Healthy people, healthy places : incorporating a health focus into the practice of planning

A significant number of studies have identified clear links between chronic health issues, including asthma, obesity, and diabetes, and the design of the built environment. As shapers of the built environment, urban planners can play a central role in ameliorating these current health epidemics. Indeed, during the early history of the planning profession the fields of planning and public health were closely connected, and improved public health was seen as a key mission of the planning profession. Today, however, public health issues are not a central concern in planning, neither as a normative value of the field nor as a core element of daily planning practice. Instead, health is a value-based cause taken up by concerned practicing planners, who face numerous challenges in incorporating a health focus into their daily work. This research argues that there is a need for a focus on health outcomes within the planning field, based on the initial mission of planning discipline and current research showing the impact of the built environment on public health. Through a nationwide survey of planners and interviews with planning and health professionals in five cities, findings show that collaboration between health and planning departments is key to instilling a health focus within the practice of planning. Planners who seek to promote a health focus in planning are pursuing this value-based imperative through a variety of ad-hoc strategies, since existing regulations and professional guidelines are inadequate in terms of facilitating collaboration between public health and planning in order to systematically address health issues related to land use and the built environment. Research also shows that collaboration between planning and public health departments, when this does occur, is often initiated and driven by processionals in the public health discipline. Though planners and health professionals who have sought to collaborate have faced institutional, political, and awareness challenges, there are opportunities that can be leveraged to overcome these obstacles. These opportunities include the professional expertise available in the public health field, the availability of health data in order to reframe planning issues, and the potential of individual champions of health to drive health considerations in planning projects, and promote health as a normative value. Ultimately, individual planners who see the creation of healthier communities as central to their professional practice pursue collaborative strategies with health professionals despite the challenges they face. From the perspective of collaborative planning theory and theories of institutional change, this individual engagement and initiative by planners through their everyday practice has the potential to effect institutional change by forging a focus on health as a normative value central to the planning discipline.