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Health in Comprehensive Planning: "We Did It and You Can Too"

Brendon Haggerty and Jonnie Hyde explain their process in authoring a health element for the update to Clark County's comprehensive plan.
Health in Comprehensive Planning: "We Did It and You Can Too"

Photo from Clark County Public Health's Community Assessment, Planning, and Evaluation Report.

Brendon Haggerty and Jonnie Hyde explain their process of authoring a health element for the update to Clark County's comprehensive plan.

August 16, 2012

"We did it and you can too!"

That’s the sentiment expressed by Brendon Haggerty and Jonnie Hyde, both of Clark County Public Health (CCPH), referring to the successful effort they led to give community planning a health focus. Haggerty, a planner, and Hyde, a public health manager, authored a health element for the update to Clark County's comprehensive plan. Earlier this summer, the Board of Clark County Commissioners endorsed the plan.

“This experience bodes well for other counties, because Clark is a lot like other counties,” said Haggerty. Added Hyde, “We usually only hear about very large cities and counties taking on forward looking actions like this, but mid-sized and mixed urban-rural counties can clearly achieve equally impressive results.”

Clark County walkability map

Walkability map from Clark County Public Health's Growing Healthier Report. Click on map to enlarge.

So what is a comprehensive plan, and why should public health care about it? Comprehensive plans provide a vision for the future. They guide local decisions with regard to transportation, utilities, land-use, recreation, and housing—all of which have important implications for public health.

In its infancy, urban planning was allied closely with public health, Haggerty notes. For example, zoning was originally enacted because people living close to factories were getting sick. Later urban planning expanded to address other interests, such as preserving property values and managing traffic flow, and the long-term health impacts of planning decisions were not routinely assessed.

Today, a broader understanding of the links between the built environment and health again points to the need for public health and planning disciplines to work together. As Haggerty puts it, “Many complex factors affect health, and many of them can be influenced through planning.”

In Clark County, the move to integrate health goals into the comprehensive plan began with an exploration of health disparities. The Public Health Advisory Council spent over two years working to increase their understanding of how environment (place) and health are connected. This led the Council to recognize the importance of modifying high level polices that shape place. The Board of Health then charged CCPH with developing a health element, or chapter, which the Board of Commissioners eventually advanced on to the Planning Department for integration into the next comprehensive plan.

Hyde and Haggerty attribute this success to a variety of factors: commitment of the advisory council; a recent history of collaboration between public health and the planning department on Health Impact Assessments; support from the county commissioners; effective public health leadership; public testimony by a broad spectrum of the community; and the presentation of scientific evidence that clearly supported recommendations.

A piece of this evidence was generated by research on climate change and human health, conducted jointly by NWCPHP and the UW Department of Environmental and Occupational Health Sciences, in collaboration with Clark, King, and Spokane county health departments in Washington State. The county-specific findings provided a way for public health to talk about local impacts and to lead on the issue of climate change, which Haggerty considers imperative: “Everything that sustains us is dependent on our ability to mitigate and adapt to climate change, so climate change is the ultimate 'upstream' issue for public health."

Clark County began with a document called the Growing Healthier Report, which addresses the health impacts of access to healthy food, active transportation and land-use, parks and open spaces, economic opportunity, affordable quality housing, environmental quality, and safety and social connections.

How can public health officials forge alliances with planners to get health issues addressed? Haggerty offers several suggestions: Take a planner to lunch or coffee; attend planning commission meetings to make public health visible and to learn of current and future planning concerns; and become familiar with the language of planners. For resources to help planners and public health officials communicate with each other, he recommends ChangeLab Solutions, (formerly Public Health Law & Policy).

Observing that a guiding principle of planning is “the more stakeholders, the better the outcome,” Haggerty is confident that the more visible public health becomes, the more planners will think to include public health at the table.

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