NEWS

Looping Public Health into Yesler Terrace's Streetscapes

Located at intersections and along a continuous loop, activity zones like the one shown in this schematic plan, will provide residents with opportunities to recreate while exploring their neighborhood and contributing to vibrant street life.

Located at intersections and along a continuous loop, activity zones like the one shown in this schematic plan, will provide residents with opportunities to recreate while exploring their neighborhood and contributing to vibrant street life.

As designers and planners continue to recognize the health impacts that our built environment has on human populations, new strategies are being deployed to create places where the "healthy choice is the easy choice." This is particularly important for communities where, due to socioeconomic circumstances, the public health odds are already stacked against residents. In Seattle, SvR and the rest of the design and development team behind Seattle Housing Authority's (SHA's) Yesler Terrace redevelopment were keenly aware of these challenges, and promoted "healthy eating and active living (HEAL)" opportunities throughout the design process. 

In early discussions with SHA and the design team, nonprofit organizations and public health officials discussed Yesler Terrace’s cultural diversity, affordability, and high populations of senior and child residents, emphasizing the importance of active spaces to help combat health issues like obesity and diabetes. All stakeholders agreed that the existing parks’ sizes and programming did not meet the needs of the anticipated population of the neighborhood. The Green Street Loop, a 1/2-mile circuit that links three pocket parks to a larger neighborhood park, helps fill this gap by creating a visible and cohesive pathway to neighborhood destinations. The Loop also became an important platform for meeting the neighborhoods' public health goals.

Eight activity zones are identified in gold stars along the 1/2-mile Green Street Loop (in green) at Yesler Terrace.

Eight activity zones are identified in gold stars along the 1/2-mile Green Street Loop (in green) at Yesler Terrace.

Activity stations contain fitness equipment such as Kompan's Complete Body Toner.

Activity stations contain fitness equipment such as Kompan's Complete Body Toner.

In addition to enhanced pedestrian amenities, larger trees and public art along the Loop, there are 8 "activity zones," each with at least one fitness station and a bench. The activity zones are equally distributed along the Loop, and the fitness equipment at each zone was selected to accommodate a range of ages and skill levels to make it easier for everyone to engage in healthy activity. From pull up bars to sit up benches to free runners, the activities provided offer a complete workout and encourage circulating around the neighborhood. 

The Loop was not only designed for physical health, but also to encourage a vibrant public realm that promotes economic development, increases safety by inviting more eyes on the street and breaks the cycle of social isolation that can beset recent immigrants and the elderly. Also arrayed around the Loop and throughout Yesler Terrace's streets are "pause places," which provide space to pull off the main path of travel to sit, lean, park a bike, wait for public transportation or catch one’s breath while navigating the steep terrain. Pause places are smaller than the activity zones, but are offered more frequently - approximately every 100 feet - on both sides of the street.

Creating a public realm that promotes physical activity will not only serve Yesler Terrace residents. Creating a socially and physically active streetscape could prove a powerful prescription for public health practitioners as our nation searches for ways to make preventative health care a daily part of our lives.

The Trees of Life

UFSP Earlier this week, the Seattle City Council passed the new Urban Forestry Stewardship Plan. The goal of the plan is "to increase the health of the urban forest and to meet Seattle's goal of 30% canopy tree coverage by 2037." SvR's Peg Staeheli served on the Urban Forestry Commission.

We thought this might be a good opportunity to clear out some of the recent articles we've come across relating to the urban nature. Enjoy!

 

To Control Health Costs, Build Sidewalks

An un-sidewalked, urban street just a ten minute walk from a light rail station.  

Perhaps the most remarkable thing about the image above is just how unremarkable it is. All around the country there are places that look like this; in fact, this is probably a more common situation than the tree-lined sidewalk that we hold up as our ideal infrastructure.

Public health practitioners look at streets like the one above and have gradually come to the conclusion--based on reams of studies--that exposure to streetscapes like it are one of the causes of Americans' ever-increasing rise chronic disease. In fact, the New England Health Care Institute estimates that our environments influence as much as 20% of our public health outcomes.

healthcaredeterminants

As with contagious diseases, researchers have also found that the more proximate you live to this type of environment, the more likely you are to be negatively affected by it. For example, we take it as a given that residents of tropical regions are more likely to get a variety of mosquito borne illnesses if they live near a fetid pool of water. Similarly, Americans are much more likely to have a harder time avoiding chronic diseases that "account for seven of every 10 deaths and affect the quality of life of 90 million Americans" if they are exposed to streets like the one above. As exposure increases, risk increases.

Dr. David Fleming, the Director of Public Health-Seattle & King County, emphasized these points during testimony to the Robert Wood Johnson Foundation in June:

Most deaths today result from diseases and conditions that are shaped by our social and environmental surroundings. Poor health almost any way you measure it is increasingly concentrated in the same locations, making it easy to identify which communities are making people unhealthy and underscoring the importance of place to health. What makes these neighborhoods unhealthy? While the role of clinical health services is vital, medical care alone accounts for only about 10 percent of premature deaths.

Neighborhoods create ill health because of their intrinsic community characteristics. Houses and rental units are substandard and contaminated with mold and toxins like lead, streets aren’t safe for walking to school or work because of crime or just a lack of  sidewalks, and healthy food isn’t easily available, though high-fat, sugar-loaded processed food is for sale at the corner  convenience store.

All of this evidence begs the question: if the built environment is a significant determinant of our public health outcomes, why aren't health entities--hospitals, HMO's and clinics--helping to build a better infrastructure that supports sound health outcomes? While public health agencies like PHSKC and the CDC have been leading the way, the private sector has been generally hesitant to directly intervene in the built environment. Yet, public health indicators will continue to decline unless the built environment is changed and cities are already financially constrained.

Dr. Fleming offers some hope, arguing that the Affordable Care Act may have unlocked a key to force the private sector to recalibrate their own financial calculus and compel them to directly intervene in reducing their patients' exposure to unwalkable streets, unsafe speeds and overly toxic emissions.

In a future of capitated payment for individual health care, health care systems may find that remaining agnostic to the community from which their patients come weakens their bottom line. Instead, targeted investments in neighborhoods with the poorest health may begin to make both good health and good business sense.

So does that mean that we'll see Group Health sidewalks, Kaiser Permanente greenways and BlueCross/BlueShield skateboard parks in our communities? As a new business paradigm sets in, the data suggests these interventions may become a cost effective way to control private sector costs and improve public health outcomes, resulting in a win for everyone involved.