Northwest Center for Livable Communities Archives - Page 2 of 3

Use of Health Impact Assessments in the Housing Sector to Promote Health in the United States, 2002-2016

Bever, Emily; Arnold, Kimberly T.; Lindberg, Ruth; Dannenberg, Andrew L.; Morley, Rebecca; Breysse, Jill; Pollack Porter, Keshia M. (2021). Use of Health Impact Assessments in the Housing Sector to Promote Health in the United States, 2002-2016. Journal Of Housing And The Built Environment, 36(3), 1277 – 1297.

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Abstract

Housing affects health, yet health is seldom considered in housing decisions. Health impact assessment (HIA) is a tool that can improve housing-related policies, plans, programs, and projects by bringing together scientific data, health expertise, and stakeholder engagement to identify the potential health effects of proposed decisions. We systematically identified and reviewed HIAs of housing decisions in the United States, yielding 54 HIAs between 2002 and 2016. Two examined federal proposals; the others explored decisions in 20 states. A variety of organizations led the HIAs, including non-profits, public health departments, and academic institutions. The primary decision-makers each HIA sought to inform were housing, planning, and/or elected officials. Eighteen HIAs focused on housing policies, codes, design elements, and utilities in residential structures. The remaining 36 HIAs included housing as one element of broader community development and transportation planning decisions. HIA recommendations changed decisions in some cases, and the assessment process helped strengthen connections between public health and housing decision-makers. To illustrate key characteristics of housing HIAs, we purposefully selected three HIAs and described the decisions they informed in detail: off-campus student housing in Flagstaff, Arizona; a rental housing inspections program in Portland, Oregon; and revitalization plans for a major thoroughfare in a suburb of St. Louis, Missouri. With a few exceptions, federal, state, and local agencies in the U.S. are not required to consider the health impacts of housing decisions, such as where housing is sited, how it is designed and constructed, and policies for ensuring that it is affordable and safe. HIA has emerged as a tool for advocates, health and housing practitioners, and policymakers to fill this gap. However, few studies have examined whether HIAs do in fact change housing decisions, shift the way that decision-makers think, or ultimately shift determinants of health (e.g., housing affordability and quality). This review demonstrates that HIAs can facilitate the consideration of health during housing decision-making. Housing HIAs can also help decision-makers address commonly overlooked effects, such as changes to social cohesion, and improve civic participation by engaging communities in the decisionmaking process.

Keywords

0; Community Development; Decision-making; Healthy Housing; Health Impact Assessment; Housing Policy; Stakeholder Engagement; Health Promotion; Public Health; Exceptions; Impact Analysis; Nonprofit Organizations; Affordability; Suburban Areas; Profits; Housing; Policy Making; Transportation Planning; Decision Making; Rental Housing; Public Officials; Policies; Regeneration; Utilities; Social Cohesion; Inspections; Community Involvement; Decision Makers; Community Participation; United States--us

Does the Built Environment Have Independent Obesogenic Power? Urban Form and Trajectories of Weight Gain

Buszkiewicz, James H.; Bobb, Jennifer F.; Hurvitz, Philip M.; Arterburn, David; Moudon, Anne Vernez; Cook, Andrea; Mooney, Stephen J.; Cruz, Maricela; Gupta, Shilpi; Lozano, Paula; Rosenberg, Dori E.; Theis, Mary Kay; Anau, Jane; Drewnowski, Adam. (2021). Does the Built Environment Have Independent Obesogenic Power? Urban Form and Trajectories of Weight Gain. International Journal Of Obesity, 45(9), 1914 – 1924.

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Abstract

Objective To determine whether selected features of the built environment can predict weight gain in a large longitudinal cohort of adults. Methods Weight trajectories over a 5-year period were obtained from electronic health records for 115,260 insured patients aged 18-64 years in the Kaiser Permanente Washington health care system. Home addresses were geocoded using ArcGIS. Built environment variables were population, residential unit, and road intersection densities captured using Euclidean-based SmartMaps at 800-m buffers. Counts of area supermarkets and fast food restaurants were obtained using network-based SmartMaps at 1600, and 5000-m buffers. Property values were a measure of socioeconomic status. Linear mixed effects models tested whether built environment variables at baseline were associated with long-term weight gain, adjusting for sex, age, race/ethnicity, Medicaid insurance, body weight, and residential property values. Results Built environment variables at baseline were associated with differences in baseline obesity prevalence and body mass index but had limited impact on weight trajectories. Mean weight gain for the full cohort was 0.06 kg at 1 year (95% CI: 0.03, 0.10); 0.64 kg at 3 years (95% CI: 0.59, 0.68), and 0.95 kg at 5 years (95% CI: 0.90, 1.00). In adjusted regression models, the top tertile of density metrics and frequency counts were associated with lower weight gain at 5-years follow-up compared to the bottom tertiles, though the mean differences in weight change for each follow-up year (1, 3, and 5) did not exceed 0.5 kg. Conclusions Built environment variables that were associated with higher obesity prevalence at baseline had limited independent obesogenic power with respect to weight gain over time. Residential unit density had the strongest negative association with weight gain. Future work on the influence of built environment variables on health should also examine social context, including residential segregation and residential mobility.

Keywords

Body-mass Index; Physical-activity; Food Environment; Structural Racism; Obesity; Neighborhoods; Associations; Health; Walkability; Exposure; Environment Models; Minority & Ethnic Groups; Urban Environments; Regression Analysis; Regression Models; Residential Density; Body Mass Index; Property Values; Body Weight Gain; Government Programs; Body Weight; Electronic Medical Records; Electronic Health Records; Fast Food; Buffers; Real Estate; Body Mass; Body Size; Socioeconomics; Health Care

Differential Associations of the Built Environment on Weight Gain by Sex and Race/Ethnicity but Not Age

Buszkiewicz, James H.; Bobb, Jennifer F.; Kapos, Flavia; Hurvitz, Philip M.; Arterburn, David; Moudon, Anne Vernez; Cook, Andrea; Mooney, Stephen J.; Cruz, Maricela; Gupta, Shilpi; Lozano, Paula; Rosenberg, Dori E.; Theis, Mary Kay; Anau, Jane; Drewnowski, Adam. (2021). Differential Associations of the Built Environment on Weight Gain by Sex and Race/Ethnicity but Not Age. International Journal Of Obesity, 45(12), 2648 – 2656.

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Abstract

Objective To explore the built environment (BE) and weight change relationship by age, sex, and racial/ethnic subgroups in adults. Methods Weight trajectories were estimated using electronic health records for 115,260 insured Kaiser Permanente Washington members age 18-64 years. Member home addresses were geocoded using ArcGIS. Population, residential, and road intersection densities and counts of area supermarkets and fast food restaurants were measured with SmartMaps (800 and 5000-meter buffers) and categorized into tertiles. Linear mixed-effect models tested whether associations between BE features and weight gain at 1, 3, and 5 years differed by age, sex, and race/ethnicity, adjusting for demographics, baseline weight, and residential property values. Results Denser urban form and greater availability of supermarkets and fast food restaurants were associated with differential weight change across sex and race/ethnicity. At 5 years, the mean difference in weight change comparing the 3rd versus 1st tertile of residential density was significantly different between males (-0.49 kg, 95% CI: -0.68, -0.30) and females (-0.17 kg, 95% CI: -0.33, -0.01) (P-value for interaction = 0.011). Across race/ethnicity, the mean difference in weight change at 5 years for residential density was significantly different among non-Hispanic (NH) Whites (-0.47 kg, 95% CI: -0.61, -0.32), NH Blacks (-0.86 kg, 95% CI: -1.37, -0.36), Hispanics (0.10 kg, 95% CI: -0.46, 0.65), and NH Asians (0.44 kg, 95% CI: 0.10, 0.78) (P-value for interaction <0.001). These findings were consistent for other BE measures. Conclusion The relationship between the built environment and weight change differs across demographic groups. Careful consideration of demographic differences in associations of BE and weight trajectories is warranted for investigating etiological mechanisms and guiding intervention development.

Keywords

Body-mass Index; Socioeconomic-status; Food Environment; Obesity; Health; Outcomes; Scale; Risk; Minority & Ethnic Groups; Urban Environments; Etiology; Demographics; Sex; Residential Density; Supermarkets; Age; Race; Ethnicity; Property Values; Body Weight Gain; Electronic Medical Records; Fast Food; Electronic Health Records; Real Estate; Subgroups; Demography; Trajectory Analysis; Weight

Northwest Center for Livable Communities

The Northwest Center’s mission is to enhance the livability of communities in the Pacific Northwest through applied research and outreach in the areas of land use planning, policy, and design; healthy communities; food security; and public participation and democracy.

The Center is a research and policy center focused on issues of environmental and economic sustainability, quality of life, and responsible governance using Washington as a model. Recognizing that the term “livability” has many different definitions and interpretations, the Center’s programs are focused on how the fields of urban planning and design, landscape architecture, and architecture work within this broader context to address livability factors.

The Center operates from the belief that the university should, in cooperation with state agencies, local governments, and community leaders, seek to improve existing social and environmental conditions through research and innovative policy development. It advocates development strategies that focus on smart and efficient land use, strong communities, high-wage, low waste jobs and economic development and public participation and accountability in government.

David Blum

Edward David Blum has spent more than 40 years as a planner in both the public and private sectors. In the public sector, he has worked for state and county governments, Native American tribes and non-profit organizations. His work experience in the private sector includes managing the development of various commercial, residential, industrial, retail and marina projects throughout the United States. Mr. Blum has taught classroom and studio courses in New Jersey, Oregon and Washington with a focus on land use planning, affordable housing, economic development and sustainable urban mobility.

Urban@UW helps BE labs collaborate

The Urban@UW initiative brings together labs that study urban issues from across the University of Washington. Urban@UW works with scholars, policymakers, and community stakeholders in order to strengthen the connection between research and solutions to urban issues through cross-disciplinary and cross-sector collaborative research. Key functions of Urban@UW include amplifying public awareness of ongoing projects, connecting researchers with outside constituencies, providing staff and administrative support services, and providing pilot funding and fundraising assistance. Multiple BE labs are involved, including the Northwest…

Anne Vernez-Moudon

Anne Vernez Moudon is Professor Emerita of Architecture, Landscape Architecture, and Urban Design and Planning at the University of Washington, Seattle. She is President of the International Seminar on Urban Morphology (ISUF), an international and interdisciplinary organization of scholars and practitioners; a Faculty Associate at the Lincoln Institute of Land Policy, in Cambridge, MA; a Fellow of the Urban Land Institute in Washington, D.C.; and a National Advisor to the Robert Wood Johnson Foundation program on Active Living Policy and Environmental Studies.

Dr. Moudon holds a B.Arch. (Honors) from the University of California, Berkeley, and a Doctor ès Science from the Ecole Polytechnique Fédérale of Lausanne, Switzerland. Her work focuses on urban form analysis, land monitoring, neighborhood and street design, and non-motorized transportation. Her current research is supported by the U.S. and Washington State departments of Transportation, the Puget Sound Regional Council, the Federal Highway Administration, and the Centers for Disease Control and Prevention.

Her published works include Built for Change: Neighborhood Architecture in San Francisco (MIT Press 1986), Public Streets for Public Use (Columbia University Press 1991), and Monitoring Land Supply with Geographic Information Systems (with M. Hubner, John Wiley & Sons, 2000). She also published several monographs, such as Master-Planned Communities: Shaping Exurbs in the 1990 ( with B. Wiseman and K.J. Kim, distributed by the APA Bookstore, 1992) and Urban Design: Reshaping Our Cities (with W. Attoe, University of Washington, College of Architecture and Urban Planning, 1995).

Dr. Moudon has been an active participant in The Mayors’ Institute on City Design since 1992. She has consulted for many communities nationally and internationally to develop urban design guidelines for new construction which respect the character of the existing landscape and built environment and which support non-motorized transportation. She has worked with planning officials, design professionals, and neighborhood groups in the Puget Sound as well as in San Francisco, CA, Toronto and Montreal, Canada, Stockholm, Sweden, among others. She taught courses and conducted seminars in urban design, planning, and housing in Japan, Korea, China, Mexico, Brazil, Venezuela, Colombia, France, the United Kingdom, and Switzerland.

Jan Whittington

Dr. Jan Whittington is Associate Professor of the Department of Urban Design and Planning, at the University of Washington, Seattle. Her research applies transaction cost economic theory to networked infrastructures, such as transportation, water, and communications systems, to internalize factors historically treated as external to transactions. Her publications include methodologies for greenhouse gas mitigation and resilience through capital investment planning, examination of the efficiency of public-private contractual arrangements for infrastructure, and the evaluation of online transactions for efficiency, security, and privacy. At the University of Washington, she is the Director of the Urban Infrastructure Lab, Associate Director of the Center for Information Assurance and Cybersecurity, and Affiliate Faculty at the Tech Policy Lab. She teaches infrastructure planning and finance, public finance, infrastructure mega-projects, science for environmental policy, planning for water, and land use planning. Her PhD (2008) is in City and Regional Planning from the University of California, Berkeley, where she was advised by economic Nobel laureate Oliver Williamson. Prior to her academic career, she spent 10 years with infrastructure giant Bechtel Corporation, as a strategic planner and environmental scientist. She holds bachelor degrees in Biology and Environmental Studies from the University of California, Santa Cruz (1987). Her master’s degree is in City and Regional Planning, from California Polytechnic State University, San Luis Obispo (1993).

Qing Shen

Qing Shen is Professor of Urban Design and Planning and Chair and Director of the University of Washington Graduate School’s Interdisciplinary PhD Program in Urban Design and Planning. He holds a PhD in City and Regional Planning from University of California, Berkeley. Professor Shen’s primary areas of interest are urban economics and metropolitan transportation planning and policy. Author of numerous scholarly publications, he has developed methodological frameworks for analyzing urban spatial structure, examined the social and environmental consequences of automobile-oriented metropolitan development, and investigated the differential impacts of information and communication technologies (ICT) on various population groups. A primary focus of his current research is on the opportunities and challenges created by mobile ICT-enabled new mobility services. Exploring the paths toward more efficient, equitable, and environmentally responsible urban transportation, he is working with colleagues and graduate students to conduct innovative research on travel behavior and its connections with shared mobility services, built environments, and transportation demand management policies.

Professor Shen’s scholarly work has gained wide recognitions, which include a Horwood Critique Prize given by the Urban and Regional Information Systems Association (URISA), an Emerging Scholar Paper Award in spatial analysis and modeling specialty given by the Association of American Geographers (AAG), a Chester Rapkin Award given by the Association of Collegiate Schools of Planning (ACSP), and a Best Paper Award by the World Society for Transportation and Land Use Research (WSTLUR). A highly active member of the academic community, he has served on the editorial boards of seven academic journals, including the Journal of the American Planning Association (since 2000; Associate Editor since 2020) and the Journal of Planning Education and Research (since 2006).

Professor Shen was educated in China (Zhejiang University) and Canada (University of British Columbia) before coming to the United States. He started his academic career at MIT as an assistant professor in 1993 and was promoted to associate professor in 1999. That was followed by his tenured faculty appointment in 2000 at the University of Maryland, College Park where he also served as the Associate Dean for Academic Affairs of the School of Architecture, Planning, and Preservation. He joined the University of Washington as Professor and Department Chair in 2009. In addition, he has served as a visiting professor at several leading universities in China. In 2005, he was appointed by the President of Nanjing University as the first holder of Siyuan Chair Professorship, an endowed visiting position. In 2009, he was appointed as a visiting Tongji Chair Professor at Tongji University. In 2014, he was appointed by the President of Southwest Jiaotong University as the Oversea Dean of the School of Architecture and Design, a visiting advisory position. He was a primary founder and former Chairman of the International Association for China Planning (IACP).

Mark Purcell

Purcell’s work explores the possibility and potential of democracy. He is interested in how democracy can be an idea that inspires resistance to neoliberalism and austerity, but, more than that, he is interested in how it can help us flee those forms of life, how we can use it to create different forms, new ways of being together, other communities in which people make decisions for themselves, collectively. In short, he is searching for ways to think democracy radically. In that project, he spends a lot of time with and draw lots of ideas from the work of Plato, Aristotle, Hobbes, Locke, Marx, Bakunin, Nietzsche, Deleuze & Guattari, Hardt & Negri, Lefebvre, Castoriadis, Ranciere, Virno, and Laclau & Mouffe. He also dabbles in some Arendt, Agamben, Abensour, Badiou, Nancy, Rosanvallon, Clastres, Foucault, and Debord. His plan is to engage more closely in the near future with Butler, Bifo, and (maybe) Dewey. (Then he’ll retire.)

He is particularly interested in democracy as it exists in cities. He wants to know more about how urban inhabitants are creating new forms of urban life, forms of life in which they manage the production of urban space themselves, without the State and without capitalist corporations. In this context, he works particularly closely with Henri Lefebvre, and especially with his ideas of urban society, autogestion, and the right to the city.