Policy and Community Development as a Means to Developing Healthier Communities

By Georgianna Reilly, LMSW
SJS Staff Writer

Coming from a macro social work background with experience in health policy development within school districts, I feel that the link between policy, community development and structure, and health is often drastically overlooked. It is clear to many that crime rates, community structure, and access to physical fitness opportunities have a drastic impact on an individuals physical and mental health. This of it this way: If you live in a high crime rate city with deteriorating sidewalks and clogged roads you are going to be far less likely to go for that morning jog. The idea of using policy and community development to offer opportunities for healthier lives is something relatively new to the field of macro community work, something which to some pushes the envelope of denying rights to particular choices. However, this field is growing in many professions and holds some hopeful opportunities to improve our nation in many ways.

At a recent meeting in Denver Colorado this past fall, the United Land Institute addressed the role that policy and community development professionals should and need to play to improve our nation’s health. According to their website, the ULI “provides leadership in the responsible use of land and in creating and sustaining thriving communities worldwide. ULI is an independent global nonprofit supported by members representing the entire spectrum of real estate development and land use disciplines”. Using obesity as an example, a panel at this meeting addressed the chances in community development which could help reduce obesity by improving access to healthier activities and environments. Some of the suggestions made?: use land properly in order to offer citizens access to parks, trails, sidewalks, open spaces, and facilities for physical activity; reduce crime rates through community restructuring; improve access to public transportation; and incorporate health and wellness assessment and intervention plans into local community development comprehensive plans.

The most interesting suggestion to me is the use of the Health Impact Assessment when making community development decisions.

“Dr. Jackson suggested that the path to healthier communities should begin with a health impact assessment (HIA). Doctors routinely advise their patients on ways they can stay healthy. An HIA provides similar advice to communities, which could help local leaders make informed choices about improving public health through community design.

The National Research Council defines an HIA as a ”systematic process that uses an array of data sources and analytic methods as well as input from stakeholders to determine the potential effects of a proposed policy, plan, program, or project on the health of a population.” Health impact assessments also provide recommendations on monitoring and managing these effects. For example, imagine that a city school board proposed consolidating two neighborhood schools into a new, larger school on the edge of town.  A health impact assessment could help the school board to understand that by closing the neighborhood schools, fewer children would be able to walk to school.  However, an HIA might also make recommendations for minimizing the negative health effects of the new consolidated school, such as constructing new sidewalks or bike trails that would connect to the new school to existing neighborhoods.”

Having used something similar called the School Health Index with schools I can say that such evaluation tools are a great eye opener to policy makers, and offer a great means of starting discussion which can direct policy changes towards a healthier direction.

Such movement in the policy and community development front is integral to our health as a nation so I enjoy this call to action from the ULI and other organizations involved in this meeting. These chances can also improve our economy too, which is a great bonus. As the article concludes:

“Developers, architects, and city planners have a role to play in preventive medicine, according to the panelists. These healthier communities can lead to more profitable real estate developments.” 

..and let’s not forget the potential benefits of decreasing medical costs for preventable diseases such as obesity!