Over a year ago, I sat with East Palo Alto (EPA) residents and listened as they identified health problems facing their community. They discussed more obvious health concerns such as EPA’s high rate of asthma (over twice the County’s rate) and challenges with accessing healthcare. Residents also raised issues like overcrowding in housing, the lack of middle income jobs, and inadequate transportation to connect the community to opportunities. This workshop was part of EPA’s effort to link health to the City’s long range planning process.

EPA and cities around California are doing this by making plans and investments to ensure residents’ good health in the long-term by including a Health Element in their General Plan. A General Plan is often considered the ‘constitution’ of a City. It guides the long-term development of a city through seven required ‘elements’ or chapters. Each element creates a vision and plan for a specific aspect of daily life, for example housing, transportation, and open space.

East Palo Alto is in the final stages of completing its General Plan and while a Health Element is not one of the required elements, we’re pleased to report the plan includes a Health Element!  Here are five reasons why I’m overjoyed East Palo Alto is including it:

• Health begins where we live. Diabetes, asthma, and obesity are chronic conditions that are related to the places where we live. EPA’s Health Element calls for policies and investments that protect health at every level. With more walkable and bikeable streets; healthier food options; safer, affordable, more stable places to live; and improved access to healthcare – EPA will create an environment that supports health for all residents for years to come.
• Healthy planning is visionary. It’s not always easy to see the forest through the trees; it takes strong vision and leadership to set goals and priorities for health.  For instance, EPA planners saw asthma as a big issue and explored how more active forms of transportation could be used to help improve air quality. Connecting the dots between land use and health outcomes helps everyone envision possibilities in even seemingly mundane decisions.
• An inclusive process makes an inclusive plan. Over the course of two and a half years, the City and the consulting team conducted thorough outreach to engage residents through workshops, focus groups, town hall meetings and many, many advisory committee meetings. These efforts led to insights into what factors affected residents’ health. For example, while facilitating the health and equity visioning workshop, residents’ identified displacement and gentrification as issues having serious consequence for their health, which is in line with research findings that people who live in healthy, affordable places live longer, healthier lives. Because of this organic input, EPA could identify preventing displacement as a City priority.
• We can measure success. Get Healthy SMC worked with the City to include data that can track the health of East Palo Alto residents. Over time, the city will measure its progress on this important issue to gauge the effectiveness of their efforts to build a healthy, equitable community, and make course corrections if necessary.
• People are a priority. Including a Health Element in a General Plan shows a commitment to the wellbeing of the people who call East Palo Alto home. Setting this priority ensures that for years to come city staff and elected officials will consider impacts to residents’ wellness in the decisions they make.

For cities on the fence about including a health element, EPA Senior Planner Guido Persicone says, “My advice to cities is definitely do it. [A health element] is not required by law but at the end of the day our job is to focus on the long term growth and resources of the city and our greatest resource is the people who live here.”

Have questions about health elements? Need help thinking it through? Interested in health data for your city? Send me an email atmjohnston@smcgov.org and let’s find a way to build health into your city’s planning.

For more information, check out ChangeLab Solutions’ and Raimi and Associates’ resource How to Create and Implement Healthy General Plans.

You can also check out East Palo Alto’s draft General Plan.