Linking public health to city planning

Many of Oakland’s community health problems can be traced to a history of bad city planning and land use, an expert from the Alameda County Public Health Department (ACPHD) said last Wednesday during a panel discussion at the American Institute of Architects East Bay offices in downtown Oakland.

Sandra Witt, the County’s deputy director of planning policy and health equity, referred often to a report published last year called “Life and Death from Unnatural Causes: Health and Social Inequity in Alameda County,” as she argued that historical segregation, racial steering and block-busting practices by real estate agents, as well as business disinvestment and concentrated poverty in urban centers, have created poor living conditions in largely non-white communities.

Witt said that this has resulted today in the proliferation of liquor stores, a lack of safe community spaces, and forced close proximity to hazardous industrial zones, just a few of the many direct causes of health inequity for these depressed communities.  People in these areas suffer from higher rates of obesity, diabetes, asthma, and early death.

The report found that both ethnicity and geography play a role in one’s health.  Compared to a white child in the Oakland Hills, a black child in West Oakland is seven times more likely to be born into poverty, five times more likely to be hospitalized for diabetes, and two times more likely to die of heart disease.  A black child in West Oakland, on average, has a life expectancy that is fifteen years shorter than that of a white child in the hills. “Looking at social inequities, it’s indicative of who makes decisions, and how we value certain populations over others,” Witt said.

Alameda County will try several strategies to overcome these challenges.  The “Place Matters Team,” formed in 2007 as an initiative of the Health Policy Institute, conducts research that focuses on the influence of social conditions on health.  The findings are designed to influence policy on issues including affordable housing, economic development, education, and land use.

The county’s public health department has also advocated on behalf of communities confronted with potentially health-averse developments.  Last year, county health officials were one of several agencies that testified before the California Energy Commission (CEC), lobbying against the construction of a power plant in a low-income area in Hayward.  The CEC ultimately denied the permit requested by the East Shore Energy Center to build.  Officials also recently testified at a San Leandro City Council Meeting, urging members to support an affordable housing complex as part of a new development project near the downtown BART.  A decision is expected by the end of the month.

The health department is also involved in the City-County Neighbor Initiative (CCNI), a partnership between the county, the city of Oakland, the Oakland Unified School District (OUSD), and various community groups aimed to help neighborhood residents tackle health inequities.  The CCNI worked with Sobrante Park area residents as they petitioned the Oakland City Council to fund improvements and safety measures at Tyrone Carney park, which was closed in 2002 due to violence and drug dealing in the area.  In 2007, the city allotted $30,000 for the redesign of the park, and public works installed new traffic safety improvements.

“Creating healthy communities is in the original DNA of the planning profession,” said Albert Lopez, director of planning for the county. “But good advice has been ignored for several decades.” He notes that urban sprawl in the last several years has been about “dumb growth,” about reckless planning in certain counties and communities.  “There’s a lack of pedestrian amenities and there’s a real sense of isolation in the hinterlands like Antioch and Pittsburgh, where they have less access to transportation and resources,” Lopez said.

But Lopez said he believes that change is coming.  Planning is moving toward regionalism and mandates from a higher level of government, a change from what had been largely a city and county’s prerogative. Lopez said he believes it’s probably better this way, because the greater oversight of planning for land usage, “will create better connectors between housing, jobs, and transit … it will reinforce sustainability and resiliency.”

As an example of this trend toward a more integrated and thoughtful planning system, the state is putting an emphasis on “going green.” In 2008, the California Legislature passed bill, SB375, which provides priority federal and state funding for communities whose plans include ample walking alternatives and public transportation. The goal of the legislation was not only community sustainability but decreased automobile usage, which would help to offset carbon emission levels.

But Lopez said planning does not hold all the answers to better health equity.

“The solution is not just a land use issue alone,” he said.  “It requires a conversation with various professions, and it needs political will.”

Witt agreed. “There are historical forces at play in shaping our communities,” she said.  “It’s not just a public health issue. It’s how we can better collaborate with transportation, educational sectors … it’s a collective effort.”