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How do we design healthy communities?

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CDR Arthur W. Wendel, Healthy Community Design Initiative.
CDR Arthur W. Wendel, Healthy Community Design Initiative.

Guest blogger: CDR Arthur M. Wendel, MD, MPH, Team Lead of the Healthy Community Design Initiative, National Center for Environmental Health, Centers for Disease Control and Prevention

A city walks into her public health doctor’s office and says, “Doctor, I’ve been feeling a bit congested.”

Although this sounds like the start of a bad joke, traffic congestion is a problem for many cities. It increases the amount of time people spend in their vehicles every day and decreases opportunities and time for physical activity. Also, traffic congestion contributes to increased air pollution, traffic injuries and fatalities, and other health-related problems. But traffic problems are not the only health-related issue that cities face. Lack of green space, suburban sprawl, and other design issues also affect health and are common to many communities.

Just as a doctor must understand health problems before he can treat them, cities can only improve community design if they understand the link between the built environment and chronic disease and injury. To do that and to develop solutions that work, city planners, developers, and community members first must collect information—data—that shows what and where the problems are. This practice is known as “surveillance.”

Communities usually use surveillance data about their traffic, economic development, and population to guide decisions. They use data related to people’s health less often. To create safer and healthier communities, public health data (and public health professionals) must be part of the planning process.

But health information is not always readily available, making it harder for communities to understand their health issues and improve their design.

The Healthy Community Design Initiative (HCDI), an activity of CDC’s National Center for Environmental Health, works to improve public health surveillance so that cities can make transportation and land-use decisions that promote health. For example, HCDI helps fund the Bicycling and Walking Benchmarking Report, which compiles data from transportation, public health, and policy sources. Professionals in several states have used this report to help design their communities to promote health.

Also, HCDI and CDC’s National Environmental Public Health Tracking Program have worked together to build a community design module that provides specific information about design elements that affect health, such as access to parks and transportation to work.

Putting existing data together in a way that can help communities make informed decisions is a relatively low-cost but necessary first step in community-design decisions. If we, as individuals and cities, are to achieve our health goals, we need public health surveillance that gathers the data necessary to help us design healthier communities. I am proud that we at CDC’s National Center for Environmental health are part of the public health team that helps individuals, communities, and cities make better and healthier design decisions.


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