Creating healthy communities through policy and systems transformation
A healthy community, as defined by the Centers for Disease Control and Prevention’s Healthy Places page , is one that is designed and built to improve the quality of life for all people who live, work, worship, learn and play within its boundaries; and where everyone has access to healthy, affordable choices. Ideally, a healthy community has clean air and drinking water, green space, places to play and engage in physical activity, and access to healthy, affordable food. Buildings and outdoor public spaces are tobacco free. A healthy community has transportation options that encourage the use of bicycles and walking, and the community as a whole is safe.
While cities across the country are working to create healthier communities, the fact remains that a person’s ZIP code is the single strongest determinant of his or her health status. This means that without large-scale policy and systems changes that support making the healthy choice the easy choice, major health disparities will continue. Now is the time to examine policies being implemented locally and develop strategies to replicate success on a larger scale.
For example, successful initiatives such as Complete Streets, which creates policies that direct transportation planners and engineers to design routes that enable safe travel for all users and makes the street network better and safer for drivers, transit users, pedestrians and bicyclists, could be implemented in every community. Tobacco-free polices that prohibit smoking in public places, including parks, significantly reduce exposure to secondhand smoke. Policies that require at least 30 minutes a day of physical activity for children in public elementary school or require dedicated time for physically active recess could help decrease the rate of childhood obesity. A true “health in all policies” approach would enable cities to ensure that all new initiatives work across sectors to address preventable health outcomes and eliminate health disparities.
Ultimately, the vision of the American Public Health Association is to create a healthy society. Recent efforts such as CDC’s Healthy Community Design Initiative, Communities Putting Prevention to Work and Community Transformation Grants have helped create significant movement toward using policy and systems change strategies to prevent disease and promote a healthy society. APHA actively supports these initiatives through the work conducted by our Environmental Health program and remains committed to building healthy communities for all through the advancement of policies and practices that improve health.
American Public Health Association
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What are your thoughts on the intersection of environmental health and a healthy community program?
Where do you think environmental health is most effective within a healthy community program?
We need to convince property owners that this is something their tenants will want. If we can give them data showing that most renters -- commercial or residents -- want healthy buildings and are more willing to lease properties that follow such standards, property owners will come on board.
I wonder if gains seem too small - a few dollars off on the energy bill. If people could have a sensory experience which indicated success in changing their household footprint, they may be more excited about more abstract goals. My eye-opening experience was in vermicomposting - a hard sell, a big step, but very direct experience. I take out 1/4 of the trash I used to take out. There is no household garbage smell. After a few weeks I have soil I can use or give to others. It's something to talk about (instead of lower energy bills). When I work on the vermicomposter, I get a little more excited about the difference one person can make. There may be other activities that are easier sells, or work better for larger families, but the immediate, experiential change may be the place to start. Likewise, if something could be done to help a neighbor, or something that was public, people would feel they were a part of something bigger than just their bill, which never feels like enough.
Lastly, working in coalitions with organizations - people can joint groups where the vision is big, but the actions are focused. Again, my experience was in rainwater capture, with applications to greenspace, open space, and water quality. Committing to a group, whose mission is big and clear (but not obsessive) and whose actions are focused and visible takes the think globally act locally to an experiential level.
Thoughts on how to address property owners' concerns? How should we encourage them to prioritize the necessary improvements?
What environmental health activities are you most excited about in 2014? Engaged in any HiAP efforts that promote environmental health priorities?