Rankings, a joint project between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, shows how communities across the country are doing and how they can improve on their health.

One of the communities highlighted in the 2014 report is Western New York. Across eight counties, the region struggles with a depressed economy and high rates of obesity, diabetes and heart disease.

They used the County Health Rankings to better understand their challenges and look at what types of programs and initiatives would help.

file

Innovative community partnerships include a Baby Café Program where moms can get breastfeeding support and connections to community resources to ensure every baby has a healthy start; a Healthy Streets initiative to create better infrastructure for a healthy community; and a Farm to School Program to support healthier schools. The fifth edition of the County Health Rankings continues to show us where we live matters to our health.

Mar 26 2014
Comments

County Health Rankings 2014: Rockingham County, N.C.

file

The County Health Rankings, a joint project between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, shows how communities across the country are doing and how they can improve on their health.

One of the communities highlighted in the 2014 report is Rockingham County, North Carolina. The community went from a wealthy county to a poor one very quickly after losing two major industries only a couple of decades ago.  

The population of about 90,000 suffers from high smoking rates, high obesity rates and high rates of smoking during pregnancy. When the 2010 County Health Rankings were released, the community's poor standing served as a wake-up call, and only a few years later the Kate B. Reynolds Charitable Trust became involved and the county started to expand the conversation, looking at health as more than simply health care access.

file

Innovative community programs include the Virtual Farmer's Market, which gives local farmers a new market for their products while also providing them with an education on how to reach out using technology as a means for boosting small business; a planned partnership between Triad Adult and Pediatric Medicine and the New Reidsville Public Housing Authority; and the planned Nurse-Family Partnership Program, which will pair home visiting nurses with at-risk moms and children up until the age of two. The fifth edition of the County Health Rankings continues to show us where we live matters to our health.

Mar 26 2014
Comments

County Health Rankings 2014: Grant County, Kentucky

file

The County Health Rankings, a joint project between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, shows how communities across the country are doing and how they can improve on their health.

One of the communities highlighted in the 2014 report is Grant County, Kentucky. The county has seen tremendous progress in its overall health outcomes and the health rankings, moving up from 89th to 60th place this past year relative to the state's other counties.  

The rural county — a "land of horses and tobacco farms" — has found that partnerships to improve health are absolutely essential, and that one of the advantages that smaller, more rural communities have is that it's relatively easy to bring together the business community, the churches, the schools and other groups.

file

Innovative community programs include Fitness for Life Around Grant County, or FFLAG, which led the company Performance Pipe to provide employees with healthier food options; the four-week Biggest Winner Challenge, which focuses on getting people to try out different kinds of physical activity; and tobacco-free policies on school campuses. The fifth edition of the County Health Rankings continues to show us where we live matters to our health.

Mar 25 2014
Comments

A Hospital Helps Revitalize the Community Outside Its Walls: Q&A with George Kleb and Christine Madigan

file

Over the last few months, NewPublicHealth has reported on initiatives of the participating members of Stakeholder Health, formerly known as the Health Systems Learning Group. Stakeholder Health is a learning collaborative made up of more than 40 organizations, including 36 non-profit health systems that share innovative practices aimed at improving health and economic viability of communities.

>>Read more on the Stakeholder Health effort to leverage health care systems to improve community health.

One Stakeholder Health member is the Bon Secours Baltimore Health System in Maryland, whose Community Works initiative helps improve the lives of the people in one of the poorest neighborhoods in the city. Bon Secours Baltimore is part of a national health system founded by the Sisters of the Order of Bon Secours.

Bon Secours engaged the community before embarking on projects and have created programs aimed at improving the community’s health through services that include the hospital, community clinics and visiting nurse programs, as well as housing, GED and financial literacy programs and revitalization programs.

The ambitious housing program will ultimately provide more than 1,000 units of affordable housing in the streets just around the hospital.

Bon Secours’ partner in its housing program is Enterprise Community Partners Inc., which builds affordable housing throughout the United States. NewPublicHealth recently visited the Bon Secours housing and services sites in Baltimore and spoke with George Kleb, executive director Bon Secours Health System, and Christine Madigan, senior vice president of development at Enterprise Homes. 

NewPublicHealth: When did the housing program begin?

George Kleb: Bon Secours here in Baltimore has been developing and operating housing since 1988. We started by developing a couple of senior buildings through a U.S. Department of Housing and Urban Development (HUD) program. Both buildings had been schools that were part of the surplus capacity in Baltimore. The HUD program serves people who are elderly, disabled, or very low income. There was a clear need and so we pursued that, and that was the start of our reach into housing. Then in the ‘90s we began work on housing really in line with a neighborhood revitalization strategy attached to our presence in the neighborhood of Southwest Baltimore. There was an area of West Baltimore Street, which is the street the hospital is on, that had become largely vacant. Two-thirds of the units in the three blocks leading up to the hospital were empty and we acquired 31 of those buildings and started a project we now call Bon Secours Apartments. We renovated three-story Victorian row homes into affordable apartments, and that’s when we started working with Enterprise. That’s a relationship that goes back to the mid-1990s.

Read more

Mar 11 2014
Comments

Why Chipotle’s Guacamole Scare Really Matters

Lost in the late night guffaws over Chipotle’s report to investors last week that future weather changes could impact the price of avocados—and in turn the availability of guacamole—is that those changes may impact far more than just chips and dips.

The Chipotle annual report told investors that “Increasing weather volatility or other long-term changes in global weather patterns, including any changes associated with global climate change, could have a significant impact on the price or availability of some of our ingredients...[and] we may choose to temporarily suspend serving menu items, such as guacamole or one or more of our salsas...”

The chain’s concern comes from scientists’ predictions for hotter temperatures and less rainfall in upcoming decades, which could reduce the yields of crops such as avocados. But a drop in rainfall impacts so much more than guacamole. Several times this year multiple communities in California, which has faced a severe drought, issued water restrictions as stringent as how frequently people could flush their toilets.

Recently The Atlantic Cities published an online quiz about how much water it takes for common activities such as showers and laundry. The quiz was developed by an Indiana University professor who was surprised by the many wrong answers he got from the thousand people he surveyed.

Do you know how much water it takes to water the lawn? Check out the quiz here.

Feb 28 2014
Comments

Faces of Public Health: Q&A with Chris Zimmerman

file

As the demand for walkable communities keeps growing, experts are moving from asking “If they build it, will they come?” to questioning how to fund the new developments, as well as keeping our eyes on issues such as transit, affordability and improving population health. As of January sharing best practices for those and many other issues is the job of Chris Zimmerman, who recently joined the staff of Smart Growth America as Vice President for Economic Development, following a very long stint as a member of the Arlington County Board in Virginia. Before his post in Arlington, Zimmerman was Chief Economist and Committee Director for Federal Budget and Taxation at the National Conference of State Legislatures. In his new role, Zimmerman will focus on the relationships between smart growth strategies and the economic and fiscal health of communities.

NewPublicHealth spoke with Zimmerman soon after he landed in his new office.

NewPublicHealth: What did you do before joining Smart Growth America?

Chris Zimmerman: For the last 18 years I’ve been a member of the Arlington County Board, the governing body of Arlington County, Virginia, an urban county of about 220,000 people right next to Washington D.C. The county functions as a comprehensive local government, with functions from school funding to land use and development to standard municipal functions such as parks and recreation, public safety, waste removal and managing public infrastructure. We don’t run the schools, but the funds for the schools are part of the county budget, at a cost of a little more than $1 billion annually.

Arlington County has become a model for transit-oriented development that is studied by folks around the country and even around the world, particularly because of the way the county has chosen to develop around the Metro system. That includes the initial commitment to be involved in Metro Rail, to fund underground Metro stations and then to focus development around them, beginning even before the ideas of the vocabulary of Smart Growth and urbanism had really gotten started, decades ago.

Prior to serving on the county board, I served on the county’s planning commission and a number of other commissions. So I’ve had about 20 to 25 years of involvement in the development of every aspect of the community, including housing, planning development and economic development, and even agencies such as the Washington Metropolitan Area Transit Authority, which runs Metro Rail and Metro Bus and every other regional transportation planning body there is here in Washington. I was involved in a lot of regional transportation issues that obviously were fundamental to our county because of the way we chose to develop and because of where we’re located. There are seven crossings of the Potomac River and five of them go through Arlington, so although there are a couple hundred thousand people in Arlington, there’s a million and a half or so in northern Virginia and large numbers of them go through Arlington every day.

Read more