The City as Health Policy conference will engage these questions with panels on the following topics:
Urban Agriculture and Food Policy
Food environment policies are health policies. At first blush, this is perhaps one of the easier connections to make between broader city policies and health.
In some cities, community leaders and legislators have sought to redress health inequalities by targeting the restaurant landscape. For example, in 2008, citing obesity rates and a heavy saturation of fast food restaurants in Black and Latino neighborhoods, the Los Angeles City Council enacted an ordinance forbidding new fast food outlets.
Policymakers posited that prohibiting additional restaurants might open up a greater diversity of food retailers, thereby promoting healthy dietary choices. But thinking capaciously about food environments reveals a number of pathways to health.
Education is a powerful health determinant, and food environments can shape whether children are equipped for schooling. Students who are hungry, or who live in food insecure environments are not optimally positioned to learn.
Food policies can also be vehicles for progressive employment opportunities, itself an important socioeconomic health determinant. Finally, food policies can develop human capital: farmers markets provide more than a variety of fresh produce—they are also public spaces that foster social interaction.
Transportation policies are health policies. Cities that create and maintain streets scaled for people rather than cars alone; and that promote direct, safe, and attractive walking, promote health.
Pedestrian-scaled streets not only promote physical activity, but they convey to city residents that the streets are theirs. Infrastructure that encourages the routine use of bicycles across age, gender, and ability enable mobility for residents from a diversity of backgrounds.
Youth can exercise independence along with their bodies, can learn to navigate their urban environment at an early age, and can start the school day with physical activity and social interaction. Rich mass transit networks reduce pollution and open up employment centers and other opportunities.
In many U.S. cities, sprawling land use makes automobiles a necessity to navigate the city. For those who are unable to own or drive a car, cities without diversity in transportation planning make navigating urban space an unnecessary challenge.
And when police selectively target bicyclists for violations and ticketing (and particularly when those cyclists are disproportionately African American, as is the case in Tampa, FL), transportation policy is not only health policy, but also law enforcement policy.
Law Enforcement and Criminal Justice
Law enforcement policies are health policies. When law enforcement is responsive to its constituents, and provides security and safety equitably, city residents have faith that their lives are in good hands.
But shootings of unarmed citizens, revenue-driven policing strategies, unconstitutional stops and searches of hundreds of thousands of city residents, and misconduct in a context of low accountability and transparency all undermine health.
Such policies and practices cause stress and trauma, reduce the state’s credibility and impede civic engagement, hamper an animated public life, and perpetuate racial and socioeconomic harms that extend beyond criminal justice.
In that regard, unjust policing could be seen as an environmental health hazard. Progressive environmental policies require hazardous industries to demonstrate safeguards for local communities, so that facility siting and operation does not cause harm. Might the same be asked of law enforcement practices?
Community and Economic Development
Community development policies are health policies. In recent years, the cratering of the housing market, the dramatic decline in wealth among African American and Latino homeowners following disproportionate exposure to foreclosure, and activism for affordable housing have been prominent in public discourse.
Neighborhood change has also put into stark relief the tensions undergirding community and economic development. Dramatic increases in real estate prices, resident displacement, and the recasting of neighborhood resources for affluent newcomers have significantly altered community social fabrics.
Cultural and structural forces create multiple, and often opposing constraints on economic development, and messages about social exclusion and participation in civic society are writ in the built environment, often times explicitly.
To the extent that community and economic development fosters or hinders the citizenry’s ability to engage with external actors in order to leverage resources, promotes or reduces stress and social pain, builds or undermines wealth and financial security, and encourages or detracts from creativity and beauty in the urban landscape, these policies are health policies.