Advancing Obesity Solutions Through Investments in the Built Environment Proceedings of a Workshop (2018) / Chapter Skim
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4 Achieving Equitable Healthy Environments
4 Achieving Equitable Healthy Environments
Pages 39-58
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From page 39... ...
• Real estate professionals, designers, financial services provid ers, and others associated with development have a responsibil ity to create healthy places that do not exacerbate inequities. (Sara Hammerschmidt)
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From page 40... ...
She suggested, for example, that communities can implement walking programs tailored to the interests and abilities of specific population groups, and streets can be designed so that walking is safe and convenient for everyone. She emphasized that approaches that consider people with less social capital who historically have been underserved could help reduce disparities in communities with minority residents of low socioeconomic status.
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From page 41... ...
"All these little hassle factors add up," he noted, and "make it too easy for parents or other caregivers to say, ‘Sorry, now is not the time to play.'" According to Siegal, to overcome these roadblocks, ideas42 suggested that communities integrate play into the everyday spaces and daily routines of children and families. Cities can have great play destinations, such as parks and playgrounds, he elaborated, but they also need playable sidewalks, bus stops, grocery stores, health clinics, and "all the places that kids and families are already spending their time." "Play can transform these moments into moments of joy," he added.
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From page 42... ...
He cited the example of Baltimore, where KaBOOM! recently partnered with a public housing development that had no play spaces for children.
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From page 43... ...
As a result, kids are going to be happier and healthier." COMMUNITY ENGAGEMENT IN ALAMEDA COUNTY Kimi Watkins-Tartt, deputy director of the Alameda County Public Health Department, defined health equity as achieving the highest level of health for everyone. "Health equity," she elaborated, "entails focused societal efforts to address avoidable inequalities by equalizing the conditions for health for all groups, especially those who have experienced socioeconomic disadvantage or historical injustices such as racism." She described the goal of the Alameda County Public Health Department as ensuring that all residents of the county, regardless of where they live, how much money they make, or the color of their skin, can lead a healthy, fulfilling, and productive life.
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From page 44... ...
Watkins-Tartt then described a partnership with the East Oakland Building Healthy Communities group, which is funded by the California Endowment, to incorporate a health equity lens into the City of Oakland planning department's reviews of new projects. A collaborative group created Healthy Development Guidelines as a tool to be used by the planning department and the general public to better understand the city's requirements and expectations for health equity.
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From page 45... ...
She pointed to the Healthy Food Retail project, which is designed to achieve and sustain healthy food retail environments in the neighborhoods most burdened by chronic disease. She explained that the project included demonstrations in both east and west Oakland, research on local policy options to institutionalize promising practices, and identification of resources for a countywide effort.
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From page 46... ...
She noted that the public health department has used its own resources to garner additional funding to support store changes. She explained that store owners are under economic pressure to replace lost profits from unhealthy products, to cover the high costs of making improvements in their stores, and to change negative perceptions of the stores among the neighborhood residents and law enforcement.
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From page 47... ...
"We recognized that the real estate community needed to do more to be part of the solution to our global health problems." According to Hammerschmidt, the Institute's theory of change is that its members (who represent development, design, financial services, the public sector, and other land use professionals) can promote health in three ways.
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From page 48... ...
For each "demonstration corridor," she explained, there is an interdisciplinary local group guiding the work that includes business owners, real estate developers, planners, elected officials, community representatives, public health professionals, and others. "We have been convening stakeholders and bringing in national experts to help each corridor address specific challenges and create actionable plans for change," she said.
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From page 49... ...
According to Hammerschmidt, the project "illustrates how innovative partnerships among real estate developers, nonprofit organizations, private philanthropy, and community institutions can produce a development with a set of shared priorities that are really focused on improving health and equity." Another example Hammerschmidt described is Arbor House, a 120,000-square-foot building with 124 units of affordable housing in the Bronx neighborhood of New York City. Located in a part of the city with disproportionately high rates of chronic diseases, such as diabetes and heart disease, the development includes features to promote healthy living, including a hydroponic rooftop farm that allows residents to buy healthy produce grown on the farm.
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From page 50... ...
National, a community development intermediary that brings capital investment from banks, foundations, investors, the public sector, and other sources together with technical resources from community development corporations, community action agencies, community-based organizations, and real estate development organizations to build community assets and local capacity. She described how developers can be both for-profit and nonprofit, and how private developers can have nonprofit missions, while nonprofit developers can have profit-driven missions.
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From page 51... ...
One goal of comprehensive community development is to strengthen communities by addressing the social determinants of health, Lauros explained, which involves working on housing, facilities, infrastructure, and other aspects of the built environment; on jobs, small businesses, financial literacy, and other features of economic vitality; on education, earlychildhood workforce training, wellness education, and other components of human capital; and on engagement, organization, connectedness, and participation in building social capital. "We look at a place as a way to bring all of the elements together," she said, "to not just work comprehensively but to leverage each other's effects for sustainability." Although she cautioned that no type of work can be continually subsidized, she asserted that the implementation of best practices can allow for sustainability, while revenue-generating opportunities can supplement and support community development beyond short-term interventions.
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From page 52... ...
Another project highlighted by Lauros was the Senior Residences development at Mercy Park in Chamblee, Georgia, which has 79 units and a 45,000-square-foot medical facility that includes 13 fixed and mobile primary care clinics, and which offers direct service, health education, and referrals on site to tenants. She also described the Neighborhood Health Association Clinic in Toledo, Ohio, a 42,000-square-foot health clinic that consolidated locations and expanded services to include family and adult medicine, urgent care, women's health, dental health, specialized care for homeless persons, a credit union, a community garden, and a pharmacy providing heavily discounted medications.
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From page 53... ...
In New York City, she reported, the health department worked with LISC to help owners of affordable housing with green and healthy retrofits, such as integrated pest management, smoking cessation programs, and active living supports. In Rhode Island, she continued, the health department initiated a Health Equity Zones initiative with extensive community planning.
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From page 54... ...
"If we are not achieving that, then we are not going to be able to address the needs of the communities that we are purporting to serve." Hammerschmidt pointed out that real estate developers do not typically take the lead on community engagement strategies. Furthermore, she observed, challenges arise when what some see as one community to engage is actually many different communities, all with different needs.
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From page 55... ...
She characterized the children as "in many cases more innovative than the adults." Instead of providing childcare at community planning events, she held planning activities with the children. "What do you want to see in the community?
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From page 56... ...
In Alameda county, Watkins-Tartt observed, a new health director came in with the mission to "put the public back in public health." He created a foundation of community engagement on which each successive director has built, she explained. Lauros echoed Watkins-Tartt's comments, noting that senior-level leaders at LISC have an understanding of the relationship between income and health.
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From page 57... ...
According to Hammerschmidt, her organization is constantly examining research so it can inform its members about trends that are taking place. She noted that the Building Healthy Places toolkit offers 21 recommendations that are based on research.
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