By Kirstin Q. Siemering, DrPH, RD
Wikipedia defines "comprehensive planning" as:
A term used in the United States by land use planners to describe a process that determines community goals and aspirations in terms of community development. The outcome of comprehensive planning is the Comprehensive Plan which dictates public policy in terms of transportation, utilities, land use, recreation, and housing. Comprehensive plans typically encompass large geographical areas, a broad range of topics, and cover a long-term time horizon.
Communities have been developing "Master Plans" to guide their long-range decision-making since the late 19th century (notably, concern about sanitation and the spread of disease in urban areas was the major early impetus). Amherst, Massachusetts calls its new Master Plan -- its first in 40 years -- a "statement of community intent."
Members of the Amherst Board of Health and Health Department staff, along with hundreds of Amherst citizens, were deeply involved in the two-year participatory process which led to development and adoption (in 2010) of the Town of Amherst Master Plan.
The plan addresses what population health researchers and advocates would recognize as key drivers of health: housing, economic development, natural and cultural resources, open space and recreation, services and facilities, and transportation.
Nobody’s calling this a Population Health Master Plan. But health infuses the entire plan from start to finish, reflecting the vision and ideals of the County Health Rankings Model and the Take Action Cycle. The 14-page “Implementation Matrix” (Appendix A of the Master Plan) is packed with plans for policies and programs across all County Health Rankings health factor areas.
And Amherst is not taking implementation lightly. The Master Plan’s final chapter is wholly dedicated to this topic, with much attention given to resources. In principle, the Master Plan guides and coordinates resource investment for annual work programs and budgets, development approvals, capital plans, economic incentives, and private development decisions. The implementation plan spells out specific guidelines for involving a wide variety of stakeholders in implementation (including the possibility of leadership through appointed public-private partnerships), developing appropriate regulatory tools and ensuring “concurrence” with the plan, and regular reporting and full updating at least every five years.
Curious about the road to implementation, I called the Town of Amherst’s offices and connected with Senior Planner Christine Brestrup. Ms. Brestrup said that although the County Select Board is still working toward formalizing the implementation plan, much progress has been made in the two years since the plan was adopted, especially with regard to targeted transportation policy and zoning by-laws. This has included a focus on complete streets (including sidewalk improvement), making buses more accessible to bicyclists, and developing growth regulations that encourages in-fill in traditional built centers and neighborhoods while keeping outlying areas less developed. Ms. Brestrup also highlighted the creation of the Safe and Healthy Neighborhoods Initiative, which is a collaborative effort among the health and fire departments, building inspectors, planning department, and town management to ensure code regulation compliance among Amherst’s many landlords and (largely student) tenants.
In his inaugural post nearly two years ago, David Kindig pointed to a “convergence” of thinking and action in support of population health improvement. The Amherst Master Plan (and others like it) may be signaling such convergence, similar to the new alignment among leaders in planning, public health (via new accreditation standards), and health care (via the Affordable Care Act’s new community benefit regulations).
But Dr. Kindig also likes to say, “Be careful what you wish for.” This convergence represents a tremendous – yet precarious – opportunity. Without a coordinated approach, communities stand to lose valuable time and money engaged in fruitless competition and/or duplication of effort. Kudos to everyone working within and across sectors to improve health where we live, learn, work, and play. Let’s continue to promote the types of coordinated effort across disciplines that community master planning fosters – but also do all we can to streamline our approaches to ensure that we continue to build synergy and momentum for population health improvement.
Many thanks to Town of Amherst Planning Department staff for assistance with this post:
Christine Brestrup, Senior Planner
Jonathan Tucker, Planning Director
Kirstin Q. Siemering, DrPH, RD is Social Media Lead with the County Health Rankings & Roadmaps program at the University of Wisconsin Population Health Institute.
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