1. Healthy Community Planning: Applying Health-in-All-Policies to Neighborhood Planning
2017 American Planning Association
National Planning Conference May 9, 2017
Amy Pow, MCIP
Principal Planner/Healthy Community Planning
Tacoma-Pierce County Health Department

2. Tacoma-Pierce County Health Department Healthy Community Planning Program
2012: Hired a planner to manage the program.
2013: Developed a Healthy Community Planning Toolbox.
: Board of Health adopted three sets of resolutions:
Neighborhoods as Determinants of Health
Health Impact Assessments to Support Environmental Impact Statements
Health-in-All-Policies in Decision-making
: Provided health input on 17 local comprehensive plans.
2015: Initiated a Healthy Community Planning Scholarship program.
2016: Launched a Healthy Communities Award program.
2017: Established a Healthy Community Planning Interest Group in Pierce County.

3. Let’s Talk about Health
Health is a state of complete physical, mental and social well- being, not merely the absence of disease or infirmity. (Source: World Health Organization). Health equity is the "attainment of the highest level of health for all people." (Source: Healthy People 2020.) Public health ensures fair opportunities for everyone to reach their full health potential. (Source: Centers of Disease Control and Prevention). Public health promotes and protects the health of people and the communities where they live, learn, work and play (Source: American Public Health Association).

4. What are we dying from in the U.S.?

5. Health Disparities in US
Source: Pierce County Environmental Health indicators report, 2014, using CDC’s National Center for Health Statistics data.

6. Root Causes of Health Determinants of Health
The person’s individual characteristics.
Access to health care.
The person’s health behaviors.
The social and economic environment.
The physical environment.
Source: World Health Organization

7. Place Matters: Zip Code Determines Your Health
Life Expectancy in Pierce County
Source: WA DOH: Washington Tracking Network ( data)

8. Health-in-All-Policies (HiAP): What & Why
Policies have cumulative health effects— positive and negative—on the communities and the people they affect.
Health-in-All-Policies is a systematic approach, integrating health into policy-making across sectors, to advance health equity by tackling the root causes of poor health outcomes.
By collaborating with non-health sectors, this approach can advance social, economic and environmental equity across all policy areas.
Source: UK Local Government Association

9. What are Healthy Communities?
People, economic prosperity and planet are tied together in a mutually supportive and interdependent way.

10. How Can HiAP Approach Make Community Planning Healthy?
Cross Sectoral Collaboration
Partner with health and other agencies/departments and stakeholders.
Plan with and for the communities
Make the invisible visible.
Let them advocate for their needs and aspirations.
Plan for healthy community outcomes
Balance the triple bottom line: people/equity, economy and environment.
Plan with a health lens
Create better places with abundant choices for people to live, work, learn and play.

11. Applying HiAP to Tacoma Mall Planning: Background, Goal and Challenge
Four unique quadrants in 485 acres.
Transient, low income and racially diverse.
Poor physical and mental health, and life expectancy.
Additional 8,800 people and 7,600 jobs by 2040.
Planning Goal
Catalyze growth and change that reflects the community’s vision of a complete, healthy, sustainable and prosperous Regional Growth Center.
Planning Challenge
A slow market.
Gentrification and Involuntary displacement.

12. Applying HiAP to Tacoma Mall Planning: Planning & Health Collaboration
Cross-sectoral Partnership without Borders
Project scoping & consultant selection.
Strategize together- Core Staff team member.
Facilitate stakeholders group conversations.
Broaden engagement through non-traditional outreach.
Apply Healthy Community Planning Tools to augment traditional planning.
Conduct livability needs assessment (focus groups).
Health input on planning policies.

13. Applying HiAP to Tacoma Mall Planning: Plan with and for Your Communities
Burden

14. Applying HiAP to Tacoma Mall Planning: Listen to Communities’ Needs &Aspirations
Use non-traditional method to reach into and engage underserved communities
Meet them where they are—Door belling.
Bring food and child care to them.
Reward their time to participate.
Conduct Community Livability Needs Assessment
Tell me how you go or come to work here.
Why did you choose this neighborhood (the Mall area) to live and/or work in?
If you live here, name FIVE things about this neighborhood that you (or your family) enjoy the most?
Name FIVE amenities or things you believe can help improve your health and quality of life?
Name your neighborhood.

15. Applying HiAP to Tacoma Mall Planning: Communities Has Spoken
Safety (neighborhood and traffic)
Walkability
Vehicular and transit access
Affordable and attractive housing
Healthy and affordable food
Safe places for kids
Green features
Positive identity & sense of ownership
Existing businesses thrive and grow

16. Applying HiAP to Tacoma Mall Planning: Plan for Healthy Community Outcomes

17. Applying HiAP to Tacoma Mall Planning: Plan with a Health Lens
Equitable placemaking with abundant choices for people to live, work, learn & play.
Social:
Placemaking to improve social interaction, safety and injury prevention.
Access to opportunities to ensure affordable housing and transportation choices for everyone.
Economic:
Local food production and distribution to bring healthy foods closer to home.
Living wage job creation near transit.
Economic development and workforce development—local and regional businesses.
Environmental:
Complete neighborhoods to reduce commuting and increase physical activity.
Natural environment preservation and climate change adaptation.

18. Applying HiAP to Tacoma Mall Planning: Built Environment and Health
Policies directly affecting physical health
Regional access.
Local connectivity (Loop road).
Complete neighborhoods & connected streets.
Transit Oriented Development.
Policies directly affecting social and mental health
Affordable housing.
Green streets, trees and linear park.
Parks, recreation and open space.
School community hub.

19. The Future of Healthy Community Planning: Lessons Learned from Tacoma Mall Plan
Think beyond plan adoption: Transition to community-led team.
Be outcome-oriented: Tangible and intangible outcomes.
The City’s role vs. the community’s role.
Meaningful engagement & coalition building.
Community livability needs assessment.
Equitable placemaking.
Neighborhood “store front”: Placemaking from the get-go.
Health in all policies: Partnership without borders.

20. Thank You!
Amy Pow, MCIP Principal Planner Healthy Community Planning Program Tacoma-Pierce County Health Department (253) WA APA Policy on Healthy Community Planning (May 2015). WA APA Resource Guide for Healthy Community Planning (May 2015).

21. Healthy Community Planning Toolbox
Process Tools
Best Practice — Health-in-All-Decisions: Process tools provide a health lens in each step of the planning and decision-making process.
Policy Tools
Policy Intervention — Health-in-All-Policies: Policy tools provide policy language to address health disparities; physical health; and social, emotional and mental wellness.

22. Health-in-All-Decisions Tools
Process
Comprehensive Planning Process Steps
Visioning
Community Assessment /Existing Conditions Update
Goal Formulation
Policy Development
Draft Plan Review
State Environment Policy Act Review
Final Plan Adoption
Plan Implementation
Plan Monitoring and Performance Management

23. Health-in-All-Policy Tools