Local Public Health and the Built Environment (LPHBE)

The LPHBE Network project provides resources, training, and networking opportunities for California's local public health departments that see the built environment, community design, and transportation infrastructure as important factors in overall public health.

Project Context:
Historically, public health has had a role in community design. Before planning became a separate discipline, local health departments performed many "planning" tasks. In the 1900's they advocated to separate noxious land uses from dwelling units and clamped down on rampant sanitation issues and poor conditions in tenement housing. Today, public health professionals are realizing that our modern built environment[1] with poorly designed streets, lack of transportation options, and sprawl, is negatively impacting health. Physical inactivity levels are significantly low among Californians of all ages and abilities. Individuals are not able to easily engage in daily physical activity due to unsafe play areas, limited access to recreational facilities, and substandard community pedestrian and bicycle infrastructure. These conditions are creating/exacerbating the symptoms of many chronic diseases and increasing the risk of serious injury as well. More and more local public health departments are getting involved in helping to mitigate these health risks. From traffic-calming to bike lanes to transit-oriented development, the public health "voice" can help inform land use and transportation decisions to help create safer, healthier communities.

LPHBE Network Project History:
In 2004 the California Center for Physical Activity (Center) and the State and Local Injury Control Section (SLIC) of the California Department of Public Health (CDPH) anticipated the need for specific training in land use and transportation planning for county health professionals. Our communities have become less-than ideal places for walking, bicycling and living healthy lives, so motivated by injury prevention and the obesity and diabetes epidemics, public health has begun to engage once again with the planning profession after decades of separation. The Center and SLIC enlisted the expertise of Tina Zenzola, Director of Safe and Healthy Communities Consulting, who has developed materials for such organizations as the National Association of County and City Health Officials (NACCHO) and a pilot program began to bring our local public health partners quickly up-to-speed on planning and built environment issues. The Local Public Health and the Built Environment Network project (LPHBE – pronounced "el feebee") approached eight local public health agencies statewide known to have expressed some interest or early expertise in built environment issues to participate in the pilot program. These eight counties continue to benefit from this intervention and lead the way for their public health colleagues – they included Riverside County, Shasta County, Contra Costa County, San Bernardino, and Solano Counties among others. Now in 2007 we continue to provide support to county public health agencies through mini-grants, educational teleconferences, and built environment trainings at the 101- and 201-level. Our built environment groundwork has empowered external partner agencies statewide to create complementary built environment trainings to meet the growing demand from county public health professionals.

Teleconferences:
Initially, the program began with teleconferences to assess the level of knowledge for each public health agency, their needs for expert speakers, and to deliver administrative and technical information. Since then, expert speakers have included a planning commissioner/landscape architect from San Diego who outlined the role of planning commissions, university faculty involved in GIS mapping of community walkability and pedestrian injury and evaluation of Safe Routes to School interventions, Health Impact Assessments, inserting health content into community visioning plans, and a leading sustainability expert. We are planning more teleconferences for 2007 including adding back in our program sharing teleconferences along with our expert speakers.

Mini-grants:
Those first eight counties also received mini-grants of $5000 to plan and implement projects that would involve their public health agency in local built environment and planning/land-use issues. Examples include convening local land-use stakeholders, conducting walking audits in neighborhoods lacking proper pedestrian and bike amenities, running smaller local trainings for county leaders, planning and public works staff, and community members, and developing strategic plans for health departments to better address the built environment as an agency. Projects required a quick turnaround for this six-month grant cycle. Since the first year we have now offered 2 more competitive rounds of mini-grant funding. The latest round of mini-grant funding in 2007 drew interest from over 20 counties and was highly competitive; this latest crop of mini-grant projects will be completed by July 2007.

Regional Trainings:
Early on, the LPHBE program hosted several regional one-day trainings in 2005: both in Southern California (Los Angeles) and in Northern California (Oakland). In an effort to broaden the project's scope and impact, these trainings were offered at no cost and open to all of California's 58 counties. Half of the Southern California counties participated, and ten counties from the northern part of the state were involved in these early trainings. Participants received materials developed just for public health professionals as well as the resources Tina Zenzola developed for NACCHO. Participant packets included explanations of acronyms and planning concepts, examples of local public health departments' involvement in the planning process, links to resources and research, as well as tips for strategic points of intervention for local agencies. Attendees also participated in a walk audit with trained California Walkability Experts in and around the regional training site. Exercises near the day's end focused on brainstorming solutions based on rural and urban land-use scenarios and important "next steps" for action once they returned to their home agencies. In 2006 we answered demand for more detail with a 201-level training in both Los Angeles and Sacramento which included more group exercises, reports from local public health agencies, and the perspective of land developers; we have more 101 and 201-level training sessions planned for 2007.

Progress
Pilot projects from 2005 have been completed; a second RFP was issued in 2006 for a second round of mini-grants, now complete. The third round of mini-grants for local health departments were awarded in early 2007 with completion expected by this summer.

For more information about the Local Public Health and the Built Environment or to get involved, please contact Jeffery Rosenhall at 916.552.9885 or Jeffery.Rosenhall@cdph.ca.gov.

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