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HEALTHY WATERWAYS:Incorporating Health into Rochester’s Local Waterfront Revitalization Program
Katrina Smith Korfmacher, PhDAssociate Professor of Environmental MedicineDirector, Community Outreach and Engagement CoreUniversity of Rochester
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OVERVIEWHealth in All Policies (HiAP)Health Impact Assessment (HIA)Rochester’s Local Waterfront
Revitalization Program (LWRP)Healthy Waterways ProjectLessons Learned/Next Steps
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FACTORS RESPONSIBLE FOR POPULATION HEALTH
Health status is determined by: genetics (5%), health care (10%), behavior (30%), Social Conditions (55%)
- WHO Commission on the Social Determinants of Health (2008)
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HEALTH IN ALL POLICIESMany public decisions affect health - not just public health decisions
Few public decisions explicitly consider health outcomes
How can we better promote health through non-health policies? “Health in All Policies” (HiAP)
Predict policies’ impact on health.Health Impact Assessment
HEALTH IMPACT ASSESSMENT (HIA): A FRAMEWORK FOR HEALTH IN ALL POLICIESDEFINITION: “A combination of procedures, methods and tools that systematically judges the potential, and sometimes unintended, effects of a policy, plan, program or project on the health of a population and the distribution of those effects within the population. HIA identifies appropriate actions to manage those effects.” -International Association for Impact Assessment, 2006
FOR MORE INFORMATION:Human Impact Partners (www.humanimpact.org)Health Impact Project (www.healthimpactproject.org)
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INCORPORATING HEALTH INTO DECISION MAKING:HEALTH IMPACT ASSESSMENT (HIA)
HIA has looked at health impacts of decisions on…
Development
Immigration
Farm Policy
Ports
Incarceration
Education
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BUT WHAT IS HIA???
An ANALYSIS that…•Clarifies health effects of a proposed project, plan or policy•Includes quantitative and/or qualitative information•Highlights health disparities; makes health impacts explicit•Considers multiple health outcomes•Provides recommendations•Shapes public decisions & discourse A PROCESS that…
Engages & empowers community Builds consensus
Builds relationships & collaborations
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STEPS OF A HIAScreening Determines the need and value of a HIA
Scoping Determines which health impacts to evaluate, methods for analysis, and a workplan
Assessment & Recommendations
Provides: 1) a profile of existing health conditions2) evaluation of potential health impacts/alternatives 3) strategies to manage identified adverse health impacts
Reporting Includes: 1) development of the HIA report 2) communication of findings & recommendations
Monitoring Tracks: 1) Process: impacts on decision-making processes and the decision2) Outcomes: impacts of the decision on health determinants
HOW DO HIAS ASSESS HEALTH IMPACTS?• Conduct a literature review • Find out about other communities’ experiences• Gather existing data or conduct new analysis on health,
environmental and social indicators• Compare data to existing regulatory criteria & standards• Utilize community expertise - e.g., focus groups, surveys• Apply specialized data collection tools for observational
data, forecasting, and modeling• MAP environmental, social, health data• NOT “new research” (usually)
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WHO DOES HIAS?• Health Departments (state and local)• City governments• Transportation• Consultants• Community Groups• Academics
• ….but few in New York State
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HIA IN MONROE COUNTY Initiated by Dr. Andrew Doniger, Health Director (2009) HIA learning group (Jan 2011)
Training/educationMappingCase studies
Speakers, training sessions, possible HIA topics Many ideas = city policies; partner with health dept. Wrote proposals to fund an HIA Pew Health Impact Project funding: Healthy Waterways
APPLYING HIA TO ROCHESTER’S LOCAL WATERFRONT REVITALIZATION PROGRAM
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NEW YORK STATE’S LOCAL WATERFRONT REVITALIZATION PROGRAM
Develop long-term plan for waterfront
Guides decisions at all levels of government
Opportunities for public involvement
13 policy statements
Many relate to health
Not required to consider health
ROCHESTER’S LWRP ……must address 13 NYS coastal policies and develop sub-policies, where necessary
(1) Foster appropriate development patterns*(2) Preserve historic resources(3) Protect scenic resources / visual quality(4) Minimize flooding/erosion impacts(5) Protect/improve water quality and
supply*(6) Protect the waterfront ecosystem(7) Protect/improve air quality*(8) Minimize solid/hazardous waste impacts(9) Provide public access to and recreational
use of the waterfront*(10)Protect/promote water-dependent uses(11)Promote sustainable use of resources(12)Protect agricultural lands(13)Promote development of energy
resources
*Most relevant to health
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ROCHESTER’S LWRP 1990 LWRP; drafted update in 1999 Revision underway; expected completion
Dec. 2013 Waterfront Advisory Committee (WAC) Next steps: public information meetings,
focus groups, web site/survey, presentations, hearing
Communications Bureau, City of Rochester
“ BENEFITS OF AN LWRP” (NYSDOS OFFICE OF COMMUNITIES AND WATERFRONTS)
Clear direction - An LWRP reflects community consensus and can significantly increase a community’s ability to attract appropriate development that will respect its unique cultural and natural characteristics.
Technical assistance - An LWRP establishes a long-term partnership among local government, community based organizations, and the State, providing a source of technical assistance to prepare and implement a local program.
State and federal consistency - State and federal permitting, funding and direct actions must be consistent, to the maximum extent practicable, with an approved LWRP. This “consistency” provision is a strong tool that helps ensure all government levels work in unison and cooperate to build a stronger economy and a healthier environment.
Financial assistance – An LWRP presents a unified vision; it therefore increases a community’s chances to obtain public and private funding for projects. Funding for development and implementation of LWRP’s is available through New York State Environmental Protection Fund grants as well as from other sources.
www.dos.ny.gov/communitieswaterfronts/WFRevitalization/LWRP.html
ROCHESTER’S LWRP UPDATE:PRELIMINARY ISSUES/OPPORTUNITIES
Brownfield Opportunity Areas (BOA’s)
Center City Master Plan / Aqueduct Plan
City/County Parks Master Plans
City Quadrant Plans
Genesee River Trail Development/Connections
Erie Canal Redevelopment and “Harbor”
U of R Campus Master PlanNOTE: Harbor Management Plan = separate but coordinated process
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HEALTHY WATERWAYS:WHY AN HIA OF ROCHESTER’S LWRP? Ongoing City planning process with
compatible timeline and partners Potential funding source (Pew) Narrow geographic scale, but broad scope Many decisions have the potential to affect
health; but LWRP does not require considering health
“Learning (HIA) by doing”: can HIA affect decision making in ways that promote community health?
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PROJECT INVOLVEMENT Staff
University of Rochester Medical Center Environmental Health Sciences Center
Community Outreach and Engagement Core Kerry Ivers, Consultant
Partners City of Rochester Monroe County Department of Public Health Non-governmental stakeholders
Support: The Health Impact ProjectA collaboration between the Robert Wood Johnson Foundation and The Pew Charitable Trusts
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What are the biggest health issues in Rochester?
How do these relate to the waterfront?
How could waterfront changes affect health?
Goal: Make policy and planning recommendations to minimize health risks and maximize benefits in LWRP
HEALTHY WATERWAYS: HOW MIGHT THE LWRP IMPACT HEALTH?
Communications Bureau, City of Rochester
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ASSESSMENT METHODSLiterature review
publications, reports, HIAsStakeholder input
meetings, individualLocal data
State/County health department, CityData collection
trail, beach, and community surveys
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LWRP “ELEMENTS” ASSESSED Waterfront trail development Beach redevelopment and management Built environment
(residential/commercial/public) Water-based recreation Stormwater management (water quality)
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LWRP Elements Health Determinants Health Outcomes
Beach Redevelopment and Management
Stormwater Management
Waterfront Trails
Water-based Recreation
Built Environment
Overall HealthMental Health
DiabetesObesityHeart DiseaseRespiratory HealthMental Health
InjuryDeath
Waterborne Illness
Physical Activity
Health Supportive Resources
Physical Safety
Water Quality
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ASSESSMENT EXAMPLE: BEACH REDEVELOPMENT AND MANAGEMENT
Why focus on beaches?
• Beach use can promote health• Physical activity• Stress reduction• Community building
• But…water use at beaches can pose health risks• Drowning/injury• Water-borne disease
LWRP POLICYProtect/improve
water quality and supply
POTENTIAL LWRP PROJECTInstall algae pump at
Ontario Beach
HEALTH DETERMINANTSPhysical activity, water quality,
and health-supportive resources, risk of injury (drowning/disease)
HEALTH OUTCOMESDiabetes (i), obesity (i),
heart disease (i), water-borne illness (ih), respiratory health (h), mental
health (h), drowning? disease?
BEACH REDEVELOPMENT AND
MANAGEMENT
What did we want to know?
• Who is using the beach?• How often do they visit?• What do they do at the beach?
(Exercise?)• What might make them visit more?
What we did
• 10 minute survey of beach visitors
• Ontario and Durand, open/closed conditions
• Asked about:• Demographics• Frequency of visits and activity• Water quality• Preferences about possible changes
Beach use
• More people visit/swim at Ontario than Durand
• There were 119,371 visitors to Durand in 2012 (21% were counted as bathers at the guarded beach)
Ontario Beach
Durand Beach
Bather count 54,000 24,951Scheduled open days 81 72Visitors who planned to swim 32% 57%
Who
Ontario Beach
Durand Beach
City of Rochester
White 94% 83% 46%Black or African American
5% 10% 41%
Other 2% 7% 13%Hispanic or Latino 14% 9% 16%
Income less than $35,000 28% 27% 56%
How often
Ontario Beach Durand BeachDid not visit last summer 25% 35%
Visited 1-4 times last summer 41% 33%
Visited 5 or more times last summer 34% 33%
Length of visit(average hours) 3.28 3.57
Where from (distance)
Ontario Beach Durand BeachMedian miles 11.00 9.00Mean miles 16.72 20.08
• 94% of all visitors travelled by car
What
Ontario Beach Durand BeachSwimming 32% 57%Picnicking 8% 16%Walking 17% 24%Sunbathing 76% 47%Sports 3% 0%Other 18% 8%
Water quality
Ontario Beach
Durand
BeachDays closed because of water quality 54% 19%
Would visit more often if quality improved 91% 65%
Visitors who planned to swim 32% 53%Were affected by beach closings 45% 32%Check closings before visiting the beach 45% 49%
• The beach is often closed because of poor water quality
Key findings
• For many, the beach is an important health resource
• Mental health • Social capital• Physical health
• Many use the beach, but not very often
• Beaches would be visited more often if improvements were made
Key findings
• Water quality is only one reason beach use is low
• Maintenance• Safety
• Monitoring matters• Bather and visitor
counts• Surveys
• User fees (parking) would affect low income visitors more
“The beaches could be made more
safe.”
“People are sketchy.”
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HIA RECOMMENDATIONS Based on assessment/findings Reviewed by stakeholders “Overarching” recommendations Element-specific recommendations
PoliciesProjectsProgramsCommunicationMonitoring
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OVERARCHING RECOMMENDATIONS Add community health to the 2013 LWRP Vision
Statement
Add community health to list of the 2013 LWRP Goals
Include information on health and demographics in the LWRP background and inventory
Incorporate community health into the Department of State’s policy guidelines for all LWRPs.
Promote HIA in future city and county decision making processes
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ELEMENT-SPECIFIC RECOMMENDATIONSEXAMPLE: BEACHFRONT REDEVELOPMENTPolicies: “Prioritize projects that promote physical
activity at beachfront areas”
Projects: “Add land-based physical activity resources, such as a pool, spray park, or exercise equipment”
Programs: “Expand programming to promote safe and healthy beach use by diverse populations”
Communication: “Promote beach as a safe and accessible place for free physical activity and recreation.”
Monitoring: “Conduct annual beach user surveys”
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NEXT STEPS City including HIA data in LWRP “Inventory
and Analysis” Adding “sub-policies” to promote health Community groups using HIA to show
people how LWRP affects their interests, encouraging involvement
Emphasize neighborhood involvement, impacts, and equity in recommendations
SUGGESTIONS FOR FUTURE HIAS IN ROCHESTER Safe routes to school Demolition plan for vacant buildings Low emission school bus purchases College Town Local waterfront revitalization plan Brownfields redevelopment
BALTIMORE HEALTH DEPT. AND HIA Too many policies to “do” full HIA Encouraging referral of more policies to
Health Department for comment Technical support/mapping for relevant
health information Full HIA on few projects
www.BaltimoreHealth.org; www.facebook.com/BaltimoreHealth
SUMMARY: IMPACTS OF HEALTH IMPACTS ASSESSMENTS?
• “Brought health concerns into the discussion; decision-makers now routinely thinking about health”
• “Addressed community concerns”• “HIA recommendations were 100% adopted into the growth
plan”• “Influenced the final design of the project”• “Educated decision-maker about how a policy that seemed to
have nothing to do with health, actually has health consequences”
• “Culture change: planning department is now routinely considering health”
• “Health is now a part of the EIS process” • “New partnerships between health and other agencies”• “Built a strong coalition of stakeholders who are now active in
the planning process”
DISCUSSION In WHAT programs/projects/policies might
HIA help improve environmental health at the county level?
WHO should be involved? HOW could HIAs be conducted/funded/lead? WHAT ROLE might the county
environmental health departments play? What OPPORTUNITIES do Community
Health Assessments provide?