Albert Iannacone, Knox County Health Department

1. Healthy Communities Through Healthy
Policy A State and Local Perspective:
Knoxville / Knox County, TN
Albert Iannacone, Environmental Epidemiologist
Knox County Health Department, Knoxville, TN
ULI Housing Opportunity, Denver, CO - May 15, 2014

2. Welcome to Knoxville and East
TN

3. Plan East Tennessee
(PlanET)
“Plan East Tennessee (PlanET) is a regional
partnership of communities building a shared
direction for our future. We seek ideas about
protecting our valuable resources and addressing
our challenges regarding jobs, housing,
transportation, a clean environment, and
community health. Our goal is to create long-term
solutions for investments in our region and to define
the next chapter in our rich history, leaving a legacy
of optimism and opportunity for future generations.”
 From the PlanET website: http://www.planeasttn.org/

4. Plan East Tennessee
(PlanET)
 3-year process
 Federal (HUD)
and local funding
 5 county area
served by MPC,
ranging from
urban to rural
communities

5. Plan East Tennessee
(PlanET)
The region’s population is projected to
grow by 300,000 over the next 30
years.
 Where will these people live?
 Where will they work?
 How will they get from one to the
other?
 What other infrastructure is needed?
 What are the implications of this?
 Will growth be managed or

6. INDICATORS: Developed Land; VMT & Travel Delay
ACRES OF
DEVELOPED LAND
2010: 317,000
2040: 432,200
VEHICLE MILES
TRAVELED
(MILLIONS)
2010: 22.5
2040: 33.8
VEHICLE HOURS OF
DELAY
2010: 87,000
2040: 269,000

7. INDICATOR: ACCESS TO TRANSIT
PERCENTAGE OF HOMES WITHIN
WALKING DISTANCE (1/4 MILE) OF FIXED TRANSIT
ROUTES
2010: 22.8% 2040: 14.2%

8. PlanET Health Impact Assessment
(HIA)
Combination of
procedures, methods,
tools…
…by which a policy,
program, or project
may be judged…
…for its potential
effects on the health of
a population, and the
distribution of those
effects within the
population.
-
http://www.cdc.gov/healthyplaces/hia.ht
m

9. One Facet of PlanET HIA Analysis
If we can project where there will
be many more seniors living in
2030…
…we can rationally plan for more
health care facilities, senior
centers, bus routes, etc.

10. Findings of PlanET HIA

11. DISPERSED GROWTH
Growth is scattered throughout the region
HIGHWAY-ORIENTED GROWTH
Growth occurs primarily in suburban
locations along major highways
GROWTH OF ESTABLISHED CITIES
& TOWNS
New development is concentrated in existing
cities & towns
GROWTH OF ESTABLISHED CITIES
& TOWNS & NEW CENTERS
Growth occurs mainly in established cities
and
towns and new mixed-use centers in
suburban
Planning
Scenarios
In the future,
how should we
accommodate
our children,
grandchildren, and
new residents?
Several Rounds of Public
Input

12. The Process Continues…
 While the PlanET grant has ended, the
community engagement process
continues
 Valuable collaborations between non-
traditional partners established;
mechanism for zoning/planning input
from beyond the landowner/developer
community
 Synergy with other efforts underway to
promote more livable communities

13. Recent Progress
 Re-energized Food Policy Council
 Formal establishment of Community
Health Council
 Expansions to Greenways and Parks
 Brownfields redevelopment
accelerating
 Promotion of public and alternative
transportation
 Agreement from MPC that Public
Health is an appropriate participant in
process

14. Recent Progress
Only three miles from downtown, Knoxville's 1,000-acre Urban Wilderness presents a unique
urban playground for hikers, mountain bikers and trail runners. The first phase … 42 miles of
natural surface trails that connects five parks and natural areas along with public and private
lands … A 12.5 mile loop connects Ijams Nature Center, Forks of the River Wildlife
Management Area, William Hastie Natural Area and Marie Myers Park with trailheads and
parking along the route. The main loop offers easy to moderate trails for all users and the
additional 30 miles of secondary trails accommodate users from beginner to advanced on
dozens of trails of varying terrain.
The vision for Knoxville's Urban Wilderness includes the addition of the Battlefield Loop …
which will provide an historic and recreational experience featuring three Civil War forts and
a city park: the River Bluff; Fort Stanley; Fort Higley; Loghaven; and Fort Dickerson Park.
The recent acquisition of 100 acres, generously donated by the Wood Family to Legacy
Parks Foundation, will provide a key connection between the existing parks and trails within
the Urban Wilderness’ South Loop Trail System and South Doyle Middle School and its
Outdoor Classroom. It will also connect additional neighborhoods into the system. The plans
for the property call for a variety of trails and features, including a one-mile introductory
mountain bike trail for riders of all ages, a skills/play area, 3.5 miles of mixed-use trails
featuring two overlooks and three creek-crossing structures.
Bikes, Canoes, and SUP Rentals: Ijams Nature Center is partnered with River Sports
Outfitters offering bike rentals for use on the trails and greenway and boats for the quarry.

15. Recent Progress

16. Ongoing Challenges
 “Tradition of suspicion” (TVA, Oak Ridge)
makes finding common ground between
urban and rural counties a challenge
 Bitter fight in County Commission over
MPC Ridge-top Development Policy
 Knoxville has 1,171 miles of streets and
319 miles of sidewalks; Knox County
1,992 miles of roads and 48 miles of
sidewalks. How to affordably develop
infrastructure at that scale to promote
healthy living?
 Health implications of economic

17. Built Environment & Health
In the 21st Century, to deal with the challenges of
obesity, diabetes, heart disease and cancer, Public
Health needs to define itself more broadly than we
have in recent years…
 Urban Design is Public Health
 Zoning is Public Health
 Brownfield Redevelopment is Public Health
 School Funding is Public Health
 Equitable Economic Growth is Public Health
 Environmental Enforcement is Public Health
 Food Policy and Food Access are Public
Health
 Safe, Clean, Affordable Housing is Public

18. Built Environment & Health
“If you want to learn about the health of a
people, look at the air they breathe, the water
they drink, and the places where they live”
– Hippocrates, “the father of medicine,” fifth century BC
“The connection between health and the
dwelling of the population is one of the most
important that exists.”
– Florence Nightingale, “founder of modern nursing” 1820-
1910

19. Built Environment & Health
The built environment includes all of the physical
parts of where we live and work… [it] influences a
person’s level of physical activity. For example,
inaccessible or nonexistent sidewalks and bicycle
or walking paths contribute to sedentary habits.
These habits lead to poor health outcomes such as
obesity, cardiovascular disease, diabetes, and
some types of cancer.
- CDC http://www.cdc.gov/nceh/publications/factsheets/impactofthebuiltenvironmentonhealth.pdf

20. Built Environment & Health

21. For More Information:
PlanET: http://www.planeasttn.org/
KCHD: http://www.knoxcounty.org/health/
MPC: http://www.knoxmpc.org/
PlanET HIA:
http://www.planeasttn.org/DesktopModules/Bring2mind/DMX/Download.aspx?
EntryId=1271&Command=Core_Download&PortalId=0&TabId=143
Together! Healthy Knox: http://healthyknox.org/
Local Food: http://www.knoxfood.org/
http://www.planeasttn.org/Newsroom/NewsArchive/ArticleView/
ArticleId/78/Local-Food-Guide-Grows-from-PlanET-Public-
Input.aspx
Brownfields: http://www.smartgrowthamerica.org/2013/11/18/mayor-madeline-
rogero-on-
brownfields-redevelopment-in-knoxville-tn/
Greenways: http://www.outdoorknoxville.com/places/greenways
Urban Wilderness: http://www.outdoorknoxville.com/urban-wilderness
Eat, Play, Live Video: https://www.knoxcounty.org/health/eplk.php

22. Questions? Get in touch:
Albert Iannacone, Environmental
Epidemiologist
Knox County Health Department
140 Dameron Avenue
Knoxville, TN 37917
865-215-5242 (desk)
865-755-2640 (cell)