Healthy Communities Are Not An Accident

For many of us the start of a new year means it’s time to get healthy! Every year millions of people set new resolutions to eat better or hit the gym with the laudable goal of living healthier. But after January ends, we continue to face a multitude of every-day decisions, big and small, that impact our health. It can often be difficult to make the right decision, but what if we had an assist in making those decision from our environment? What if our communities were designed to help us be healthier?

Health by Design, an Indiana non-profit that works at the intersection of health and the built environment, certainly thinks so. Given the focus on personal health every January, I reached out to Health by Design’s Executive Director, Kim Irwin. Below are a few key highlights from what I learned during our conversation.

Health by Design advocates for infrastructure that allows for more walking, biking and transit.

First Things First: What is Health by Design?

According to their website, Health by Design “is a coalition of diverse partners working to ensure that communities throughout Indiana have neighborhoods, public spaces and transportation infrastructure that promote physical activity and healthy living.” In other words, the organization focuses on improving the features of the built environment that contribute to or detract from people leading active and healthy lives.

A presentation during one of Health by Design’s Bike and Walk state summits.

What Does This Look Like in The Real World?

The Health by Design website offers a few examples we see every day of the built environment keeping us from becoming our healthiest selves:

• Neighborhoods with no sidewalks
• Retail and service outlets more accessible by car than other means
• Suburbs spread far and wide, disconnected from services, amenities and each other
• Schools built far from homes, for students arriving by bus and car
• Streets unfriendly to pedestrians, cyclists and other non-motorized travelers

To combat these issues, the non-profit promotes improvements to the built environment typically centered around walking, biking, and public transit.

One of the activities that Health by Design leads during their workshops is a Walk Audit, which test to see how pedestrian-friendly a neighborhood is and provides tips for improvement.

How Does Health by Design Improve Community?

Chiefly, the work is done through its education, advocacy, and technical assistance to communities that are interested in promoting active living. Health by Design has accomplished a lot since its founding in 2006, including;

• Holding over 40 Complete Streets and Active Living workshops where communities learn about best practices and identify specific goals they want addressed in an active living action plan.
• Assisting in the development of more than 20 public health, pedestrian, bicycle, and transit plans.
• Supporting the development and adoption of Indiana’s 24 Complete Street policies, 7 of which were named best in the nation.
• Helping develop the Indiana Safe Routes to School guidebook and leading workshops, events, and plan development related to walking and biking to school.
• Contributing to state legislative action and the successful Marion County referendum which resulted in system expansion and increased funding for transit.

For additional examples of what Health by Design accomplished click here.

In-depth conversation during the Indiana Walk and Bike Summit.

What Are The Biggest Issues Health by Design Faces?

Early in our conversation, I asked Kim about the struggles Health by Design faces in its work and she was quick to offer two big ones:

• Funding. Not so much for the organization, but for the communities they work with throughout Indiana. Kim noted that more money is needed to design and build infrastructure and public spaces that promote active living, and that the money that is currently being used for infrastructure should be spent more wisely. Investing in design that promotes active living takes large, upfront investments, and even though they will save people and communities money over time (by lowering medical expenses, for example), it’s difficult to convince decision-makers that the investments are worth it.
• Policy. According to Kim, “health doesn’t drive policy decisions.” While more government agencies and elected officials recognize the effect of the built environment on health, this isn’t an issue that has a strong impact on their decision-making… yet.

A riding tour is ready to go during the Walk and Bike Summit.

Is There Hope for The Future of Such Work?

While the issues that Health by Design tackles are big, Kim was also quick to offer exciting insights that gives hope for solving them:

• More people are “getting it.” Even though health isn’t driving policy decisions, the last ten years have seen exponential growth in the number of organizations, government agencies and elected officials that value quality of life improvements, including those that improve health.
• The partners working in this space are diverse in goals and outlook. Many of Health by Design’s partners are ones you would expect, including health-based agencies and organizations that work with the built environment. However, other partners might surprise you, like AARP Indiana or the MIBOR REALTOR® Association. Kim explained that while these organizations might not focus exclusively on health, or the built environment, they have goals that can be served by working in this space. In these cases, AARP wants their members to be able to age in place and many homebuyers want walkable neighborhoods which can be seen as a value to realtors.

Another walk audit.

What New Topics is Health by Design Focusing on Now? What Should Community Projects be Thinking About During the Planning Process?

Towards the end of our conversation I asked Kim about the topics that Health by Design is thinking about right now and what she would recommend Patronicity project creators keep in mind for their public spaces. She highlighted three key ideas - Intersectionality, Health Equity and Accessibility.

• Social Determinants of Health. Those who work in these spaces need to look at problems holistically by recognizing that many issues affect health, not just diet or the immediate environment. Kim called these issues Social Determinants of Health, which include housing, poverty, education, jobs, violence, etc. as factors that affect health outcomes.
• Health Equity. Related to intersectionality is the idea of health equity. Health by Design will be focusing more on this topic in the months and years ahead by recognizing that not everyone gets the same opportunities to be healthy. According to the Robert Wood Johnson Foundation: “Health equity means everyone has a fair and just opportunity to be healthier. It acknowledges that it’s hard to be healthy without access to good jobs, homes and schools. It requires concerted effort to increase opportunities to be healthier for everyone — especially those whose obstacles are greatest.”
• Accessibility. For those who are working on individual public space projects, such as those on Patronicity.com, Kim recommended keeping accessibility at the top to the list of considerations. This includes not just ADA compliance but other important features as well, such as whether or not the project can be reached via a bus route or if it has bike parking and how often the space is open to the public, etc.

For more information about Health by Design’s unique work at the interaction of health and the built environment, as well as an overview of its past, present and future work — check out their website: http://healthbydesignonline.org/

Thank You to Kim Irwin for taking the time to share her work and answer questions, and Kate Riordan for sharing resources, including all of the photos shown in the post.

If you’re interested in implementing projects in your neighborhood that promote health and physical activity, let us know how we can help by connecting with us through our website: https://www.patronicity.com. The friendly staff at Patronicity loves meeting new folks, and hearing great ideas, from around the world from people who are passionate about creating communities that are great places where we can all live, work, play, and get healthy.