Advocacy and Public Health: Partners for Walkable, Bikeable Communities

Washington State
Source: Pedestrian and Bicycle Information Center (PBIC)

Problem

Advocates need professional partners who share their vision for walkable bikeable communities.

Background

Public Health staff at the Washington State Department of Health (DOH) took note of emerging evidence that links physical activity levels to a community's land use and transportation environment. They were aware that scientists at the U.S. Centers for Disease Control & Prevention (CDC) had shown interest in "active community environments" as a public health strategy. The DOH reviewed programs and approaches to catalyze built environment change processes. The crafted a program based on two key ingredients of citizen champions and educated transportation professionals. This program received funding as part of a statewide CDC "Obesity Grant" that ran from 2003 to 2008.

Solution

The ACEs project developed the concept of an Active Living Task Force to formalize collaboration among people from diverse sectors with a stake in the way a community supports active living.

The DOH offers this definition: "Active Living Task Forces are community driven health coalitions that advise policy makers and planners to ensure quality of life, particularly through supporting and enhancing community designs that encourage all citizens to be physically active in their daily lives. Active Living Task forces are the key to implementing Active Community Environments."

Benefits of collaborating with Public Health

Public Health professionals work to reduce "threats to the overall health of a community based upon population health analysis." (Wikipedia) Specialty areas include infectious diseases, vaccination programs, occupational health, violence & injury prevention, chronic disease prevention, health education, and environmental health, among others. Practitioners are rich with skills and training in fields such as social work, marketing & communications, epidemiology, education, policy science, statistics, economic analysis, nursing and medicine. Local public health departments serve virtually every county in the United States.

Advocates play a needed role in successful pedestrian- and bicycle-friendly projects. Unfortunately, even in cities that identify active transportation as a priority, advocating for pedestrian or bicycle improvements is hard work that can often feel lonely. Exerting the consistent effort needed to see these projects through to completion exhausts individual champions. Forming a pedestrian or bicycle advocacy group increases the sheer numbers of supporters. Nevertheless, a misunderstanding of walking and biking as "special interests" remains and can even be compounded when an advocacy group thrives. Walking and bicycling are relevant issues to the broader public, but their advocates may not be best situated to deliver this message convincingly.

Walking and bicycling advocates gain several things from expanding their circle to include public health partners. Public health offers:

  1. Knowledge about health. Health is an issue of broad public interest. Practitioners in the areas of prevention, education, and environmental health are particularly interested in the benefits of increasing physical activity and reducing reliance on motor vehicles for transportation.
  2. Rigorous scientific research and evaluation methods. Medical and public health researchers hold themselves to high standards and they may have access to funding that can assist with active transportation research or evaluation.
  3. Sensitivity to equity and disparity. Public health maintains a tradition of attending to the conditions of those people who are worst off in a community. This sensitivity can offer new insight regarding how a project can best serve all segments of a community.
  4. Experience advancing causes in the context of public policy and decision-making. Public health professionals are themselves public servants. They themselves must know whether specific actions benefit the community at large or serve only a narrow interest group within the community. Professional responsibility and experience equips them to be persuasive in presenting evidence that can support walking and bicycling advocates' efforts.
  5. A fresh face in transportation and land use discussions. In many communities, decisions about transportation and land use involve a fairly unchanging cast of characters. Public Health voices may be novel in this context. Transportation staff, agency directors and elected officials may respond differently to their recommendations in part because a new face often enables people to hear even familiar messages in a new way.

Partnering with public health may be as easy as picking up the phone and calling the local health department. Asking for a contact in the areas of "Physical Activity," "Chronic Disease," or "Environmental Health," should yield logical allies for promoting walking and bicycling. For even greater benefit, communities are forming "Active Living Task Forces."

What is Special about an Active Living Task Force?

An Active Living Task Force (ALTFs) has several characteristics that distinguish it from a typical advisory group or committee. Many cities and counties across the nation have established citizen advisory groups for pedestrian and/or bicycle issues. Some bear names that are some variation of "pedestrian advisory group," "bicycle advisory committee," "citizens non-motorized transportation committee," or "trail planning group." Usually, meetings of a bicycle/pedestrian/non-motorized advisory group are attended by lay people and professionals who are focused on and passionate about the issue and run by a single staff coordinator from the transportation or public works department. In contrast, ALTFs typically involve people from multiple aspects of government, business and community sectors. The focus on active living appears to be successful in attracting diverse representatives in a community. (Note: Though this case study focuses on the Active Living Task Force, it is not essential that this specific name be used. Some communities have chosen names such as "healthy communities partnership" or "physical activity coalition" for historic purposes or even to include broader community nutrition issues.)

An active living focus serves the interests of community activity broadly and is not conflated with advocacy for a single mode of transportation. As part of their Active Community Environments program, Washington State DOH recommends that ALTFs include:

  • Older adult (age 50 and over) representation
  • Representatives from health organizations
  • People familiar local transportation policies and plans
  • People interested in non-motorized transportation
  • Representatives from schools, school districts, or parent associations.

This diversity assures that the group encompasses the technical expertise, stakeholders, community awareness, and prominent user groups who can together address unique problems and tap special opportunities to improve conditions for active living. By having multiple agency representatives participating, ALTFs reduce the burden on a single staff member and increase the number of official channels for follow-through on the task force's recommendations. By also including Regional Transportation Planning Organization staff in meetings or communications, ALTFs can help align policies and priorities at the local level with those at the regional and state level.

ALTFs can be established informally or through a government resolution. Whereas traditional advisory groups' charters restrict their purview to government affairs, ALTFs adopt a more holistic perspective. Community organizations and businesses participating in ALTF meetings may determine that they are best situated to follow through on recommendations. An ALTF thrives when its mission is infectious, spawning greater involvement and interest in the topic. Advocates who team with others in this manner increase their political, technical, and community resources and help focus funding and expertise on the task of improving our communities.

Process

Active Living Task Force meetings should be regularly scheduled and open to the public. Though most often they will elect to use a meeting room, groups should not hesitate to set up meetings in a variety of environments, including the out-of-doors. A "walking meeting" can be fruitful from time to time, especially when discussing specific design policies or project ideas. Though efforts to make a community more walkable and bikeable may be a central concern, "active living" permits and invites consideration of other opportunities such as community gardens, dance, skating, and a host of activities that fall under parks & recreation departments. Active community environments are not created through a sole focus on physical improvements, so an ALTF will also discuss and address issues related to preparation, programs, promotion, and policy. (Readers who wish to gain a better understanding of these other aspects of ACEs are encouraged to explore the "Community Action Model" developed by the Robert Wood Johnson Foundation Active Living by Design program.)

Washington State DOH has constructed an additional layer of support for ALTFs. Representatives from the Department of Transportation and from the Department of Community, Trade, & Economic Development (the agency that administers the state's land use policies) join DOH staff and representatives from the various ALTFs and Regional Planning Offices for monthly conference calls in which technical assistance, coaching, and progress updates are shared. The collaboration among state-level agencies mirrors the kind of collaboration that one observes within the local ALTFs.

Results

ALTFs identify needs, establish priorities, recommend policy changes, and even sponsor events. Washington State communities have benefitted from better communication and coordination between agencies and participation in free training publicly available to both staff and citizens.

Community Assessment

One of the first results generated by an ALTF is a community assessment. Washington's Community Assessment Tool was developed in 2004, adapted from the Michigan Department of Community Health's Promoting Active Communities Assessment. A major revision in 2007 updated the Community Assessment Tool for ease of use and to incorporate specific references to relevant state policies and guidelines. By completing this assessment, communities establish a baseline "ACEs Score" and receive a comprehensive list of action items. The assessment is conveniently structured to enable the ALTF to forward policy recommendations to decision makers in the areas of transportation & land use, public safety, community resources & recreation, worksites, schools, and public transportation.

Capacity

Be Active Skagit County in Mt. Vernon, WA used the ALTF experience to further establish collaboration with traffic engineers and regional transportation planners. Their ability to bring in a broad range of participants has been remarkable. Even the publisher of the local newspaper participates, giving them access to additional publicity. The group has been able to roll out successful seasonal events. With the experience garnered through this collaboration, the coalition and Mt. Vernon schools have crafted compelling safe routes to schools projects that have consistently scored at the top of the state's grant funding competitions.

Policy Change

The Spokane County ALTF has become the springboard for numerous projects and policy changes. There have been strong trail and bicycle advocates in the region for quite some time, but it was only after the ALTF bridged the health and planning communities that local advocates started gaining inroads into the mainstream. Though the city and county themselves at the time were not ready for a Complete Streets policy, this group promoted the idea to the Board of Health which crafted its own resolution. These are only the beginning of a burgeoning list of accomplishments in the region. A bicycle master plan is being completed and a pedestrian master planning process is about to commence.

Physical Improvements

Though no centralized list has been created to register the physical improvements attributable to these ALTFs, merit worthy work is being accomplished in each of these communities. The success from such collaboration is sometimes visible at ribbon-cutting ceremonies, but more frequently apparent in changed attitudes, shifting norms, or altered institutions. Two of the great things that come with this collaboration are an appreciation for the need to weave bicycle and pedestrian advocates goals more tightly into the fabric of community values and the systematic change process tools to achieve this.

Cost

A grant from the CDC provided support for Department of Health staffing, plus approximately $50,000 per year for 5 years of community funding and consulting assistance. Both the Washington State Department of Transportation and the Washington Department of Community Trade and Economic Development provided staff time as in-kind contributions to the project.

Web Links

Program site: http://www.doh.wa.gov/cfh/NutritionPA/our_communities/active_community_environments

Community sites:
Clark County - Community Choices
Cowlitz County - Health Department
Tri-County Region (Colville, WA) - (no link available)
Kitsap County - Health District
Skagit County (Mt. Vernon, WA) - Physical Activity Coalition
Spokane County & City - Regional Health District
Tacoma-Pierce County - Health Department
Thurston County - Health Department
City of Kirkland - recipient of EPA's 2007 Active Aging Award

Contact

James Kissee, Physical Activity Specialist
Nutrition and Physical Activity Program
Washington State Department of Health
111 Israel Road SE
Tumwater, WA 98501
360-236-3623
James.Kissee@doh.wa.gov
http://www.doh.wa.gov/cfh/NutritionPA/our_communities/active_community_environments/

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