National concerns with health problems and rising health care costs have led leaders and citizens alike in search of new ways to promote healthier lifestyles and get at the health care dilemma through prevention. While people's lifestyles certainly impact their health, even the most health-conscious people are bound by their surrounding environment, especially outside of the home. Land use decisions impact our health on a daily basis. The following list is a summary of land use impacts on public health pulled from the Eastern Neighborhood Community Health Impact Assessment Final Report (2007).
- Relatively expensive housing may force low-income tenants to use more of their resources to obtain shelter, leaving less for other necessities such as food.
- Overcrowded housing conditions contribute to mortality rates, infectious disease risk, and respiratory infections.
- Children living in homeless shelters have been found to suffer from depression, have a behavioral problem, or have severe academic delay.
- Residential segregation is associated with teenage childbearing, tuberculosis, cardiovascular disease, availability of food establishments serving healthy foods, and exposure to toxic air pollutants.
- Segregated neighborhoods have been shown to have fewer assets and resources, such as schools, public transportation, food retailers and libraries, than non segregated neighborhoods and a host of unwanted land uses such as power plants, solid and hazardous waste sites, and bus yards.
- Substandard housing conditions can increase the risk of injury through exposed heating sources, unprotected upper-story windows and low sill heights, slippery surfaces, and breakable window glass in sites with a high likelihood of contact, and poorly designed stairs with inadequate lighting.
- Living in proximity to high-traffic density or flow results in reduced lung function and increased asthma hospitalizations, asthma symptoms, bronchitis symptoms, and medical visits.
- Sidewalk cleanliness and width, street design for pedestrian safety and speed control, and street lighting influence levels of pedestrian walkability and neighborhood crime and safety.
- Walking or biking to work helps meet minimum requirements for physical activity.
- People walk on average 70 minutes longer in pedestrian-oriented communities
- Chronic noise exposure can adversely affect sleep, school and work performance, and cardiovascular disease.
- Both the number of neighborhood parks in proximity to one's residence and the types of amenities at the park predict the duration of physical activity in children.
- Living in proximity to green space is associated with reduced self-reported health symptoms, better self-rated health, and higher scores on general health questionnaires.
- Vehicle miles traveled are directly proportional to air pollution and greenhouse gas emissions.
- Exposure to air pollution contributes to the development of cardiovascular diseases, heart disease, and stroke.
- Areas with high levels of vehicle miles traveled per capita also tend to have higher accident and injury rates.
- Compact areas with lower levels of vehicle miles traveled per capita tend to have lower accident and injury rates.
- Proximity to transit links is associated with reduced vehicle trips and improved access to social, medical, employment-related, and recreational activities.
Communities have been urging developers to consider these elements. The use of Health Impact Assessments (HIA) to measure the health impacts of land use projects are gaining traction (see this recent article for more information) in the United States. San Francisco has led the way with HIAs. San Francisco's Department of Public Health has developed a Healthy Development Measurement Tool to provide a comprehensive evaluation of health needs in urban development plans and projects.
While most agree that planning healthier communities is something we should strive for, how would we go about ensuring it is built into local power structures? Discuss strategies and practices communities could implement to consider the health impacts of land use decisions.