The determinants of health include those that are social, economic and educational, but there is another powerful determinant, the environment, that is often ignored because it seems immutable. It is not. In epidemiology, when everyone develops the same illness about the same time, it is almost inevitably a “common source epidemic” that has its origin in the environment. Our society is confronting a crush of chronic diseases including obesity, diabetes and depression. These too have environmental origins, often in the built environment. Jackson will discuss ways the built environment can aggravate or ameliorate health risks. Creating places to promote health does not just happen; it takes attention and work. This is what Richard Jackson will explore in his presentation.
Dr. Reibel will briefly summarize the role of contextual and neighborhood effects in public health and related fields of research, noting the importance of analytical scales - micro, meso and macro. He will then discuss the special problems of research involving inferred effects at multiple scales (the so-called ecological fallacy) and the limitations of linear and generalized linear methods for analyzing joint categorical and quasi-categorical effects. Following this will be a brief review of emerging methodological approaches for confronting these special problems of contextual research in public health, including examples from Dr. Reibel's demographic publications and from contributions to the ongoing Deceased Donor Potential Study commissioned by the U.S. Health Resources and Services Administration.
By converting an obsolete railway system into a healthy amenity to change and enhance the built environment, the Pacific Electric Trail (PET) has become a healthy and inviting place for residents to become active, use as a mode of transportation and move freely throughout the City of Fontana. With access to schools, businesses, library, retail establishments, Farmers’ Market and places of worship, the PET connects the City from East to West and is an identifiable feature for the revitalized downtown area.
Through this multi-departmental approach, an overview of the PET from inception to completion including construction, zoning, funding, safety, GIS applications, and community uses will be addressed.
Under SB 375, the state’s various regional governments are now tasked with coordinating investments in transportation networks with the projected growth in housing and jobs to reduce greenhouse gas emissions from vehicle trips. As the nation’s largest MPO, the Southern California Association of Governments (SCAG) addressed these new requirements through the 2012–2035 RTP/SCS. The Plan, which was adopted in April 2012, will not only achieve the region’s GHG emission reductions but will also help the region contend with many ongoing issues across a wide range of concerns, including creating better places to live and work, reducing the cost of living, addressing environmental impacts, responding to changing demographics, and improving accessibility and mobility. These co-benefits are a result of land use and transportation strategies that focus on increased investment in active transportation and transit along with new development patterns along high-quality transit areas and corridors. Throughout the 2012–2035 RTP/SCS process, SCAG worked with various regional stakeholders to discuss public health implications under SB 375. SCAG continues this discourse and hopes to develop supportive projects and strong policies by providing a forum for public health issues, forming partnerships with industry professionals, information sharing on public health topics, and identifying potential performance measures for public health.
SANDAG's 2050 Regional Transportation Plan and Sustainable Communities Strategy (2050 RTP/SCS), adopted by its Board of Directors in October 2011, acknowledges the link between land use and transportation policies and public health both in terms of air quality and physical activity. SANDAG has been working with the County of San Diego Health and Human Services Agency (HHSA) since March 2010 on the Healthy WorksSM/Communities Putting Prevention to Work (CPPW) program. The objective of this program was to address public health concerns in the San Diego region by increasing opportunities for physical activity and the availability of healthy food and nutrition. The project was funded by a $373 million nationwide program of the U.S. Centers for Disease Control and Prevention (CDC) through the federal American Recovery and Reinvestment Act of 2009 (ARRA). HHSA received $16.1 million through this program, the largest obesity prevention grant in the country, and contracted with SANDAG for about $3 million to implement projects and programs at the local and regional level that improve opportunities for physical activity. This presentation will highlight key outcomes and accomplishments of the Healthy Works/Communities Putting Prevention to Work (CPPW) program.
Health in All Policies is a collaborative approach to improving health by incorporating health considerations into decision making in all sectors and policy areas. This approach convenes diverse partners to consider how their work influences health and how collaborative efforts can improve health while advancing other goals. Health in All Policies is based on the acknowledgement that non-health government agencies, at all levels, have an impact on health and health equity outcomes. Health in All Policies is being employed as a response to the increasingly “siloed” structure of government, growing health and healthcare costs, increasing health inequities, and the need for more efficient strategies for achieving government goals with shrinking resources.
California’s interagency Health in All Policies Task Force brings together eighteen state agencies (e.g., education, transportation, social services, criminal justice, etc.) to identify and implement policies and programs that aim to create healthier and more sustainable communities. Facilitated by the California Department of Public Health, in partnership with the Public Health Institute, the Task Force is working to implement action plans spanning the policy areas of community safety through violence prevention; active transportation; healthy food; housing and indoor spaces; parks, urban greening, and places to be active; and healthy public policy.
As more and more questions are asked about the built environment and its ability to nurture a healthy community, more and more answers are being given using maps. In addition to creating a picture of the dysfunction of the built environment, a map can be used to design and analyze changes made to this environment. This session will show several examples of how maps are being used to analyze and communicate healthy communities, as how they can be used to fix the problem. Attendees will engage in a discussion on the use of these tools, and provide feedback on how they can be improved and utilized more accurately and efficiently.
HAZUS-MH is a powerful, free tool and methodology developed by the Federal Emergency Management Agency. HAZUS-MH works with ArcGIS Desktop 10 to display hazard data and estimate the impacts of hurricanes, floods, and earthquakes on communities including damage to buildings and lifelines, estimates of displaced populations and shelter needs, and short- and long-term economic impacts. It can be used by individuals and organizations with limited knowledge of hazard analysis, as well as by those with extensive expertise in the earth, building, and GIS sciences due to its diverse range of options. This presentation will demonstrate the out-of-the box capabilities and outputs of HAZUS-MH as well as discussing options that are available for integrating locally developed building and hazard data for improved model performance. It will specifically address ways that Hazus supports the goals of public health practitioners.
The call for healthy communities has spurred new ideas and practices emphasizing people-powered forms of getting around that promote improved personal health, environmental stewardship, and community cohesion. This session will examine emerging innovations in transportation planning practices around health promotion and their representations at multiple scales. Special attention will be given to demonstrating how healthy community planning is helping to foster increased cooperation between institutional and grassroots efforts to promote healthy urban design that bolsters opportunities to improve personal wellbeing.
The tremendous benefit that GIS can bring to public health is just now beginning to be realized. The City of Rancho Cucamonga has incorporated GIS technology into the way it does business. This tool has been very instrumental in developing positive outcomes for its Healthy RC projects. Whether it involves engaging local decision makers or neighborhood residents, GIS has proven to be an easy-to-use tool that provides instant interactivity and results. This presentation will not only educate attendees on GIS technology, but will also provide attendees with an opportunity to use mobile devices to track, create, and post public health data in real time. An interactive breakout session led by GIS specialists from the City of Rancho Cucamonga will provide attendees with an opportunity to use GIS on commonly accessed mobile devices without the need to purchase more costly equipment. Yes, there is an app for that!
The STAR Community Rating System is based on the definition of sustainability described in Dr. Brundtland’s UN Commission Report, Our Common Future, which called for “meeting the needs of the present without compromising the ability of future generations to meet their own needs.” STAR recognizes that sustainability has three interdependent and mutually reinforcing pillars: a) economic development, b) social development, and c) environmental protection. When released this fall, STAR will provide communities a standard and comprehensive set of goals, objectives and performance measures by which to improve these interdependent conditions. Within the 7 goals areas, 7 of the objectives relate directly to creating healthy communities, and of the other 37 at least 15 have significant impacts on health as well. In addition to covering the overall system, Chris will delve more deeply into the objectives related to Active Living, Food Access & Nutrition, Community Health Systems, Compact & Complete Communities, Transportation Options, and Emergency Prevention and Response.
The U.S. Department of Health and Human Services (2012) acknowledged on its Healthy People 2020 web site that it envisions “a society in which all people live long, healthy lives” (http://www.healthypeople.gov/2020/about/default.aspx). The department’s overarching goals are to improve the quality of life regardless of ethnicity, culture and gender. Its goals focus on prevention and eliminating health disparities. Bridging research with practice by creating programs and projects that reflect the psycho-social and physical environments of targeted underserved populations is the pathway to measuring achievements Healthy People 2020 wish to realize. Practicing within the framework of an ecological approach to behavior change to achieve self-efficacy is an arduous task that will require multi-sectorial collaboration. This presentation will focus on broadening the understanding of heterogeneity within cultures/subcultures to begin the process of tackling behavioral issues such as drug addiction, domestic violence, chronic disease, employment barriers, crime, and gender/race inequities.
The Coachella Valley, located in the eastern part of Riverside County, is a center of agriculture and tourism, as well as one of the poorest areas in the United States. More than one in ten families lives below the Federal Poverty Level. The towns of Coachella, Thermal, Mecca and North shore are home to many farm workers and Native Americans who live in substandard conditions with contaminated drinking water, leaving families with young children exposed to high levels of carcinogens and other pollutants.
Per capita, the annual income in some of these communities is $7,000 and below. Chronic health conditions such as diabetes, asthma, hypertension and cancer are widespread, with the majority of farm workers and other residents unable to access a regular source of health care. In addition, there is a distinct lack of dental care available to farm worker families and most go without or go to Mexicali where treatments are less expensive. Despite these challenges these communities are growing with many vital community-based organizations and a new, progressive leadership. Because of this emerging political will and increased community support, a movement to improve conditions for these farm worker communities is growing.
The City of Coachella for example, is in the process of updating the General Plan for the City. The General Plan is a statement of community priorities and values developed to guide public decision making for future growth and development within the City. This document will include a Health and Wellness Element which will be a comprehensive examination of health conditions in Coachella and will identify policies that will help promote healthy lifestyles and active living for residents within the City. The California Endowment has made significant investments in community organizing and advocacy in these communities, which has helped strengthen the voice of the farm worker community. Other foundations have made significant investments in health, environment, education, disease prevention, and dental services in the region as well. With their growing list of assets, these communities are ready to move toward improved health for its families and the community as a whole.
This session explores the intersection of active living, healthy eating, environmental quality, and violence in San Bernardino, the 100th largest city in the United States. San Bernardino has long suffered from poor health outcomes resulting from the unintended consequences of environmental, economic and social determinants. Mortality rates and hospitalization rates from preventable diseases far exceed statewide averages. In this panel, you will learn about the County's Healthy Communities program, a model 19-city collaborative, and its largest member, the Healthy San Bernardino Coalition. Panelists will cover: 1) the structure, processes, and best practices of the Coalition; 2) major findings of a baseline environmental scan; 3) community and multi-sectoral outreach process, and 4) initiatives to improve the health of San Bernardino residents. Attendees will walk away with a model of how a voluntary grassroots coalition can pursue a vision and plan to create a City synonymous with Health, Hope and Purpose.
The Healthy Loma Linda Coalition presentation will review how a city known for its healthy living and longevity is having to think about a purposeful strategy to maintain its healthy status. The city of Loma Linda is known as a health professional community with its health Science University and medical center. The city has received national and international recognition as the only Blue Zone in North America and one of five Blue Zones in the world. Important lessons on partnerships between the city, the university, and the surrounding community will be shared in this session and how the healthy communities’ movement has helped frame these partnerships and the collaborative work. Attendees will learn a) about tools to measure the food environment in their communities; b) the important intersection between Public Health and City Planning; c) tools that assist communities in making health a central part of a city’s general plan; and d) the process of partnerships, community engagement, and creating an environment that promotes health.
Most studies that examine the equity in spatial access to parks rely on GIS and measure access strictly in terms of distance, leaving out other important determinates of access. Moreover, a growing literature has found that environmental factors such as perceptions of safety, the presence and quality of sidewalks, and heavy traffic play a key role in determining levels of physical activity. In order to gain local knowledge of the environmental factors that facilitate or inhibit access to a planned urban greenway in Northern Kentucky, this study details a qualitative GIS approach that combines GIS-based distance measures with environmental audits, digital photography, and participatory methods. The qualitative GIS approach draws upon the knowledge of fifteen local adolescents (ages 12-17) and consists of the following steps: first, an environment audit tool is used to assess the walkability of neighborhoods surrounding the greenway, while digital photography is used to document barriers to walking and biking; second, focus groups are conducted to gain further insights into the barriers and facilitators to physical activity, using the photos taken during the audits as prompts for discussion; third, the audit and focus group data, along with the photos, are integrated into a GIS and overlayed with conventional, distance-based GIS access buffers; fourth, results and maps are presented to community members, greenway planners, and local policy-makers. The results reveal that safety is a major potential barrier in areas surrounding access points, particularly in low-income neighborhoods surrounding the greenway. By including local perceptions of the built environment, the qualitative GIS approach provides a more realistic portrayal of access, one that includes local youth insights to the barriers to physical activity and that reveals potential issues related to inequities in access.
Outcome: Attendees will understand basics about 2-1-1 and the inherent richness, value, and potential uses of both 211 resource data and the data collected from callers.
Background and Purpose: Did you know that there is needs assessment data being generated continuously for over 85% of vulnerable populations? About 17 million calls occurred nationwide last year from people dialing 2-1-1, a rapid evolution stemming from an FCC decision in the year 2000 to utilize the 3-digit dialing code, 2-1-1, for health and human service information & referrals. In California those calls connect to a live information specialist supported by a comprehensive relational database of free and low cost resources 24-hours per day. This results in a rich set of resource and caller data not available anywhere else, a powerful information source to inform community analysis and decision making processes.
Learn the whats and whys of 2-1-1 data, its potential when used in conjunction with GIS mapping, and explore ideas about how using this information may benefit your work.
Mr. Early will speak on how issues of public health are being incorporated into place-based land use planning and design, beginning with land use regulations all the way through the development process.