Healthy By Design

Wellbeing and good health contributes significantly to the sustainability and resilience of any community by improving the quality of people’s lives. Planning places for better physical health, results in faster recovery from illness; fewer limitations in daily life; higher educational attainment; greater likelihood of employment and earnings; and better social relationships. Recognition of the importance of the built environment and land use policy in promoting good health is growing.  Florida communities will continue to address health issues and look for ways to protect and improve the public’s health, and reduce risk. The discussions below take a brief look at three examples of how land use relates to health concerns.

Physical Fitness: Obesity, which results from poor diet and physical inactivity, is a leading public health challenge facing Florida today. In Florida, it is estimated that almost 3.7 million adults are physically inactive, and approximately 4.0 million adults are obese. These groups represent approximately 65% Florida’s population. Additionally, 1 in 3 children in Florida are considered overweight or obese (Florida Department of Health).  These Floridians are at a higher risk to develop coronary heart disease, high blood pressure, type 2 diabetes and stoke.  Left unchecked, the impact of increasing obesity rates will be devastating in both public health and economic terms.  In recognition of the seriousness of this health threat, there is a growing trend among local governments, private developers and community groups to increase opportunities for physical activity and easier access to healthy foods when planning cities and communities.

Aging:  In addition to becoming more overweight, Florida’s population is growing older at a faster pace than the rest of the nation.  By 2025, the proportion of Florida’s population aged 65 years or older is projected to be 26%.  This leads to increased health concerns and limited lifestyle choices by older Floridians. Issues such as health care cost and the ability to “age-in-place” will be an increased concern in the future.  Older Floridian’s will drive less, requiring better access to goods and services.  While, many communities have some programs to address the needs of an aging population, very few have a comprehensive assessment of what it would take to make their community “elder friendly.”  Nevertheless, comprehensive plans and land development regulations throughout Florida are beginning to recognize and address the needs of older Floridians by creating more opportunities for “aging-in-place,” accessibility, social interaction, and care giving.  Placemaking efforts by planners can create inviting, walkable public streets and special destination places near where seniors live to encourage more active healthy lifestyles and social well-being.

Mental Health: Mental disorders are among the most common causes of disability. An estimated 26% of Americans ages 18 and older — about 1 in 4 adults — suffers from a diagnosable mental disorder in a given year.  Additionally, U.S. health officials estimate that one in 10 American adults reports symptoms of depressive disorders. Studies show that individuals living closer to green spaces in urban areas tend to exhibit better mental health.   Furthermore, population data suggests that parks and open spaces can have a tremendous impact on the well-being of all residents. These findings should benefit urban planning and public health recommendations.

Designing Healthier Communities: Decisions made today about land use and transportation in our communities have huge impacts on how people live and can facilitate or obstruct the creation and maintenance of healthy communities, resulting in healthier citizens. The design of cities, neighborhoods, and individual buildings can affect levels of physical activity, which is an important factor in the prevention of obesity and its associated adverse health consequences. Community design influences the amount residents depend on automobiles, whose use contributes to air pollution, motor vehicle crashes, and pedestrian injuries. The design of the built environment affects the ability of older persons and persons with disabilities to be physically active and to be socially integrated into their community. Additionally, the mental health of individuals and a community’s social capital is influenced by the design of the built environment and access to recreational opportunities and green open space.  Inclusion of shade trees and green spaces in city planning are keys to a healthier urban environment: cleaner air, a reduction in polluted storm water, reduced urban heat island effect and improved health outcomes for residents.

The relationship between land use, development, redevelopment, open space and community health is attracting increasing interest from a myriad of stakeholders, ranging from planners, landscape architects, architects, engineers, public health officials and elected officials.  Close cooperation and partnering among these and other stakeholders are critical if we are to be successful in creating healthy communities that sustain and improve the health of Florida residents.

The natural and built environments are fundamentally important to both our physical and psychological wellbeing. Actions that promote sustainability and protect our environment help to increase our ability to flourish in life. In turn, people and communities that are flourishing, i.e. have high levels of wellbeing, tend to be environmentally responsible in their behavior and can, therefore, contribute to environmental sustainability. The design choices we make in our homes, schools, workplaces, communities, and transportation systems can have major, long lasting effects on health, which is defined by the World Health Organization as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”  A healthy community protects and improves the quality of life for its citizens, promotes healthy behaviors and minimizes hazards for its residents, and preserves the natural environment.

Actions Planners Can Take: There are a number of measures that can be implemented at various levels of planning and community development, i.e.: comprehensive plan, zoning, land development regulations, capital improvement plans, neighborhood design, etc.  The objective is to strategically select options that fit the local context.  The health, social, and economic consequences of doing nothing are apparent.  While understanding that we cannot make people choose to be healthy, we can make a difference by implementing a sound policy framework as part of our community planning programs that:

• Provides more opportunities and access by building sidewalks and bike trails, promoting farmer’s markets, allowing mixed land uses, and building schools that children can walk and bike to;
• Removes barriers by retrofitting streets that are unfriendly to pedestrians and bicyclists, permitting seasonal produce stands closer to residential areas and reconnecting isolated communities;
• Fills in gaps by connecting pedestrian and bike pathways strategically locating parks and guiding or incentivizing full-service grocery stores to underserved neighborhood locations.
•  Becomes a facilitator or catalyst for creating active, healthy communities by educating the public, local officials, advocacy groups, developers, traffic engineers, and others.  Identify the problems, formulate a vision for where the community wants to go, and develop solutions.
• Provides easier access to healthy foods by encouraging full-service grocery and farmers markets where fresh fruits and vegetables as well as other nutritious foods can be purchased nearby residents, especially in disadvantaged low income neighborhoods. Encourages programs such as community gardens and revises regulations to allow private urban food gardens. How we get our food should be a basic question asked when we plan new communities or make plans to improve existing one.
• Preserves open space, provides parks and protects environmentally critical areas.  Incorporates trees in public areas and streets, utilizing “green infrastructure” to improve air quality, capture stormwater runoff and reduce the urban heat island effect as well as improving physical and mental health of residents.
• Creates complete neighborhoods where daily needs are close to homes; keeps communities compact and less auto-dependent. As a result, a mix of uses decreases segregation by age, income and race and thus develops social and cultural capital. Residents spend less time commuting to jobs and family members. Provides more opportunity for walking to destinations, thus increasing physical activity and decreasing ailments associated with inactivity. Improves air quality and helps decrease respiratory problems. Supplies fresh, local food for maximum nutritional benefit at a lower environmental cost.
• Fosters distinctive communities with a strong sense of place, increasing civic pride and sense of ownership in communities. Supports a strong public realm and helps cultural and social interaction among citizens. Encourages preservation of historic buildings and landscapes, cultural and natural resources unique to a place contributing to a sense of community pride and identity. Decreases depression and sense of isolation and increases the perception of safety.
• Provides for accessory living units to enable families to be care givers for older family members in their neighborhoods rather than in institutional settings.
• Collaborates and partners with other governmental agencies and community stakeholders, i.e.: health departments, recreation departments, school boards, neighborhood associations, hospitals, employers, etc.