Strengthening the Relationship between Design and Health

Education & Outreach, Healthy Living, Northwest

Alta and University of Washington Students Collaborate on a Health Impact Assessment

By Chris Saleeba and Cailin Henley, Alta Planning + Design 

Wide lanes, fast cars, anxiety-inducing street noise, expansive parking lots and unsafe crossings afflict the 1.25 mile Commercial Avenue south of Anacortes, WA, a small coastal city north of Seattle. To improve safety conditions, the City of Anacortes hired Alta Planning + Design to design a multimodal vision plan for this corridor, which also serves as a state highway. Chris Saleeba, the Project Manager, a licensed landscape architect and holds a Masters in Public Health, saw the opportunity to integrate and emphasize a health perspective into this plan. With support from the City, Chris connected with Dr. Andy Dannenberg, a public health professor at the University of Washington and a national leader in conducting and teaching on the subject of Health Impact Assessments (HIA).

Over the past 10 years, Dr. Dannenberg has focused his research and teaching on examining the health aspects of community design including land use, transportation, urban planning, and other issues related to the built environment. Together, Chris and Dr. Dannenberg created an opportunity for graduate students in public health, urban planning and transportation engineering to conduct an HIA of the proposed Commercial Avenue corridor plan.

A Health Impact Assessment combines processes, methods, and tools to evaluate the potential health effects of a policy, plan, program, or project. It assesses these effects on the health of a population and the distribution of effects within the population. Ideally, an HIA occurs in the early stages of a project prior to implementing project decisions, so that health-supporting alternatives or modifications can be proposed. HIAs are commonly conducted for land use and transportation planning projects, as a formal process to highlight potential health repercussions. Comprehensive HIAs can be cost and time intensive, while rapid or “desktop” HIAs may not provide enough analysis for specific projects. Given these challenges to conducting HIAs, providing students enrolled in HIA courses with real world projects enriches their education. This collaboration also allowed Alta to directly identify and address potential health impacts of the proposed design.

When conducting an HIA, there are standardized steps to follow to increase the tool’s validity, these steps include screening, scoping, assessment, recommendations, reporting, and monitoring.  After identifying this as a great project for conducting an HIA, the class worked through each step with technical guidance from Dr. Dannenberg, while Chris worked closely with the students to help them understand the city’s  goals and explain the vision plan that Alta developed.

Chris led the class on a site visit along the corridor to expose students to the current conditions and challenges, and allow them to envision the proposed design for the corridor. In walking the corridor on a sunny spring day, the students mentioned feeling anxious, evoked by the fast-paced, noisy traffic. They spoke of feeling hot, from lack of shade and no trees. And they were forced to jaywalk to cross this main street highway, from a deficit of dedicated crosswalks.

The class’ final HIA report dove into six topics with ties to health: (1) Transportation, (2) Environmental Health, (3) Land Use and Public Places, (4) Public Safety, (5) Economic Health, and (6) Community Cohesion and Social Capital. Within these categories, specific recommendations for the city and plan emerged. For example, one of the recommendations was to evaluate stakeholder engagement at each phase of the design and implementation process to ensure community support and community-wide representation. This is important from a public health perspective because it has been found that reducing engagement barriers encourages community buy-in, which can result in increased ownership and thereby increase physical activity along the corridor.  Additionally, each health impact topic area supported full implementation of the proposed vision plan designed by Alta, with some recommendations that aim to improve the potential health impacts of the community.

This Health Pathway Diagram, included in the Commercial Ave south vision plan, is a framing tool that depicts the connections between design strategies and health impacts. Students’ research on the health implications of the vision plan’s design strategies helped to validate these health impacts.

This partnership proved to benefit everyone involved in the project, including the City of Anacortes, UW students, and Alta. The City of Anacortes was thrilled with the final HIA report. City staff is using the report to support their vision for Commercial Ave and as a resource to point out the specific health benefits of the project. The students had the opportunity to work on an HIA for a real world project and make recommendations that would be considered by the city.  For Alta, we are continuing to promote the use of HIAs in our work, which reaffirms our commitment to creating healthy and active communities. In addition to the success of this project, this partnership has also led to creating student internships at Alta that focus specifically on the relationship between design and health.

Read the final Health Impact Assessment here

The Health Impact Assessment conducted on the South Commercial Avenue Corridor Plan has found the plan to have significant potential to improve the health of the corridor and its users by providing protected bike lanes, curb bulbouts, wider sidewalks, increased vegetation, and overall better conditions for all types of users.

The Health Impact Assessment conducted on the South Commercial Avenue Corridor Plan has found the plan to have significant potential to improve the health of the corridor and its users by providing protected bike lanes, curb bulbouts, wider sidewalks, increased vegetation, and overall better conditions for all types of users.

Chris Saleeba

About Chris Saleeba

Chris is passionate about creating safe and healthy streets that promote physical activity. With an interdisciplinary background in public health, sustainability, and site engineering, he brings a unique perspective to the practice of landscape architecture. His areas of expertise include active transportation, green stormwater infrastructure, and Safe Routes to School. Throughout the design process, he is an advocate for creating places that positively impact the environment, human health, and social relationships. Chris was trained in conducting Health Impact Assessments at the Centers for Disease Control and is experienced in applying quantitative tools to assess the impact of the built environment on human health. Chris holds a Master of Public Health and a Master of Landscape Architecture from the University of Washington.
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