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derstand and articulate how San Francisco
<br />land -use development could promote and
<br />protect health. The goals of the ENCHIA were
<br />to identify and analyze the likely impacts of
<br />land -use plans and zoning controls on com-
<br />munity concerns —including housing, jobs,
<br />and public infrastructure —and to provide
<br />recommendations for land -use policies and
<br />zoning controls that promoted community
<br />priorities through consensus in land -use
<br />policy making (San Francisco Department of
<br />Public Health zoo7).
<br />The Eastern Neighborhoods commu-
<br />nity planning process began in zoos with
<br />the goal of developing new zoning controls
<br />for the industrial portions of these neigh-
<br />borhoods. Starting in zoos, the planning
<br />department began working with the neigh-
<br />borhood stakeholders to create area plans
<br />for each neighborhood to articulate a vision
<br />for the future. The resulting Eastern Neigh-
<br />borhoods Development Plan required that a
<br />Draft Environmental Impact Review (DEIR) be
<br />completed. The DEIR specifically referenced
<br />the 18-month-long HIA and acknowledged
<br />that the ENCHIA explicitly called attention
<br />to the "growing scientific understanding
<br />that optimal health could not be achieved
<br />by health services and individual behaviors
<br />alone." The DEIR also indicated that the
<br />planning department, in conjunction with
<br />the public health department, was commit-
<br />ted to monitoring the progress in community
<br />health indicators (Ko zo11).
<br />Overall, participants felt that the EN-
<br />CHIA was successful in a numberofsignifi-
<br />cantways. It broadened participant under-
<br />standing of how development affects health,
<br />built new relationships among participants,
<br />and created a practical tool for evaluating
<br />land -use plans and projects. It also showed
<br />that a government -led public process could
<br />sustain diverse participation, employ con-
<br />sensus techniques, and shift participant
<br />focus from problems to solutions. The East-
<br />ern Neighborhoods area plans and rezoning
<br />were adopted by the board of supervisors,
<br />signed by the mayor, and became effective
<br />on January 19, 2009.
<br />THE ROLE OF PLANNERS IN USING HlAs
<br />The information obtained from an HIA can
<br />provide guidance on land -use decision mak-
<br />ing in a way that can promote or improve the
<br />health of a given population and mitigate
<br />the negative effects of changes to the built
<br />environment. Planners who understand and
<br />utilize the methods or tools provided by an
<br />HIA can make important contributions to the
<br />health and sustainability of the communities
<br />they serve. Specifically, planners can
<br />® educate public officials about the health
<br />implications of their decisions regarding
<br />growth, development, and transportation;
<br />e analyze local land -use decisions related
<br />to transportation, safety, environment,
<br />and health in a manner that considers
<br />the diverse needs of the population while
<br />evaluating the benefits, as appropriate, of
<br />mitigating factors such as planned unit de-
<br />velopment (PUD), mixed use development,
<br />changes to zoning taws and comprehensive
<br />plans, and crime prevention through envi-
<br />ronmental design (CPTED);
<br />® guide or influence development and other
<br />land -use decisions in a positive manner
<br />while preserving and strengthening the com-
<br />munities through the creation of affordable
<br />housing opportunities, transportation op-
<br />tions, pedestrian -safe roadways, and access
<br />to healthy foods; and
<br />® utilize the different HIA tools available for
<br />planning and land -use decision making to
<br />determine when, and if, HIA is appropriate.
<br />INCORPORATING NIA INTO LAND -USE
<br />DECISION MAKING
<br />To date, most of the HIAs completed in the U.S.
<br />that deal with land use focus on one of five
<br />main objectives: pedestrian and transit -related
<br />improvements; zoning changes; neighborhood
<br />density/use restrictions; housing development
<br />projects; and various redevelopment projects
<br />for residential, commercial, or industrial sites.
<br />Notably, the majority of land -use -related
<br />HIAs were designed to evaluate factors that
<br />might impact health determinants or health
<br />outcomes that may be caused by rezoning,
<br />redevelopment, or other significant changes
<br />to the built environment, with transportation
<br />projects and redevelopment accounting for at
<br />least half of the HIAs completed. The following
<br />discussion of three specific initiatives high-
<br />lights how HIAs may be used to inform land -
<br />use decisions.
<br />TransForm Baltimore HIA
<br />The TransForm Baltimore HIA was one of the
<br />first to evaluate comprehensive changes to a
<br />municipal zoning code. When the decision to
<br />rewrite Baltimore's zoning code was made,
<br />the Center far Child & Community Health
<br />Research at Johns Hopkins University was
<br />enlisted by the Baltimore City Health Depart-
<br />ment to conduct an analysis of the impact the
<br />changes would have on the community. The
<br />goal of the HIA was to contribute information
<br />and resources that would be used to revise
<br />the code and inform the mapping phase of
<br />the process. The Baltimore City Health De-
<br />partment determined that collaboration on
<br />an HIA targeted to identify areas of potential
<br />health impacts, both negative and positive,
<br />could influence policy decisions and could
<br />also help to promote the growth and devel-
<br />opment of a healthier city.
<br />The aim of the TransForm Baltimore HIA
<br />was to research and evaluate how zoning
<br />can be used to improve overall health of the
<br />citizens in an urban environment and how
<br />to optimize the utility of the HIA in inform-
<br />ing and influencing policy decisions. The
<br />recommendations made in the completed
<br />HIA included retaining several elements of
<br />the proposed new code that the HIA team
<br />demonstrated were "likely to contribute
<br />positively to creating healthy communi-
<br />ties," including improving access to healthy
<br />foods, creating walkable environments,
<br />and expanding mixed use areas. Further
<br />recommendations by the HIA team included
<br />revisions that should be made to the pro-
<br />posed new code, including the prevention of
<br />off -premise alcohol sales outlets in transit -
<br />oriented development and industrial mixed
<br />use zones, and the use of CPTED principles
<br />in landscaping and design standards.
<br />The Department of Planning released
<br />a draft of the new code in June 2010. Since
<br />then, the department has held several major
<br />public presentations and discussions around
<br />the city to broaden the opportunity for public
<br />input. The department also extended the
<br />comment period on the draft code and, due
<br />to strong interest and the number of com-
<br />ments, ideas, and suggestions to date, has
<br />decided to prepare a second draft prior to
<br />presenting legislation to the city council. This
<br />second version is expected to reflect, among
<br />other things, the input of the HIA.
<br />HIA ON TRANSPORTATION POLICIES IN THE
<br />EUGENE CLIMATE AND ENERGY ACTION PLAN
<br />In Oregon, the Health Impact Assessment on
<br />Transportation Policies in the Eugene Climate
<br />and Energy Action Plan was completed in
<br />August z010 through a collaborative effort of
<br />Upstream Public Health, the City of Eugene
<br />Office of Sustainability, the Community Health
<br />Partnership (Oregon's Public Health Institute),
<br />and Lane County Public Health. The HIA was
<br />designed to evaluate the proposed action plan
<br />because it had the potential to impact not only
<br />the environment but also public health. As
<br />a result, the HIA focused on a section of the
<br />Climate and Energy Action Plan (CEAP) called
<br />"Land Use and Transportation" to assess po-
<br />ZONINGPRACTICE
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