Role of Environmental Health Professionals in Improving the Built Environment
Ponder, Paris, Dannenberg, Andrew L., Journal of Environmental Health
Environmental health professionals (EHPs) have always played a critical role in protecting the public's health by preventing outbreaks, responding to environmental emergencies, and enforcing public health standards. Traditionally, this role has not focused on improving the built environment, which is the physical environment where people live, work, and play. The design of the built environment, however, affects physical activity and obesity, air pollution and respiratory diseases, injuries, mental health, social capital, and environmental justice (Frumkin, Frank, & Jackson, 2004). Therefore, EHPs can increase their impact on public health if they expand their role to address the built environment.
This issue of the Journal of Environmental Health presents four case studies (Roof & Glandon, 2008; Roof & Maclennan, 2008; Roof & Oleru, 2008; Roof & Sutherland, 2008) in which EHPs collaborated with internal and external partners to improve the built environment. EHPs and their colleagues successfully became involved in the land use planning process and implemented policy and community changes through strong leadership and teamwork. Each case study describes the significance of building a multidisciplinary team as a first step to becoming engaged in planning discussions. These partnerships include environmental health department staff, such as directors, health analysts, health educators, and program managers; urban planners; developers and builders; elected and appointed officials; planning commissions; planning agencies and consultants; university faculty; business owners; homeowners associations; realtor associations; park managers; and non-profit organizations, such as nature and water conservancy groups. In addition, having bankers and others who make financial decisions present at the discussion table would likely benefit the group. One study said that "the creation of the multidisciplinary team early on in the process was key to their past and to their future success (Roof & Oleru, 2008)."
All four reports acknowledged formal and informal communications as significant factors that led to EHPs' enhanced involvement in land use planning. Several reports mentioned that the formation of partnerships increased the likelihood of planners and developers considering the health implications of their plans and, consequently, seeking the input of environmental health professionals. For example, the Puget Sound Regional Council asked the Seattle and King County Health Department to write a health issue paper about the relationship among health and growth management, economic development, and transportation; as a result, public health language was added to the county's Vision 2020 plan (Roof & Oleru, 2008).
Another important theme in the case studies was educating planners, developers, and city officials about the links between community design and health. For example, Tri-County Health Department in Colorado educated planners about designing active community environments (Roof & Maclennan, 2008). Once planners and developers are receptive to receiving input from local health officials, they are more likely to consider incorporating public health principles into land use plans. Several health departments presented at planners' meetings, which led to EHPs attending the meetings regularly and making joint presentations to policy makers. As a result, developers are beginning to recognize the benefits of and incentives for incorporating healthy design choices. In Ingham County, Michigan, some developers are adding more green space, trails, and sidewalks to increase physical activity in exchange for higher densities (Roof & Glandon, 2008).
The expanded role of EHPs during the planning review process was valuable in all four case studies. For example, Seattle and King County's environmental health division was instrumental in establishing and adopting a county-wide resolution that focused on obesity prevention through physical activity and nutrition policies as well as improved community design for pedestrians and bicyclists (Roof & Oleru, 2008). …