By Ruth Petersen MD, MPH, Section Chief, Chronic Disease and Injury Section, N.C. Division of Public Health and Julie Hunkins, Manager, Quality Enhancement Unit, N.C. Department of Transportation
In 2006, the North Carolina Department of Health and Human Services (NCDHHS) convened a meeting of the state Departments of Transportation (NCDOT), Environment and Natural Resources (NCDENR), and Commerce to discuss the possibility of the four agencies working together on common goals where public health, the natural environment, economic prosperity, and the built environment (e.g., greenways, bike ways, roads, parks) intersect.
The result of this conversation was the development of the Healthy Environments Collaborative (HEC), an interagency partnership whose mission is to integrate and align departmental efforts to improve the health of North Carolina’s people, economy and environments.
When the HEC began meeting, partners focused on gaining an increased understanding of the work of each agency and where there were potential opportunities to work together to achieve common goals.
Over the next couple of years, the HEC created a vision, mission and a strategic plan, and gained support from the Secretaries of the four state departments. In 2009, NCDHHS received Communities Putting Prevention to Work (CPPW) funding, through the American Reinvestment and Recovery Act (ARRA), to
create more physical activity opportunities for North Carolinians by creating environments that support physical activity. With guidance from the University of North Carolina at Chapel Hill, Gillings School of Global Public Health, the HEC analyzed and prioritized the importance and feasibility of different activities that would support physical activity environments across the state.
They also identified opportunities where they, as state agencies, could help remove obstacles that local governments face in their efforts to create physical activity environments.
Most recently the HEC held a strategic planning session and identified three key areas where all four departments could work together for mutual benefit: data, comprehensive planning and research. These key areas support current initiatives of all four agencies and provide an opportunity to undertake common efforts that align with the work that all agencies are already undertaking, which increases efficiency and use of resources. In addition to the collaborative efforts of the HEC, each agency now better understands and can support the efforts of other agencies. For example, NCDHHS was awarded Community Transformation Grant funding and is working very closely with NCDOT, NCDENR and Commerce to increase the number of communities across North Carolina that include health considerations in their comprehensive plans. NCDOT has included a health component in the development of its comprehensive
Statewide Bicycle and Pedestrian Plan and is also working closely with NCDENR and Commerce to better connect biking and walking facilities to existing trails and provide active transportation options that enhance economic prosperity and promote a healthier workforce within the state.
Commerce has added attributes, such as greenways, bike trails, and other recreational venues to its “Buildings and Sites” website as an offering to local communities to further showcase available commercial buildings and industrial sites as “healthy worksites.” The allowance of this information informs prospective relocating businesses that there is access to parks and recreation, greenways, pedestrian walkways, etc., that is readily available to their employees. NCDENR and NCDOT have partnered to work through environmental design issues that, in the past, have been problematic for greenway construction.
The HEC has led to the identification of opportunities where four state departments can work together and achieve mutual goals — even with different organizational missions. The agencies have learned that the state will not realize significant positive changes in public health unless they look at the built environment in concert with efforts on prevention and the treatment of chronic disease.
Health and Transportation
The NCDOTs mission is to connect people and places safely and efficiently with accountability and environmental sensitivity and to enhance the economy, health and well-being of North Carolina.
NCDOT recognizes that the opportunity to increase physical activity, and therefore improve public health, lies in the department’s concept of “active” or “healthy” transportation. It is reported that people who live walking distance to trails, paths or stores report higher amounts of walking than those who do not. NCDOT recognizes that active transportation is important to creating livable, vibrant and healthy communities and is working to affect policy and organizational change through several collaborative efforts.
One such collaborative effort, currently underway, is the development of the Statewide Bicycle and Pedestrian Plan. The plan will integrate public health considerations; demonstrate how active transportation contributes to a healthier workforce that can increase worker productivity and enhance North Carolina’s recruitment/retention of businesses; and describe how biking and walking facilities can be co-located to provide enhanced access to conservation and green open space, as well as minimize overall impacts to the environment.
With regard to the transportation-related strategies, NCDOT recognizes that it will also have to be strategic to ensure the state is getting the best bang for the buck. For example, sidewalks, bike lanes and greenways cannot be put everywhere as funding is limited. This means that as NCDOT, state agency partners and local governments work together, they must understand what the community’s needs are with regard to mobility, while also considering where facilities could have the most potential to create increased choices for physical activity for the most at-risk populations.
There has never been a comprehensive statewide bicycle and walking plan, anywhere in the nation, as wide reaching as one NCDOT is creating. As part of the plan’s development, NCDOT is performing a Health Impact Assessment to articulate the benefits of integrating bicycling and walking intentionally into transportation policies and practices. The project, widely supported and funded by the Federal Highway Administration, Blue Cross Blue Shield of NC Foundation, Commerce, NCDENR, NCDHHS and others, has become a unique collaboration. When completed, the plan will reflect the linkages of active transportation, the economy, natural environment and public health. Going forward it will also help drive policy and decision making around bike and pedestrian transportation outcomes in local communities.
The Statewide Bicycle and Pedestrian Plan is one example of how NCDOT is collaborating with its partners to create the opportunity for improved health outcomes throughout North Carolina communities. North Carolina agencies will continue to engage others and work together toward common goals for healthy communities in order to more efficiently leverage resources and achieve goals related to mobility, public health, commerce, and environment and natural resources.
Healthy Communities and a Healthy Economy
Commerce has a web-based tool on its Access NC website containing information that allows prospective business and industry clients to search for specific attributes of buildings and sites available within the state. Going one step further, Commerce recently added health and quality of life attributes that can now promote the availability of sites with access to parks and recreation, greenways, pedestrian walkways, etc. Commerce believes that illustrating health and recreational access can be a major selling point in attracting and retaining businesses and talent.
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