Healthy Planning Topics Active Living: Health & Human Services: • Active transport • Access to healthcare and social services • Recreation • Aging • Injury Food & Nutrition: Environmental Health: • Access to Food & Healthy Food Options • Air Quality • Water • Water Quality • Land Use • Brownfields Social Cohesion & Mental Health: Emergency Preparedness: • Active transport • Climate change • Recreation • Natural & Human-caused Disasters • Crime and Public Safety • Infectious Disease Other: Economic Conditions: • ??? • Economic development • ??? • Access to well-paying jobs • ??? • Education and training Adapted from: Healthy Plan Making, APA
Key Findings from a National Web-based Survey • 900 completed surveys from local government planners • 31 percent of responding jurisdictions have comp plans that explicitly address health topics • Top 10 cited public health topics were: recreation, public safety, clean water, active transportation, clean air, emergency preparedness, active living, physical activity, environmental health and aging. • Two models for incorporating health: – Standalone, voluntary health element – Include health-related goals and policy into existing mandatory elements (Parks & Open Space, Transportation/Circulation, Urban Design) Source: Healthy Plan Making, APA
Results of 22 Plan Review Strengths Areas for Improvement • Active living was strongest across • Most plans had weak coverage of: all plans Food & Nutrition, Emergency Preparedness, Health & Human • Environmental health well covered Services, and Social Cohesion/ - especially water and trees Mental Health • Emergency Preparedness, when • Limited use of imagery and maps covered, was strong and specific • Limited use of public health data • Food & Nutrition, when covered, were strong with attention to • Virtually no health-related equity and access for vulnerable performance metrics populations • Most plans lacked specific • Health was emphasized to a implementation strategies greater extent when plans included a stand-alone element Source: Healthy Plan Making, APA
Seven Detailed Case-studies Source: Healthy Plan Making, APA
Case Studies: Key Elements of Success • Champions • Context & Timing • Outreach • Health Priorities • Data • Collaboration • Funding • Implementation • Monitoring and Evaluation Source: Healthy Plan Making, APA
Examples…..
Developing Trenton’s Health & Food Systems Element
Trenton Healthy Communities Initiative • Health and Food Systems Element (HFSE) for the Trenton250 Masterplan • HiAP training for Trenton City decision makers and Departments • Statewide knowledge transfer – Model Health and Food Systems Element – HiAP training for local decision makers in integrating planning and public health
Trenton’s Plan4Health Coalition • Initiative supported by: – Rutgers University New Jersey Health Impact Collaborative – APA New Jersey Chapter – New Jersey Public Health Association – City of Trenton – Trenton Division of Planning – Trenton Department of Health – Trenton Health Team
Partnerships and Collaborations
Trenton Community Health Needs Assessment Process Community Advisory Board • Data Sharing and Data • Analysis PICO interviews and forums • Validation, Verification and • Prioritization by Community Creation of a unified TCHNA • Development of a unified • Community Health Improvement Plan TCHIP Dashboard •
Community Health Priorities POVERTY Health Literacy Safety & Crime Obesity SAMH Chronic Disease
Health Literacy Goals Strategies Align with goals of HHS National Incorporate health literacy • improvement in mission, planning, and Action Plan To Improve Health evaluation Literacy: Support health literacy research, • • Increase access for everyone to evaluation, training, and practice accurate and actionable health Conduct formative, process, and • outcome evaluation to design and assess information materials, messages, and resources • Deliver person-centered health Enhance dissemination of timely, • information and services accurate, and appropriate health • Support lifelong learning to information to health professionals and the public promote good health Design health literacy improvements to • healthcare and public health systems that enhance access to health services
Safety & Crime Goals Strategies Reduce street-level violence Targeting resources to • • individuals and communities Increase residents’ perceptions • most at-risk of safety Enhancing data collection and • Implement Trenton Violence • analysis Reduction Strategy (TVRS), an evidenced-based, public health Building community and agency • approach modeled on Boston capacities trough collaboration Ceasefire and CURE. and mobilization Buy-in and trust among key • partners, including TCNJ and Trenton Prevention Policy Board
Obesity/Healthy Lifestyles Goals Strategies Increase Trenton residents’ Creation of joint-use • • access to and consumption of agreements between TPS and healthy foods City for opening of school parks outside of school hours Increase access to and practice • of physical activity Creation of Healthy Food • Network – Seek funding for creation of Healthy Food Network – Expand Healthy Corner Store initiative of NJPHK – Increase availability of fresh produce at food pantries Offer cooking classes at • neighborhood schools
Substance Abuse & Mental Health Goals Strategies Improve access to quality Create a pilot “transitional” • • behavioral health treatment outpatient clinic model – services stopgap to decrease ER visits and engage individuals with Improve access and utilization • treatment programs of prevention services in Trenton Develop “Ready Access” system • for behavioral clients Reduce barriers related to • culture for behavioral health Develop resource for helping • treatment individuals pay for medications Expand SBIRT to additional • settings Increase available information • through social media
Chronic Disease Goals Objectives Reduce rates of diabetes, high Implement evidence-based • • blood pressure, and cancer practice guidelines for diabetes through evidence-based and high blood pressure in each practices at the city’s clinics and of the city’s seven clinics improved self-management by Engage a certified Diabetic • patients Educator at each of the seven clinics Screening for tobacco use and • Smoking Cessation counseling available at all seven clinics
CHIP: Supporting Health Impact Health Impact Pyramid: Affecting Change at Multiple Levels Smallest Impact Counseling & Education Clinical Community Interventions Health Needs Long-lasting Identified Protective Interventions Changing the Context to make individuals’ default Largest decisions healthy Impact Socioeconomic Factors
Master Plan Framework – 5 Pillars of Sustainability
Supporting Docs – Plans, Reports, Studies, etc.
District Plans
Putting the Plan to Work and Evaluating Progress The Planning Lifecycle
Trenton250 Vision Principle: Cultivate a Healthy City Trenton will be a clean city where there is access to natural resources, fresh foods, and high quality healthcare facilities.
Overview of HFSE • Hybrid approach – Health-related vision and goals – Health-informed mandatory elements – Voluntary, stand-alone health element • Incorporates health data and priorities • Focuses on addressing the social and environmental determinants of health • Includes Action Plan with: Policy, Project, Program, Partnership and Advocacy recommendations with responsibilities, timelines, milestones and potential implementation resources
HFSE Outline • Introduction – Background – Purpose – Legal Authority • Trenton Today – Current Health Status of Trenton Population – Social and Environmental Determinants of Health in Trenton • Trenton’s Health Vision • Nexus Between Health and Other Trenton 250 Master Plan Elements – Economic Development & Education – Land Use & Housing – Circulation – Environment
HFSE Outline Increase access to healthy foods • Expand access to healthy food outlets • Expand opportunities for community-based agriculture • Support school-based initiatives that promote good nutrition and healthy eating • Use government policies and programs to increase access to healthy foods
HFSE Outline Increase physical activity among Trenton residents • Improve access to parks and recreational programming • Improve conditions for active transportation • Promote physical activity through school-based programs • Use government policies, programs and incentives to increase physical activity
HFSE Outline Improve health literacy and access to healthcare services • Expand primary care provider capacity • Expand healthcare access for children and adolescents • Expand/integrate mental, behavioral and substance abuse services in primary care settings • Improve transit accessibility to healthcare facilities • Promote non-traditional settings for health care services • Promote health literacy
HFSE Outline Address unhealthy housing conditions • Create healthy and green building guidelines for new and existing housing • Improve the conditions of Trenton’s housing stock to promote the health of Trenton residents • Improve the conditions of vacant and abandoned properties that are health hazards to neighboring properties
HFSE Implementation • HFSE integrates with Trenton250 One Plan portal • Strong partnership with Trenton Health Team and THT collaborators • Health in All Policies training for department heads +
Statewide Knowledge Transfer • Model Health & Wellness Element • “How to” guide for local planners and public health officials • Training webinars and workshops
Planning for Health Data resources Presented by New Jersey Public Health Association Oliver Lontok, MD, MPH & Kevin McNally, MBA
Example: SES • 2010_Census_Data: Variables from the 2010 US Census Profile of General Population and Housing Characteristics. • Housing Units and Vacancy • Household and Family Counts • Race/Ethnicity. • Age_Sex_Pyramids_2010: Data from 2010 US Census, file: QT-P1: Age Groups and Sex 2010 . • Age-Sex Pyramids organized by municipality • Economic_Indicators: • Median Household Income (ACS 2010 5-yr estimates) • Unemployment Rates 2011 (NJ Department of Labor and Workforce Development) • Education_Language: Data from New Jersey School Report Card 2011, Department of Education. • List of (first) languages spoken at home of NJ students • IRS_2008_data: Data from 2008 Tax Forms via Brookings Institution, compiled at the Zip Code level. • Income data compiled at the Zip Code level Source: Brownlee, Rutgers Center for State Health Policy
Example: Housing • Multifamily_Housing: Data on Multifamily Housing. • Counts of properties, property units, and assisted units (source: Multifamily Assistance and Section 8 Contracts Database, HUD.) • Counts of properties (& number of associated units) receiving failing score on most recent physical inspection (source: Multifamily Physical Inspection Scores, 2011 , HUD) • Public_Housing_pis_2011: • Count of public housing properties, count of properties receiving failing score on most recent physical inspection (source: Public Housing Physical Inspection Scores, 2011 , HUD) Source: Brownlee, Rutgers Center for State Health Policy
Example: Health Birth_Indicators: Queried at the municipal level. (New Jersey State Health Assessment Data, Center for Health Statistics, NJ Dept of Health and Senior Services) • Infant Mortality Rate (2000-2008) • Mothers not receiving prenatal care (2004-2008) • Mothers not receiving prenatal care until their third trimester of pregnancy (2004-2008) • Low birthweight (2004-2008): percentage of infants with birthweight <2500g • Very low birthweight (2004-2008): percentage of infants with birthweight <1500g • Mortality_Indicators (2004-2008): Queried at the municipal level. (New Jersey State Health Assessment Data, Center for Health Statistics, NJ Dept of Health and Senior Services) • Average age at death • Death by age cohort Source: Brownlee, Rutgers Center for State Health Policy
New Jersey Department of Health • Uniformed Billing data • NJ SHAD • NJ BRFS • New Jersey Department of Labor and Welfare
Source: http://www.nj.gov/health/
Source: http://www.nj.gov/health/
Source: http://www.nj.gov/health/
Source: http://www.nj.gov/health/
Source: http://www.nj.gov/health/
Other Resources Behavioral Risk Factor Surveillance System American Community Survey Kaiser Permanente The Robert Wood Johnson Foundation
The Robert Wood Johnson Foundation County Health Rankings
Source: www.countyhealthrankings.org
Source: www.countyhealthrankings.org
Source: www.countyhealthrankings.org
The Henry J Kaiser Family Foundation
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