Tag Archives: Health Impact Assesment

Sprawl, Health, and creating better cities through Smart Growth

Urban Sprawl and Public HealthPart 2 on Urban Sprawl and Public Health looks at potential interventions and theories that can help reduce the impact of sprawl (read part 1 here). For authors Howard Frumkin, Lawrence Frank, and Richard Jackson, hope lies in the new strategies being put forth under the terms Smart Growth and New Urbanism, arguing for Smart Growth at least as a public health strategy. I have a lot of issues with New Urbanism and Smart Growth as they are so often removed from issues of equity and spatial justice, but it’s interesting to think of how to rebuild and rework our cities as part of a plan around improving health.

They trace a lineage of people working on the connections between health and cities — Dr. John Henry Rauch (1828-1894) in Chicago arguing for land use policies to improve public health, cemeteries at a remove from dense neighborhoods being one of them. Frederick Law Olmstead, and garden cities. Edwin Chadwick working sanitary regulations, housing standards, public water and sewage systems in the UK, Thomas McKeown at Birmingham, who

showed that many of the health advances of the nineteenth and twentieth centuries resulted not from better medical care, but from ‘upstream’ improvements such as better urban infrastructure–better housing, neighborhoods, water, food, and transport. (203)

They also name psychiatrist Leonard Duhl, who has looked at connecting mental health with urban design and community involvement. His ideas have been broadened by physician Trevor Hancock. In 1987, the World Health Organization jumped on the bandwagon, initiating a Healthy Cities Network, which I confess I had never heard of.

There are of course many who could be added to this list, and in the UK at least you have the Marmot Review among others, trying to move health care providers to think more broadly about wellness and how it connects to social and environmental factors.

So…to return to the strategies they promote, we start with Smart Growth. The Environmental Protection Agency itself formed the Smart Growth Network in 1996 together with a number of other nonprofits and governmental organizations. The Networks’ ten Smart growth principles (the whole document ‘Getting to Smart Growth: 100 Policies for Implementation’ can be found here):

1. Mix land uses
2. Take advantage of compact building design
3. Create a range of housing opportunities and choices
4. Create walkable neighborhoods
5. Foster distinctive, attractive communities with a strong sense of place
6. Preserve open space, farmland, natural beauty, and critical environmental areas
7. Strengthen and direct development towards existing communities
8. Provide a variety of transportation choices
9. Make development decisions predictable, fair and cost effective
10. Encourage community and stakeholder collaboration in development decisions

The book goes on to give a more elaborate set of principles in full…they’re interesting, so I do the same — the full text can be found here:

Community principles

  1. All planning should be in the form of complete and integrated communities containing housing, shops, work places, schools, parks and civic facilities essential to the daily life of the residents.

  2. Community size should be designed so that housing, jobs, daily needs and other activities are within easy walking distance of each other.

  3. As many activities as possible should be located within easy walking distance of transit stops.

  4. A community should contain a diversity of housing types to enable citizens from a wide range of economic levels and age groups to live within its boundaries.

  5. Businesses within the community should provide a range of job types for the community’s residents.

  6. The location and character of the community should be consistent with a larger transit network.

  7. The community should have a center focus that combines commercial, civic, cultural and recreational uses.

  8. The community should contain an ample supply of specialized open space in the form of squares, greens and parks whose frequent use is encouraged through placement and design.

  9. Public spaces should be designed to encourage the attention and presence of people at all hours of the day and night.

  10. Each community or cluster of communities should have a well defined edge, such as agricultural greenbelts or wildlife corridors, permanently protected from development.

  11. Streets, pedestrian paths and bike paths should contribute to a system of fully connected and interesting routes to all destinations. Their design should encourage pedestrian and bicycle use by being small and spatially defined by buildings, trees and lighting; and by discouraging high-speed traffic.

  12. Wherever possible, the natural terrain, drainage, and vegetation of the community should be preserved with superior examples contained within parks or greenbelts.

  13. The community design should help conserve resources and minimize waste.

  14. Communities should provide for the efficient use of water through the use of natural drainage, drought tolerant landscaping and recycling.

  15. The street orientation, the placement of buildings and the use of shading should contribute to the energy efficiency of the community.

Regional Principles

  1. The regional land use planning structure should be integrated within a larger transportation network built around transit rather than freeways.

  2. Regions should be bounded by and provide a continuous system of greenbelt/wildlife corridors to be determined by natural conditions.

  3. Regional institutions and services (government, stadiums, museums, etc.) should be located in the urban core.

  4. Materials and methods of construction should be specific to the region, exhibiting continuity of history and culture and compatibility with the climate to encourage the development of local character and community identity.

Implementation Principles

  1. The general plan should be updated to incorporate the above principles.

  2. Rather than allowing developer-initiated, piecemeal development, local governments should take charge of the planning process. General plans should designate where new growth, infill or redevelopment will be allowed to occur.

  3. Prior to any development, a specific plan should be prepared based on the planning principles. With the adoption of specific plans, complying projects could proceed with minimal delay.

  4. Plans should be developed through an open process and participants in the process should be provided visual models of all planning proposals.

Of course, in years of community work around development, I have never seen anything actually work like this.

The authors look at how this compares/ overlaps with New Urbanism and its principles (see the Congress for the New Urbanism for more…):

walkable neighborhoods, a range of housing choices, a mix of land uses, participatory planning, revitalization of urban neighborhoods (206)

They talk about some of the critiques. They come from wildly different directions…

  1. the public doesn’t want it
  2. it limits consumer choice — it’s a form of coercive social engineering
  3. can exacerbate traffic congestion by creating greater density
  4. smart growth projects are isolated enclaves, not integrated
  5. encourage gentrification (213)

Then go on to look at a public health approach to Smart Growth. It’s a very different perspective though concerned with all of the same things. They begin with constructing a community health assessment — paralleling the medical assessment. One method they believe has great promise is the Health impact Assessment, as a way to measure the health benefits from a Smart Growth approach. Nor is it surprising that many of the potential indicators would be the same as for sustainability — transit ridership, percentage of population living within ten minutes of a park, incidence of asthma, extent of recycling. (217) A few useful checklists exist already that could serve, one is the Built Environment Site Survey Checklist in London (this is news to me, this BESSC).(218)

I like how numerous things are coming together — concerns for the health of individuals and communities and neighbourhoods, issues of sustainability and the health of the land and environment. I think, again, there’s a lot more to think about in terms of equity. People’s own power in the process is always the first thing to go — if it ever was on the table. The cold hard facts of development and politics are not amenable to such things, so progress has been made where it helps certain kinds of development become more marketable. But criticism to come…