Embrace Shared Values

While the planning field overall has not yet fully embraced a health focus, the values and interests of individual planners may align with the notion of healthier built environments. A public health staff member from San Francisco articulated the role that public health can play for reshaping the practice of planning: “I think one thing that we try to do is be helpful. My goal is not to be perceived as another stakeholder, but [as]

another city agency that can be helpful for us to achieve this larger vision for San Francisco, which I think often very clearly articulates health as a value” (San Francisco Interviewee B, personal communication, February 26, 2014). These personal values can be promoted throughout planning departments through conversations with others who share them. Planners interviewed from San Francisco felt that the overall public health mindset is not strong within the San Francisco planning department, but one interviewee from planning noted that a personal interest in health might prompt planners to talk to each other—and to health department staff—about issues that impact health (San Francisco Interviewee D, personal communication, February 26, 2014).

Recognizing and embracing shared values of health between the departments can help grow the relationships needed for successful collaboration. Said an interviewee from the Columbus planning division, “I think that ultimately…personalities and relationships are really crucial to moving things forward. Having a higher level champion and the front line staff to keep it going [are necessary for collaboration]” (Columbus Interviewee C,

personal communication, June 30, 2014). Taking advantage of not only existing relationships but also existing shared values can help initiate and sustain processes of collaboration.

In Cincinnati, planning and health staff found that building relationships around a shared mission and values—in this case, crafting a successful comprehensive plan for the city—helped build sustained collaboration. Said an interviewee from the planning division, “Once you build the relationship is just becomes easier to [collaborate]. So when they need our help they know that they can contact us, and that we will help them out because we are invested in their mission as much as they are” (Cincinnati Interviewee A, personal communication, June 13, 2014). Beyond this, finding commonalities on which to build relationships can facilitate future collaboration efforts. An interviewee from the Orange County Health Department in Orlando noted: “If we hadn’t taken the time on the front end to build those relationships and bring partnerships, sometimes funding, to work with our counterparts in other agencies, we wouldn’t have had nearly any of the opportunities or success that we’ve had” (Orlando Interviewee C, personal communication, July 15, 2014).

Ultimately, while interviewees agreed that support of elected officials is important to the integration of health into planning, they also agreed that staff relationships are critical to push collaboration forward. However, in order build these relationships, staff members will need to both understand and take advantage of shared values. In most cities, while the health staff primarily pushed the relationship with their planning counterparts, the planners who shared their values were more apt to embrace this relationship. In general, my research found that planning staff understood the importance of collaboration, but could think about health more often and more regularly invite health department staff to participate in the planning process.

The existence of shared values between department staff and leadership also reflects a shared normative vision for a focus on health goals within planning processes, and leveraging and embracing these values also reflects a desire for relationship building and collaboration that will serve to put this vision into practice. The opportunity to embrace these values to incorporate a health focus into planning reflects the importance of defining both the process aspect of planning (the “means”) and the outcomes of planning (the “ends”) when entering into collaborative processes with other departments.

Though the “means versus ends” debate has drawn a great deal of commentary (see Healey 1993, Forester 1999, Fainstein 2005, and MacCallum 2008), both theories have certain limitations that indicate that, if taken together, a strong and inclusive field of planning that has intentions of focusing on complex social issues, such as health and health equity, could emerge.

7.3CONCLUSION

Despite very real challenges to collaboration between planning and health, opportunities exist that can be leveraged to allow for the insertion of a health focus into the planning field. As evidenced by the historical evolution of the field of planning, the values of the profession—and individual planners—do indeed change and influence planning practice (Sloane 2006). Thus, reshaping the ways that planners view their position within the intersection of health and the built environment is key to establishing and maintaining collaboration with health departments. Existing champions for health, as well as the influence of department leaders and elected officials, offer opportunities to facilitate collaboration. Existing touch points between planners and health

professionals—such as committee and coffee meetings—can be utilized as informal spaces for sharing knowledge. And, framing health as a neutral factor and embracing health data and language can help bring credibility to existing plans and planning processes and integrity to the profession of planning.

However, changing how planners view their role is inextricably linked to changing the values of the field of planning, and ultimately changing how planning is practiced. Recognizing that health professionals constitute a source of knowledge can help bridge a resource gap that survey respondents and interviewees named as a barrier to the inclusion of health in planning processes. Leveraging existing relationships between health professionals and planners, or taking steps to establish new relationships, can lead to more regular collaboration. This can be especially simple to facilitate between planning staff members who share the values of health professionals and already understand the importance of considering health impacts of planning.

Cities that have been able to establish processes of collaboration have viewed the shared work as very successful. Survey findings showed that departments currently collaborating highly valued the level of trust and respect that has grown between them.

Based on this, it appears that once planning departments and health departments begin to work together, the process is seen as generally positive and useful. Said an interviewee from the Cincinnati planning division, “To be honest with you, I’m not sure how we [initially] made that connection [with the health department]. But I think once we made that connection we both recognized how important it was” (Cincinnati Interviewee A, personal communication, June 13, 2014). Taking advantage of available opportunities to educate planners and bring health professionals into the planning process can begin to establish and sustain collaboration between the two departments, and the two fields.

Building on these insights and experiences of planners and health professionals, in the

next chapter I present four general recommendations and a number of specific action strategies for establishing successful, sustained collaboration.

Chapter Eight: Recommendations: Collaboration and the Development of a Health Focus in Planning

8.0INTRODUCTION

For planners to effectively engage with health in their work, not only should they value the incorporation of health in planning, they should also be offered practical opportunities to make health a central element of the planning process. The challenges and opportunities presented in the previous chapters show that planning staff and leadership across the country are generally aware of the impacts of planning decisions on health, supportive of collaboration with health professionals, and willing to adopt a health focus in their work. The survey results indicate that in medium to large sized cities, there is a fairly good chance (60 percent) that the planning department has already engaged in some form of collaboration with the local, county, or state health department. However, this engagement also appears to be sporadic and ad-hoc rather than based on a methodical approach to collaboration. The ability to systematically and regularly include health in planning processes requires an effective and productive process of collaboration between the two professions.

In this chapter, I provide four overarching recommendations and a series of specific, actionable strategies for promoting a focus on health in the planning field. The appropriateness of each of the specific strategies is context-dependent, contingent on the perception and state of public health concerns of any given city, the regulatory and institutional context on the municipal and state levels, staff and leadership interest in both departments, and resource availability. However, the following recommendations are

important starting points to facilitating collaboration between planning and public health and ultimately create lasting change within the institution of planning.