It might seem like a dull subject for policy wonks, but there’s a growing awareness that local government policies and planning can have a direct impactnd on public health.
That’s why towns and counties in New Jersey are being urged to assess the public-health impact of planning and policy decisions. .
Over the past year, Rutgers University policy experts have been working on four “health impact assessments” around the state.
There are many ways that local decisions can affect health, from maintaining clean water and fostering the development of healthcare facilities to encouraging walking and bicycling. Even projects that aren’t normally thought of as health-related, such as economic development that helps create good jobs, can have a positive effect on residents’ health.
“I think the challenge is getting people to think about health in a broader context, and one of the foundations of health impact assessment is thinking about the range of social and environmental determinants of health,” said Jon A. Carnegie, executive director of the Alan M. Voorhees Transportation Center at Rutgers and one of five Rutgers authors of a recent report on the assessments.
While municipalities have programs to promote health, the health impact assessments are a way to make –formalize health considerations a formal part of planning decisions. The professional association for public health workers, the American Public Health Association, is promoting a related process, known as Health in All Policies, as a way of including health impacts in all decisions, not just planning.
“There is growing consensus in both the planning and public health professions that the way we have designed communities over the past 50-60 years plays an important role in determining health outcomes, according to the Rutgers paper, which was written for the New Jersey State League of Municipalities Educational Foundation.
For example, establishing zones that allow for only a single use for land has separated residential neighborhoods from all other zoning uses and made it more difficult to walk to jobs, shops or schools, increasing the reliance on cars.
Health impact assessments are done by professionals trained in examining all of the ways that local policies affect health, and include extensive reviews of plans, data and interviews with local stakeholders.
While health impact assessments have been common in Europe, only 400 have been done in the United States – and only one of those was done in New Jersey prior to 2014 (an assessment of potential changes at the Trenton Farmers Market in 2006).
But staff members at Rutgers’ Edward J. Bloustein School of Planning and Public Policy saw health impact assessments as a way to improve planning in the state and launched a program to help local communities do the assessments.
Rutgers officials worked with Together North Jersey, a federally funded regional planning effort, to assess the health impact of redesigning a 4.3-mile stretch of Bloomfield Avenue in Essex County and potentially eliminating one or two lanes of the four-lane roadway. The assessment predicted that the proposal would indeed make the road safer for drivers, bicyclists and pedestrians.
Another assessment for Together North Jersey examined strategies to encourage people to use the Middlesex Greenway, a walking and biking path in Metuchen, Edison and Woodbridge. The report said there would be many health benefits if the path was better used, and recommended that the it be better connected to nearby neighborhoods, parks and trails.
Two current assessments are underway, both involving Hurricane Sandy recovery.
One is examining the health impact of a proposed stormwater management plan for Hoboken, while the other assesses a volunteer residential buyout program in Mystic Island in Egg Harbor Township. The Pew Charitable Trusts and the Robert Wood Johnson Foundation funded these assessments, which are scheduled to be completed in August.
“Our hope is that by getting some experience with health impact assessment in a variety of settings, we’ll be able to broaden the focus of community planning to include health considerations” in all kinds of local policy decisions, Carnegie said.
Carnegie noted that public health – a term for organized efforts to promote the health of an entire population – and government land-use planning both developed from efforts to prevent the spread of diseases. Over time, they’ve become separated, but he sees health impact assessments bringing them back together. This can leave public-health officials cut off from some of the largest decisions that affect community health.
Jeanne Herb, associate director of the Bloustein School’s environmental analysis and communications group, said the assessments can be a practical tool in policy-making.
“The value, I think, is getting folks together who typically aren’t having conversations together,” she said.
She noted that government decisions can affect the environment, economy, schools, healthcare facilities, public safety, and even residents’ diet and exercise patterns – all of which have an impact on people’s health.
“What’s clear is that the work in terms of improving health needs to come from all of those elements,” she said.
Mike Cerra, policy advisor for the New Jersey State League of Municipalities Educational Foundation, said he expects interest in the assessments to grow.
“Local decision-makers want every bit of information they can have at their fingertips going forward and this is certainly part of that equation,” Cerra said, adding that interest in health impacts is growing at every level of government, due in part to the growing ability to use health data in policy decisions.
On May 7, Rutgers will host the state’s first health impact assessment conference at the Cook Campus Center. Carnegie said the event is intended to draw elected and appointed officials; planning and public-health professionals, and private-sector executives like developers.
Herb said that while New Jersey is “definitely far behind some of the experience in other states,” the conference aims to help the state build its capacity to conduct health impact assessments and teach participants about the value of the assessments.