3. What determines health?
Healthcare Genetics Social, Environmental, Behavioral Factors
20% 60%20%
Based on: Slide from The American Healthcare Paradox, Lauren Taylor; Original Source:
McGinnis et al, 2002
6. Why do we do this work as
planners?
Counseling
& Education
Clinical
Interventions
Long-Lasting Protective
Interventions
Changing the Context to make
individuals’ default decisions healthy
Socioeconomic Factors
Smallest
Impact
Large
st
“Eat healthy, be physically active”
Rx for high blood pressure,
high cholesterol, diabetes
Vaccinations, cessation
treatments (e.g. for
smoking)
Fluoridation,
tobacco tax,
smoke-free laws
Income, Race,
Education
Complete streets,
speed limits,
walkability, access to
green space
Housing,
Zoning,
Economic
Development
Examples from Other Sectors
Traditional Public Health
CDC Health Impact Pyramid
7. Slower vehicle speeds make people feel safe and
encourage them to be active and walk and bike more.
For example, we know that is you are hit by a car going
25 mph, you have a less that a 1 in 10 chance of being
killed; at 40mph, you have a nearly 7 in 10 chance of
being killed.
It’s not right that residents of certain neighborhoods have
to experience speeding vehicles and be at greater risk
for severe injury and death while others do not.
To change this, the officials, planners and public health
professionals should use community strategies like traffic
calming and slower speed limits to reduce speeding.*
* Adapted from Talking about Health in All Policies, Dorfman & Krasnow, Berkeley Media Studies Group
10. 10
• Adopt slow zone policy or
enact local legislation
Policy
Change
• Reducing design speeds
used as part of local
engineering guidance and
regulations
Systems
Change
• Traffic calming measures
like speed humps,
neighborhood traffic
circles, and chicanes
Environment
al Change
Sources: Adapted from The National Association of County and City Health Officials definition of PSE Changes
Targets of Change
11. Housing insecurity results from individuals and families can no
longer afford to live in stable and safe housing. Sadly, housing
insecurity is issue in our community and having real effects. For
instance, children who experience housing insecurity have been
associated with poor health, lower weight, and developmental
risk.
We can’t address the housing insecurity problem working in
isolation. We need to work with partner in housing and
community development to incorporate health criteria into our
housing priorities.
Working together, we can address the issue of housing
insecurity and fix multiple problems at the same time. It will
create more stability in people’s lives, improve childhood
outcomes, and strengthen our economy.*
* Adapted from Talking about Health in All Policies, Dorfman & Krasnow, Berkeley Media Studies Group
15. 15
• Adopt inclusionary zoning
policy
• Develop HPP with health
element
Policy
Change
• Use Managing Neighborhood
Change Approach (Anti-
Displacement Strategies Toolkit)
Systems
Change
• Use or leverage resources
to increase affordable
housing choices
Environment
al Change
Sources: Adapted from The National Association of County and City Health Officials definition of PSE Changes
Targets of Change
16. People are healthier when they have a say in how in
their neighborhoods are maintained and how they
change.
We need to engage residents, especially those who
do not typically participate in neighborhood activities,
so that we can make improvements like fixing
sidewalks and parks so that everyone feels as part
of the neighborhood.
To do that, the officials, planners and public health
professionals should work with residents to support
mutual goals that create inclusive and resilient* Adapted from Talking about Health in All Policies, Dorfman & Krasnow, Berkeley Media Studies Group
17. Photovoice
• Record and reflect on community
strengths and concerns
• Promote critical dialogue and knowledge
about important issues through group
discussion of photographs
• Reach decision-makers
18. Placemaking
Allows people to
create places and
streets which are
healthy, safe, active,
and useful.
Photo Credit: Principle+
Incremental, small-scale improvements
Local ideas for local planning challenges
Short-term commitment and realistic expectations
Low-risk, with a possibly of high reward
Tactical Urbanism by The Street Plans Collaborative
20. 20
• Develop community/public
engagement guidance
(promote adult education approach)
Policy
Change
• Support training of
municipal staff and
residents in photovoice
Systems
Change
• Use available materials to
make short-term changes
and test ideas
Environment
al Change
Sources: Adapted from The National Association of County and City Health Officials definition of PSE Changes
Targets of Change
As MAPC started thinking more about their role, they started to think about what has the greatest impact on health, its mainly social, environmental and behavioral factors. And what roles has planners do we play in these factors?
Small scale changes can lead to larger more permanent changes in the community. Through the pictures that you’ve taken, why you took those pictures, and the way the places/pictures make you feel.