Measuring, Assessing, and Certifying Healthy Places
To know whether a community can be considered a healthy place and how it can be improved, tools are needed to measure and analyze health-risk and health-protective factors and to convey such information to decision makers. Instruments such as walkability
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troduction In 2003, at the request of community organizations concerned about adverse health consequences likely to result from the eviction of tenants, the San Francisco Department of Public Health (SFDPH) conducted a health impact assessment (HIA) of the proposed redevelopment of the Trinity Plaza Apartments. A developer had proposed to demolish the 360-unit apartment building in order to build 1,400 new, market-rate condominiums. SFDPH officials used focus groups, housing statistics, empirical research, and their own expertise to support the analysis. Expected impacts of the eviction included psychological stress, fear, and insecurity caused by eviction; crowding or substandard living conditions because of limited, affordable replacement housing; food insecurity or hunger caused by increased rent burdens; and loss of supportive social networks owing to displacement. A.L. Dannenberg et al. (eds.), Making Healthy Places: Designing and Building for Health, Well-being, and Sustainability, DOI 10.5822/978-1-61091-036-1_20, © Island Press 2011
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STRATEGIES FOR HEALTHY PLACES: A TOOLBOX
The California Environmental Quality Act (CEQA) requires examination and mitigation of state and local public agency decisions that may result in a significantly adverse environmental effect, including environmental effects that are potentially adverse to humans. SFDPH communicated the findings of this HIA as an official comment on the CEQA review process, leading the city planning department to require the developer to study the impact on displacement and propose an alternative project that did not result in displacement (Bhatia 2007). The developer—who was facing tenant organizing, public criticism, the potential for adverse environmental impact report findings, and a possible citywide legislative moratorium on demolition—ultimately agreed to negotiate with tenants. In 2005, the city approved a revised proposal calling for one-for-one replacement of the existing 360 rent-controlled units, continued leases for existing tenants, a 1,000-square-foot meeting space, and a children’s play structure. In 2010, residents of the old Trinity Plaza Apartments moved into units in the new building (Rajiv Bhatia, SFDPH, personal communication 2010).
Most people would prefer to live, work, and play in healthy places, but how can one know if a place is healthy? Different tools are needed at different decision-making stages of the community design and implementation processes. Measurement tools are used to gather community design or health information about a community, some of which permits comparisons among neighboring communities. Assessment tools, such as health impact assessment (HIA), provide a systematic framework for predicting the health outcomes of proposed projects and policies. Certification tools, such as LEED for Neighborhood Development (LEED-ND), provide a means of assessing and communicating whether communities are healthy and sustainable. When used successfully, these tools facilitate evidence-based practice and enable the conside
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