Dec. 12, 2022
Planning and public health share a history: Both professions took root in the U.S. as industrial production and urbanization ramped up after the Civil War. Today, increasing concern about equity and the COVID-19 pandemic, among other developments, keep that connection between the two professions front of mind, putting health at the forefront of planning and heightening the spatial dimension of public health.
The City Health Dashboard, launched by New York University (NYU) Grossman School of Medicine, working with partners like ICMA, the National League of Cities, and the National Resources Network, makes public health data available in a user-friendly, planning-ready format. It can help planners get a deeper understanding of their communities, develop plans that address less obvious needs, and secure additional resources by identifying relevant policies and programs — and even funding opportunities.
What it is
The dashboard provides geospatial data at the census tract level about community health measures — obesity rates and breast cancer deaths, for example — as well as some of the factors that can influence these outcomes, such as air quality, employment status, tobacco use, and access to care.
While not all data are available for each of the measured cities, more than 40 metrics across five domains are tracked and analyzed. These include social and economic factors, such as educational attainment, as well as certain physical qualities of the environment like walkability and lead exposure, for example. The dashboard also tracks health-related behaviors, including physical activity and binge drinking, and outcomes like opioid deaths and diabetes prevalence. A snapshot of local medical care shows the percentage of uninsured residents and uptake of dental services.
At its inception, the dashboard covered about 500 of the biggest US cities, following the CDC's model for its 500 Cities project (now expanded and called PLACES), which aggregated data by Census tract to enable more detailed epidemiological analysis.
Since then, the list of cities has expanded to more than 900 as the team has broadened its outreach and its definition of "city" to encompass other jurisdictions, such as boroughs, townships, and villages. "That expansion will continue," says Samantha Breslin, the dashboard's senior program coordinator. "We're always thinking about how to expand down to smaller places." (An APA project with funding from the public health sector, Everyday Destinations, focuses on 15 approaches to planning and public health in small and rural communities.)
Other improvements on the horizon include the ability to save groups of tracts for future reference and analysis, making it easier to follow trends over time. Breslin says the team welcomes suggestions for more ways to expand datasets or improve navigability, as well as stories of successful efforts to integrate health data into planning.
Most of the data come from the American Community Survey and the CDC's PLACES and National Vital Statistics System databases, enhanced with information from federal agencies such as the Environmental Protection Agency, academic sources such as Stanford University's Education Archive, and proprietary sources such as Walkscore.
The dashboard organizes the data and makes it available free and open source, which is easily exported in a .csv format. Its user-friendly interface and organization makes it simple to see a snapshot of a city, neighborhood, or tract. Users can download .csv files on, say, physical inactivity with a single click and fold new data into tools planners are already using, such as ArcMap.
"Its great strength is that it reduces the level of skill needed," says Sagar Shah, PhD, AICP, APA's Planning and Community Health Manager.
Use cases for planners
While the dashboard wasn't created as a planning tool, it's a use NYU stewards are hoping to expand. They have partnered with the International City/County Management Association (ICMA) to spread the word to local governments and advise them on how the dashboard might evolve to better serve local planning functions.
ICMA Senior Program Manager (and professional planner) Clark Henry, who works with NYU on this, says it can be used like other geospatial data to inform site planning or policy decisions. "It can help governments create public policy to, say, incentivize new grocery stores or parks," he says, "and start programming what public investment might look like."
Local governments can also use the health data to make the case for funding planned or desired projects. Henry notes that many of the existing and new programs funded by the federal government's Bipartisan Infrastructure Law are subject to guidance under the Biden Administration's Justice40 Initiative, which seeks to ensure that 40 percent of the benefits of certain federal investments in transportation, housing, and other areas accrue to historically underserved and environmental justice communities.
City Health Dashboard can be particularly helpful for smaller communities, which might have just a single planner or administrator on-staff (or rely on a consultant), says Shah. Navigating Census data can be challenging, and some geographic data might be locked behind a paywall or accessible by limited numbers of staff who are assigned licenses. Local government staff working on planning projects might not have access to GIS or the training to use it, but this tool doesn't require users to have sophisticated skills.
"This is a good way of helping to tell an evidence-based story about a community's quality of life and well-being," he says.
The dashboard could also help deepen engagement for both professions, says Henry. It can give planners a more comprehensive understanding of a community's needs and the potential impact of proposals under consideration. For example, asthma rates could influence the location of freight routes or the development of policies to encourage electric vehicle use. At the same time, in places where local governments might have limited planning capacity, mission-driven nonprofits and citizen groups can advocate for improvements or even use it to inform their own grassroots projects.
Better integration between planning, with its spatial analysis framework, and public health, with its abundance of datasets (encompassing, for example, mental as well as physical health), helps everyone, says Shah.
"Planners are interested in the well-being of their communities, but if health isn't already known to be a core issue, they might not think to ask," he says. "This is an easy way to expand their thinking."