[PPT] - Planning for Health: Incorporating Health Considerations into PowerPoint Presentation

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Planning for Health: Incorporating Health Considerations into Community Master Plans

New Jersey Planning Conference Hyatt Regency, New Brunswick January 28-29, 2016

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Panelists

Jennifer Senick PhD, Executive Director

Rutgers Center for Green Building Rutgers, The State University of New Jersey Phone: 848-932-2904 Email: jsenick@rci.rutgers.edu Web: www.greenbuilding.rutgers.edu

Elizabeth Hartig, Project Coordinator

Planning and Community Health Center American Planning Association Phone: 202.349.1003 Email: ehartig@planning.org Web: www.planning.org

Jon Carnegie AICP/PP, Executive Director

Alan M. Voorhees Transportation Center Rutgers, The State University of New Jersey Phone: 848-932-2840 Email: carnegie@ejb.rutgers.edu Web: www.vtc.rutgers.edu

Jeffrey Wilkerson PP/AICP, Principal Planner

Division of Planning, City of Trenton Phone: 609-989-3502 Email: jwilkerson@trentonnj.org

James Brownlee MPH, Director/Health

Officer Department of Health and Human Services/Trenton Health Team, City of Trenton Phone: 609-815-2556 Email: jbrownlee@trentonnj.org Web: www.trentonhealthteam.org

Oliver Lontok MD/MPH, President

New Jersey Public Health Association New Jersey Public Health Association Email: oliver.lontok@rutgers.edu Web: www.njpha.org

Kevin McNally MBA, President-Elect

New Jersey Public Health Association Email: kmcnally3@comcast.net Web: www.njpha.org

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Welcome!!!

Introductions
Learning Objectives -

Agenda

Plan4Health Project Video

(permission form)

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Learning Objectives (1 of 2)

Learn how the Plan4Health project is reuniting the fields
f planning and public health;
Gain exposure to the research and tools developed by

APA’s Planning and Community Health Center;

Be introduced to the concept of Health in All Policies

(HiAP) and Health Impact Assessment (HIA);

Hear about lessons learned from the Trenton Health

Communities Initiative and the Trenton Health and Food Systems master plan element;

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Learning Objectives (2 of 2)

Learn about sources of health statistics and community

health improvement planning; and

Explore how a model Health & Wellness plan element and
ther healthy community planning tools can be used locally

here in New Jersey to further a Culture of Health

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Release Form

Name Signature Date

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Elizabeth Hartig, Project Coordinator

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Introduction to:

Planning and Community Health Center
Plan4Health

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www.plan4health.us

National Centers

What is the Planning and Community Health Center?

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Planning and Community Health Center

Active Living
Food Systems
Health in all Planning Policies

https://www.planning.org/nationalcenters/health/

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Frederick Law Olmsted Jane Addams

Planning and Public Health

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Healthy Planning Resources

https://www.planning.org/research/publichealth/

In partnership with the CDC, the PCH Center is conducting a multi-year research study to understand the role

f comprehensive plans in promoting

health:

National survey
Plan evaluation
Case study analysis

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5. SERVICES
General
Accessibility to Health & Human

Services

Aging
6. SOCIAL COHESION & MENTAL

HEALTH

General
Housing Quality
Green & Open Space
Noise
Public safety / Security

BROAD ISSUES

Substantive Issues: Vision

Statement, Guiding Principles, and Background data

Procedural Issues
1. ACTIVE LIVING
General
Active Transport
Recreation
Injury
2. EMERGENCY
Climate Change
Natural and Human-caused

Disasters

Infectious Disease
3. ENVIRONMENTAL EXPOSURES
General
Air Quality
Water Quality
Brownfields
4. FOOD & NUTRITION
Access to food and healthy food
ptions
Water
Land use

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www.plan4health.us

Our Community

What is Plan4Health?

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www.plan4health.us

Overview

APA received three-year commitment from

the CDC.

$4.5 million sub-granted to 35 local

coalitions. Plan4Health is also part of a larger, national coalition: Partnering4Health.

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Division of Community Health 97 coalitions across the country

Partnering4Health

www.plan4health.us

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Key Partnership

APA’s Plan4Health project partner is the American Public Health Association. APHA is leading our evaluation efforts as well as providing public health expertise.

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Overview

Shared Vision

Promote health equity
Reduce disparities in implementation,

access and outcomes Plan4Health’s Vision Full integration of planning and public health where people live, work, and play.

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Goals

APA and APHA are working to:

Increase collaboration
Increase community capacity
Increase messaging

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Focus Areas

Nutrition Increased access to environments with healthy food or beverage options. Physical Activity Increased access to physical activity

pportunities

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www.plan4health.us

Core Values

Plan4Health leverages cross-sector collaborations and member expertise to build local capacity for the implementation of policy, systems, and environment strategies.

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Coalition Partners

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Peer Learning Network

The goals of the PLN are to:

Share experiences and lessons learned

within and across the Plan4Health cohorts

Connect external peer experts to expand and

strengthen the Plan4Health community; and

Contribute to the movement of multi-sectoral

professionals committed to creating healthier communities nationwide.

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www.plan4health.us

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Coalitions

Where are these 35 coalitions?

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www.plan4health.us

Plan4Health Grantees

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Questions?

Elizabeth Hartig, Planning and Community Health Center ehartig@planning.org

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www.plan4health.us

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Health in All Policies and HIA

Jeanne Herb, Associate Director Environmental Analysis and Communications (EAC) Group

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The Problem

So many daily policy decisions made outside of the health sector have significant health implications that go unrecognized because health is just not on the radar screens

f decision makers.

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Social Determinants of Health

Source: Dahlgren and Whitehead, 1991

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Health in all Policies

A strategy that strengthens the link between health and other policies, creating a supportive environment that enables people to lead healthy lives.

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Urban Planning as a Tool to Promote Health & Wellness

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Think of Health Impact Assessment (HIA) as …

…a tool to understand the health implications . . .of PROPOSED policies, plans or projects on communities.

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Housing Air quality Noise Safety Social networks Nutrition Parks and natural space Private goods and services Public services Transportation Livelihood Water quality Education Inequities

How might the proposed project, plan, policy affect: And potentially lead to predicted health

utcomes?

HIA in Action

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Step 1: Screening

Determine whether an HIA will add value.

Step 2: Scoping

Develop a plan for the HIA.

Step 3: Assessment

Identify current and predicted health impacts.

Step 4: Recommendations

Identify actions that protect health.

Step 5: Reporting

Communicate findings.

Step 6: Evaluation

Monitor impacts.

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Health Impact Assessment is…

Predicts anticipated health outcomes using public health

and scientific evidence

Recommends balanced, well-informed decisions
Weigh trade-offs, direct and indirect health impacts
Includes strong engagement of community, business,

decision-making body …a structured, but flexible, process that

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HIA is NOT…

Used to make the case for why a policy, program or

project should or should not be proposed.

An assessment to understand the impacts of a program
r policy after it has been implemented.
A community assessment tool (i.e., MAPP & CHIP).

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What Topics Have HIAs Addressed in the U.S.?

Courtesy of Health impact project

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Planning for Health: Incorporating Health Considerations into Community Master Plans

Healthy Plan Making & The Trenton 250 Health and Food Systems Element

Jon Carnegie, AICP/PP Jeff Wilkerson, AICP/PP James Brownlee, MPH

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Planning in the United States

riginated with a public health
purpose. Planning was rooted in the

need to reduce congestion, improve public health, and support social reform in housing and sanitation. Rapid urbanization resulted in

vercrowded and often poorly

constructed housing, noxious industrial and manufacturing uses, new levels of human and animal waste, and intensified outbreaks of infectious diseases. The planning and public health professions were joined by a shared focus on urban reform and a common goal to prevent

utbreaks of infectious disease.

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Active Living:

Active transport
Recreation
Injury

Emergency Preparedness:

Climate change
Natural & Human-caused Disasters
Infectious Disease

Environmental Health:

Air Quality
Water Quality
Brownfields

Food & Nutrition:

Access to Food & Healthy Food Options
Water
Land Use

Health & Human Services:

Access to healthcare and social services
Aging

Social Cohesion & Mental Health:

Active transport
Recreation
Crime and Public Safety

Economic Conditions:

Economic development
Access to well-paying jobs
Education and training

Other:

???
???
???

Healthy Planning Topics

Adapted from: Healthy Plan Making, APA

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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

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Strengths

Active living was strongest across

all plans

Environmental health well covered
especially water and trees
Emergency Preparedness, when

covered, was strong and specific

Food & Nutrition, when covered,

were strong with attention to equity and access for vulnerable populations

Health was emphasized to a

greater extent when plans included a stand-alone element

Areas for Improvement

Most plans had weak coverage of:

Food & Nutrition, Emergency Preparedness, Health & Human Services, and Social Cohesion/ Mental Health

Limited use of imagery and maps
Limited use of public health data
Virtually no health-related

performance metrics

Most plans lacked specific

implementation strategies

Source: Healthy Plan Making, APA

Results of 22 Plan Review

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Seven Detailed Case-studies

Source: Healthy Plan Making, APA

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Case Studies: Key Elements of Success

Champions
Context & Timing
Outreach
Health Priorities
Data
Collaboration
Funding
Implementation
Monitoring and

Evaluation

Source: Healthy Plan Making, APA

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Examples…..

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Developing Trenton’s Health & Food Systems Element

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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

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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

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Partnerships and Collaborations

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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

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Community Health Priorities

POVERTY

Health Literacy Safety & Crime Obesity SAMH Chronic Disease

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Health Literacy

Goals

Align with goals of HHS National Action Plan To Improve Health Literacy:

Increase access for everyone to

accurate and actionable health information

Deliver person-centered health

information and services

Support lifelong learning to

promote good health

Strategies

Incorporate health literacy

improvement in mission, planning, and evaluation

Support health literacy research,

evaluation, training, and practice

Conduct formative, process, and
utcome evaluation to design and assess

materials, messages, and resources

Enhance dissemination of timely,

accurate, and appropriate health information to health professionals and the public

Design health literacy improvements to

healthcare and public health systems that enhance access to health services

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Safety & Crime

Goals

Reduce street-level violence
Increase residents’ perceptions
f safety
Implement Trenton Violence

Reduction Strategy (TVRS), an evidenced-based, public health approach modeled on Boston Ceasefire and CURE.

Strategies

Targeting resources to

individuals and communities most at-risk

Enhancing data collection and

analysis

Building community and agency

capacities trough collaboration and mobilization

Buy-in and trust among key

partners, including TCNJ and Trenton Prevention Policy Board

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Obesity/Healthy Lifestyles

Goals

Increase Trenton residents’

access to and consumption of healthy foods

Increase access to and practice
f physical activity

Strategies

Creation of joint-use

agreements between TPS and City for opening of school parks

utside of school hours
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

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Substance Abuse & Mental Health

Goals

Improve access to quality

behavioral health treatment services

Improve access and utilization
f prevention services in

Trenton

Reduce barriers related to

culture for behavioral health treatment

Strategies

Create a pilot “transitional”
utpatient clinic model –

stopgap to decrease ER visits and engage individuals with treatment programs

Develop “Ready Access” system

for behavioral clients

Develop resource for helping

individuals pay for medications

Expand SBIRT to additional

settings

Increase available information

through social media

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Chronic Disease

Goals

Reduce rates of diabetes, high

blood pressure, and cancer through evidence-based practices at the city’s clinics and improved self-management by patients

Objectives

Implement evidence-based

practice guidelines for diabetes and high blood pressure in each

f the city’s seven clinics
Engage a certified Diabetic

Educator at each of the seven clinics

Screening for tobacco use and

Smoking Cessation counseling available at all seven clinics

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Health Impact Pyramid: Affecting Change at Multiple Levels

Largest Impact Smallest Impact

Socioeconomic Factors Changing the Context

to make individuals’ default decisions healthy

Long-lasting Protective Interventions Clinical Interventions

Counseling & Education

CHIP: Supporting Health Impact

Community Health Needs Identified

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Master Plan Framework – 5 Pillars of Sustainability

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Supporting Docs – Plans, Reports, Studies, etc.

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District Plans

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The Planning Lifecycle

Putting the Plan to Work and Evaluating Progress

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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.

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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

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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

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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

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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

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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

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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

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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

+

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Statewide Knowledge Transfer

Model Health & Wellness Element
“How to” guide for local planners and public

health officials

Training webinars and workshops

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Planning for Health

Data resources

Presented by New Jersey Public Health Association Oliver Lontok, MD, MPH & Kevin McNally, MBA

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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

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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

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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

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