1. Planning for Safe and Healthy Communities ASTHO/NACCHO Joint Conference Presentation by Marya Morris, AICP American Planning Association Boston, July 14, 2005

2. Public Health Community Planning and Design Community Planning and Design Physically Active Communities Physically Active Communities A Convergence of Priorities

3. Thesis: Communities that reduce sprawl and effectively address the public health and safety implications of community design and transportation systems will have safer, healthier, and more physically active residents.

4. The Many Ways the Built Environment affects Health? Obesity, physical activity, CVD, injury Water quantity and quality Pedestrian injuries Air pollution and asthma Climate change contribution Car crashes Mental health impacts Social capital, social isolation Terrorism, crime Related to land use and transportation Related to automobile dependency Related to social processes

5. The Forgotten Pedestrian Traffic flow prioritized over safety Only 1% Federal Hwy spending on peds Traffic laws reflect bias and lack of understanding of child/senior behavior & development

6. Is sprawl dangerous to pedestrians? Most dangerous metro areas = Southern and Western cities 2%-4% decrease in ped fatality rates with every 1% increase in compact design Sources: STPP. Mean Streets, 2002. Ewing, R, Scheiber R, Zegeer C. AJPH 2003;93(9).

7. Barriers to Health and Physical Activity: Is Community Design Part of the Problem? Separated land uses High traffic speeds Auto-dominated community design Large lots Ignoring human scale Prohibited connections between origins and destinations

8. Its a widely accepted activity It can be done in a variety of settings It promotes other beneficial outcomes (e.g., environ- ment, transportation) Its relatively inexpensive compared to other physical activities Why Walking and Bicycling? Sources: Brownson, Ross C., et al. Promoting Physical Activity in Rural Communities: Walking Trail Access, Use and Effects. American Journal of Preventive Medicine (2000), Vol. 18, No. 3.

9. Built Environment Determinants of Physical Activity People are more likely to walk if: Walking trails, parks and gyms are accessible Sidewalks present and scenery are enjoyable Many people are out walking or exercising Friend(s) are available with whom to walk People are less likely to exercise if: Too little time Too tired Unmotivated Perceived traffic, crime or other danger Long distance to exercise location Source: Brownson RC et al, AJPH 91:1995, 2001; HealthStyles Survey, 1999

10. 1.Motorists speed in my neighborhood. 2.There are no sidewalks in my neighborhood or parts of sidewalks are missing. 3.Sidewalks are broken, cracked, or blocked by obstacles in my neighborhood. 4.There are no safe or easy ways to cross the streets in my neighborhood. 5.People are intimidated by crime in my neighborhood. 6.People dont want to walk in my neighborhood at night. 7.My neighborhood is not a nice place to walk, there is trash everywhere and buildings are not kept up. 8.My neighborhood looks barren, there are no trees and buildings are too far from the street. Why People are Reluctant to Walk: Its All About Safety Neighborhood Walking Guide http://www.walkinginfo.org

11. Pedestrian Injuries and Fatalities What makes a road dangerous? Multiple lanes High speeds No sidewalks Long distances between intersections or crosswalks Lined with commercial establishments & apartments Source: Hanzlick R, et al. Pedestrian fatalitiesCobb, DeKalb, Fulton, and Gwinnett Counties, Georgia, 1994-98. Morbidity/Mortality Weekly Report 1999;48:601-05.

12. Pedestrian Injuries and Fatalities: Theres Good News and Bad News 8.6% of trips are on foot but 11.4% of traffic deaths are pedestrians 12.5% decline in ped fatalities from 1994 to 2003 (51,989 people died while walking during that period) 65+ make up less than 13% of the U.S. pop. but accounted for ~ 22% of the 4,882 car-related pedestrian deaths in 2003. Ped fatalities in 0-14 age group decreased by 46% from 1992 to 2002 Elderly, children suffer disproportionate share of pedestrian injury and fatality Source: National Center for Statistics and Analysis. 2003a. Traffic Safety Facts 2002: Pedestrians. Washington (DC): Natl Highway Traffic Safety Admin.

13. Barriers to Walking or Bicycling to School (as identified by parents) 55% said distance; 40% said danger And is it any wonder why? Source: MMWR 2002;51(32):701-704

14. Photo: Frederick County, Md. Public Schools

15. Impact of Community Design on Activity Composite IndicesOutcome Density, design, land-use mixIncrease non-auto commuting Aesthetically pleasing and perceived as safe components Increase in non-auto trips in areas that are safer and more aesthetically desirable Provision of sidewalks, street lights, length of block, presence of planting strips, lighting distance, and terrain features Increase in non-auto trips in areas with high pedestrian-friendly pedestrian safety factors Quality of sidewalks, street crossings, transit amenities, and proximity to services Increase in non-auto trips in areas with higher transit friendliness factors Sources: Cervero (1999); Cambridge Systematics (1994); Cervero and Kockelman (1997); Douglas et al. (1997); Ewing et al. (2001)

16. Health Promoting Community Design Pedestrian-oriented design Compact, mixed use, diverse housing Traffic calming Connectivity and destinations More transportation choices Open and recreational space

17. Five Strategic Points of Intervention Where Planners Can Affect Change 1. Visioning and goal setting 2. Rethinking planning in all contexts 3. Local implementation tools 4. Site Design and Development 5. Siting Public Facilities and Capital Spending

18. Where Physical Activity/Injury Prevention Fits in the Visioning and Goal Setting Process Residents shared desire for healthy communities Enhancement and improvement of quality of life It is governments responsibility to protect the publics health, safety and general welfare Environmental justice (and the removal of health disparities) is a land-use issue

19. 2. Rethinking State and Local Planning Comprehensive plans Neighborhood plans Redevelopment plans Functional Plans –Bicycle and pedestrian –Transit –Streets and circulation –Trails –Parks –Human services –Housing –Economic development –Schools and campuses

20. How Health and Physical Activity Fit into State and Local Planning Smart growth is, by definition, supportive of physical activity Increasing transportation options –Injury prevention –Reducing VMT –Improving air quality –Open space, trails, bike/ped Creating urban service limits –Monitors utility extensions Minimizing health risks –Natural hazards –Hazardous materials –Noise –Injury prevention

21. 3. Local Implementation Tools Zoning and subdivision regulations –Rethink development density –Mix land uses –Street connectivity –Require sidewalks Streetscape improvements Neighborhood traffic calming Capital improvement programs

22. How Can Plan Implementation Tools Promote Activity and Aid Injury Prevention? Open space, trails, bike, and ped encourage routine activity Traffic calming Pedestrian and Bike plans address safety and injury prevention Equitable allocation of capital improvements Neighborhood planning, TND, mixed use, increase density address social isolation and loss of community

23. 4. Site Design and Development Improve the pedestrian environment Provide security, lighting, visibility Protect people from traffic Adequate accommodation of bike and ped facilities Building orientation, setback requirements Street trees, landscaping, open spaces Well connected routes between origins and destinations

24. How Site Design and Development Can Encourage Aid Injury Prevention Physical Activity? Adequate street lighting can reduce crime, personal injury Parking lot circulation, and street redesign reduces pedestrian and vehicle crashes Streetscape enhancements include shade trees, awnings, pedestrian comfort, and amenities, promote walking and social interaction

25. 5. Siting and Use of Public Facilities Public Spaces Schools Post offices Libraries Museums Parks Plazas City Hall Campuses Community Centers

26. How Public Facility Siting Relates to Physical Activity Aid Injury Prevention Siting and design of public spaces, parks, post offices, libraries serve as walking destinations, community gathering places Addresses school location, size, travel mode choice Can promote safe routes to schools Addresses full spectrum of elderly housing, mobility issues Capital budgeting can address equity, minimize disparities

27. Neighborhood/ City/Region Downtown/Strip Mall/School Site Street/School Route/Intersection Influence over- arching policies, practices and processes Interject health into current development projects Retrofit existing problems Moving Upstream for Broader Impact UpstreamMidstreamDownstream

28. Roles for Injury Prevention in the Smart Growth/ Transportation/ Land Use Planning Arena Injury impacts (existing and potential) make a compelling argument; Safety is a winning message Raise awareness among planners of injury prevention programs; learn about their efforts Support funding for nonmotorized travel that includes safety component Build programmatic bridges w/other state programs –SR2S legislation & projects Bring message to state Departments of Transportation Collaborate with state Smart Growth initiatives

29. Thank You! Marya Morris, AICP American Planning Association mmorris@planning.org