Presentation from Partners in Innovation Policy Forum in Denver, CO on September 27, 2010.

1. Toward Healthy Communities & a Healthy Environment:
The Role of Public Health in TOD and Livability
together
WE BUILD A BRIGHTER FUTURE
Monica Buhlig, MPH
Sr. Community Health Specialist
Kaiser Permanente Community Health Initiatives
kp.org/communitybenefit

2. together
Our Mission: To provide high-quality, affordable health care services
to improve the health of our members and the communities we serve.
Nation’s largest not-for-profit health plan
National Statistics (2008):
 8.6 million members
 35 Medical Centers/Hospitals; 431 Medical Offices
 14,600 Physicians; 167,300 Employees
 $40.3 billion Operating Revenue; $1.18 billion Community
Benefit
Regions:
 Northern California
 Southern California
 Northwest (Oregon/Washington)
 Colorado
 Georgia
 Mid-Atlantic States (VA, MD, DC)
 Ohio
 Hawaii
kp.org/communitybenefit
2

3. Factors Influencing Health Status together
Source: McGinnis, J.M and Foege, W.H. (1993). “Actual Causes of Death in the United States,” Journal of the American Medical Association.
kp.org/communitybenefit

4. The Challenge for the Health Sector
together
• Excellent medical care alone is insufficient
• Major drivers of the (obesity) epidemic and related
chronic diseases are environmental
• Consensus: Comprehensive environmental and
social change is required to turn down the
epidemic – we will be part of the solution
Our Members Can’t be Healthy
if They Live and Work in Unhealthy Communities
kp.org/communitybenefit
4

5. A SHARED VISION: The Four Health/Wealth: Working
in the Nexus
Individual and Population Health Ecological Health
Nexus
Opportunities:
Transportation/
Land use
Food systems/
access
Access to goods/
services
Violence
Prevention
(Green) Jobs
Environment(al
justice)
Community
power
Civic Health Economic Health Social connection
See, for instance, Serageldin and Steer (1995), “Expanding the Measure of Wealth, “
World Bank monograph

6. together
kp.org/communitybenefit
6

7. together
“A Good Solution Solves
Many Problems”
…And involves
many partners…..
kp.org/communitybenefit
7

8. Unique Partnerships  Common Strategies and
Multiple Benefits
together
Partnership for Sustainable Communities (HUD, EPA, DOT)
Livability Principles:
1. Provide more transportation choices (Economic and
Ecological)
2. Promote equitable, affordable housing (Economic Health)
3. Enhance economic competitiveness (Economic Health)
4. Support existing communities (Ecological and Civic Health)
5. Coordinate policies and leverage investment (Economic
Health)
6. Value communities and neighborhoods (Civic Health)
…Where is the fourth health?...
kp.org/communitybenefit
8

9. Sustainable Communities Regional Planning Grant
Denver Region: Centers and Corridors (TOD) together
Areas of Greatest Focus
• Livability principles
• Public engagement
• Inter-disciplinary engagement
• Goals and metrics
• Tools to make it happen
Health Impact Assessment-Like Tool
Equity Focus
kp.org/communitybenefit
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10. Livability Principles:
Unique Partnerships  Multiple Benefits together
Federal State Local
Regional
Livability LiveWell 22
SCRPG communities
Prin Colorado
kp.org/communitybenefit
10

11. A Value-Added Partnership: Public Health
Contributions together
PUBLIC HEALTH ASSETS
• Evaluation and Data (Health status and costs)
• Collaboration
• Community Engagement
• Focus on disparate populations
• Evidence-base => Utilize models identifying how to
address links between health and built environment
kp.org/communitybenefit
11

12. Your Partners: Who is “Public Health”?
together
• Communities Putting Prevention to Work
• HCR Community Transformation Grants
• Local/State Public Health Departments
(Epidemiology/Obesity/Disparities)
• Health Foundations
• Health Plans
• Health Care Professionals
kp.org/communitybenefit
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13. together
Thank you for
your
contributions
to health!
kp.org/communitybenefit
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14. Relationship Between Built
Environment and Public Health together
• Inactivity/Obesity
• Injuries/Fatalities
• Stress/Mental Health
• Air Quality
• Water Quality & Quantity
• Climate
• Food Supply
kp.org/communitybenefit

15. Economic consequences of obesity
together
• Base on a study in managed care:
• BMI 30-34.9 = 25% increase in costs
• BMI 35 and above = 44% increase in costs
• Colorado’s annual obesity costs:
• $500 million (direct cost) + $470 million
• (lost productivity) = $970 million
kp.org/communitybenefit

16. together
Healthy Community Design
• Improves individual & population health
• Improves environmental health
• Improves economic health
• Promotes sustainability
kp.org/communitybenefit

17. Elements of Healthy Community
Design together
• Transportation
• Land Use
• Public Spaces
Plans, Built and Public &
Health of
Codes, Natural Individual
People
Policies Environments Behaviors
kp.org/communitybenefit

18. Transportation
together
Neighborhood traffic
calming
Bicycle lanes and paths
Wide sidewalks
Street trees
Mode options
Built and Natural
Environments
kp.org/communitybenefit

19. Transportation
together
• Decreases air
• Slows traffic & makes pollution, carbon
neighborhood streets dioxide omissions
safer for pedestrians
and cyclist
• Reduces injuries
• Provides alternatives to • Reduces risk for chronic
automobile travel diseases
• Increases opportunities • Reduces obesity and
for walking or cycling to associated diseases
transit
• Reduces asthma
Public & Individual Behaviors Health of People
kp.org/communitybenefit

20. Land Use
together
• Compact mixed-use
development; Co-location of
housing, jobs, services, &
transportation
• Healthy food retail and
restrictions on unhealthy
food outlets
• Land-use patterns that
encourage neighborhood
interaction and a sense of
community
Built and Natural Environments
kp.org/communitybenefit

21. Land Use
together
• Decreases automobile use • Decreases air
pollution, carbon
• Increases walking and
dioxide omissions
bicycling
• Encourages healthy food
choices
• Reduces injuries
• Can foster “eyes on the
street” • Reduces risk for chronic
diseases and obesity
• Encourages social
interaction and community • Fosters positive mental
connection health & social capital
• Increases neighborhood • Reduces asthma
safety, reduces violence
Public & Individual Behaviors Health of People
kp.org/communitybenefit

22. Public Spaces
together
•Parks
•Trails
•Urban forests
•Community gardens
and urban farms
•Paths
•Greenways
•Street trees
Built and Natural Environments
kp.org/communitybenefit

23. Public Spaces
together
• Increases walking, • Improves air quality
bicycling and other
physical activity and
recreation
• Reduces risk for chronic
• Invites community activities
diseases and obesity
• Encourages social
interaction and community • Reduces stress and
connection isolation
• Encourages gardening and • Fosters positive mental
other interactions with health & social capital
nature
• Reduces asthma
Public & Individual Behaviors Health of People
kp.org/communitybenefit

24. Economic Impact
together
• Public transit investments yield 19% more jobs than highway construction
• More walking / biking supports local retailers
• Public transit projects concentrate and attract development
• Better transportation policies are key to connecting low income people with
jobs…and food, healthcare, etc.
Sources: Littman, 2008; Center for Transit Excellence, 2008
kp.org/communitybenefit

25. Ray LaHood U.S. Secretary of
Transportation
together
• DOT encourages states, local governments, community
organizations and public transportation agencies to:
“Consider walking and bicycling as equals with other
transportation modes: The primary goal of a
transportations systems is to safely and efficiently move
people and goods. Walking an bicycling are efficient
transportation modes for most short trips and. Where
convenient intermodals systems exist, these
nonmotorized trips can be linked with transit to
significantly increase trip distance.”
kp.org/communitybenefit

26. Kaiser Permanente’s Involvement in
Healthy Community Design together
• Safe Routes to School National Partnership
• International Walk to School Day
• Community Health Initiatives (CHI)- Healthy Eating
Active Living
• Thrive Campaign
• National Healthy Eating Active Living Convergence
kp.org/communitybenefit

27. Why We Can’t Fail
together
•“The steady rise in life
expectancy during the
past two centuries may
soon come to an end”
• -- N Engl J Med 2005;
352:1138-1145
kp.org/communitybenefit