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(5) Health in All Policies in the Imagine 2040 Tampa Comprehensive Plan: An integrative review


Ayesha Johnson, PhD – Senior Health Researcher, Florida Department of Health in hillsborough County

Pedro Parra, BA – Principal Planner, Hillsborough County City-County (Planning Commission)


When a comprehensive plan is developed for the community, the impacts to human health are sometimes overlooked. To promote equitable development, sustainable communities and longevity, the unintended impacts of plans and policies should be explored before they are implemented. The Office of Health Equity (OHE) at the Florida Department of Health in Hillsborough County (DOH-Hillsborough) has sought to empower other public facing agencies to understand the health impacts of plans and policies that are implemented. Since 2015, OHE has collaborated on many projects with Plan Hillsborough, the umbrella organization responsible for transportation and land use planning in Hillsborough County, Florida. The partnership’s history includes conducting a health impact assessment on a complete streets plan, establishing community gardens to promote healthier communities, working to reduce traffic deaths to “0” and participating in several inter-agency committees and workgroups. DOH-Hillsborough has also participated in collaborations on various other community projects, including work to adopt a Health in All Policies (HiAP) planning approach intended to formalize the consideration of health into transportation planning decisions. Key HiAP principles include promoting health, equity and sustainability; supporting inter-sectoral collaboration; benefitting multiple partners; engaging stakeholders; and creating structural or procedural change. From ongoing HiAP work with Plan Hillsborough’s Metropolitan Planning Organization, a health priorities matrix was developed which highlighted agency cross-sectoral alignments. In early 2018, Plan Hillsborough’s Planning Commission undertook a qualitative review of the Imagine 2040 Tampa Comprehensive Plan (TCP), adopted by Tampa City Council, to assess the plan’s alignment with state and local health priorities established. This review identified no less than 153 policies and objectives that directly or indirectly addressed one or more of the state and local health departments’ priority areas. To follow this work in identifying alignment, the Planning Commission requested that DOH - Hillsborough further analyze the TCP and make health recommendations about the plan to the Tampa City Council. The review was intended to be through a HiAP lens to build on prior work. The problem statement for this collaborative project was to develop a suitable framework to evaluate health in comprehensive plans and policies. Problem Statement: Identifying a framework to evaluate health in comprehensive plans and policies.
Methods: To address the problem, OHE staff searched the literature for frameworks to evaluate a comprehensive plan for how it addresses health and identified a few. These included conducting health impact assessments (HIA) on individual level comprehensive plan policies, using AARP’s Age Friendly Community Program standards, evaluating the policies for HiAP, and using ChangleLab Solution’s Healthy Comprehensive Plan Assessment Tool (HCPAT). The TCP contains more than 400 pages of text and more than 1,000 goals, objectives and policies (GOPs). For this reason, an actual HIA on individual level policies was not feasible. The team chose ChangeLab Solution’s framework to evaluate the TCP. The tool calls for implementing keyword searches within health-related domains. Researchers also compared the TCP to the Orlando Growth Management Plan (OGMP) as Orlando is a municipality similar in size and demographics to Tampa.
Results: The review found that the TCP performs stronger in some health-related domains and weaker in others. The TCP performed similarly to the OGMP in the various health-related domains. This review conducted was able to determine that the TCP contains health-related terms and references. However, the review cannot say that the plan sufficiently includes health. This would require more in-depth analysis. However, this is a beginning step to incorporate health into comprehensive planning and can serve to help other “non-health” sectors to evaluate policies for their impact on human health. It is also a reasonable undertaking in terms of time, staff commitment and resources available to a local health department. Recommendations: To further advance the comprehensive plan effectiveness in addressing health the authors recommend: using a quasi-health impact assessment approach. This would be supplementing the HCPAT review with exploring a few of the individual level comprehensive plan policies that were identified as containing health-related references, for how they impact human health; and adopting an evidence-based measurement platform for gauging plan effectiveness, explicitly highlighting health in plan brochures and introductions, and evaluating intersectoral collaborations in plan development.



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