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Health Equity Assessment and Policy Recommendations

The World Health Organization defines health as “a state of complete physical, mental, and social well-being and not merely the absence of Disease.”

Research highlights that clinical care impacts approximately 20 percent of people’s health. Thirty percent of people’s health can be connected to diet and exercise with 10 percent going to physical environments such as housing, air quality, and transit. This leaves 40 percent of health impact from social and economic factors which include education, employment, and income. The built environment directly impacts health and transportation is a major component of the built environment.

Determinants-of-Health-pie-chart
Note: Excludes the role of genetics. Source: McGovern, Laura, Miller, George and Hughes-Cromwick, Paul. Health Policy Brief: The Relative Contributions of Multiple Determinants to Health Outcomes. Health Affairs. August 21, 2014. sycamoreinstitute.org

The intersection of health and the built environment including transportation presents itself in a multitude of ways. Bike trails and sidewalks to destinations, and built transportation facilities for pedestrians and cyclists can provide physical activity through using active transportation and active recreation. Public transit can reduce vehicle miles traveled which reduces traffic which reduces pollution that can increase respiratory health.

Addressing the environmental and social equity impact of the built environment can help regardless of age, race, gender, income, or ability.

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Communities
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Health Equity Ambassadors
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Organizational Assessments
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Community Health Equity Assessments

During the Health Equity Technical Assistance Pilot, communities participated in the Community Health Equity Assessment. This assessment served to evaluate and address health disparities within a community, ensuring that all individuals have an equal opportunity to attain their highest level of health. Data collected at the community level was aggregated to determine community-level thoughts and opinions of the health status of both the community and the individual. Overall, community members throughout the state rated the health of their community as neither healthy nor unhealthy or a 3.17 out of 5 using a scale of 1-very unhealthy to 5-very healthy. Respondents tended to rank their health higher than that of the community. Collectively, community members ranked themselves as healthy (3.83 out of 5).

Community members also ranked their top five important factors for a healthy community, health problems in their community, and behaviors that impact the health of their community.

Most Important Factor for a "healthy" community

  • Good Schools
  • Low crime/safe neighborhoods
  • Affordable and safe housing
  • Parks and recreation
  • Clean environment

Top Health Problems in the Community

  • Mental Health Problem
  • Lack of health insurance
  • Domestic Violence
  • Child abust/neglect
  • Cancers

Top Behaviors that Impact Health of the Community

  • Alcohol abuse
  • Lack of exercise
  • Poor eating habits
  • Being overweight
  • Drug or Substance abuse

In planning for healthy communities and addressing the top health concerns, communities should consider general policies contributing to the complete health and well-being of individuals such as:

  • Physical Health and Well-Being
  • Social Health and Well-Being
  • Mental Health and Well-Being

Policy Recommendations

By incorporating public health and transportation justice approaches into these recommendations, Vermont can work towards building not only more inclusive and equitable communities but also healthier ones, where all residents have equal opportunities to lead fulfilling lives. Collaboration among various stakeholders, including public health agencies, transportation authorities, and community organizations, is essential for successful implementation.

1.

1.

Outdoor Activity and Recreational Area

Enact a policy that encourages the construction of open-to-public areas for recreation and outdoor activities. The areas would serve as public outdoor spaces for running cultural events, providing recreational equipment, and facilitating gatherings of residents. Make sure these areas are accessible to every member, regardless of race, ethnicity, and religion. The goal is to create a safe and enjoyable environment that brings vitality and connectivity to the community.

2.

2.

Accessible and Inclusive Facility Design

Develop a policy aimed at enhancing accessible and inclusive facilities in the community neighborhood, with a focus on supporting the principles of the Americans with Disabilities Act (ADA). Ensure that people with disabilities have ample resources and opportunity to access essential amenities and services, including healthcare, education, employment, and recreational areas.

3.

3.

Spaces for All Ages

Frame a policy to conduct a comprehensive survey to understand the diverse age distribution in the community. Collaborate with various stakeholders such as parents, teachers, caregivers, and retirement community representatives to identify the specific challenges faced by children and seniors. Develop clear guidance for building either children-friendly and senior-support spaces to bring communication intergenerationally. Ensure any updates information dissemination through various formats to cater different communication needs.

4.

4.

Food Supply and Basic Livelihood Security

Implement a policy to conduct outreach programs to understand the present conditions and needs of the marginalized communities. Collaborate with various stakeholders, including local NGOs and government agencies that can assist in the implementation of comprehensive food pantry and shelter programs. Develop strategies to ensure the long-term sustainability of these programs, considering social and economic factors. If necessary, implement skill development and job placement programs to empower marginalized groups, enabling them to achieve long-term self-sufficiency.

5.

5.

Streetscape and Greenspace

Introduce a policy to enhance the streetscape following the current zoning and land use by providing well-designed street furniture such as bollards, benches, etc. that are both functional and align with the overall aesthetic of the area. Improve beautifying and greening of the neighborhood. Conduct a comprehensive survey to identify vacant or underutilized land parcels suitable for greenspace development. Preserve existing green areas and convert suitable spaces into community green space, ensuring accessibility and inclusivity for everyone.

6.

6.

Non-motorized Friendly Community

Create a policy to enhance non-motorized infrastructure by assessing, maintaining, and improving the current pedestrian or bicycle facilities to ensure the residents have safe and reliable access to essential amenities even without a vehicle. Conduct necessary road construction to create a more walkable and bike-friendly environment, dedicated to fostering a healthier community.

7.

7.

Flood Inundation Sensor and Natural Disaster Early Warning

Develop a policy to introduce an advanced natural disaster early warning system, utilizing state-of-art expertise to increase community resilience. Conduct regular flood safety drills in schools and rural communities to enhance the preparedness, particularly emphasizing public self-protection and collaboration with rescue operations. Establish a comprehensive emergency response plan to ensure effective and responsive actions during unforeseen emergencies.

8.

8.

Environmental Conservation and Public Awareness

Establish a policy to conduct a thorough evaluation of current environmental conservation efforts, raise public awareness about the changing environment in the community over the years and provide essential training to enhance public understanding of coexisting harmoniously with nature.

9.

9.

Public Information Board and Community Engagement

Establish a policy to introduce and install digital devices in front of several important amenities within the community to disseminate information to the public in a more timely and inclusive manner. Provide equal community engagement opportunities for every community member, regardless of age, gender, race, ethnicity, religion, disability, or economic status. Create sufficient resources, spaces, and facilities for community communication and engagement, ensuring community empowerment and encouraging participatory decision-making process.

10.

10.

Community Revitalization and Site Renewal

Enact a policy to support renewing sites that have been abandoned for historical reasons. Evaluate the economic impact and assess the social benefits resulting from the renewal efforts. Encourage the design and construction of placemaking around the historic site, including landscaping and interactive installations that enhance the sites’ appeal and create opportunities for community gatherings and enjoyment, while also facilitating community vitality.

By incorporating public health and transportation justice approaches into these recommendations, Vermont can work towards building not only more inclusive and equitable communities but also healthier ones, where all residents have equal opportunities to lead fulfilling lives. Collaboration among various stakeholders, including public health agencies, transportation authorities, and community organizations, is essential for successful implementation.