Embedding Health in Affordable Housing Development: Results of the Health Action Plan Pilot Project

By De Scisciolo, Stephany; Egger, Krista et al. | Cityscape, May 1, 2018 | Go to article overview

Embedding Health in Affordable Housing Development: Results of the Health Action Plan Pilot Project


De Scisciolo, Stephany, Egger, Krista, Ayala, Mary, Cityscape


Background

Place matters. This simple statement reflects our growing understanding of how the social and physical environment in which people live can influence both individual and population health outcomes. Housing is one of the most important places we inhabit and has the potential to significantly impact resident health in numerous ways-from site selection to the building materials used to operations and maintenance procedures.

Architects, planners, and developers play roles in ensuring that the built environment is health promoting. Factors such as walkability, access to services, healthy food, transportation, and safety all translate to better health (Berke and Vernez-Moudon, 2014). Similarly, quality design and construction, coupled with regular building maintenance, can help to prevent illness and contribute to improved physical and mental wellbeing (Robert Wood Johnson Foundation, 2011).

Enterprise Green Communities Criteria

Enterprise Community Partners (hereafter, Enterprise) launched its Green Communities Initiative in 2004. The central element of the initiative is the Green Communities Criteria (hereafter, the Criteria), which is the nation's leading green building standard for affordable housing. The Criteria have been used to certify properties in 43 states, ensuring healthy design and building practices across the affordable housing field. Protecting human health by reducing greenhouse gas emissions and by promoting proven healthy housing design and operations practices has been an imperative of the Criteria since its inception. During its most recent update, Enterprise sought to amplify this emphasis on health, and the current version of the Criteria includes best practices in active design, healthrelated criteria inspired by the Health Impact Assessment (HIA) process and new standards for indoor air quality. More specifically, the 2015 update includes two process-based criteria that interweave the integrative design process from the green building sector with the HIA process from the public health sector. By so doing, the Criteria provide affordable housing developers an actionable path to considering and prioritizing resident health-promoting outcomes through design. One of these criteria is mandatory for all projects pursuing Enterprise Green Communities certification (Criterion 1.2a, Resident Health and Well-Being: Design for Health) and one is optional (Criterion 1.2b, Resident Health and Well-Being: Health Action Plans; Enterprise, 2015). Although both these criteria ask developers to consider resident health in their project designs, Criterion 1.2b requires a more rigorous association with a public health professional and community stakeholders, as well as more robust followup action. These criteria were developed through a partnership involving Enterprise, the Health Impact Project (a collaboration between the Robert Wood Johnson Foundation and The Pew Charitable Trusts), and the U.S. Green Building Council-all organizations poised to promote the comprehensive and systematic consideration of health in housing through green building certification programs.

The Health Action Plan Process

Although many affordable housing developers include health-promoting design features in their buildings, these design decisions are often made without regard to the specific health needs of a building's current or future residents. Development of a Health Action Plan (through Criterion 1.2b) calls for housing developers to collaborate with public health professionals to assess, identify, implement, and monitor achievable actions to enhance the health-promoting features of their project and to minimize features that could present health risks. The Health Action Plan framework identifies five Resident Health Campaigns that encompass many of the health issues that disproportionately affect low-income communities-injury and accessibility, asthma and respiratory health, cardiovascular diseases, Type 2 diabetes and obesity, cancer and health outcomes related to toxin exposure, and mental health. …

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