Background
Relationships between health and built environment are gaining increasing attention in local and regional policy arenas. It is becoming more evident that the presence and concentration of various land uses and transportation systems shape communities and the people living there. City planners and policy-makers however, typically do not directly consider individual and community health impacts of these features. The Border Health Equity Transportation Study (BHETS) serves to evaluate the significance of various mobility/built environmental factors in the health of San Ysidro community members, with a particular focus on developing a model for integrating this understanding into typical long-range planning processes carried out by city planners and policy-makers at the local and regional level. Ultimately, the study seeks to elucidate a process for directly including health considerations in long range land use and transportation planning practice. San Ysidro is the southernmost community within the City of San Diego, adjacent to the world’s busiest land crossing border. The San Ysidro community experiences a variety of distinct environmental, economic, and social impacts related to its proximity to the border. As a majority of border crossers are traveling by car, approximately 35,000 northbound vehicles per day idling an average of 100 minutes, air quality impacts are of particular concern. In addition to this unique dynamic, San Ysidro also shows high concentrations of low-income, minority populations, leading to broad concerns related to social and environmental quality.
Description
The initial existing conditions analysis utilized data from two publicly available sources: the 2012 Healthy Communities Atlas and the 2013 San Diego Community Profiles provided by the San Diego County Health and Human Services Agency. The Healthy Communities Atlas includes seven groupings of mobility/built environment variables at the census block group level: 1) demographics; 2) transportation systems; 3) physical activity support; 4) traffic-related safety; 5) access to social support; 6) crime-related safety; and 7) food environment. The community profiles provide health data aggregated by Subregional Areas (SRA), allowing for health outcome comparisons of 41 SRAs across San Diego County. Partial correlations were performed to understand the significance, direction and strength of the relationships between mobility/built environment factors and health outcomes across San Diego County, while controlling for age and income. Results of the partial correlations analysis were used to prioritize mobility/built environment factors having the most consistently significant effect on a range of health outcomes across the San Diego region. Previous planning documents and studies were reviewed to identify a preliminary set of recommendations (for their potential to influence positively community health) related to the highest priority mobility/built environment factors resulting from the partial correlations analysis. These preliminary recommendations were then vetted with community members at a workshop and at a stakeholder group meeting. The public review led to the identification of gaps in the preliminary recommendations, and further research was conducted to develop supplemental recommendations, leading to a final set of 16 focused mobility/built environment recommendations.
Lessons Learned
The analyses found that community members in the South Bay SRA (including the community of San Ysidro) appear to experience several health outcomes, such as diabetes, asthma, COPD, and rates of pedestrian injury, at relatively higher rates than the region as a whole. In addition, mobility/built environment factors with the strongest and most consistent associations with health outcomes across the San Diego region include: Percent of Households within 500’ of Transportation-Related Air Pollution Sources; Sidewalks Coverage; Access to Trails and Parks; Pedestrian Safety (composite of pedestrian collisions, traffic density, high volume arterials, and sidewalks); Youth Safety (composite of access to parks, schools, daycare, cyclist collision, pedestrian collision, traffic density); and Youth Physical Activity Support (composite of trail access, sidewalks, and elementary school access). A final set of 16 focused mobility/built environment recommendations have been identified, including a landscaped active transportation corridor that traverses the San Ysidro community, a recreational wayfinding program, an air quality monitoring program, installation of a traffic signals, and creation of a ten-acre park site.
Conclusions
The analysis process developed for this study is unique in that it establishes a framework for identifying significant health-related issues within a community, the mobility/built environment factors related to those health issues, and a set of land use/transportation recommendations intended to address the identified health issues. It provides a model for integrating health directly into long range planning, thereby equipping local planners with ability to direct decision-making toward recommendations that will improve community health.
Next Steps
The next stage of the BHETS will focus on developing an evaluation and monitoring plan to provide a clear framework for local and regional governments to track trends in key mobility/built environment factors and health outcome known to be associated with them.
Support / Funding Source
The BHETS was made possible by funding from the Caltrans Environmental Justice Transportation Planning Grant program.
