Planning and Health: How Two Members Got Their Start

Have you ever wondered how APA members started working on healthy communities? Grace Kyung, MPH, and Fred Neal, Jr., AICP, recently exchanged stories about their interest in the intersection of planning and health, their current work, and how other APA members can get involved.

The following is an edited transcript of their conversation with Dustin Calliari, APA's Content Marketing Coordinator.

How did your interest in planning and health develop?

Fred Neal, Jr., AICP: As a planner who follows and is curious about national trends, I started to hear planning and health coming up over and over. I live in New Orleans and worked on a couple of public-sector planning and code development projects. While health wasn't necessarily the focus of those projects in the beginning, as it evolved we started to hear questions like, "what is the health impact assessment," and "how does this plan or code help create healthy communities?" I started to wonder what this was all about, and how health and planning should connect.

One project that got me interested in in these issues was a policy project that we worked on with a local group that runs farmers' markets in New Orleans. Our initial focus was on the permitting and zoning side of things, but as a number of these really became neighborhood markets, it became more about the role farmers' markets can play in increasing food access and creating healthier communities. It was a specific hook that connected to my day-to-day work and brought me to think more broadly about health.

Grace Kyung, MPH: My interest in planning and health developed while I was in graduate school. I was getting a public health degree and I got really interested in how the built environment shapes our access and opportunity to physical activity and healthy food options. So, I realized what I really wanted to understand is how cities were built and why they made decisions that they did in designing cities. So, as I was finishing my MPH, I decided to apply to the planning program. The dual degree of planning and public health has really helped me understand how decisions are made on a local or city level and how we can take those principles and practices from planning and public health to design healthier communities.

How did you get involved in Plan4Health?

Grace: I got involved in Plan4Health in May of 2015 when I was hired to work on the St. Louis Plan4Health project. Our project — a partnership with APA Missouri — is a local heath coalition called the HEAL Coalition. We wanted to talk about street design standards, and did it through pop-up traffic calming demonstrations. We educated community members, public officials, and city staff on street design and how the way our streets are designed affects our access to physical activity and ability to walk safely on our streets. St. Louis streets are designed to be very wide with not a lot of traffic calming features, so it makes it very unsafe to walk outside. The City of St. Louis is also known as a focus city for a high number of pedestrian and bicyclist deaths. We really wanted to target this issue within the city and find easy ways to help people understand what traffic calming is and what sort of infrastructure improvements we could bring into the community.

We created a toolkit that explains how to create these demonstrations, how to get the community involved, and what the benefits are. We created a lending library of all the equipment we used in our Plan4Health project, and turned it into a free lending library resource for the community. We had different videos created about the project, and the project won a Transportation Research Board award for how easy it was for the public to understand.

The exciting part is, we've already seen changes come through in the built environment by using these tactical urbanism projects. We've seen beautification projects, a $30,000 crosswalk improvement, and they all happened in less than a year since the demonstrations took place. It's been a great and exciting story and has built momentum for the City of St. Louis. On top of that, we've also created a traffic calming policy as another tool to educate elected officials and city staff about why traffic calming was such an important issue in St. Louis and why the community really cared to see these kinds of changes continue to be made.

Fred: In Louisiana, we're just getting involved with Plan4Health. We were awarded one of the Planners4Health (cohort three) awards. This is one of the first chances we have had to do it statewide and to get planners and health professionals together to talk about our work, understand, and see where there are opportunities to work together.

In a lot of cases, we're finding just in our initial work that planners and public health professionals have the same goals and the same desired outcomes. As a state, this is our first involvement and all the feedback has been overwhelmingly positive.

 We want to conduct an assessment and host roundtables to try to get to achievable and important outcomes for Louisiana.

We just had our state conference last week and the theme of our conference was "Healthy Communities." Overall it was a really good kickoff to this project and connection to what we want to do with Plan4Health.

What are some of the biggest opportunities for planners and public health professionals to work together?

Fred: I think one of the biggest opportunities we have is the potential for local, chapter-specific outcomes. We have a lot of coastal issues — land loss, sea level rise, climate change, and erosion caused by canals and pipelines used for oil and gas. Regardless of why it happened in the past, our state is being forced to reckon with this. We're thinking about communities that are in these areas where there is a lot of land loss and considering how to plan for them, and health is a big part of that. I hope to interject health into this conversation — it's not just about whether the community has the right land use and transportation, but how we make these communities healthier for current and future residents. Planning not only for sustainable communities, but planning for healthy communities.

For us, the conversations have to start somewhere. That sounds simple, but a lot of planning issues are complicated with a lot of things involved. We're trying to make sure health is on the table in the same way as transportation, public and social services, and access to education. How do we make sure that health is talked about by both planners and health professionals?

Grace: Some of the best opportunities that we've noticed — in some ways we already know this — is that planners and public health professionals in some way have the same agenda. We're trying to create communities that are successful for all people, not just people who can afford it or for a specific race or ethnicity.

The great thing about the Plan4Health project and the doors that were opened in St. Louis is that we were not only able to work with a coalition that was really strong and focused on the built environment factors that affect physical activity and healthy eating, but we were able to use this project as a tool to work win vulnerable St. Louis communities. We went through extensive review of different health outcomes — age, socioeconomic status, access to schools, food, and transportation options.

While working alongside planners and public health professionals, we were able to pick the four neighborhoods we thought had the greatest need. We worked in those four neighborhoods, doing extensive community engagement and understanding who lived there, what issues they cared about, and what streets within their community they wanted to change.

That was a neat project — to work alongside planning and public health professionals and think of how we can align our goals. Someone in planning may be focused on building better traffic calming infrastructure so the area is more walkable and bikeable, while the public health professional may think, "I just want people to be more physically active so that they can live a healthier lifestyle and reduce obesity and other chronic diseases." We were able to align our stories about what we were trying to do and it was a great opportunity for us to work toward a common goal in order for something greater to happen.

Fred: I think the important thing is aligning stories and creating a common goal. We understand that planners and health professionals are really part of the same family. In graduate school, we all were taught about the origins of planning and the origins of public health, and we all come from basically the same place. One of the things were going to try to emphasize is even if were working on different projects and even if were using different terminology, in the end were all hopefully trying to get to the same place.

Would you recommend that other APA members get involved in Plan4Health? And what are some first steps that interested planners can and should take?

Grace: I 100 percent think all APA members should be involved in Plan4Health. I think it's been a huge, successful collaborative effort between APA and APHA. It really shows the value — if you give people like Fred and me, or coalitions, or state chapters some funding — of what we can do with it and what sorts of opportunities it opens for us. Any APA members who aren't involved in it should seek out their local or state chapter that is working on it and see if they can have a role.

Some of the first steps planners can take, especially when working with public health professionals, is to join the APA interest group called the Healthy Communities Collaborative. I'm one of the co-chairs, and we wanted to make sure it wasn't just APA members, so folks who worked in fields outside of planning had a space to come in and speak with planners about what it means to build healthy communities and have an open dialogue. We're focusing on three different topic areas: policy, education, and partnerships and outreach.

We're just starting this group and it's not too late for anyone to get involved. They can email me if they have any direct questions, and we have a listserv that people can join. We send out resources through it — where funding opportunities are coming up, being part of the dialogue, etc.

If there are planners looking to get involved on more of a local level, I think it's just reaching out to your local public health department, advocates who have been leading the dialogue on the public health, or nonprofits in the community that have a public health focus. Find out how can you align your efforts. It's not necessarily that you're asking someone to do something, but it's cutting costs. If you're already doing that, as we continue to do this, how do we align these to make it more advantageous for our city and town? I think it's been a really successful story, at least for the work I've been working on.

Fred: At our level, we haven't had statewide efforts before, but we had individual planners and health professionals really interested in this work. As a chapter, we saw the Planners4Health opportunity and decided to apply; meanwhile, we made health a major component of our state conference.

Part of it is looking at recurring chapter events, and a conference is an easy way to start, but also thinking about projects you've worked on individually with health components and sharing those with your colleagues in the chapter. Secondly, think through if you've done projects that have had connections to public health or healthy communities issues.

Five years ago, I wouldn't have thought of the farmers' market project I mentioned earlier as a public health-focused project, but it is. There's a need to break down silos to consider health impacts within different projects we work on and use this information to facilitate future work and collaborations.

Also, use your personal networks. The best thing I've learned in the last month and a half or so working on this is speaking to friends who had MPH's, but I never really knew what they did and they didn't know what I did. There's opportunity to facilitate conversations between the two professions — we're working on the same types of projects.

Utilize some of the existing events within your state chapter, whether those are conferences or gatherings. And think about other projects and where there are collaborations — sometimes it's as simple as putting two and two together and realizing this is a great shared outcome.

Top image: Health word cloud.

March 30, 2017

By Dustin Calliari