2. Improving Health
“Many would be surprised to learn that the
y p
greatest 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,
Public Health Physician
P bli H lth Ph i i
3. About Raimi + Associates
Comprehensive Planning
Sustainable Development
p
Public Health and Planning
- LEED ND Public Health Criteria Study USGBC
LEED-ND Study,
- 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
10. Mix of Land Uses
More types of uses
More retail uses
• Neighborhood retail uses
• R t
Restaurants & taverns
t t
• Grocery stores
Employment destinations
Civic uses
11. Urban Form and Character
Building relationship to street
Building l ti
B ildi relationship t other
hi to th
buildings
Building design
B ildi d i
Overall character and
attractiveness of environment
12. Transit Access and Availability
Proximity
Frequency
Density of Destinations
Pedestrian environment and
amenities
14. Bicycle and Pedestrian Facilities
Bicycle
Proximity
Design
Completeness of network
C l t f t k
Pedestrian
Sidewalk presence and completeness
Pedestrian facilities
Pedestrian crossings
15. Access to Parks and Open Space
Proximity
Aesthetic Appeal
A th ti A l
Source: Dan Burden
Real and Perceived Safety
Presence of others exercising
16. Access to Healthy Foods
Supermarkets
Farmers Markets
F M k t
Locally grown foods
17. 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
18. As Driving Increases
Tendency to be overweight
increases
Occurrence of traffic crashes
increases
Exposure to air pollution increases
Driving related stress (road rage)
increases
Water quality decreases
Civic participation declines
19. 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
times more likely to get recommended amount of physical activity.
f
- 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.
20. A National Evidence Base
A 5% increase in walkability is associated with:
32 % 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.
21. A Note on Health Disparities
Asthma:
Death rates from asthma are almost three times higher for African
Americans than for white Americans (US EPA 2003)
Traffic injuries:
j
African 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
facilities, well-funded schools and playground structures, possibly
f ili i ll f d d h l d l d ibl
contributing to disparities in physical activity rates (PolicyLink, 2002)
22. Policy Decisions
Urban Form,
Transportation System, and
Land Use
Built Environment
Access t G d and Services
A to Goods d S i
Travel Choices
Street Design
Health Indicators
Physical Activity Levels, Time spent driving,
Access to Nutrition and Healthcare
Pollution, Stress
Health Outcomes
Diabetes, Obesity
Traffic Accidents, Respiratory Illness
Crime,
Crime Mental Health Issues
Making the Connection
24. What is a General Plan?
Vision for the County’s future
Long-term policy guide f
L t li id for:
Physical Changes
Economic Development
Preservation of Open Space
All land use decisions must derive from the GP
Covers 20 30 year time period
20-30
25. South Gate: An Overview
8 miles southeast of downtown LA
Population: 115 000 to 125 000
115,000 125,000
7.5 square miles
> 95% Latino
Median age 26 y
g years of age
g
Working class
27. Process
1. Create partnerships
2. Existing conditions analysis
3.
3 Public workshops
4. Healthy City Element and General Plan
Policies
5.
5 Implementation
29. Partnerships and Outreach
Informally disseminate information
Set
S t up partnerships with other d
t hi ith th departments
t t
Pass Board/Council Resolution on Health
Create a Healthy Community
Committee/Coalition
Public Workshops
Walk Audit
W lk A dit
30. 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.
5 Kaiser Foundation (funder)
32. Rank South Gate LA County
1 Heart Disease Heart Disease
2 Stroke Stroke
3 Diabetes Lung Cancer
4 Emphysema/COPD Emphysema/COPD
5 Lung Cancer Pneumonia/Influenza
Leading Causes of Death
33. 30 26.4%
25
20.6%
%
20
15
10
LA County South Gate &
sourrounding cities
Adults with Fair or Poor Health
34. LA County South Gate & Surrounding Cities
g
Overweight Overweight
35.5 39.5
Obese Obese
20.9 33.1
Overweight and Obese Adults
41. Data Challenges
Creating connections between land use
and health outcomes
Many data sources – difficult to get info
Obtaining
Obt i i accurate city-level and sub-city
t it l l d b it
level information (LA County is the
exception)
p )
47. A Healthy General Plan
Health informs vision
Regulates L d use and urban f
R l t Land d b form
Requires “healthy” transportation and infrastructure
systems
t
Layers health policies throughout
May includes a stand-alone “Healthy Community” Element
48. Elements of the Plan
Land Use
Circulation
Ci l ti
Healthy Community
Public Facilities and Services
Safety
Parks and Open Space
Conservation
49. Vision Statement
HEALTHY ENVIORNMENT: South Gate supports
public health through a healthy environment that
includes and promotes walkable communities, safe
neighborhoods,
neighborhoods enhanced recreational and cultural
amenities, reduced noise and air pollution, water and
energy conservation, and an attractive natural
environment.
50. 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 2
dimensional plan
53. Source: WRT, City of Sacramento
Community Design: Land Use, Form & Character
54. 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
55. Community Design: Policies
Mixed use development
Higher density development
Infill development (downtowns,
community centers, along corridors)
Manage outward growth
Build around transit
Include urban design considerations
Agricultural land preservation
56. Mobility Element
Streets as public space
Prioritize moving people not cars
Integrate land use and transportation
- context-sensitive roadway
context sensitive
classifications
Safety improvements in
y p
neighborhoods
Identified pedestrian and bicycle
infrastructure
Promote transit improvements
57. Green City Element
Green streets and infrastructure
New parks and open spaces
N k d
Expanded trail network
Climate change/GHG emissions
58. Healthy Community Element
Stand-alone Healthy Community
“element”
- Overall health and well-being
- Land use patterns that support physical
activity
y
- Active and safe transportation
- Access to healthy foods
- Access to health care
- Air pollution
- “Traditional” safety element topics
“T diti l” f t l tt i
(seismic, emergency preparedness)
59. Overall Health
Take health into consideration in city’s decisions
Monitor health
M it h lth conditions
diti
Focus on preventive care
Build and maintain partnerships
60. 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 facilities
Reinforces policies in Community Design Element
61. Active and Safe Transportation
Promote transit service
throughout the city
Improve bicycle and pedestrian
connections
Monitor areas with high-frequency
injuries and accidents
j
Promote safe routes to schools
Reinforces and references
policies in Mobility Element
62. Access to Healthy Foods
Encouragement of healthy food
stores
Promote and support farmers
markets
Create community gardens and
support “edible” school y
pp yards
Avoid concentrations of unhealthy
food, particularly around schools
,p y
63. Respiratory Health
Siting of “sensitive receptors”
- Freeways (I 710)
(I-710)
- Truck routes
-HHeavy i d t i l areas
industrial
Addresses tension between
density and air pollution
d it d i ll ti
Promotes reduction of auto trips
64. Additional Topics
Access to health care
Partnerships with local health providers
Incentives for hospitals and clinics
Full
F ll range of h lth care, i l di
f health including
mental health
Seismic safety
Emergency preparedness
Hazardous materials
67. Reform Zoning
Focuses on separation of uses
Separates uses that should b
S t th t h ld be
mixed to encourage active
transportation
Is a blunt instrument
Associates form standards (lot
coverage, setbacks, etc) with
use not place type
p yp
71. Conclusions
Build partnerships – NGOs, Public Health Dept, community
Health should be integral part of all General Plans
Reinforce good land use and transportation decisions with
health
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
72. for additional information
Matt Raimi
Raimi + Associates
510-666-1010
matt@raimiassociates.com
matt@raimiassociates com
Healthy General Plans Toolkit:
y
www.healthyplanning.org/toolkit_healthygp.html
