Carrie "Shellie" Cobbs
Public and Community Health
HCS 457
Dee Martinez, RN, MSN
April 20, 2014
Positive Public Health
Doctors advise their patients to be healthy and work towards wellness. This advice affects more than the patient and their immediate actions to make corrections to their own wellbeing. Making changes to yourself can inspire other family members, friends, and co-workers to get up and start making changes for themselves. In theory the Health Impact Assessment (HIA) has the same effect on communities and how they make changes to the communal areas shared by the citizens. The Health Impact Assessment is a “process that helps evaluate the potential health effects of a plan, project or policy before it is built or implemented” ("HIA," 2014, p. 1). The advice given to a community helps them make informed choices about designing their community and how these choices will help improve public health.
Describe the demographics of the area the issue affects
The broad spectrum of HIA is on a national level but on a more specific level the HIA focuses on individual communities and projects to improve the public communal areas. The U.S. Department of Health and Human Services …show more content…
Healthy People 2010 report describes a healthy community as “one that continuously creates and improves both its physical and social environments, helping people to support one another in aspects of daily life and to develop to their fullest potential” ("Healthy Places," 2014, p. 1). Healthy community places are designed and built to improve the quality of life for all the community members and allows the individual the ability to make better choices to be healthy.
Explain the effect of the issue, such as volume and prevalence over time, and before and after the intervention
As America has grown and people have immigrated to this country the major metropolitan areas experienced rapid growth. This growth was especially fast during the industrialization era between 1876-1900. The rapid population growth during this time led to overcrowding and poor housing conditions. Poor sanitation resulted in higher rates of infectious disease. As public health, planning officials, and the overall communities started working together improvement to the water and sewer systems, trash collection, and the overcrowding of housing a decrease in infectious disease was evident. As sanitation efforts progressed and improved in U.S. cities public health officials and planning professionals stopped working together. Currently in America today we have an epidemic of obesity and related chronic disease and the public health and planning professional sectors are uniting once again and the Health Impact Assessment is one tool that is rejuvenating the partnership again.
Discuss the significance or effect on the community.
Healthy environments are essential to the wellbeing of the community inhabitants. The environment is the air we breathe, water that we drink and use, land, structures, natural and man-made conditions that affect the quality of our lives. Healthy community environments deal with aspects of human health, disease, and injury affected by our surroundings. Understanding how health and the environment interact allows us to incorporate physical surroundings, land use, transportation, industry, and farming.
Discuss possible causes, and contributing behavioral and environmental factors.
Rapid population growth is a cause that affects healthy environments. Poorly planned development of communities and transportation is another problem. The life expectancy of Americans has increased by 40 years since the end of the industrial era. When the public health and planning professionals created solutions for the infectious disease in our country environmental conditions improved allowing people to live longer lives.
Incorporate the PERI model you created to support the epidemiological model and evidence-based care.
Problem
Poor health
Etiology (Cause)
Lack of education, medical care, medical insurance, and resources.
Recommendations
Creating associations between public health and community planning departments to reinvest in local communities.
Implementation
Community revitalization to create more walking areas, open space, parks, gardens, and increase local businesses.
Does this disease expand to a global setting?
The problem of poor health environments is a global issue still evident in every country on Earth. Third world countries are greatly affected by poor public health and lack of planning of community areas. Even in our own country major metropolitan cities are in ruin because of the lack of proper community planning for growth and for the loss of jobs. Detroit is a perfect example of how the automotive industry created a mecca for population growth because of the jobs created but also how a city can go to ruins by the decrease or removal of the jobs.
Government role and level of effect: national, state, and local
The government structure involves all levels of government.
The Centers for Disease Control (CDC) is involved with sponsored programs like Active Community Environments Initiative (ACES) that promotes walking, biking and development of accessible recreation areas. Also the Division of Nutrition and Physical Activity (DNPA) promotes and provides information on different types of physical activity and nutrition. The National Center for Environmental Health (NCEH) “works to prevent illness, disability, and death from interactions between people and the environment” ("Government," 2014). Air pollution, heat exposure, housing, pest management, lead poisoning, and environmental health are all areas that the National Center for Environmental Health
covers.
The Health Impact Project is a collaboration of the Robert Wood Johnson Foundation and the Pew Charitable Trusts is a national initiative to promote the use of Health Impact Assessments as a decision making tools for policymakers and the state involvement hits home right here in Colorado. The Colorado Statewide Regulatory Structure for Retail Marijuana-Rapid HIA is a collaboration of the Colorado School of Public Health and Colorado’s Children’s Hospital that “focused on the health impacts to children through unintended ingestion of marijuana and how child-resistant packing could potentially mitigate these impacts” ("Colorado HIA," 2009-2011, p. 1). The HIA grouped stakeholders together from labeling, packaging, safety, and marketing groups. A consensus was reached that marijuana products be sold in child-resistant packaging.
Local governments are able to request Health Impact Assessments in order to apply for grants to help cover the costs associated with renovating communities that have fallen on hard economic times. The CDC outlines different projects funded by grants throughout the country.
Baltimore, Maryland
Baltimore, Maryland’s mayor asked the Baltimore City Health Department to conduct a Health Impact Assessment to look at the functionality of the Lexington Market area. The Lexington Market is the world’s largest continuously operating market since 1782. Surrounded by historic neighborhoods that have fallen into disrepair the City of Baltimore and the University of Maryland want to revitalize the neighborhood. The Health Impact Assessment collects community feedback, holds workshops, interviewed people who work and live in the area. The biggest concerns in the collected data were economic issues, safety, and the ability to access business and social events within walking distance. Reducing violent crime and increasing job opportunities were also main concerns. These factors all have the ability to increase the risk of poor health. A plan was developed to involve the City of Baltimore and the surrounding neighborhoods and business to reinvest into the local economy and rebuild the area.
Boston, Massachusetts
The Codman Square Neighborhood had a series of vacant lots on Ballou Avenue. Located in a low-income area there is a higher population of people likely to experience health issues, including young people and people of color. The Codman Square Neighborhood Development Corporation (CSNDC) conducted a Health Impact Assessment with a local non-profit and secured a grant from the CDC to repurpose the vacant lots in to a “tot lot” playground, gardens for public use, and a public kitchen where residents can use the food grown in the gardens to practice and share their cooking skills.
Davidson, North Carolina
The Davidson Design for Life (DD4L) is a local government initiative to promote better public health. The Mecklenburg County Health Department and the North Carolina Department of Health are both involved in the Davidson Design for Life project. In 2011 Davidson, North Carolina was the only small town, 12,000 or less residents, that has been awarded a grant from the CDC to start a Health Impact Assessment. Davidson, North Carolina is looking to see how the construction of sidewalks, bike lanes, better street signs and road construction can help make the residents healthier. The town of Davidson created the Pedestrian and Active Transportation Plan, The Ped Plan, to pinpoint ways of improving health across all ages in the community and to increase mobility and physical activities.
Omaha, Nebraska
Omaha, Nebraska, birthplace of Malcom X, was once a thriving African American neighborhood. Known for jazz, swing, and blues music Omaha, Nebraska has fallen on hard economic times. Their Health Impact Assessment focused on restoring and improving Adams Park to attract residents and visitors as well as local business. The plan also included a community garden, new trails, multipurpose sports field, and swimming pool. The data collected in Omaha showed that the big grocery chains were few and far between and that Omaha has higher levels of heart disease and diabetes, two diseases that can be impacted by the access to healthy food and physical activity.
San Francisco, California
The San Francisco Department of Public Health (SFDPH) was asked by the San Francisco Planning Department to conduct a Health Impact Assessment to extend the city’s Municipal Railway known as Muni to add 1.6 miles of new track into the Subway system to reach the South of Market (SOMA) District. The CDC gave a grant for this project. The information form the communities is concern for lack of green spaces, pedestrian and biker safety. By focusing on one specific area the ability to focus on community concerns and issues is greater. Collaborations on housing, transportation, and land-use will be focused onto help increase health in this neighborhood.
Describe the health objectives at each level.
The health objectives overall the scenarios of Health Impact Assessments is how to improve the public health. A focus is found on obesity and childhood obesity and how to increase activity for all citizens.
Intervention and treatment
Community involvement and participation to grow and develop new and established areas for interaction.
Discuss the effect or effectiveness of the intervention
The effect of HIA are enormous and meaningful for the communities that are involved. Creating new and improved areas for people to gather and interact helps strengthen the community.
Discuss the opportunity for change and continued improvement
The opportunities for change and improvement are limitless. As long as public health and community planners continue to work together and involve the neighborhoods to be worked in the improvement can become infectious.
Identify the social and behavioral effect of this issue: Discuss the strategies for successful effects on these variables.
Identify resources in the community and their support or effect on the issue and the interventions.
Identify gaps in the community plan, actions, and resources, and recommend strategies to address the gaps.
From your research, what changes do you anticipate over the next 5 years related to this issue in your community?
References
About Healthy Places. (2014). Retrieved from http://www.cdc.gov/healthyplaces/about.htm
Additional Resources. (2014). Retrieved from http://www.cdc.gov/healthyplaces/resources.htm
Colorado Statewide Regulatory Structure for Retail Marijuana-Rapid HIA. (2009-2011). Retrieved from http://www.healthimpactproject.org/hia/us/colorado-statewide-regulatory-structure-for-retail-marijuana-rapid-hia
Health Impact Assessment. (2014). Retrieved from http://www.cdc.gov/healthyplaces/hia.htm