Land Use and Health Team

State: MI Type: Model Practice Year: 2005

The Land Use and Health Team is a collaborative effort in the tri-county, mid-Michigan area that involves planners, university faculty, business and public health. The purpose of the Team is to educate and engage the community regarding impacts of community design on health, and facilitate improvement through refinement and promotion of a health impact assessment tool. There is growing body of evidence that design of the built environment influences the physical and mental health of residents. The population of the mid-Michigan region is shifting from urban centers to farmlands, a process that has resulted in land uses changes with health consequences to urban and rural residents. The Team has increased public engagement in regional planning by increasing awareness of local land use trends and health impacts. The Team is refining and promoting use of a health impact assessment tool to encourage discussion among planners and developers and others about health impacts of proposed developments. The most important element of this practice is involvement of a broad based team of interested stakeholders who represent expertise and resources. Staff support to coordinate activities is necessary to maintain the practice. The Team has experienced success in increasing community engagement in regional planning and pilot tests of the assessment tool have resulted in design improvements that will increase walkability and will likely increase physical activity. If Team efforts resulted only in improved physical activity in the area there would be significant health and financial returns to the community.
There is a growing body of evidence that design of the built environment influences water and air quality, noise, physical activity, injury, social capital, health equity and consequently the physical and mental health of residents. The capital area of Michigan is a tri-county regional of nearly 500,000 people. In this area, population growth and development has shifted over the past fifteen years from urban centers to rural farmlands. This relocation of our population has resulted in land use changes with health consequences for urban and suburban/rural residents. The purpose of the Land Use and Health Team is to develop collaborative relationships with area planners, academia, developers, public health and others to improve our understanding of land use and health relationships, increase community understanding and engagement, and facilitate positive change. Land use can influence the health of residents in several ways. One important example is the impact of land use on physical activity. A defining characteristic of the pattern of development in our rural areas is large distances between homes and destinations. A consequence is increased reliance on automobiles and reduced engagement in physical activity, which negatively affects obesity, diabetes and heart health. The northern portions of the capital area is one of the most sprawling in the U.S. Local behavior risk factor surveys (conducted with CDC protocol) show over 30% of the population in northern capital area is inactive – far from the Healthy People 2010 goal of 10% inactive, and there is a relatively high incidence of hypertension in that area. Overall, the percentage residents who are overweight has increased to 60%, obesity exceeds 20% and diabetes is the seventh leading cause of YPLL. The Team addresses the issue in two ways: The Team is increasing awareness in the planning and development communities and among residents about concepts of land use and health issues. The Team is refining and promoting the use of a health impact assessment tool to encourage health impact discussion among planners and developers and improve development projects. The Health Impact Assessment (HIA) tool is a refinement of the prototype checklist developed by NACCHO. The tool has two components; one is a planning matrix that considers several factors including impacts on water and air quality, noise, physical activity, injury prevention, health equity, and consistency with RGP objectives. The second HIA component is a user friendly GIS encompassing the tri-county area and containing several electronic data layers. This practice differs from past planning approaches by improving public education and engagement regarding planning, and by promoting consideration of health impacts through use of assessment tools. Historically in the capital area, there has been little public engagement in planning. This practice shows that public involvement can be increased by increasing awareness of relationships between built environment and community and personal health, especially if the discussion is placed in a local context with local information. This kind of public education has increased pubic participation in capital area regional planning. In the mid-Michigan area, health impact considerations in development plan reviews are often very limited. Through the HIA tool, this practice offers a focus for considering important impacts that can affect physical and mental health of residents.
Agency Community RolesThe Ingham County Health Department has several roles and responsibilities: Articulate the land use and health concept; Develop partnerships with area planning, academia, and development community, others; Provide support to projects in the community such as Regional Growth Project; Collect and organize data and information related to land use and health, especially at the local level; Facilitate development and use of assessment and improvement tools; and Apply for grants and funding. Partners in this project include: Tri-County Regional Planning Commission (Michigan State University Departments of Planning, Urban Development, Extension, Resource Development; City of Lansing); Meridian Township; Developers and builders; and Greater Lansing African American Health Institute. Land use and health is a major issue for the Ingham County Board of Health, which serves as an advisory board for county commissioners and the health department.Team members have been essential to this practice. They have taken on several roles: Provide data and information; Assist with information analysis; Assist in communicating with respective colleagues and associations; Promote use of information and tools; and Assist with grant applications. The health department fosters collaboration with stakeholders by: Identifying areas of common interest, such as improving community health community health, increasing public involvement, improving public education; Helping partners meet their organization’s objectives in related activities, such as public participation in planning commission’s town meetings, enhancing site plan review processes; Provide practical examples of topical public health/planning concepts for academic curriculum development; Jointly submit proposals; Co-author articles; Co-present at conferences; Participate at trainings; and Collaborate on future direction of the Team practice. Ultimately, successful collaboration in this practice involves developing positive personal relationships among individual members. Costs and Expenditures 1 FTE (in the case of Ingham County Health Department 1 FTE represents involvement of a Health Analyst and project manger) plus indirect costs, for each year. $8,000 total printing costs. $15,000 contract to develop GIS data base for HIA tool. $65,000 for community survey and data gathering to improve walkability in urban center. In kind contributions from 12 Team members, ranging from 2 to 6 hours per month. Funding for staff time is from the Ingham County general fund. The Michigan Department of Community Health supported funding for urban community survey. Lastly, support for the GIS contract came from Michigan State University. ImplementationThis practice has several objectives and is progressing in all of them. The following are objectives and a description of steps taken so far. Articulate the concept of land use and health; Convene a broad based group to consider land use and health; Increase understanding of land use and health relationships; Describe local status; Increase community understanding and engagement; and Facilitate positive change. The Land Use and Health Team is three years old and improvements are made on all of the objectives mentioned above. The following activities were started in the first year:   Articulating land use and health concept; Forming and maintaining the Land Use and Health Resource Team; Community education and participation in the Regional Growth Project; and  Identifying products that would be useful to our community.   The second year included continued work on all of the above steps, as well as collecting information about local status. A major report on local status is planned for June 2005. The third year to present involves continued refining a Health Impact Assessment tool, completing the GIS data base for the HIA tool, expanded piloting of the tool in Ingham County,and training planners in all 50 civil divisions of the capital area on use of the HIA tool.
Commitment of Team members over the past three years has been significant and encouraging. There has been some turnover in membership as the practice moved from one phase to another but enthusiasm remains high, especially as products are developed. It is our expectation that funding for this practice will continue as state and federal agencies and Michigan State University continue to address America’s obesity epidemic and the relationship between obesity and other health matters and community design. Based on positive experience of piloting the HIA tool in one of our townships we expect the HIA tool will be incorporated into the review process there. The township is well respected in the capital area and by their example, and training, use of an HIA tool could become widespread in the area. Use of Team products could become self sustaining. The health department sees significant public health value in this effort and will continue to request county general fund support.