Over the past few decades, the planning and public health professions have collaborated to address the impact of the built environment on health. However, some of these collaborations have harmed vulnerable communities or led to the creation of ineffective policies.
In "Getting to Root Causes: Why Equity Must Be at the Center of Planning and Public Health Collaboration" (Journal of the American Planning Association, Vol. 89, No. 2), Benjamin Chrisinger claims that a focus on equity in planning-health collaborations is the solution to creating better health outcomes.
Chrisinger thinks that planning-health collaborations have been hindered by the framing of the built environment as an upstream factor for downstream health outcomes and disparities. Chrisinger believes that this is an issue because it "restricts the policymaking discourse." Instead, Chrisinger uses Laura Wolf-Powers' (2014) "three theories of action: norms, markets, or justice" for community development projects to frame the three approaches planning-health collaborations take to determine solutions on how to improve the built environment. Chrisinger claims that most planning-health work focuses on either markets or norms, leaving justice out.
He highlights the negative effects of leaving justice out in two case studies. The first case is the planning-health collaboration of improving housing for health and the second is improving food environments for health.
Urban renewal housing efforts which were partially rooted in efforts to improve public health. He claims this work was misguided because it excluded upstream considerations of root causes and led to analyses of neighborhoods that were misguided.
Efforts to improve food environments for health approached this issue by designating food deserts and creating policies to create short term support to create supermarkets. These efforts did not recognize the root causes for these food deserts — such as redlining and wage inequality.
The author thinks that equity planners can address these and other planning-health problems with a new perspective. He outlines the differences between conventional and equity-focused interventions in Figure 1. He puts the equity planners’ perspective into three main categories, outlined below:
- Participation and engagement — Equity planners can use participation and engagement to determine root causes and not give too much weight to quantitative data that is frequently used in planning-health collaborations.
- Local needs, conditions, and histories — Equity planners need to be careful of the frameworks that they use when trying to solve a problem and should use their knowledge of historical planning injustices when framing problems and solutions.
- Government and policies — Equity planners should keep focused on upstream factors that affect health and use their knowledge of local government to help create policies that create positive health outcomes.
Figure 1. Conventional and equity-focused interventions to improve the built environment and health.
As planners strive to center equity in their practice this article highlights why this lens needs to be applied in planning collaborations too. Historical examples Chrisinger highlights show that when planning-health collaborations lack equity interventions the implementation of this work can be harmful and ineffective. I found that this article helps to further strengthen arguments for the need to center equity in planning work because it shows that centering equity will lead to more effective outcomes.
The Journal of the American Planning Association is the quarterly journal of record for the planning profession. For full access to the JAPA archive, APA members may purchase a discounted digital subscription for $36/year.
Top image: Inner city neighborhood in Holyoke, Massachusetts. Credit: iStock/Getty Images Plus - DenisTangneyJr.
About the author
Holly Hodge is a master of urban planning candidate at Harvard University.