American Public Health Association: Connecting Health and the Built Environment

The American Public Health Association (APHA) is a 140-year-old nonprofit organization whose central goal, and challenge, is to create the healthiest nation in one generation. To do so, APHA promotes health in all policies by building partnerships, coalitions and connections with people outside of the public health community, such as transportation professionals, land use and community planners, equity advocates and design professionals.

With 25,000 active members and many partners, APHA strives to integrate public health into other professional fields through evidence-based advocacy and programs.

As a longtime advocate for walkability and healthy community design, APHA is pleased that the U.S. Surgeon General is elevating the discussion of healthy communities through his recent Call to Action. APHA is using this critical time as an opportunity to work with people in a variety of professional fields to illustrate how everyone can improve community health.

At the same time, the built environment continues to pose barriers to healthy lifestyles, due to insufficient or poor quality infrastructure.

“People are recognizing that the built environment impacts people’s daily choices, but unfortunately, not everyone has access to sidewalks or public transit,” said Kate Robb, a Policy Analyst for APHA’s Center for Public Health Policy.

Even in communities that have access to public transit, transit may not connect people to the jobs they want and need to reach.

Health and Transportation

APHA hopes to ignite a conversation between public health and transportation professionals through the Transportation and Health Tool, recently released by the U.S. Department of Transportation and the Centers for Disease Control and Prevention.  The Transportation and Health Tool (THT) provides easy access to data that practitioners can use to examine the health impacts of transportation systems. APHA supported development and testing of the tool.

The THT uses data on 14 transportation and health indicators to measure how transportation affects health with respect to safety, active transportation, air quality, equity and connectivity to destinations. THT also suggests 25 strategies for improving a community’s health outcomes.

“We’re hoping that for transportation and health professionals who haven’t already started this conversation, they’ll realize that transportation affects health, and they can look at their state’s indicators and see which ones they want to raise,” Robb said.

So far, APHA has heard from three separate communities – Columbus, Ohio, Clackamas County, Oregon and Columbus, Indiana – how they plan to use the Transportation and Health Tool. Learn more at the 2016 New Partners for Smart Growth Conference in February, where APHA will host a session on the tool.

“We’re looking forward to case studies of communities that are using the Transportation and Health Tool, and we would love to feature those communities to demonstrate how specific communities are using it, and how other communities can use it,” Robb said.

Health and Planning

Plan4Health further demonstrates APHA’s commitment to forming relationships across sectors to improve health outcomes – this time, with land use and community planners. Plan4Health, a partnership between APHA and the American Planning Association (APA), provides funding to bring local coalitions of stakeholders together in communities across the country to work on creating vibrant, healthy places.

The coalitions use both planning and public health strategies to promote physical activity and access to healthy food, two of four major determinants of chronic disease according to the Centers for Disease Control and Prevention.

This partnership ensures that the lessons learned and experiences of towns and cities across the country are part of the national agenda to prevent chronic diseases and promote health in all communities.

“Plan4Health gets planners and public health professionals to the same table with other community-based organizations in coalitions that plan and implement policy, systems and environmental change strategies to prevent chronic disease,” Robb said.

Health and Equity

While almost 90 percent of wealthy communities have sidewalks on one or both sides of the street, in low-income communities that percentage drops to 49 percent, according to the Safe Routes to School National Partnership’s report Fighting For Equitable Transportation: Why It Matters.

Low-income individuals are also twice as likely as high-income individuals to be killed while walking, according to the same report.

Some low-income communities have two times the amount of heavily-trafficked streets and fewer street lights than high-income communities, according to At the Intersection of Active Transportation and Equity.

Additionally, a large obstacle to physical activity is crime or fear of crime.  This can result in low physical activity which can lead to obesity.  Unfortunately, youth obesity is higher in low-income communities and communities of color, according to Taking Back the Streets and Sidewalks: How Safe Routes to School and Community Safety Initiatives Can Overcome Violence and Crime.

APHA strives to eliminate such disparities by highlighting them as issues of concern.

“A nice sidewalk network allows people to walk to their destinations, and not have to resort to the car because they don’t feel safe walking,” Robb said. “That’s essential to the healthy design of a community.”

Local governments and planners receive so many requests for sidewalk maintenance and installation, and they struggle with prioritization.

On January 19, APHA will host a webinar focused on how to build a walkable community. The webinar will highlight Minnesota’s statewide pedestrian plan and a rural community in Minnesota that is working collaboratively to implement healthy community design initiatives. (Stay tuned for details!)

Health and Community Design

APHA partnered with American Planning Association and Georgia Tech to develop the Built Environment and Public Health Clearinghouse (BEPHC), a resource for relevant news at the intersection of community design and health. The clearinghouse was designed to provide resources to multiple sectors within the built environment and public health fields to support workforce development and training needs.

The partnership, known as Building Bridges, has also hosted webinars on the topic, which are archived in the clearinghouse for anytime viewing.

Health and the Future

APHA recently reinvigorated the Environmental Health Coalition, a group of national organizations that provides a unified voice for environmental health through collaborative partnerships and resources. Next month, the Environmental Health Coalition will discuss priority areas for the coalition, which includes climate change, to create healthier communities for all.

APHA recognizes the strength in creating relationships across sectors and breaking down silos to implement health in all policies.  This goal is on its way to being realized, thanks to APHA initiatives such as the Transportation and Health Tool and Plan4Health and support from the Centers for Disease Control and Prevention.

APHA hopes to continue forming new relationships and implementing health in more professional fields and policy areas.