Land use planning: Why public health must be involved

The legislative branch at the local, state, and federal levels must get involved in rethinking land use planning's natural relationship to public health. After all, land use has a direct impact on public health through its influence on housing and the natural and social environments in which people live. In order to become involved, legislators must be informed regarding land use planning's impact on public health. Legislators at every level of government have influence on the way land is used. City councils, boards of aldermen, boards of selectmen, and other local bodies have perhaps the most direct influence on land use through land disposition agreements, zoning ordinances, and city plan approval.

At the state level, the legislature sets policy standards for housing developments, playgrounds, parks, school buildings, sidewalks, and other community properties. As an incentive to adhere to state land use policy, a state legislature may also fund many programs that meet standards. At the federal level, Congress allocates money for special programs related to land use. It also establishes spending programs covering such activities as HUD redevelopment, privatization of federal housing projects, establishment of greenways/trail projects, and similar initiatives.

Legislators at all levels have an ability to promote change in land use policy through use of the bully pulpit. They can bring influential people together to learn about the relationship between land use planning and public health and to begin to address the issue as it relates to various settings.

Intervention at New Haven, Connecticut: An Example of Local Action to Promote Effective Land Use Planning to Improve Public Health

A land use planning/public health intervention occurred in New Haven, Connecticut as an outcome of a collaboration that was suggested and technically supported by Milbank Memorial Fund. The collaboration utilized legislative relationships to bring influential people to the table to discuss New Haven's childhood obesity problem and the means by which land use planning could address this problem.

New Haven's children are more obese than those in the United States as a whole. Recent studies in the city have shown that up to 60% of adolescents are obese. Type 2 diabetes is diagnosed in children as young as 5 in the city, and 40 percent of newly diagnosed cases of diabetes in youth are type 2, a previously rare diagnosis for young people. These youth are at risk of other health problems associated with diabetes by the time they reach their mid-twenties.1

New Haven's committee of stakeholders to address the childhood obesity problem in a land use context included the city planner, the community services administrator, school officials, an alderman, a family resource center representative, a child day care commissioner, a pediatrician working with the Department of Health on school nutrition, and others. The committee decided upon a project to reduce childhood obesity in New Haven by proposing low-cost modifications of indoor and outdoor school space in order to encourage school children to increase their physical activity. Much of the work of the project is being carried out by the staff of Project for Public Spaces, an internationally known non-profit organization based in New York City that has worked on other projects involving the redesign of schools and adjacent space. Project for Public Spaces and the Milbank Memorial Fund, an endowed private foundation, agreed to finance the work on the project. The Fund will pay for an intern recruited to work on the project through the City of New Haven City Planning Department. The intern's responsibility will be to coordinate the redesign.

This project will enable New Haven to increase usage of space and physical activity within school grounds and buildings. The Project for Public Spaces will use participatory planning techniques to involve children, teachers, and other members of the community in the process. The following phases describe the planning and implementation steps.

Phase 1: A meeting/brain storming session with key decision-makers and their agents.

Phase 2: On-site user evaluations of three newly built schools grounds.

Phase 3: A pilot project evaluation in one school. Low cost modifications arising from Phase 2 will be tested in one school and their effectiveness evaluated.

Phase 4: A briefing session with users to evaluate Phase 2 and Phase 3.

Phase 5: Evaluation of plans for buildings currently in design.

A mixed group of users (drawn from the onsite evaluation) will become members of the School Construction Advisory Committee (SCAC), and design professionals will review the existing school plans in a one-day workshop. The workshop will start with a video presentation based on footage taken from the onsite evaluations and recommendations. It is hoped that children and other users involved in the evaluation will assume an ongoing role as advisors to SCAC.

Phase 6: Presentation of deliverables to decision-makers.

Key decision-makers and their agents will be presented with recommendations for schools that are newly built or in design, along with a design manual (both video and Web-based) and summary project findings (i.e., quotes and statistics). These will be submitted in draft form for comments.

BROADER DISSEMINATION OF RESULTS

In consultation with important decision-makers, Project for Public Spaces will aim to leverage the outcomes of the project into a nationwide program on school design and programming. Currently, no national programs in the United States are dedicated to design and management of school premises, and remarkably few regional initiatives exist. The New Haven program could result in the production of a video as a training tool, the production of regular training programs, and further development of the Web-tool kit to include a resource center of images and research. The timetable for production of such training material would be approximately two months. The entire New Haven project should be completed by the end of 2002.

The project, named Healthier School Buildings and Grounds for New Haven, is just one example of how legislative collaboration with a private sector foundation, with city planners, with community leaders, and with government officials brought land use planning and public health together. Participants in the project believe that this project will make a positive difference in the health of New Haven's children and in the health of the children in those communities that choose to replicate this project.

Initiatives of the Regional Plan Association

The Regional Plan Association (RPA) works with communities in the New York metropolitan area to initiate and implement land use projects that promote a healthier environment. The RPA does so through its Healthy Communities for the New York Metropolis (Healthy Communities) project. To date, the RPA has undertaken numerous initiatives.

NEW WAYS TO WORK AND PLAY: USING THE MILL RIVER CORRIDOR TO CONNECT STAMFORD'S COMMUNITIES

The City of Stamford, Connecticut is making a major public investment in the Mill River corridor with the creation of a new park system in the downtown and with the commitment, in the new Master Plan, to a larger greenway network extending from the Merritt Parkway to the South End waterfront. This Healthy Communities project will leverage the benefits of these investments in several ways:

A. Promote increased activity levels in the disadvantaged and largely minority neighborhoods on the west side of the new Mill River Park, both through recreational opportunities in the park itself and through increased connectivity between the neighborhoods and the new downtown Mill River Park. The project will explore ways of increasing activity levels by promoting pedestrian and bicycle connections to the park, to the downtown beyond, and to the larger greenway network.

B. Provide opportunities for biking, jogging and walking for the employees in the large corporate campuses along Long Ridge Road as well as the residents of the elder care facilities along this corridor.

C. Promote bicycle and pedestrian activity throughout Stamford by linking open space resources and providing alternative modes for journey-to-work.

GREEN LINKAGES FOR WESTCHESTER COMMUNITIES

Westchester County, New York continues to explore ways of balancing intense suburban development with the need for greenways and other alternative ways of connecting cities, towns, and villages. Several greenway opportunities, many based on the historic parkway systems, are playing an increasingly important role. This project will identify strategic connections between the various greenway initiatives and several different kinds of communities in Westchester. The greenway projects will be used to educate local partners on healthy community design and will provide valuable design input for the greenways themselves.

CHANGING LANDSCAPES IN NEW JERSEY: HEALTHY COMMUNITIES AND ALTERNATIVES TO SPRAWL

New Jersey has just adopted its State Development and Redevelopment Plan, which seeks to promote growth in compact, mixed use centers and protect open space and farmland in the most densely populated state in the nation. While there are currently many progressive ideas relating to concentrated mixed-use development and transit-friendly design strategies, these ideas have yet to be linked explicitly to a healthy communities agenda. This project will explore several ways of leveraging the health agenda to design and implement new alternatives to sprawl development patterns. The project will exploit the fact that New Jersey is a laboratory for virtually every form of urban, suburban, and rural settlement and that a policy framework already exists in the form of the State Plan, which does recognize the linkage between land use and public health.

THE NEW JERSEY MAYORS' INSTITUTE ON CITY DESIGN

The New Jersey Mayors' Institute on City Design (MICD) provides a two-day retreat for eight mayors to come together with a panel of national experts on community design, public health, and the development process. The mayors present case studies of urban design problems and receive advice from the panel on how to make their communities more livable, walkable, and successful places. Between those discussions, the panelists make presentations on topics such as urban and landscape design, the development process, state resources, and the connection between public health and community design.

The MICD was established by RPA to promote smart growth through better design of communities in New Jersey, empowering mayors with knowledge and a vision to implement high-- quality, sustainable community plans to promote more active lifestyles. The goal of the MICD is to educate local officials about state-of-the-art design theory and techniques and to provide mayors with the opportunity to bring a case study to national and state experts for ideas and suggestions. A secondary goal is to create a "fraternity" of mayors with strong design knowledge who can serve as experts to other communities.

The program is modeled on the successful nationwide program sponsored by the National Endowment for the Arts. However, the MICD is unique in closely involving state government and focusing on the special role that design has in public health issues. Panelists and speakers at past institutes have included national experts on urban design and public health issues, including Mayor John Norquist of Milwaukee, Mayor Joseph Riley of Charleston, and Thomas Schmid from the federal Centers for Disease Control and Prevention.

RPA organized the first MICD in 2001 with the assistance of the National Endowment for the Arts, the New Jersey Department of Community Affairs (Office of State Planning), the New Jersey State League of Municipalities, and Princeton University's School of Architecture. A number of design and planning experts provided technical assistance, including the Centers for Disease Control and Prevention. Contacts are being made with the New Jersey chapter of the American Planning Association and other planning-related entities, a number of other higher education institutions such as Rutgers University and the New Jersey Institute of Technology, and environmental organizations to encourage other partnerships and expand the technical resources available to communities.

THE NORTHEAST STATE PLANNING DIRECTORS RETREAT

Created in 1999, the Northeast State Planning Directors Leadership Retreat (NESP) has provided an annual forum for state planning officials from the Northeast States-Maryland to Maine-to come together for a two-day workshop to learn from each other about new initiatives and opportunities in state land use policy. Co-sponsored by RPA and the Lincoln Institute for Land Policy, these annual workshops have evolved into a critical forum for these policymakers to learn the state of the art and share their own successes and failures with their peers. Guest speakers and presenters are brought in for each session, and roundtable discussions provide participants with the opportunity to explore the possibilities for using new techniques and information to better manage land use patterns and control sprawl in their home states.

Beginning in 2002, RPA introduced the healthy communities agenda to this important constituency. The outcomes and process objectives of this initiative are to integrate land use and public health policies at the state government level by educating state officials about the connections between land use and public health and by demonstrating ways that land and environmental policies can promote healthier communities.

The first NESP forum to incorporate these issues was held on April 11 and 12, 2002, in Cambridge, Massachusetts. In addition to RPA and Lincoln Institute staff, participants included commissioners and directors of state planning and growth management from Vermont, Massachusetts, Delaware, Maryland, Pennsylvania, New York State, Maine, New Jersey, and Connecticut.

At this forum, a roundtable discussion titled "Planning and Designing the Physically Active Community" was moderated by RPA President Robert Yaro. Panelists included Marla Hollander, a program officer with the Robert Wood Johnson Foundation; Reid Ewing, a researcher on public health and land use from Rutgers University; and Marya Morris, a senior research associate at the American Planning Association and the program director for the APA's initiative to promote understanding of healthy communities in the planning profession.

Conclusion

Federal, state, and local governments, together with concerned citizens, can play a strong part in promoting land use policies that address public health directly. Through collaborative efforts with private organizations and others, it is possible to conduct land use planning that promotes healthy habits as a way of both preventing and addressing diseases whose development is partly aided by poor land use policies. The project now nearing completion in New Haven, Connecticut is an example of the way in which communities can improve public health through effective land use planning. The initiatives of the Regional Planning Association in the New York metropolitan area furnish yet another example of the numerous ways that government leaders and governmental activities can bring focus to the issue of creating healthy land use policies.