National Minority Health Month: Build Equitable Communities with Complete Streets

bicyclists riding on a path with the Golden Gate Bridge in the background

Complete streets is the concept of designing streets so that all people—no matter if they’re walking, bicycling, using public transportation, driving, or mobility impaired—can safely and easily get where they’re going. Complete streets improve health, safety, and economic opportunities for communities.

Neighborhood Differences

Picture your neighborhood, including all the people, pets, trees, houses, schools, churches, parks, businesses, and streets. What parts of the neighborhood make people healthier? What parts negatively affect people’s health?

Not everyone has the same opportunities to be healthy. Because of discriminatory law and policy decisions made in the past, residents of low-income neighborhoods and communities of color often face greater barriers to health than those who live in wealthier, whiter areas. The conditions underlying health inequities exist in many different forms. These might include greater exposure to harmful pollutants, reduced access to fresh food and low-sugar beverages, disparities in economic opportunity and political influence, and an unsafe built environment that discourages active forms of travel and physical activity.

Low-income communities and communities of color consistently have lower access to safe streets because of long-standing disinvestment that has resulted in disparities in neighborhood conditions. As a result, these neighborhoods are often the least safe for people walking and bicycling.

One overlooked factor in community health is street design. Think back to your neighborhood. Are the streets clean, maintained, and safe for pedestrians, bicyclists, and people who use mobility assistance devices, like wheelchairs? Are there painted crosswalks and comfortable bus stops? What about the sidewalks? Are they well-lit and free of obstructions and hazardous cracks?

If the answer to these questions is yes, then there’s a good chance your neighborhood already has complete streets! But not every neighborhood is so lucky.

Completing the Streets, Ensuring Equity

In many communities across America, street design and transportation infrastructure are not conducive to positive health outcomes.

In Baltimore, for example, nearly one-third of city residents lack access to a car—a statistic that rockets to 80% in “historically disenfranchised” parts of the city that still suffer from the residual consequences of redlining and other discriminatory policies. The region’s public transportation system is disconnected from many centers of employment. And city residents endure higher rates of asthma, diabetes, obesity, and pedestrian fatalities than those who live in suburban or rural parts of the state.

In response to these pervasive and harmful injustices, community advocates and city leaders worked together to pass a complete streets ordinance in the city in 2018. While over 1,400 governments across the country have ratified complete streets policies in recent years, perhaps the most unique aspect of Baltimore’s ordinance is its commitment to “ensure equity by actively pursuing the elimination of health, economic, and access disparities.” Local leaders reached out to ChangeLab Solutions, a public health law & policy non-profit, for help ensuring the racial and economic “equity lens” in draft versions were included in the final ordinance.

Baltimore’s complete streets ordinance is a shining example for other cities, counties, and states that want to improve health and opportunity for all residents.

Tools for Public Health Professionals

Complete streets resolutions and ordinances like the one adopted in Baltimore are a powerful tool for transforming health in underserved communities. But many community advocates and policymakers don’t know where to begin when trying to implement complete streets. That’s why non-profit organizations like ChangeLab Solutions have created easy-to-use guides and model policies to help facilitate healthy, equitable changes at the local and state level.

Adapting an equitable complete streets policy that incorporates feedback from community members isn’t an easy process. City councilmembers’ policy priorities may differ radically from the needs of business owners or residents. Without thorough outreach efforts to minority groups that are often excluded from the policymaking process—like communities of color, folks with disabilities, older adults, low-income folks, and people without cars—community changes might only reflect certain privileged priorities and viewpoints.

Local public health professionals play a crucial role in enacting equitable complete streets policies.  Because of their unique perspective and placement within the community, public health leaders are positioned to see connections between policy, the built environment, economic opportunity, and health. From organizing community workshops and advocacy coalitions to conducting health impact assessments and data analysis, public health professionals can serve as a nexus between important but disconnected stakeholders.

Learn more about how complete streets can improve health and equity in your community with A Guide to Building Healthy Streets: How Public Health Can Help Implement Complete Streets.

About the Authors:

Tina Yuen, MPH, MCP, is a senior planner at ChangeLab Solutions. She works on active transportation and supports cross-sector collaboration and systems change aimed at fostering healthy, sustainable, and just communities.

Patrick Glass is a digital content writer at ChangeLab Solutions. He works on showcasing the organization’s impact around the country through storytelling.

The mission of ChangeLab Solutions is to create healthier communities for all through equitable laws and policies. Check out our online catalog, connect with us on Twitter or Facebook, and join our email list.

Originally posted by Michelle Shapiro for the National Association of County & City Health Officials at Reprinted with the permission of the authors.

Plan4Health Success Story: Sustaining the Momentum in Illinois

Photo of Planners4Health roundtable in Chicago

Plan4Health connects communities across the country, funding work at the intersection of planning and public health. Anchored by American Planning Association (APA) chapters and American Public Health Association (APHA) affiliates, Plan4Health supports creative partnerships to build sustainable, cross-sector coalitions.

The Illinois Planners4Health task force convened in an effort to carry on the work of the three Plan4Health coalitions in the preceding years. The task force consisted of a representative from each of the Plan4Health coalitions and emphasized diversity in terms of geography and discipline.

The task force embarked on an assessment to inventory existing efforts and a survey to gauge interest in the topic of integrating health and planning. The survey received 259 complete responses, 38 percent of which were from American Planning Association (APA) members — one indication of the broad reach of the survey.

The survey was designed to assess current efforts as well as gauge interest in the topic of integrating health and planning.

Gathering data for the Plan4Health project in Bensenville, Illinois. Photo by Elizabeth Hartig.

For example, the most common “completed or current initiatives” were: ADA compliance, comprehensive planning, walkability, and use of health data. The highest-ranking topics that respondents were interested in learning more about were: health in all policies, health impact assessments, and use of health data.

The survey also asked specific questions about the individual’s interest in the topic versus their organization in order to assess capacity. The survey results provided a good snapshot of the ways that American Planning Association – Illinois Chapter (APA-IL) may support early adopters of health and planning initiatives to get more organizations comfortable tackling such programs.

In July 2017, the APA-IL hosted approximately 70 professionals interested in integrating the fields of health and planning through the Advancing a Healthy Community Workshop. Attendees participated in small table conversations based on topics lead by subject matter experts. Attendees represented various levels of government, nonprofits, consulting firms, community activists, and public health departments.

Small group discussions during Illinois Planners4Health Roundtable. Photo courtesy Illinois Planners4Health Task Force.

The conversations ranged from transportation to health impact assessments. One goal of the workshop was to identify roadblocks to this work and ways that the chapter can reduce them. There was some consensus on these road blocks including lack of political will, funding, difficulty with attaining or using data, or a lack of institutional knowledge that has so far prevented them from creating health conscious plans and programs. The event aimed to bring practitioners to the table to share ideas and insights on how they may have tackled these issues.

In addition to small table discussions, there was a resource library available to participants. The resources provided examples and case studies in public health and planning programs. Participants left with new ideas to implement health based planning strategies as well as new connections to foster partnerships.

Based on the assessment and the workshop, the task force decided that the most helpful deliverable to come out of Planners4Health initiative would be some sort of “infrastructure” to facilitate idea-sharing and to connect practitioners.

The result is the website you are currently visiting, the Healthy Communities Illinois microsite. The microsite features a forum that is password-protected and moderated to ensure a high quality of information. The site will be designed to be easy to use and impactful as a “one stop shop” for the integration of health and planning in Illinois.

Learn more about the APA-IL’s efforts to advance healthy planning:

About the Author: Courtney Kashima, AICP is an urban planner and small business owner of Muse Community + Design in Chicago.

Feature image at top: Planners4Health roundtable in Illinois. Photo courtesy Planners4Health Illinois Task Force.

Reproduced with permission of the author. Originally posted at