Design for Health (DFH) History and Activities

Municipalities across the Twin Cities Metropolitan Area are mandated to prepare comprehensive plans for the Metropolitan Council, the regional governing body, every ten years. Completed plans in the most recent cycle were due in 2008. This vital window of opportunity to integrate healthy-living principles into the municipal plans for the next decade provided the impetus for the DFH project. In response, and drawing on several years of prior research on the connections between physical activity and health by some of the DFH investigators, DFH created an interdisciplinary project team working with urban planners, urban designers, parks planners, public works officials, and public-health professionals. The project continues as a continuously updated web-based information center.

Public-health models indicate that many factors affect human health: biology, individual behavior, social and economic factors, policies and services, and environments. A key aspect of the DFH project has been clearly identifying how the built environment, including the planted environment, affects health. Often, planners and designers rely on commonsense notions of healthy environments when the healthiness may have far more to do with the kind of people there than the kind of place. Giving the environment its due without overestimating its influence is a major focus of DFH. Key questions include:

  • What are the key relationships between the environment and human health?
  • What are some important thresholds at which human health is affected?
  • How can planning and design improve human health and ameliorate problems?
  • Can we develop tools to more clearly connect health and the work of landscape architects, architects and planners?

Activities

The DFH project was designed over a period of two years from 2004 to 2006. It involved early conferences sponsored by the funder to draw attention to issues and gauge interest in various research products. An early active living toolkit was prepared by Ann Forsyth, then of the Metropolitan Design Center. As designed, the project draws on research in several ways:

  1. Scientific Studies
     The DFH team has collectively conducted over a dozen scientific studies on the links between health and the built environment, focusing on walking, cycling, access to food, impact assessment, and the many roles of parks. With funding from several federal agencies and a number of foundations over the past decade, and particularly since 2002, it has developed and conducted surveys; developed new ways of using ArcGIS to measure the built environment related to these topics; and helped create new ways to assess urban-design character and active transportation facilities. Between them, the principal investigators have published, or have under review, three books and some dozens of scholarly articles (almost 30 peer reviewed) on these topics, with more in the pipeline.
  2. Research Syntheses
    The DFH project has drawn on this base of research, merging it with a close reading of the research of others to provide syntheses of evidence on topics relevant to the comprehensive planning and urban design processes. DFH focuses on the following Key Questions:
    • Accessibility of places, from parks to transit;
    • Air quality, including the positive role of the urban forest;
    • Climate change, as it relates to local and regional contexts;
    • Environment and housing quality, including brownfield remediation;
    • Food access and quality, from supermarkets to community gardens;
    • Healthcare access, including transportation to healthcare facilities;
    • Mental health, particularly the restorative role of green spaces and views;
    • Noise, including ways to mitigate harmful effects;
    • Physical activity, options from trails to stairs;
    • Safety, from traffic and crime;
    • Social capital, or social connections; and
    • Water quality, as it relates to human health.
  3. Assessment Tools
    Health impact assessment (HIA)—an emerging and critically important method of assessment—is central to the DFH project. HIAs developed specifically for this project integrate the evidence in the previous steps to create tools for assessing the health effects of specific projects and plans. Other HIA approaches tend to be either very broad (considering a range of social issues potentially associated with health and well-being) or narrowly focused on only quantifiable aspects of public health. In contrast to these approaches, this subject-specific HIA tool focuses on the work of urban planners, urban designers, landscape architects, and parks planners. The DFH HIA targets issues where there is some evidence that aspects of the built environment—over which these professions have some control—actually influence human health.

    Three linked HIA tools, and a planning and design checklist, reflect the research outlined above and allow people in particular places to structure research on the health impacts of projects and plans. The DFH team and an independent evaluator are also assessing the results of this work.
  4. Evidence-based Guidelines, Critiques, and Illustrations
    The research base described above is also used to create strategies and guidelines for incorporating health into comprehensive plans and ordinances, as well as parks planning, urban design projects, streetscape design, and stormwater management. These applied products are targeted both at specific partner communities and a broader audience, and are published in the DFH Information Sheet series. In addition, DFH workshops, conducted from 2006-2007, offered a research-based and application-oriented discussion of health and urban form topics along with feedback sessions (critiques) on local projects. Image slide shows illustrate concepts and provide visual resources (see illustrations).

Results

By 2008 partner communities had created three active living plan elements, two public and community health elements, five bicycle and/or pedestrian mobility plans, two multi-modal plans, one zoning ordinance and land development manual, and seven comprehensive plans incorporating health throughout the entire document. Partners had also conducted 11 HIAs covering a wide range of topics including mental health, social capital, food access, water quality, air quality, environment and housing, and noise.

The Design for Health Project won the EDRA/Places Great Places Research Award (2009), American Planning Association (APA) National Planning Excellence Award for Best Practices (2009), and an APA Minnesota Chapter, Merit Award (2008).

Design for Health has published about these tools and cases and provides trainings.


Design for Health (DFH) involves participants from the University of Minnesota, Cornell University, and the University of Colorado.
E-mail: info@designforhealth.net