Clara IrazábalUniversity of Missouri- Kansas City
November 2017
Urban Planning & Public Health:Collaboration for Integral Urban Rehabilitation
OutlineIntroduction
• Context for Urgent Urban Intervention
Foci at the intersection ofurban planning & public health
• Air Quality• Accessibility/ Mobility• Open Space
Exploring collaborations between urban planning & public health
• What is Urban Planning?• Urban Planning & Public Health• Methods/ Case Studies• Environmental Justice• Medellín, Colombia¿Cómo Vamos?
Concluding Remarks• Where do we go from here?
Outline
Introduction• Context for Urgent Urban Intervention
Foci at the intersection ofurban planning & public health
• Air Quality• Accessibility/ Mobility• Open Space
Exploring collaborations between urban planning & public health
• What is Urban Planning?• Urban Planning & Public Health• Methods/ Case Studies• Environmental Justice• Medellín/ Colombia ¿Cómo Vamos?
Concluding Remarks• Where do we go from here?
Breathing to live or breathing to die?
Cities: Problem or solution?
0
10
20
30
40
50
60
70
80
90
Urban Population 1960-2016
LAC North AmericaEurope East Asia & PacificMiddle East World
1960 1970 1980 1990 2000 2010 2016
Pe
rcen
tage
Year
7.6 billionOctober 2017
3,800,000,000+urban population
People exposed to out/indoor air pollution
Santiago, Chile
7,000,000 PD + 1,000,000 PND
7M premature + 1M pre-natal deaths/year
Ciudad de Mexico, Mexico
+ 15,000,000+ 10,000,000+ 7,000,000
30 largest urban agglomerations
*
*Largest: Guangzhou, China 48,6000,000
5% GDP in developing countries
+ 5,000,000
+ 1,000,000
- 1,000,000
Pollutants Exceeded Standards
Did Not Exceed Standards
No Information or Insufficient
No Monitoring
Air quality in LAC 2006
Over 100 million people in
Latin America and the
Caribbean were exposed
Impact of outdoor air
pollution in LAC:35,000 annual premature deaths
276,000 years of life lost
Standards vary between countries if present
Air quality in LAC 2016
OutlineIntroduction
• Context for Urgent Urban Intervention
Foci at the intersection ofurban planning & public health
• Air Quality• Mobility• Open Space
Exploring collaborations between urban planning & public health
• What is Urban Planning?• Urban Planning & Public Health• Methods/ Case Studies• Environmental Justice• Medellín/ Colombia ¿Cómo Vamos?
Concluding Remarks• Where do we go from here?
Fuel
Inefficiency
Industry
Air pollution and its causes
Transportation
Urbanization
Building CO2 Emissions
1970-2000-2030
http://www.unep.org/sbci/pdfs/SBCI-BCCSummary.pdf
Pollutant Source Health Impacts
Particulate Matter Transportation and industrial sources
Cardiovascular Disease; Asthma; Cancer; Premature Death; Brain Damage
Nitrogen Oxide Transportation and industrial sources
Premature Death; Heart Disease; Lung Disease; Biological Mutations
Carbon Dioxide Transportation and industrial sources
Global Warming
Carbon Monoxide Transportation and industrial sources
Premature Death; Prenatal Damage/Death
Hydrocarbons Transportation and industrial sources
Cardiovasculal Damage; Brain Damage; Premature Death
Sulfur Dioxide Transportation and industrial sources
Acid Rain; Respiratory Disease; Premature Death
Lead Industrial metal processing Damage to Kidneys, Liver, Nervous System, Brain; Mental Retardation
Air pollutants, sources & health impacts
Global deathsair pollutants, chemical exposure & natural disasters
Indoor air pollutants (2012) 4+ million
7.8 of annual deaths%
Outdoor air pollutants (2012) 3+ million / 6.7% ad
Chemicals 1.3 million / 2.6% ad
(single chemicals, occupational
exposures, and poisoning) (2004)
Contaminated drinking 1.7 million
water and poor sanitation/ 3.4% of annual deaths
diarrhea (2002)
Natural disasters 107,000
(global annual avg. 2002-2011) 0.2% ad
Technological disasters 8,735
(global annual avg. 2002-2012) 0.02% ad
Global deathsair pollutants, chemical exposure & natural disasters
Place exposures
Air quality Major roads with multiple lanes; smokestack industry;
wood, dung, or similar fuel sources
Disasters & Low elevation zones; flood plains; hazardous industries
climate change (nuclear power plants etc.); areas with substantial paved areas and
little vegetation; areas where people are close to locations with
disease vectors like mosquitoes; coastal areas
Noise Major roads; high speed roads; airports; entertainment districts
Toxics Problematic past, current, or proposed uses such as nuclear
facilities, heavy manufacturing, and busy traffic corridors; areas with
older housing with likely contaminants (chemicals, mold)
Water quality Un-sewered areas; areas without clean drinking water
Health concerns & place exposures
Global CO2 emissionscompared internationally
90%
Planning for accessibility & mobility
• over 90% of air pollution in
the cities of developing
countries is attributed to
vehicle emissions
• high number of older
vehicles, poor vehicle
maintenance, inadequate
infrastructure and low fuel
quality
• reduce dependency on
motorized, fossil-fueled
vehicles
Cartagena had it right the first time!
Planning for accessibility & mobility
Mobility planning
Accessibility planning
Urban parks
Recreational
facilities (other than parks)
All parks, including pocket
parks for different people and
uses
Playgrounds, beaches,
pools, community gardens and
centers, picnic areas, sports
fields, exercise equipment, etc.
• Protection from heat
• Psychological well-being
• Socializing
• Relaxation and
psychological well-being
• Physical activity
• Socializing
Green space type Health outcomes
Types of green space & health outcomes
Off-road trails,
paths, and
greenways
Landscaping &
gardens near
buildings
Tree canopies
• Access to community
resources
• Safety from traffic
• Storm water infiltration
• Protection from heat
• Buffer from traffic &noise
• Psych wellbeing through
personalization
• Climate change mitigation
(carbon dioxide removal)
• Protection from heat (urban
cooling)
• Buffers from traffic & noise
Linear parks that connect
people & places
Fauna migratory corridors
Especially for schools,
retirement homes, &
hospitals, etc.
Street trees, trees on
public & private property
Types of green space & health outcomes
Green space type Health outcomes
OutlineIntroduction
• Context for Urgent Urban Intervention
Foci at the intersection ofurban planning & public health
• Air Quality• Mobility• Open Space
Exploring collaborations between urban planning & public health
• What is Urban Planning?• Urban Planning & Public Health• Methods• Environmental Justice• Medellín, Colombia
Concluding Remarks• Where do we go from here?
a multidisciplinary field in which professionals work
to improve the welfare of persons and communities
by creating more convenient, equitable, healthful, efficient, and attractive places
now and for the future
-American Planning Association
What is urban planning?
What is urban planning?
“no city is more healthy than the
highest death rate in any ward or block
and […] no city is more beautiful
than its most unsightly tenement”
- Benjamin Clarke Marsh, 1909: 27Social worker pioneer of planning in the US (1878-1952)
Urban planning & public health:Intertwined histories
• In 1854, British physician John
Snow used geographic
mapping of an outbreak of
cholera in London to identify a
public water pump as the
outbreak's source
• Geographic analysis is a key
planning tool shared by urban
planning and public health
Urban planning &public health:Intertwined histories
In the mid-1800s, planners such as Frederick
Law Olmsted bridged the gaps by:
• advancing the concept that community design
contributes to physical and mental health
• serving as Pres. Lincoln's U.S. Sanitary
Commission Secretary
• designing hundreds of places, e.g., NY's
Central Park
• By 1872, the disciplines
were very aligned
• two of the seven founders of
the American Public
Health Association were
urban designers, architects
and housing specialists
Urban planning & public health:Intertwined histories
• In 1926, the U.S. Supreme
Court, in validating zoning and
land-use law as a legal
government authority cited the
protection of public health as
part of its justification
• Village of Euclid v. Ambler
Realty, the first significant
case regarding the relatively
new practice of zoning
Urban planning & public health:Intertwined histories
• During the 1960s, pioneering
urbanist Jane Jacobs
• called for community design that
offered safe and convenient options
for walking, biking, and impromptu
social interaction
Urban planning & public health:Intertwined histories
• During the 1980s the WHO Healthy
Cities project movement began in
Europe and the US
• it engages local governments in
health development through a
process of political commitment,
institutional change, capacity-
building, partnership-based
planning and innovative projects to
address inequality in health and
urban poverty.
• includes projects in A.1,000 cities
that highlight the role of health as
more than the presence of medical
care
Urban planning & public health:Intertwined histories
Creation of green space to promote
physical activity, social integration,
and mental health
Prevention of infectious diseases
through community infrastructure,
such as drinking water and sewage
systems
Protection of persons from
hazardous industrial
exposures and injury risks
through land-use and zoning
ordinances.
Urban planning & public health:19th and 20th centuries
• Transportation planning to improve air quality, encourage
physical activity, prevent injuries, and promote wellness.
• Some original crossover ideas, such as the potential for
parks and recreational facilities to contribute to physical
activity and mental health, have reemerged.
Urban planning & public health:20th and 21st centuries
• Climate change (community design, energy use and
greenhouse gas emissions)
• Emergency preparedness (community infrastructure,
evacuation planning)
• Access to health care (accessibility and adequacy of facilities)
Urban planning & public health:20th and 21st centuries
Benefits of long-term collaboration
Public health professionals
engaging in the urban planning
arena, incorporating health into
urban planning decision-making
Urban planners engaging in the
public health arena, incorporating
planning/design into public health
decision-making
Cities synthesizingurban planning and public health, 2010
• 13 U.S. cities winners of the 2016 National Disaster Resilience Competition by:– the U.S. Dep. of Housing and Urban Development (HUD)
– the Rockefeller Foundation
• 4 cities received $400 million-plus for resilience projects
Cities synthesizingurban planning and public health, 2016
NYC’s Lower Manhattan Protectand Connect Project ($176 million)
• a community-focused resilience plan for a coastal protection
system
• also use the money to protect public housing projects vulnerable
to storm surge and flooding
Cities synthesizingurban planning and public health, 2016
The Gentilly Neighborhood: New Orleans ($141M)
• “resilience district”
• coastal restoration, workforce
development and parks
• Gentilly will become a national
model of a resilient community in
terms of everything from safety to
economic opportunity
Cities synthesizingurban planning and public health, 2016
Methods: APA
845 encuestas, 2010
Integrating public health into planning
Methods: Interdisciplinary collaboration• professionals drawing on tools and processes developed by the other field:
– geographic information systems
– health impact assessments, such as the Protocol for Assessing Community Excellence in Environmental Health (PACE-EC)
• National Association of County and City Health Officials (NACCHO)
• Centers for Disease Control and Prevention (CDC)
The indicators are organized under their respective
Community Health Objective within 8 elements:
San Francisco Indicator Project
1) Environment
2) Transportation
3) Community
4) Public Realm
5) Education
6) Housing
7) Economy
8) Health Systems
Create a resource-efficient, equitable transportation system• Motor vehicle access
• Trips by non-auto mode
• Time spent walking or biking
• Transit subsidy utilization
• Public transit score
• Bike shares
Ensure the safety of the transportation system• Severe/fatal traffic injuries
• Pedestrian environmental quality index
• Bike lanes and paths
• Speed limit compliance
• Curb ramps
Reduce adverse environmental health impacts of the
transportation system• Distance traveled in automobiles
• Traffic density
• Truck routes
SF Indicator Project: Transportation
Indicator: Transportation accessibility
Indicator: Serious and fatal accidents
Indicator: Pedestrian environmental quality
SF Indicator Project: Housing
Preserve and construct housing in proportion to
demand with regards to size, affordability, and tenure• Housing production and affordability
• Excessive rent burden
• Housing purchasing capacity
• Home ownership
• Overcrowding
• Housing wage & minimum wage
• Residential density
Protect residents from involuntary displacement• Market rate rent affordability
• No-fault evictions
• Affordable rental housing stock
Decrease concentrated poverty• Ethnic diversity
• Low-income households
Assure access to healthy quality housing• Housing health & safety violations
Indicator: Housing safety and habitability
Indicator: Violation rate housing and habitability
Environmental justice
Planning for environmental justice
Huachipa
Peru
Particular groups
disproportionately affected by
the location of polluting
sources
Poor and etnoracial minorities
Disproportionate Environmental Impacts on Minorities: Top Ten Metropolitan Areas
0
10
20
30
40
50
60
70
80
Birm
ingh
am, A
L M
SA
Bat
on R
ouge
, LA M
SA
Mem
phis, T
N-A
R-M
A MSA
Chica
go, I
L PM
SA
Har
risbu
rg-L
eban
on-C
arlis
le, P
A MSA
Louisv
ille,
KY-
IN M
sa
Gar
y, IN
PM
SA
San
Diego
, CA M
SA
Milw
auke
e-W
auke
sha,
WI P
MSA
Taco
ma,
Wa
PM
SA
Metropolitan
Perc
en
tage
Minority Share of thePopulation
Minority Share ofToxic Score
Planning for environmental justice
0
5
10
15
20
25
30
35
Birmingh
am, A
L M
SA
Baton
Rou
ge, L
A MSA
Mem
phis, T
N-A
R-M
A MSA
Chica
go, I
L PM
SA
Har
risbu
rg-L
eban
on-C
arlis
le, P
A MSA
Louisv
ille, K
Y-IN
Msa
Gar
y, IN
PM
SA
San
Die
go, C
A MSA
Milw
auke
e-W
auke
sha,
WI P
MSA
Taco
ma,
Wa
PMSA
Pe
rce
nta
ge
Metropolitan Area
Low-Income Discrepancy to Minority Discrepancy:
Top Ten Metropolitan Areas
Low-Income Discrepancy
Minority Discrepancy
Planning for Environmental Justice
Vulnerable populations and place-related health issues
Place-related health issues
Air quality
Climate/ Heat-illnesses
Disasters
Housing
Noise
Toxics
Water quality
Access to community resources
Social capital
Mobility/ Universal design
Access to healthy food
Physical activity
Safety
Planning for Environmental Justice
Vulnerable populations
Low-Income
Ethnic/racial minoritized
Children
Older adults
Chronically iII
Disabled
Women
City dwellers
Rural populations
Heavy labor employees
Those socially isolated
Redistribution
, reconception
of
industry
Urban farming,
green roofs,
River bank
restoration
Community
planning and
ownership
Environmental justice: Trends
Training for
Green jobs
River
naturalization
Open space planning: Trends
Reuse of
outmoded
infrastructure
Temporary reuse
of roads
Landfill
remediation
Green roofs
Urban agriculture
Colombia/Medellín: ¿Cómo vamos?
• Social Urbanism
• Metropolitan greenbelt
• Metrocable
• Kindergardens
• Health facilities
Colombia/Medellín: ¿Cómo vamos?
Mobility Planning
Community gardens
Belen outdoor GymsJoaquín Antonio Uribe Botanical Gardens
Rio Cali Park
Colombia/Medellín: ¿Cómo vamos?
OutlineIntroduction
• Context for Urgent Urban Intervention
Foci at the intersection ofurban planning & public health
• Air Quality• Accessibility/ Mobility• Open Space
Exploring collaborations between urban planning & public health
• What is Urban Planning?• Urban Planning & Public Health• Methods/ Case Studies• Environmental Justice• Medellín/ Colombia ¿Cómo Vamos?
Concluding Remarks• Where do we go from here?
Reckoning: Where are we?
It's already too late
cap and trade is a scam,
only the few will survive…?
• solar thermal and wind power as
substitutes for burning fossil fuels
• emergency global geo-engineering
projects might cool the planet
• no voluntary act can slow climate
change
• democracy may need to be abandoned?
• few safe havens from the drought that
will overtake most of the Earth—the far
north and south
Puerto Rico
September 26, 2017
• Resilience
• Redundancy
• Emergency preparedness,
response, reconstruction
systems
Reckoning: Where are we?
Economic crises and climate change are opportunities to improve!
We must invest in:
• education
• planning & public health
• green jobs
• environmental research
• evaluating and monitoring
• daring projects
Where do we go from here?
Sustainable development?
Just & sustainable development
Just & sustainable development
Breathing to live, not breathing to die!