Health Affairs
November 2014; Volume 33, Issue 11
http://content.healthaffairs.org/content/current

Theme: Collaborating For Community Health
Integrating Public Health And Community Development To Tackle Neighborhood Distress And Promote Well-Being
Manuel Pastor1,* and Rachel Morello-Frosch2
Author Affiliations
1Manuel Pastor is a professor of sociology and of American studies and ethnicity and director of the Program for Environmental and Regional Equity, University of Southern California, in Los Angeles.
2Rachel Morello-Frosch is a professor in the School of Public Health and the Department of Environmental Science, Policy, and Management, both at the University of California, Berkeley.
Abstract
Recently there have been calls for public health to reconnect to urban planning in ways that emphasize the impact of place on health and that address fundamental causes of poor health, such as poverty, social inequality, and discrimination. Community developers have realized that poor health limits individuals’ and communities’ economic potential and have begun to integrate into their work such neighborhood health issues as access to fresh food and open space. In this article we review recent shifts in the community development field and give examples of programs that operate at the intersection of community development, public health, and civic engagement. For example, in Sacramento, California, the Building Healthy Communities program successfully promoted the creation of community gardens and bike paths and the redevelopment of brownfields. A major housing revitalization initiative in San Francisco, California, known as Sunnydale-Velasco, is transforming the city’s largest public housing site into a mixed-income community that provides existing residents with new housing, infrastructure, services, and amenities. These examples and others illustrate the need to identify and make use of interdisciplinary approaches to ensure that all places are strong platforms for economic mobility, full democratic participation, and community health.

Case Study: San Francisco’s Use Of Neighborhood Indicators To Encourage Healthy Urban Development
Rajiv Bhatia1
Author Affiliations
1Rajiv Bhatiais a visiting scholar at the University of California, Berkeley, and director of the Civic Engine, an organization that develops innovations for civic engagement and healthy public policy, in Oakland, California.
Abstract
Neighborhood indicators are quantitative measures of neighborhood quality, including measures of attributes such as crime, noise, proximity to parks, transit services, social capital, and student performance. In 2007 the San Francisco Department of Public Health, with broad public input, developed a comprehensive system of neighborhood indicators to inform, influence, and monitor decisions made by the Department of City Planning and other community development institutions. Local public agencies, businesses, and citizens’ groups used the indicators to identify disparities in environmental and social conditions, inform and shape neighborhood land use plans, select appropriate sites for development projects, craft new environmental regulations, and justify demands on developers to make financial contributions to community infrastructure. Among other things, the use of indicators contributed to policies to prevent residential displacement, a city ordinance requiring stricter building ventilation standards in areas with high air pollution, and the redeployment of traffic police to high-injury corridors. Data that can be used to create neighborhood indicators are increasingly available, and participation by public health and health care institutions in the indicators’ development, dissemination, and application could help improve several conditions that contribute to poor population health.

A Framework To Extend Community Development Measurement To Health And Well-Being
Joseph Schuchter1,* and Douglas P. Jutte2
Author Affiliations
1Joseph Schuchteris an independent consultant in Berkeley, California.
2Douglas P. Jutte is an associate professor at the University of California, Berkeley, and executive director of the Build Healthy Places Network, in San Francisco.
Abstract
Measurement can help community development and health practitioners align and optimize their investments and leverage additional resources to achieve shared goals. However, there is no clear guidance for reconciling the established systems for measuring community development activities and outputs—such as housing units built, jobs created, and people served—with the outcomes and impacts of health. We therefore reviewed community development measurement systems—encompassing assessment, monitoring, evaluation, and standards—and identified strategies for using those systems to support health in community development decision making. We highlight promising innovations by organizations such as the Reinvestment Fund and NeighborWorks America and place these in an ecosystem framework to illustrate opportunities for shared measurement. We then discuss policies and processes to build the ecosystem’s infrastructure, balance stakeholders’ priorities within the ecosystem, and use it to drive investments in health.

The Child Opportunity Index: Improving Collaboration Between Community Development And Public Health
Dolores Acevedo-Garcia1,*, Nancy McArdle2, Erin F. Hardy3, Unda Ioana Crisan4, Bethany Romano5, David Norris6, Mikyung Baek7 and Jason Reece8
Author Affiliations
1Dolores Acevedo-Garcia is the Samuel F. and Rose B. Gingold Professor of Human Development and Social Policy and director of the Institute for Child, Youth, and Family Policy at the Heller School for Social Policy and Management, Brandeis University, in Waltham, Massachusetts.
2Nancy McArdle is a senior research consultant at the Heller School for Social Policy and Management, Brandeis University.
3Erin F. Hardy is research director of diversitydatakids.org and a fellow at the Heller School for Social Policy and Management, Brandeis University.
4Unda Ioana Crisan is a research associate at the Heller School for Social Policy and Management, Brandeis University.
5Bethany Romano is senior department coordinator for the Institute for Child, Youth, and Family Policy at the Heller School for Social Policy and Management, Brandeis University.
6David Norris is a senior researcher at the Kirwan Institute for the Study of Race and Ethnicity, Ohio State University, in Columbus.
7Mikyung Baek is a research and technical associate at the Kirwan Institute for the Study of Race and Ethnicity, Ohio State University.
8Jason Reece is director of research at the Kirwan Institute for the Study of Race and Ethnicity, Ohio State University.
Abstract
Improving neighborhood environments for children through community development and other interventions may help improve children’s health and reduce inequities in health. A first step is to develop a population-level surveillance system of children’s neighborhood environments. This article presents the newly developed Child Opportunity Index for the 100 largest US metropolitan areas. The index examines the extent of racial/ethnic inequity in the distribution of children across levels of neighborhood opportunity. We found that high concentrations of black and Hispanic children in the lowest-opportunity neighborhoods are pervasive across US metropolitan areas. We also found that 40 percent of black and 32 percent of Hispanic children live in very low-opportunity neighborhoods within their metropolitan area, compared to 9 percent of white children. This inequity is greater in some metropolitan areas, especially those with high levels of residential segregation. The Child Opportunity Index provides perspectives on child opportunity at the neighborhood and regional levels and can inform place-based community development interventions and non-place-based interventions that address inequities across a region. The index can also be used to meet new community data reporting requirements under the Affordable Care Act.