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Policy change. Environmental trigger + efficiency and government accountability values (audience: elected officials and city/county manager)
We are spending billions of dollars every year on healthcare for people with chronic illness when we could avoid many of these costs by making smarter investments in the first place. If we make sure our school lunches are healthier, and our sidewalks are better lit and safer for children to walk to school, we could save a lot of money in the long term. That’s why we want to work with the managers of all of the city’s agencies to make sure that funding decisions are made with the health of our children in mind.
Systems change. Environmental trigger + efficiency value (audience: other agencies) Government agencies are continually being asked to do more, often with fewer staff and resources. If we could work together on a regular basis, we could eliminate redundancies, better meet our goals, and improve our ability to support communities. We know this isn’t just an issue for public health and transportation, though. We need public works to help us look at street lighting, police to help parents feel that it’s safe to walk to school, the school districts to provide healthy lunches, and planners to create walkable neighborhoods with inviting destinations. When you think about it, we need a formal Health in All Policies group that can meet regularly to help us figure out how all of our agencies can work together for better health.
SAMPLE ANSWERS TO COMMON QUESTIONS ABOUT HEALTH IN
ALL POLICIES
There are sure to be hard questions about Health in All Policies from colleagues, partners, stakeholders, and policymakers. Below are a number of sample answers to questions using the formula of Environmental Frame + Solution + Values = Health in All Policies.
Question: How do we know that Health in All Policies works? Answer: Public health professionals have known for a long time that we need to consider the environment and circumstances in which we live to help ensure optimal health (environmental trigger). Local, state, and national governments worldwide have been using a Health in All Policies approach (even before it had that name) in order to devise creative solutions to seemingly intractable health problems. Public health worked with public works agencies to build sewage and sanitation systems that reduced infectious disease and simultaneously reduced rodent populations and prevented flooding. Public health also worked with transportation agencies to introduce seat belts, safer road designs, and other innovations that together have led to major declines in rates of automobile crash deaths. Health in All Policies applies the lessons learned from those experiences to today’s key health challenges (solution). (Values: Efficiency, Government Responsibility)
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Question: We’re all so stressed out and busy already—why should we in other agencies get involved in health when that’s the job of the Public Health Agency? Answer: Of course, the Public Health Agency has a big role to play. But we’ve known for a long time that community environments have a huge impact on health—even more than the effect of medical care (environmental trigger). In the Public Health Agency we don’t have the expertise or authority to change those environments. We can only do this with your help. We all have a role to play in creating healthy environments to solve some of our most pressing health problems. If we work together, we can find solutions that will be win-wins and move us all toward shared goals. For example, we know that building bike and pedestrian infrastructure creates more jobs, decreases air pollution and greenhouse gas emissions, and increases physical activity which improves both health and academic performance for students. And we know that “farm-to-fork” activities help to protect agricultural lands, support local economies, and increase healthy eating. Leadership and innovation aren’t always easy, but we owe it to the people we serve to work together to find the best ways to solve complex problems, and Health in All Policies is one strategy that will help us to do that (solution). (Values: Collaboration, Efficiency, Government Responsibility) Question: Won’t Health in All Policies be expensive? Why should other agencies spend their precious resources on issues outside their purview?
Answer: We can’t afford not to use a Health in All Policies approach. These days, social and environmental problems are so complex that lasting solutions require everyone in government to work together. The consequences of city planning, sanitation, transportation, or food systems policies can include lifelong effects on the health of whole communities (environmental trigger). In part, siloed approaches got us into this problem in the first place, and the poorest communities have borne the brunt of this inefficient approach. We can do better. By investing the time and creativity now to consider how health will be impacted, we can prevent expensive problems from happening in the first place. It is not only in our best interest to consider how all policies affect health, but it is our job (solution). (Values: Equity, Government Responsibility, Ingenuity or “Can-Do” Spirit)
Question: Aren’t these health problems really just the result of people making bad decisions? Answer: People in the United States have always believed in the idea of opportunity, but some people don’t have many opportunities for health. It makes sense that it’s easier to exercise if you have a safe park or playground nearby, or nice, well-lit sidewalks to walk on. And we all know it’s more tempting to buy a soda if you walk by lots of places that sell them cheaply on your way down the street (environmental trigger).
Government does have a role in protecting and serving its people, especially when it’s hard for people to do something by themselves. One way government can do that is by affording all people more opportunities for health, for example by building safe places to play, inviting in new food sources (like grocery stores and farmers’ markets), or creating safer routes to work and school. Using a Health in All Policies approach gives all government agencies the opportunity to think big-picture about how their work will have lasting impacts, and to find the best possible solutions that serve everyone (solution). (Values: Opportunity, Government Responsibility)
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CONSIDER THE WHOLE MESSAGE STRATEGY (MESSAGE, AUDIENCE,
MESSENGER)
The way we talk about Health in All Policies is a critical part of our work. Health in All Policies is about changing the way government works so that health is taken into account in decisions that are made across government, with an eye toward creating healthy community environments that provide everyone with opportunities and resources for health. Because the default frame in our society is one of individualism, many people may challenge the idea that government should consider health across policy areas. To effectively communicate about Health in All Policies, it is important to consider your audience, trigger an environmental frame, use an appropriate messenger, provide a vivid description of the environment that contributes to poor health (and your vision for one that supports health), and state the values that motivate your effort to create change. Messages that incorporate each of these critical elements will be the most successful at gaining supporters and addressing other people’s concerns.
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The following case study on the California Health in All Policies Task Force describes a formal Health in All Policies group that has been in existence for over three years. This is just one way of doing Health in All Policies work, and there are many other ways to use this approach, as described throughout this Guide.
PART III. CASE STUDY: CALIFORNIA
HEALTH IN ALL POLICIES TASK FORCE
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KEY POINTS
The California Health in All Policies Task Force came about because a number of California’s leaders across multiple agencies had a common interest in climate change, health, and childhood obesity.
A governor’s executive order provided high-level support and accountability for Health in All Policies, created a structure, and provided a policy focus.
The Task Force engages non-governmental stakeholders and representatives of local government through workshops, stakeholder and key informant meetings, and public comment and testimony.
SECTION 8: The California Story
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8.1 The Creation of the California Health
in All Policies Task Force
Several key factors set the stage for the creation of California’s Health in All Policies Task Force, including the Governor’s strong interests in health and the environment, increasingly upstream work on the part of the public health agency, and a funding opportunity that created a venue for engaging high-level leadership.
Former California Governor Arnold Schwarzenegger’s long-standing interest in fitness and childhood obesity, as well as his commitment to addressing climate change and environmental sustainability, created a “window of opportunity” for pursuing innovative policies. During his administration, the California legislature passed a series of landmark climate laws, one of which required better coordination of land use and transportation planning (SB 375 Steinberg, 2008).216,217 Also in 2008, legislation established the Strategic Growth Council (SGC) to support state agencies in coordinating their work on climate change and sustainability.218 The members of the SGC are secretaries from the California Business, Consumer Services and Housing Agency, the California Transportation Agency, the California Health and Human Services Agency, the California Environmental Protection Agency, and the California Natural Resources Agency. The SGC also includes the director of the Governor’s Office of Planning and Research and a public member appointed by the Governor.
At the same time, the chronic disease staff at the California Department of Public Health (CDPH) were increasingly aware that, along with obesity, climate change is one of this century’s biggest threats to public health. While reviewing the literature regarding obesity and chronic disease prevention strategies, as well as strategies to reduce greenhouse gas emissions, health department staff were struck with the congruence of approaches, and learned of the Health in All Policies approach.
Over a period of several months, CDPH leadership discussed the connections between obesity prevention and greenhouse gas reduction with the secretary of the Health and Human Services Agency, which oversees CDPH, specifically with respect to a “window of opportunity” for CDPH to get involved in the implementation of the aforementioned SB 375 law. In 2009, CDPH incorporated a Health in All Policies proposal into their application for Communities Putting Prevention to Work funds through the American Recovery and Reinvestment Act. The proposal identified state efforts to coordinate sustainable community development as an opportunity for public health to shape policy regarding access to safe places for physical activity. In this application, CDPH proposed that the governor convene a task force on Health in All Policies.
While this piece of the proposal was not funded, the internal approval and submission process for the grant afforded an opportunity for continued discussion about the Health in All Policies approach.
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“[The governor understood] that if we really care about improving the health status of the people of our state, we have to care about the health of our communities. That’s why he has embraced a very broad community-based approach to prevention. [The] Health in All Policies Task Force reflects his recognition that if we’re going to make success in improving health status broadly and particularly addressing health disparities and health inequities we have got to engage the community broadly: the transportation sector, agriculture, education, economic development. That’s what the Health in All Policies Task Force is about. It’s about working in a coordinated and coherent way to improve the communities in which people live, so that the choices people make are healthy choices.” —Kimberly Belshé, former Secretary, California Health and Human Services Agency, November 2010222 In February 2010, Governor Schwarzenegger held a “Summit on Health, Nutrition and Obesity: Actions for Healthy Living.”219 During a moderated discussion with former President Bill Clinton, he announced that he would pursue eight specific actions to support healthy living in California, one of which was to issue an executive order establishing a Health in All Policies Task Force. Executive Order S-04-10 placed the Task Force under the auspices of the SGC and identified CDPH as the facilitator.220 The SGC was identified by the governor and members of his cabinet as a natural site for this undertaking because it already included many of the agencies and departments that impact health, and because the SGC is explicitly mandated to foster coordination and collaboration of state agencies in order to promote public health and safety among other things.
Executive Order S-04-10 called for the Task Force to:221 • Identify priority programs, policies, and strategies to improve the health of Californians while advancing the other goals of the SGC. The SGC’s goals include improving air and water quality, protecting natural resources and agricultural lands, increasing the availability of affordable housing, improving infrastructure systems, promoting public health, planning sustainable communities, and meeting the state’s climate change goals;
• Submit a report to the SGC recommending programs, policies, and strategies to improve the health of Californians while advancing the SGC’s goals;
• Describe the benefits for health, climate change, equity, and economic well-being that may result if the recommendations are implemented;
• Review existing state efforts, consider best/promising practices used by other jurisdictions and agencies, identify barriers to and opportunities for interagency/intersectoral collaboration, and propose action plans;
• Convene regular public workshops to present its work plan; and • Solicit input from stakeholders in developing its report.
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8.2 Task Force Membership
In March 2010, the SGC convened the Health in All Policies Task Force, designating 19 California state agencies, departments, and offices to participate:
• Air Resources Board
• Business, Transportation and Housing Agency
• Department of Community Services and Development
• Department of Education
• Department of Finance
• Department of Food and Agriculture
• Department of Forestry and Fire Protection
• Department of Housing and Community Development
• Department of Parks and Recreation
• Department of Social Services
• Department of Transportation
• Environmental Protection Agency
• Governor’s Office of Gang and Youth Violence Policy
• Governor’s Office of Planning and Research
• Health and Human Services Agency
• Labor and Workforce Development Agency
• Natural Resources Agency
• Office of the Attorney General
• Office of Traffic Safety
Each designated agency, department, and office was asked to identify a representative who was familiar with the breadth of their agency’s activities, connected to staff with in-depth expertise, empowered to speak on their agency’s behalf, and able to engage agency leadership in discussions and decisions about the Task Force’s work. CDPH established a team of backbone staff to support the Task Force.
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8.3 The Health in All Policies Task Force
Process
BUILDING A SHARED VISION
Initial Task Force meetings in the spring and summer of 2010 focused on developing a common understanding of the problems at hand, identifying how each partner’s work connects to public health issues, establishing a shared vision and aspirational goals for a healthy California, and exploring and developing expectations, commitments, and decision-making parameters. Five activities were particularly useful in this process:
DEVELOPMENT OF HEALTHY COMMUNITY FRAMEWORK
At the first meeting of the group in June 2010, Task Force members were asked: “When you hear the term ‘healthy community,’ and you think about the health of yourself and your family and kids, what comes to mind?” The responses demonstrated that the Task Force members intuitively understood that health happens in schools, neighborhoods, and workplaces, and that environments shape their own health behaviors. After several rounds of review and refinement, including discussion at the stakeholder input workshops (described below), the Task Force adopted the Healthy Communities Framework (available in Section 1.3). This framework was foundational to the Task Force’s shared vision and created a map for Health in All Policies-related endeavors in California.
CREATION OF ASPIRATIONAL GOALS
Task Force members developed aspirational goals as a way of building a cohesive vision. At the first Task Force meeting, staff provided two sample goals to frame the discussion, and at subsequent meetings the group developed a total of six aspirational goals (available on page 118). Aligned with the Healthy Communities Framework, the aspirational goals focus on areas with a very clear nexus between the work of the SGC and the Task Force member agencies. The goals’ simple language has made it easy for staff, other agencies, the public, and policymakers to understand and share a vision with the Task Force. Together, the Healthy Communities Framework and aspirational goals served as a good starting point for talking about the social determinants of health and the need for Health in All Policies.
ROOT CAUSE MAPPING EXERCISE
California Health in All Policies Task Force members used a root cause mapping exercise (see Sections 2.2 and 6.1 for a description and examples) to help elucidate the complexity of interrelated determinants of health and outline the need for Health in All Policies. The exercises focused on two problem statements:
“Unable to walk, bike, or take public transit to school, work, play, or other essential destinations” and “Healthy and affordable food not available at school, work, or in neighborhood.” The full Task Force reviewed and discussed each of the maps (drawn in real-time on large butcher paper in small groups), and then each participant noted places on the map where their agency might have a role. This process helped members visualize the complexity of the problems faced by California communities, and the necessity for and promise of intersectoral collaboration to achieve common goals.
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THE CALIFORNIA HEALTH IN ALL POLICIES TASK FORCE’S
ASPIRATIONAL GOALS223
• Active Transportation. All residents have the option to safely walk, bicycle, or take public transit to school, work, and essential destinations • Healthy Housing and Indoor Spaces. All residents live in safe, healthy, and affordable housing
• Parks, Urban Greening, and Places to be Active. All residents have access to places to be active, including parks, green space, and healthy tree canopy • Community Safety through Violence Prevention. All residents are able to live and be active in their communities without fear of violence or crime • Healthy Food. All residents have access to healthy, affordable foods at school, at work, and in their neighborhoods
• Healthy Public Policy. California’s decision-makers are informed about the health consequences of various policy options during the policy development process
DEVELOPING JOINT POLICY BRIEFS
California Health in All Policies Task Force staff and key policy experts worked with Task Force members to develop policy briefs that explored the links between health and the areas of responsibility of Task Force member agencies. This process helped staff and Task Force members better understand the relationships between health and other sectors, provided staff with an improved understanding of how the partner agencies see their own work, and helped staff to more fully appreciate the importance of partner agencies’ work. Working on the briefs also provided many reminders about the importance of refraining from using public health jargon or framing every issue only from a health perspective. The briefs can be viewed in Appendix 4 of the Health in All Policies Task Force Report to the Strategic Growth Council. 224
ENGAGING STAKEHOLDERS
In the first four months of the California Health in All Policies Task Force, staff held over 100 individual meetings with Task Force members and policy experts. These were essential for building relationships and gathering information that shaped recommendations. The stakeholder input workshops, described in more detail below, were also an essential part of developing a vision.
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DEVELOPING RECOMMENDATIONS
The Executive Order required the Task Force to produce a report with recommended programs, policies, and strategies to improve the health of Californians while advancing the SGC’s goals. The Task Force followed several steps to accomplish this deliverable.
GENERATING IDEAS
From August to October of 2010, the Task Force and staff collected over 1,200 ideas for government action to improve health. Ideas came from a variety of sources including Task Force agency members, public health practitioners, academic experts, nonprofit advocacy organizations, stakeholder input workshops (see below) and a review of published literature and compilations of recommendations such as the Institute of Medicine’s report Local Government Actions to Prevent Childhood Obesity, 225 the Robert Wood Johnson
Foundation’s Action Strategies Toolkit,
226 the surgeon general’s Call to Action to Promote Healthy Homes,227 and The Climate Gap: Inequalities in How Climate Change Hurts Americans and How to Close the Gap. 228
Many of the ideas that were generated involved elevating projects or proposals that had been developed by community organizations, but would benefit from the endorsement and involvement of state-level agencies and leadership.
APPLYING CRITERIA
The Task Force developed criteria for the selection of recommendations, which were applied informally in November of 2010. Criteria included:
• Population health impact
• Co-benefits and nexus with other SGC objectives
• Evidence-informed
• Ability to foster collaboration among state agencies and stakeholders • Equity impact
• Measurability
• Feasibility
• Ability to transform state government culture
A health lens was informally applied by a group of health experts from a wide variety of programs at CDPH who reviewed the recommendations and rated their potential impacts on health. Staff sorted the long list of policy ideas in several ways (e.g., by government function, sector impacted, and policy topic area) in order to cluster similar ideas and gather feedback from stakeholders. Sorting the ideas also helped the Task Force identify important health policy areas that did not initially appear on the list.
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DECISION-MAKING
The Task Force explored the different types of decisions that the group would need to make, discussed various approaches including consensus decision-making and gradients of agreement, and set ground rules for making decisions as a group. Task Force members chose to use a consensus decision-making process, and agreed that Task Force members should speak up with concerns so that the group could reach the best possible decisions. During these conversations, members also discussed attendance and decided that if members send a designee in their place, they need to make sure that the designee has been briefed and can participate fully in the decision-making process.
The Task Force selected its initial set of recommendations in the fall of 2010. This involved several meetings of the whole group, meetings with individual members to discuss recommendations related to their agency, and collective editing of documents to ensure that every Task Force member (and their agency leadership) felt comfortable with the ideas and specific language of the recommendations. Any Task Force member could veto a recommendation if they did not feel comfortable with it, and many recommendations were left on the cutting room floor. Reaching consensus was time-consuming and required an iterative process of repeated review and revision. However, this process built cohesion in the Task Force and strengthened its recommendations—in terms of content, acceptability, and feasibility—in large part because the Task Force addressed the concerns of and built on ideas from staff at so many different agencies. The fact that the final recommendations were based on true consensus of all participating state agencies lends tremendous credibility to the Task Force’s work.
WRITING THE REPORT
Drafting the 2010 report, Health in All Policies Task Force Report to the Strategic Growth Council, with the Task Force’s recommendations proved to be a tremendous task. The report not only required a consensus process to craft exact wording of recommendations, but also included a rationale for Health in All Policies, and a discussion of the links between each recommendation, sustainability, and health. Getting all of the partner agencies to support and approve the report involved many rounds of meetings, emails, phone calls, and sometimes negotiation between multiple partner agencies that were not in agreement. However, the process was incredibly important in allowing participants to gain a better understanding of the issues and opportunities for collaborative action.
The Task Force approved 34 recommendations and presented them to the SGC in a December 2010 report.229 The recommendations were clustered in six topic areas, listed below, which align with the Task Force’s six aspirational goals:
1. Active transportation
2. Housing and indoor spaces
3. Parks, urban greening, and places to be active
4. Community safety through violence prevention
5. Healthy food
6. Healthy public policy
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It is important to note that the Task Force’s recommendations do not represent an overall health strategy for the state (such as the National Prevention Strategy230 or the Healthy Chicago Priorities231); they are a set of policy suggestions that this group of agencies and departments felt were feasible, had co-benefits for multiple parties, and represented a consensus that was achievable at a particular moment in time.
In addition, because of the connection to the SGC, all recommendations were required to align with California’s sustainability goals. The recommendations set forth in December 2010 do not address a number of important health issues or determinants of health (e.g., lactation, drugs and alcohol, poverty, and economic development) that either lacked sufficiently direct environmental sustainability links or were not viewed as within the purview of Task Force members. These topics could still be addressed in the future.
PRIORITIZING RECOMMENDATIONS FOR ACTION
When the SGC approved the Health in All Policies recommendations in December 2010, it asked the Task Force to select a smaller set of initial priority recommendations and to develop implementation plans for each. The SGC requested that the Task Force focus on near-term feasibility, actions within the SGC’s jurisdiction, and efforts that could have a significant impact. With input from a second series of stakeholder input workshops conducted around the state in the spring of 2011, the Task Force selected 11 priority recommendations spanning the six topic areas of the initial report. These were presented to the SGC in June 2011.
MOVING FROM IDEAS TO ACTION
In 2012, the Task Force moved to a new stage, turning its focus to implementation.
DEVELOPING IMPLEMENTATION PLANS
From July 2011 through May 2012, Task Force staff and agency members developed eight implementation plans for the 11 priority recommendations. This was done through large and small group in-person and phone meetings, and with significant input from experts and stakeholders. The implementation plans identify action steps, timelines, agencies responsible, and deliverables. In addition, the implementation plans each describe considerations related to four cross-cutting themes that emerged from the 2011 stakeholder engagement process: 1) interagency collaboration, 2) equity, 3) community engagement, and 4) data. To develop these implementation plans, Task Force members offered ideas, committed to specific action steps, and agreed to take on leadership roles in implementing specific recommendations.
For example, the California Department of Forestry and Fire Prevention took the lead on the plan for urban greening.232
CARRYING OUT IMPLEMENTATION PLANS
As of spring 2013, the Task Force is carrying out all eight implementation plans. Backbone staff facilitate frequent interagency meetings to coordinate efforts, and Task Force members use the implementation plan action steps and timelines to track accountability. The Task Force is completing most of the actions without any additional funding, and with voluntarily support from existing staff within partner agencies. The Task Force staff has secured additional funding to support three implementation plans related to “farm-to-fork” policies, healthy and sustainable food procurement, and community safety through violence prevention.
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HARMONIZING POLICY GOALS
An important ongoing role of the California Health in All Policies Task Force is to address areas in which there is a need to harmonize multiple important and health-related policy goals across agencies. The following example illustrates how multiple agencies, through the Task Force, have worked together to create alignment between important policy goals related to land use and health.
California has enacted laws promoting the integration of transportation, air quality, and land use planning to address climate change and other public policy objectives.233,234,235 It is challenging to implement all of these goals simultaneously, particularly in areas where many sites that might be available for affordable housing are located near busy roadways. Also, several laws, executive orders, and guidance related to land use either require or encourage state and local agencies to pursue interrelated and health-promoting goals such as:
• Promote and prioritize infrastructure, infill, and transportation-oriented development; • Support reduction of automobile travel and vehicle miles traveled (VMT) per capita, and promote active transportation infrastructure to increase walking and bicycling; • Keep people and goods moving, which is good for health and the economy; • Preserve environmental and agricultural resources including land and water, which are required to feed a growing population;
• Reduce greenhouse gas emissions, to reduce catastrophic climate change impacts; • Assure housing needs are met for all income levels;
• Mitigate known significant environmental and health impacts of projects; and • Improve regional air quality and reduce exposure to harmful air pollutants to reduce risks for cardiovascular and respiratory disease.
In response to this challenge, the Task Force convened a multi-agency Housing Siting and Air Quality Workgroup, which seeks to increase intersectoral understanding on the part of agencies and stakeholders about the interrelatedness of these issues, the need for harmonization, and strategies to support harmonization, such as better data or more research on effective methods to improve indoor air quality in polluted areas.
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ENGAGING STAKEHOLDERS
The California Health in All Policies Task Force has employed a variety of methods for engaging stakeholders and gathering their input.
STAKEHOLDER INPUT WORKSHOPS
The Task Force partnered with local health departments to host eight stakeholder input workshops across California in two rounds, in 2010 and 2011. Invitations were disseminated through partners, including Task Force members, local health departments, and the informal stakeholder group described below, and the workshops attracted between 15 and 90 attendees each. Outreach targeted community-based and health organizations and the housing, food, transportation, and environmental groups and agencies with whom they work. A professional facilitator guided staff in designing agendas and facilitated the workshops in a way that fostered solution-oriented input.
The first round of workshops introduced the Health in All Policies Task Force and engaged attendees in the “What is a healthy community?” exercise that the Task Force used early in its own process. The facilitator briefed attendees on the role of state agencies as compared to local agencies, and participants were asked to discuss how state agencies contribute to or impede their ability to advance healthy communities and to provide recommendations for state agency action. The second round of workshops gathered input on prioritization of recommendations for near-term implementation, contributing to the 11 priority recommendations described above.
The stakeholder input workshops provided several benefits including increasing awareness of and support for the Health in All Policies approach and the Task Force itself. They also provided an opportunity for people working on many different issues to meet and talk with others in their own communities, and led to broader, ongoing engagement through written and in-person public comments at SGC public meetings.
STAKEHOLDER GROUP AND KEY INFORMANT MEETINGS
Health in All Policies staff meets periodically with an informal stakeholder group of leaders from health and policy nonprofit organizations that are interested in the Health in All Policies approach and that maintain on-going engagement with local stakeholder groups in their own work to advance healthy and equitable communities. Staff also consults with experts from local health departments, community organizations, advocacy groups, academics, and others engaged in Health in All Policies efforts in the United States and abroad in order to further the work of the Task Force.
PUBLIC COMMENT AND TESTIMONY
The Task Force provides periodic progress reports to the SGC. These presentations provide an opportunity to celebrate achievements and to engage SGC members in providing additional support and guidance when needed. The SGC is subject to California law that requires state boards and commissions to publicly announce their meetings and agendas and include opportunities for public testimony and comment.
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STAFFING, FACILITATION, AND RESOURCES
Task Force members devote significant time to Task Force meetings, subgroup meetings, consultation with the Health in All Policies staff team, and review of all Task Force written materials. In addition, Task Force members facilitate meetings with other staff in their departments or agencies as well as with Health in All Policies stakeholders.
The Task Force is staffed and facilitated by CDPH in partnership with the Public Health Institute. The Health in All Policies backbone staff team serves as the hub linking many concurrent projects, ensuring that the broader effort maintains coordination and momentum. To accomplish this, they develop meeting agendas, facilitate meetings, collect and compile best practices and public comments, convene public workshops, review the policy and academic literature, propose strategies for approaching tasks, and provide support for the partners engaged in implementing Health in All Policies, with continual consultation and input from Task Force members and key staff from the SGC.
EXPENSES AND RESOURCES
It is difficult to quantify the resources and expenses of the California Health in All Policies Task Force because much of the work is provided in-kind by partner agencies. The California Health in All Policies Task Force’s major expenses and resources are summarized below.
Expenses.
• Health in All Policies Task Force staff. The current staff includes one CDPH public health medical officer who dedicates part of her time to Health in All Policies, and core staff (4.5 FTE) who are employed by the Public Health Institute. Of these, one FTE was hired through grant funding to support implementation of a specific Task Force project (healthy food procurement), while the rest address all other aspects of the Task Force’s work. In-kind contributions of staff time from Task Force member agencies and the SGC are significant and vary by agency and over time. A variety of other staff at CDPH support the work of the backbone team and of the Task Force by sharing their expertise and exploring ways to align their efforts with those of the Task Force. • Stakeholder input workshops. Expenses have included a professional facilitator, facility rental, food, and travel.
• Subcontracts. The Task Force uses subcontracts to secure input from policy experts on specific topics. For example, grant funding is allowing the Task Force to subcontract with the Local Government Commission to develop guidance materials on violence prevention through changes in the built environment.
• Interns. The Task Force hires two to three student interns each year to foster professional development in Health in All Policies and to support Task Force work. In 2012, the Task Force placed a summer intern in a partner agency’s office, and had that intern conduct projects that involved collaboration between the host department and CDPH.
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Resources.
• California Department of Public Health. In addition to state staff time, CDPH underwrites a portion of operational costs for the Task Force backbone staff. • Grants. Primary funding for Public Health Institute backbone staff and Task Force expenses comes from The California Endowment. The Kaiser Permanente Community Benefits Foundation has also funded one staff person to implement the Task Force recommendation on healthy food procurement.
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PROCESS EVALUATION OF CALIFORNIA HEALTH IN ALL
POLICIES TASK FORCE236
In 2012, the Public Health Institute, with funding from the American Public Health Association, hired the independent firm Harder + Company Community Research to conduct a process evaluation of the California Health in All Policies Task Force. The evaluation involved surveys and interviews of Task Force members and key stakeholders, and focused on relationships, meeting effectiveness, reasons for and barriers to continued engagement, and lessons learned about the process. Below are some highlights from the evaluation’s findings.
Measuring Success
• The top three reported “elements of success” for the Task Force:
1. Politically and financially feasible and actionable recommendations
2. Intersectoral participation
3. Establishment of a high-level directive
• Ninety percent of Task Force members indicated that the Health in All Policies collaborative process produced recommendations that will promote the goals of their own agency. • Fifty-nine percent of Task Force members indicated that they now have greater trust in other state agencies as a result of participating in the California Health in All Policies Task Force. • Fifty-four percent of Task Force members reported that they collaborate more with nongovernmental organizations and community-based organizations as a result of the Health in All Policies process.
• Task Force members reported that the collaborative linkages and relationships established through the Health in All Policies process have fostered intersectoral collaboration on other issues, with Health in All Policies serving as a model for “effective and improved governance.” • Task Force members’ motivation to stay involved was based upon the significant statewide impact and potential to improve the health of California’s residents.
Learning Opportunities
• Although they were time consuming for staff, Task Force members overwhelmingly reported that one-on-one meetings with Health in All Policies staff were important for sustaining engagement, building an understanding of how agency work impacts health, and vetting ideas.
• Task Force members requested clarification of the expected time commitment and duration of participation, so that they could secure permission from their own agency leadership to engage in this work in an ongoing manner. This is especially important because there are no funds specifically to support the staff time contributed by participating agencies.
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8.4 Challenges, Accomplishments, and
Looking to the Future
CHALLENGES
Key challenges for California’s Health in All Policies Task Force are described below. • Sustaining staff and other resources. The California Health in All Policies Task Force continues to rely upon nonprofit organizations with external foundation funding to support the work of the Task Force. The California Health in All Policies Task Force does not have specific funding for the work of partner agencies, which makes it difficult to secure commitments to long-term, labor-intensive projects or processes. Each member carves out resources where they can, knowing that this work is an executive-level priority. As Health in All Policies is increasingly recognized as a successful approach for addressing complicated and interrelated issues, requests for technical assistance at the local and federal level have increased, and current resources are inadequate to meet the increasing need for this assistance.
• No established roadmap. Because California is the first state in the country to take this approach, there is no roadmap for how to do this kind of work, so each step is taken with heightened deliberation and scrutiny. While breaking ground is demanding, it has also made the work exciting and particularly meaningful as others look to California to share the lessons it has learned along the way.
• Balancing implementation activities with a larger vision. Task Force members face a continuous tension between implementing specific and feasible policy and program ideas and pursuing big picture goals such as integrating a health lens into decision-making throughout government. While it is important for any initiative to pursue both focused short-term activity and long-term planning, there is a risk that the resources required for implementation will make it difficult for the Task Force to stay focused on the big picture of embedding health and equity into decisionmaking processes across government. • Turnover in leadership and in partners. Turnover among leaders and partners is a continual challenge for the Task Force. In 2011 a transition between gubernatorial administrations caused high turnover among agency partners. Health in All Policies Task Force staff dedicated significant time to orienting new partners and learning about their priorities—which did not always match those of their predecessors. In some cases, new agency staff were less receptive to Task Force involvement, and in other cases, new agency staff had greater enthusiasm and new ideas that needed to be incorporated into the ongoing work of the group.
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• Measuring incremental change. The work of transforming government culture is tremendously important but can be undervalued, especially because it is difficult to measure and may take many years to achieve. Measuring the health outcomes of this work is difficult, especially because health is influenced by so many different factors. The Task Force has documented an increase in interagency trust and collaboration as a result of its work, and is achieving policy changes as well. Health and equity outcomes resulting from the Task Force’s efforts are likely to take many years to become evident, and even then it may be difficult or impossible to trace them back to specific actions.
ACCOMPLISHMENTS
While its work has been challenging, the Task Force has had some notable successes, with more on the horizon. It has not only led to a cultural shift among state agencies, as described in the evaluation outcomes above, but has led to concrete changes in state policy and programs, and has spawned an awareness of and interest in intersectoral collaboration in local communities and among decision-makers and advocates across California. Many of California’s successful Community Transformation Grant applications, such as San Francisco’s, incorporated a Health in All Policies approach. Twelve smaller counties across California have also incorporated Health in All Policies approaches into their Community Transformation Grant work.
Local jurisdictions around California are adopting formal Health in All Policies approaches, and many have expanded intersectoral collaboration as a part of their regular business practices.
California’s legislature issued a joint resolution to express its support of the Health in All Policies concept and of the Health in All Policies Task Force. Issued in June 2012, Senate Concurrent Resolution 47 encourages:237
• Task Force members to provide leadership on implementing the recommendations put forth in the Health in All Policies Task Force Report;
• Interdepartmental collaboration with an emphasis on the complex environmental factors that contribute to poor health and inequities when developing policies in a wide variety of areas; • Consideration of both short- and long-term health impacts, costs, and benefits, where appropriate, when weighing the merits of proposed legislation; and
• Public officials in all sectors and levels of government to recognize that health is influenced by policies related to air and water quality, natural resources and agricultural land, affordable housing, infrastructure systems, public health, sustainable communities, and climate change, and to consider health when formulating policy.
The Health in All Policies Task Force has been named as a key partner for a number of state-level initiatives.
For example, California’s December 2012 Let’s Get Healthy California Task Force Final Report, which provides a 10-year plan to make Californians healthier, lists Health in All Policies as a strategy for promoting healthier communities.238 In addition, the Health in All Policies Task Force has been embedded within the newly established Office of Health Equity at CDPH,239 with the recognition that achieving greater health equity is inextricably tied to the work of Health in All Policies. The Health in All Policies backbone staff are now housed within the Office of Health Equity and will be involved in developing the new Office’s strategic plan.
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In carrying out its implementation plans, the Task Force has seen a number of early successes. With a few exceptions, most of the early gains listed here are “low-hanging fruit” that will serve as building blocks for deeper collaboration and development of more substantial wins moving forward. • In August 2012, the California Department of Finance executed an Interagency Agreement between the California Department of Education, the California Department of Food and Agriculture, and CDPH to develop an interagency Office of Farm to Fork, drawing resources from all three agencies.
This office will promote policies and strategies to improve access to healthy, affordable food. • The Governor’s Office of Planning and Research and CDPH have partnered to identify land use strategies to expand the availability of affordable, locally grown produce. The two agencies are now integrating this information into a range of other planning programs and guidance documents. • The Task Force hosted an orientation workshop called Complete Streets: Designing for Pedestrian and Bicycle Safety for staff from nine different agencies, in order to provide an opportunity for a multi-sectoral dialogue among agencies with a stake in creating “complete streets.” • The California Department of Forestry and Fire Protection worked with the Governor’s Office of Planning and Research to develop a webpage that provides information for local governments to use in planning for a healthy urban forest that optimizes benefits to the environment, public health, and the economy.
• Staff from the California Department of Education, the Governor’s Office of Planning and Research, the SGC, and the Task Force met to explore the linkages between health, sustainability, and school infrastructure, and to explore opportunities to promote these multiple goals through the State’s General Plan Guidelines and the section of the California Code of Regulations that relates to K–12 school facilities construction and rehabilitation.
• The SGC integrated language into their Sustainable Communities Planning Grants Program to encourage regional entities applying for funding to incorporate health into their planning and decision-making processes and to partner with local health agencies. • The Healthy Community Framework has been incorporated into programs such as the 2010 California Regional Progress Report, which provides a framework for measuring sustainability using place-based and quality-of-life regional indicators.240 • The SGC has funded the development of a core set of indicators to measure and monitor each of the components of the Healthy Community Framework.
• The Southern California Association of Governments has created a public health committee to support its Regional Transportation Plan, and has invited Task Force staff to serve on that committee and help the region make links to health and equity as it develops policy proposals for the upcoming plan.
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LOOKING TO THE FUTURE
While the California Health in All Policies Task Force is focused on implementing its 2010 recommendations, it continues to uncover new opportunities for growth. The SGC Strategic Plan 2012-2014 leaves open the possibility of the development of a new set of Health in All Policies Task Force recommendations, and the Task Force continues to meet quarterly, with smaller multi-agency work groups focused on specific projects as needed. As relationships and trust have deepened, and as new champions have emerged in partner agencies, some topics that did not move forward in 2010 have gained traction since. For example, a newly elected superintendent of education has prioritized health promotion in schools, which has opened the doors to not only promoting physical activity, healthy food, and drinking water, but has also launched an exploration of how schools can prioritize health and sustainability when making funding decisions about infrastructure projects.
One of the priority recommendations of the Task Force is to embed health not only in programs and policies, but in government processes, by laying out a broad, voluntary process for state agencies to promote health and equity through their guidance documents, technical assistance programs, and data collection processes. In addition, the passage of the California Senate Concurrent Resolution supporting Health in All Policies opens the door for further work with the legislature on the integration of health considerations into legislative processes. Both of these could pave the way for the Task Force to make significant strides in embedding health considerations into the way that business is conducted at the state level in California. Finally, the Health in All Policies approach has resonated around the state with many local health departments and community-based organizations. A growing number of local elected bodies are exploring ways to place health considerations more squarely into the center of the policy-making process, based on the value of having a more efficient government, which in turn yields a more equitable society and a healthier, more productive population.
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The public health challenges of the 21st century are extremely complex, and solutions will require actions that go beyond the purview of public health, bringing together partners across policy areas and sectors.
While public health has a long history of intersectoral collaboration, Health in All Policies is an emerging approach that aims to formalize the consideration of health in decision-making at all levels of government in order to promote healthy community environments and prevent adverse health impacts in the future.
Five key elements of Health in All Policies are vital to the success of this work:
1. Promote health and equity by incorporating health and equity into specific policies, programs, and processes, and by embedding health and equity considerations into government decisionmaking processes;
2. Support intersectoral collaboration by bringing together partners from many sectors to recognize the links between health and other issue and policy areas, break down silos, and build new partnerships to promote health and equity and increase government efficiency;
3. Benefit multiple partners and simultaneously address the policy and programmatic goals of both public health and other agencies;
4. Engage stakeholders beyond government partners, such as community members, policy experts, advocates, the private sector, and funders; and,
5. Create structural or procedural change in order to fundamentally change how government works by embedding health and equity into government decision-making processes at all levels.
Health in All Policies actions and groups can take many forms, but the ultimate goal of this approach is to fundamentally change government so that agencies are aligned around a common vision for a healthy and equitable society, and so that health is considered in decision-making across sectors and policy areas. With this vision in mind, opportunities to do this work can emerge nearly anywhere. Health in All Policies can be implemented through creation of a new structure or group, or can be applied to existing processes such as strategic planning and grant-making, or both. Many options exist for how to consider health in decisionmaking, from using formal health impact assessment tools to an informal application of a health lens.
Partners, leaders, and focus areas will vary, depending upon political support, community needs, and resources.
By their very nature, Health in All Policies initiatives will give rise to tensions between agencies on specific issues, but these tensions may be managed through relationship-building and collaborative decisionmaking structures. Over time, Health in All Policies can help build interagency trust and promote deeper collaboration and robust stakeholder engagement on high-stakes issues, leading to more efficient and effective governance.
CONCLUSION
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This is a particularly exciting moment in public health history in the United States, as more and more attention is focused on health equity and the underlying social determinants of health. The concept of Health in All Policies is taking hold across the nation, and is being practiced under many names. This approach will evolve as more states and local governments employ this approach. There is tremendous need right now for cities, counties, and states to share their stories and help build the body of knowledge and evidence supporting Health in All Policies work. In the meantime, the authors hope this guide will help support current and future endeavors to promote healthy communities across the country.
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APPENDICES
I. Glossary
ACTIVE TRANSPORTATION. Walking, biking,
wheeling, and taking public transit. Public transit
is considered active transportation because
it generally involves an active mode at the
beginning or end of the trip.
BACKBONE ORGANIZATION. Described as part
of the Collective Impact Model, “backbone”
organizations provide supporting infrastructure
for collaborative efforts through meeting
facilitation, fundraising, data collection and
reporting, administration, and communications
support.241
BUILT ENVIRONMENT. Human-made (versus
natural) resources and infrastructure, including
homes, schools, workplaces, roads, parks,
restaurants, and grocery stores, that form the
physical setting for community activities.
CO-BENEFIT. A secondary benefit arising from
implementation of a policy or program that has
a different primary benefit as its purpose. Health
co-benefits can result when non-health policies
intentionally or unintentionally impact health
outcomes. A Health in All Policies approach
embraces integrating efforts to address different
agency goals in order to achieve “win-win” or
co-beneficial solutions. For example, policies
to reduce greenhouse gases may have public
health co-benefits through positive impacts on
air pollution, active transportation, etc. (Also see
Win-Win)
COLLABORATION. Two or more parties or
organizations working together to pursue new
approaches that achieve goals that satisfy all
engaged parties. In general, collaboration
involves more than just an intersection of
common goals, but actually working together to
identify shared objectives.
COMMUNITY ENGAGEMENT. Public participation
that involves dynamic relationships and promotes
a mutual exchange of information, ideas, and
resources between community members and
public agencies in a context of partnership and
reciprocity. Community engagement can include
varying degrees of involvement, decision-making,
and control.
COMMUNITY GREENING. Planting and managing
“green” infrastructure, including trees, gardens,
parks, agricultural land, and other vegetation.
This term is often used interchangeably with
urban greening, but is inclusive of both urban
and non-urban communities.
COMMUNITY SAFETY. Community safety
encompasses both the perception of safety
and the implementation of strategies that
protect the population from crime, violence,
and injury hazards or threats. Rates of crime,
violence, and preventable injury are indicators
of community safety.
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COMPLETE STREETS. Streets that are planned,
designed, operated, and maintained to provide
safe travel and access for all users, including
bicyclists, pedestrians, transit riders, and
motorists of all ages and abilities appropriate to
the function and context of the facility.
CRIME PREVENTION THROUGH
ENVIRONMENTAL DESIGN (CPTED). A
method of deterring crime by creating physical
environments that discourage criminal behavior
and encourage healthier use of space.
DATA. The factual points of information
(e.g., measurements or statistics) that are used
as a basis for reasoning or calculation242 or
simply “a collection of items of information.”243
(Also see Evidence)
DISADVANTAGED POPULATIONS. Generally
defined by economic parameters that
demonstrate a low household income. More
broadly, these populations result from social
isolation and limited access to opportunities
and resources. This cluster of factors makes
it hard for members of these populations
to achieve positive life outcomes. (Also see
Marginalized Groups)
ECOSYSTEM SERVICES. The benefits to human
communities from resources and processes
supplied by the natural environment. Ecosystem
services can be very difficult to monetize and so
are often taken for granted. Examples include
clean air, clean water, and wetlands that buffer
coastal or riparian zones, provide habitat, and
filter water flow.
EVIDENCE. Evidence can simply be “proof
supporting a claim or belief.”244 For public
health interventions, evidence often refers to
information regarding “the effectiveness of
an intervention in achieving an outcome that
will create lasting changes in the health of the
population.”245
FARM-TO-FORK. A strategy to increase access
to affordable healthy foods by supporting farms
in production and delivery to local consumers
(including individuals and organizations). This
can include linking consumers directly to growers
and establishing local or regional distribution
systems.
GENERAL PLAN/COMPREHENSIVE PLAN. A
long-term plan that includes a vision and policies
for the physical development of a county or city.
GUIDANCE DOCUMENT. A written statement,
often issued by a government agency, that contains
instructions for meeting a set of expectations or
interpreting laws or requirements.
HEALTH. The World Health Organization defines
health as “a state of complete physical, mental
and social well-being and not merely the
absence of disease or infirmity.”246 Health is a
fundamental component of quality of life, and a
healthy population is a critical building block for
a sustainable and thriving economy.
HEALTH DISPARITIES. “Differences in health
status among distinct segments of the population
including differences that occur by gender, race
or ethnicity, education or income, disability, or
living in various geographic localities.”247 Health
disparities may result from random variation,
individual biology, economic, educational, and
social opportunity, social and cultural beliefs,
or access to health care. Health disparities are
not necessarily unfair or inequitable and may be
unavoidable if changing the health determinants
is impossible or ethically unacceptable.
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HEALTH EQUITY. A situation in which all
people have the opportunity to achieve their
full health potential, with no one at a
disadvantage because of socially-determined
circumstances.248 Health equity is the absence
of systematic and potentially changeable
differences in health (or in major social
determinants of health) between socially,
economically, demographically, or geographically
defined populations. Achieving health equity will
involve focusing societal efforts on addressing
avoidable inequalities by equalizing the
conditions for health for all groups, with efforts
specifically placed on improving conditions for
those who have experienced socioeconomic
disadvantage or historical injustices.
HEALTH IMPACT ASSESSMENT (HIA). The health
impact assessment process is “a systematic
process that uses an array of data sources and
analytic methods, and considers input from
stakeholders to determine the potential effects
of a proposed policy, plan, program, or project
on the health of a population and the distribution
of those effects within the population. An HIA
provides recommendations on monitoring and
managing those effects.”249
HEALTH IN ALL POLICIES (HIAP). A collaborative
approach to improving health that incorporates
health considerations into decision-making in all
sectors and policy areas. A Health in All Policies
approach convenes diverse partners to consider
how their work influences health and how
collaborative efforts can improve health while
advancing other goals.
HEALTH INDICATOR. A measurable characteristic
of an individual, population, or environment that
can be used to describe its health status.
HEALTH INEQUITY. A subset of health disparities
“that are a result of systemic, avoidable and
unjust social and economic policies and practices
that create barriers to opportunity.”250
HEALTH LENS. A systematic way of finding
opportunities to improve health and embed
health in decision-making. Using a health lens can
involve formal (e.g., health impact assessment,
South Australia’s Health Lens Analysis process) or
informal methods.
HEALTH OUTCOME. A change in the health
status of an individual, group, or population as
the result of planned or unplanned interventions
rather than simply change over time. This
includes intended or unintended changes
resulting from government policies.
HEALTH STATUS. The National Institutes of
Health defines health status as “the degree to
which a person is able to function physically,
emotionally, socially, with or without aid from the
health care system.”251
HEALTHY COMMUNITY. A community that
embodies economic, physical, social, and service
environments that are known to promote health.
The California Health in All Policies Task Force
defines a Healthy Community as a community
that provides for the basic needs of all, quality
and sustainability of environment, adequate
levels of economic and social development,
health and social equity, and social relationships
that are supportive and respectful.
HEALTHY PUBLIC POLICY. A policy or set of
policies that is explicitly responsive to health
needs. It may be designed specifically to
promote health or, if not dealing directly with
health, have an influence on the determinants
of health and, in turn, positively impact
health outcomes.
INFILL. Building on, developing, or redeveloping
unused, vacant, and underutilized urban or
largely developed areas.
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INTERDEPENDENCE. A relationship between
individuals, communities, or individuals and the
communities in which they live, such that each
is mutually reliant upon and responsible for the
other. Local, state, national, and global public
health initiatives and their societal and political
contexts are interdependent. Interdependence
between people is the essence of community.
INTERSECTORAL COLLABORATION. A
recognized relationship—ranging from a formal
agreement to an ad hoc group—between
different sectors of society working together in a
way that can improve outcomes more effectively,
efficiently, or sustainably than when working
independently from one another.
MARGINALIZED GROUPS. Groups of people
who are generally not considered or included in
important processes, and are often discriminated
against, face greater inequalities, and are
deprived of inclusion and access to resources
due to factors beyond their control.
METROPOLITAN PLANNING ORGANIZATIONS
(MPO). A federally defined regional council
of governments within a metropolitan area
that is authorized to develop a Metropolitan
Transportation Plan/Regional Transportation Plan.
METROPOLITAN TRANSPORTATION PLAN (MTP)/
REGIONAL TRANSPORTATION PLAN (RTP).
Metropolitan Planning Organizations (MPOs) are
required by federal law to produce a MTP, also
known as an RTP. The RTP is a process that MPOs
embark on every four to five years to identify how
a region will spend transportation revenue over
the next 25 years.
MOBILITY. The ability of an individual to
physically move freely and easily.
MONITORING. Performing routine measurements
with the goal of detecting environmental, health,
or other status changes.
POLICY. An agreement on issues, goals or a
course of action by the people with power to
carry it out and enforce it.252,253
PUBLIC POLICY. A course of action adopted
and pursued by governments in response to a
perceived problem. Laws, regulations, decisions,
funding priorities, and other actions of government
express public policy. Public policies are
implemented and enforced by public agencies.
PROGRAM. An organized set of procedures,
routines, or activities, usually to achieve a specific
goal or policy objective.
ROOT CAUSE MAPPING. A structured process for
identifying key factors contributing to community
health problems in order to identify methods for
correcting or eliminating these underlying factors
and promoting improved outcomes. This can be
useful for identifying leverage points and helping
agencies outside the public health field discover
links to health and each other’s work.
SMART GROWTH. A theory of transportation
and land use planning that concentrates growth,
avoids sprawl, and promotes a mixture of land
uses in order to serve a community’s economic,
health, environmental, and social needs.
SOCIAL DETERMINANTS OF HEALTH. The
biological, behavioral, economic, physical,
environmental, and political factors that shape
the health of individuals, communities, and
jurisdictions.
STAKEHOLDERS. The individuals, groups, or
organizations with an interest in a project, policy,
or program but who are not already partners in
a process. This can include those with decisionmaking authority, funders, clients, the public, community-based organizations, advocacy
groups, local agencies, academic experts, or
public health practitioners. In many contexts
this implies non-governmental parties; in state
processes this can include local governments.
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SUSTAINABILITY. Creating and maintaining
conditions so that humans can fulfill social,
economic, and other requirements of the
present without compromising the ability of
future generations to meet their own needs. This
can be thought of in terms of environmental,
economic, and social impacts, and encompasses
the concept of stewardship and the responsible
management of resources.
TRANSIT-ORIENTED DEVELOPMENT. Compact,
mixed-use development (including housing,
offices, retail, and other amenities) that supports
active transportation and is located near public
transportation facilities or corridors.
VULNERABILITY. The degree to which an
individual or group of people are susceptible
to harm. In public health, this term is commonly
used in the fields of disaster response and
climate change adaptation, but can also apply
to the broader social determinants of health.
Vulnerability of individuals and populations to
injury or chronic disease can vary as a result of
socioeconomic status, social cohesion, gender,
health, age, and other factors. Differences in
vulnerability can often be attributed to social or
health inequities.
WHOLE-OF-GOVERNMENT. Includes public
agencies “working across portfolio boundaries
to achieve a shared goal and an integrated
government response to particular issues.”254
WIN-WIN. A solution that is satisfactory or
guarantees a favorable outcome for all parties.
This may be an outcome with one benefit for all
parties, or may have multiple benefits. A Health
in All Policies approach seeks to find win-win
solutions. (Also see Co-benefit).
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II. Definitions of Health in All Policies
“Health in All Policies is a collaborative approach that integrates and articulates health considerations into policy making across sectors, and at all levels, to improve the health of all communities and people.” - Association of State and Territorial Health Officers (ASTHO)255 “Health in All Policies is a collaborative approach to improving the health of all people by incorporating health considerations into decision-making across sectors and policy areas.” - California Health in All Policies Task Force
“Health in All Policies is the policy practice of including, integrating or internalizing health in other policies that shape or influence the [Social Determinants of Health (SDoH)]… Health in All Policies is a policy practice adopted by leaders and policymakers to integrate consideration of health, well-being and equity during the development, implementation and evaluation of policies.” - European Observatory on Health Systems and Policies256 “Health in All Policies is an innovative, systems change approach to the processes through which policies are created and implemented.”
- National Association of County and City Health Officials (NACCHO)257 “Health in All Policies aims to improve the health of the population through increasing the positive impacts of policy initiatives across all sectors of government and at the same time contributing to the achievement of other sectors’ core goals.”
- South Australia258
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III. South Australia’s 10 Health in All
Policies Principles
A Health in All Policies approach reflects health as a shared goal across government.
In particular it:
1. Recognizes the value of health for the wellbeing of all citizens and for the overall social and economic development of South Australia—health is a human right, a vital resource for everyday life and a key factor of sustainability.
2. Recognizes that health is an outcome of a wide range of factors—such as changes to the natural and built environments and to social and work environments—many of which lie outside the activities of the health sector and require a shared responsibility and an integrated and sustained policy response across government.
3. Acknowledges that all government policies can have positive or negative impacts on the determinants of health and such impacts are reflected both in the health status of the South Australian population today and in the health prospects of future generations.
4. Recognizes that the impacts of health determinants are not equally distributed among population groups in South Australia and aims at closing the health gap, in particular for the Aboriginal peoples.
5. Recognizes that health is central to achieving the objectives of South Australia’s Strategic Plan (SASP)—it requires both the identification of potential health impacts and the recognition that good health can contribute to achieving SASP targets.
6. Acknowledges that efforts to improve the health of all South Australians will require sustainable mechanisms that support government agencies to work collaboratively to develop integrated solutions to both current and future policy challenges.
7. Acknowledges that many of the most pressing health problems of the population require long-term policy and budgetary commitment as well as innovative budgetary approaches.
8. Recognizes that indicators of success will be equally long-term and that regular monitoring and intermediate measures of progress will need to be established and reported back to South Australian citizens.
9. Recognizes the need to regularly consult with citizens to link policy changes with wider social and cultural changes around health and wellbeing.
10. Recognizes the potential of partnerships for policy implementation between government levels, science and academia, business, professional organizations and non-governmental organizations to bring about sustained change.
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Part I. What is Health in All Policies and
Why Do We Need It?
SECTION 1: BACKGROUND
1.1 WHAT IS HEALTH IN ALL POLICIES?
Environmental HiAP Toolkit. National Association of City & County Health Officials. Available at:
http://www.naccho.org/toolbox/program.cfm?id=32&display_name=Environmental Health in All Policies (HiAP) This toolkit includes a searchable database of tools and resources on Health in All Policies and environmental health policy to help raise awareness and to educate local decision-makers.
Health in All Policies: Strategies to promote innovative leadership. Association of State and Territorial Health Officials. (January 2013). Available at: http://www.astho.org/Programs/Prevention/Implementing-theNational-Prevention-Strategy/HiAP-Toolkit/ This document provides a description of the National Prevention Strategy, key talking points to explain a Health in All Policies approach, characteristics of successful intersectoral collaboration, and case studies of states uses Health in All Policies approaches.
Implementing Health in All Policies, Adelaide 2010. Kickbusch, I., & Buckett, K. (Eds). (2010). Rundle Mall, South Australia: Government of South Australia, Department of Health. Available at: http://www.who.int/ sdhconference/resources/implementinghiapadel-sahealth-100622.pdf This document summarizes the establishment of Health in All Policies in South Australia, reviews other international Health in All Policies examples, discusses theoretical frameworks and methodological perspectives, and provides case studies describing how Health in All Policies has been utilized in projects throughout South Australia.
1.2 WHY WE NEED HEALTH IN ALL POLICIES
A framework for public health action: The health impact pyramid. Friedan, T.R. (2010, April). American Journal of Public Health, 100(4), 590–595.
This article uses a 5-tier pyramid to describe the range of intervention necessary for maximum public health benefit. This model shows that interventions focusing on the social determinants of health reach broader segments of society than clinical interventions.
IV. Annotated References
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America’s tomorrow: Equity is the superior growth model. Treuhaft, S., Blackwell, A.G., & Pastor, M. (2011). Oakland, CA: PolicyLink, University of Southern California’s Program for Environmental and Regional Equity. Available at: http://www.policylink.org/atf/cf/%7B97c6d565-bb43-406d-a6d5-eca3bbf35af0%7D/ SUMMIT_FRAMING_WEB_FINAL_20120127.PDF
This report makes the case that achieving equity is of vital importance to the nation’s economic recovery and economic future, and frames equity as the new economic growth model. The authors highlight the opportunity to leverage the United States’ growing racial and ethnic diversity as a competitive asset in the face of current workforce challenges.
Closing the gap in a generation: Health equity through action on the social determinants of health (Final Report of the Commission on Social Determinants of Health). Commission on Social Determinants of Health. (2008). Geneva: World Health Organization. Available at: http://whqlibdoc.who.int/ publications/2008/9789241563703_eng.pdf
This report calls for global action from the World Health Organization and all governments to close health inequity gaps in the timespan of a generation. The Commission sets forth three overarching recommendations and three principles of action to achieve this goal.
Overcoming obstacles to health. Robert Wood Johnson Foundation, Commission to Build a Healthier America. (2008, February). Princeton, NJ. Available at: http://www.commissiononhealth.org/report. aspx?publication=26244
This report provides data and discussion on social differences in health in the United States, including affected populations and associated costs. This report analyzes the role of social factors in the causal pathway of health disparities, emphasizes the transmission of health across generations, and provides guidance on finding solutions to reduce current health disparities.
Promoting health equity: A resource to help communities address social determinants of health.
Brennan Ramirez, L.K., Baker, E.A., & Metzler, M. (2008). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Available at: http://www.cdc.gov/ healthycommunitiesprogram/tools/pdf/SDOH-workbook.pdf
This workbook provides nine case studies of communities working to achieve health equity, as well as step-by-step guidance for readers on how to start, evaluate, and maintain a social determinants of health inequities initiative.
Roots of health inequity: An online learning collaborative. National Association of County and City Public Health Officials (NACCHO). (2012). Available at: http://www.rootsofhealthinequity.org This online course allows participants to explore how to address health inequities. Key topics include public health history, root causes of health inequities, principles of social justice, where to start working, and how framing works. Content allows for group-directed learning and includes interactive media, case studies, readings, and presentations.
The spectrum of prevention: Developing a comprehensive approach to injury prevention. Cohen, L., & Swift, S. (1999). Injury Prevention, 5, 203–207.
This article proposes a framework to support multi-faceted approaches to injury prevention that can help public health practitioners move beyond a focus on education interventions. The authors show the importance of working across a spectrum of prevention in order to meet public health prevention goals.
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The spirit level: Why greater equality makes society stronger. Wilkinson, R., & Pickett, K. (2009). New York, NY: Bloomsbury Press.
This book argues that the income gap between a nation’s richest and poorest is the strongest predictor of the functioning and health of a society. The authors prioritize the need for societies to achieve equality, and argue that both government redistribution of wealth and market forces can be effective in closing equality gaps.
Unnatural causes: Is inequality making us sick? Adelman, L. (Creator and Executive Producer). (2008).
California: California Newsreel. Available at: http://www.unnaturalcauses.org This four-hour, seven-part documentary series highlights the root causes of socioeconomic and racial inequities in health. A discussion guide contains pre- and post-viewing activities, comprehension and discussion questions, and suggested follow-up actions for participants.
Why place matters: Building a movement for healthy communities. Bell, J., & Rubin, V. (2007).
Oakland, CA: PolicyLink. Available at: http://www.policylink.org/atf/cf/%7B97c6d565-bb43-406d-a6d5- eca3bbf35af0%7D/WHYPLACEMATTERS_FINAL.PDF
This report establishes a framework for understanding the relationship between community conditions (class, race, ethnicity, neighborhood segregation, and the economic, social, physical, and service environments) and health. It provides case studies of how communities have addressed health disparities and includes fourteen recommendations for moving forward.
1.3 WHAT IS A HEALTHY COMMUNITY?
Beyond health care: New directions to a healthier America. Robert Wood Johnson Foundation, Commission to Build a Healthier America. (2009, April). Princeton, NJ. Available at: http://www. commissiononhealth.org/Report.aspx?Publication=64498
This report sets forth ten recommendations for building healthier communities, including action steps that community groups, schools, employers, businesses, health care providers, philanthropic organizations, and government entities can take.
1.5 A BRIEF HISTORY OF HEALTH IN ALL POLICIES
The items in this section are listed in chronological order and correspond to the timeline on page 19.
Declaration of Alma-Ata. World Health Organization. (1978, September 6-12). Adopted at the International Conference on Primary Health Care, Alma-Ata, USSR. Available at: http://www.who.int/publications/almaata_ declaration_en.pdf
The Declaration of Alma-Ata is frequently cited as the first acknowledgment of the importance of intersectoral action for health. The declaration states that both health services and efforts to engage other sectors in the social, economic, and political determinants of health are required to achieve significant health gains.
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The Ottawa Charter for health promotion. World Health Organization. (1986, November 21). Adopted at the First International Conference on Health Promotion, Ottawa, Canada. Available at: http://www.who.int/ healthpromotion/conferences/previous/ottawa/en/
This document introduced “healthy public policies” as a key area for health promotion, calling for other sectors to invest in health and directing policymakers in all sectors to consider the health and equity impacts of their decisions.
[Health policies towards the year 2000: National health plan]. Nasjonal helseplan. Norway Ministry of Health and Care Services. (1987). Helsepolitikken mot år 2000. No 41, 1987/88. Oslo: Sosialdepartementet [in Norwegian]. (As cited in: St-Pierre, L. (2009). Governance tools and framework for Health in All Policies. National Collaborating Centre for Healthy Public Policy. Available at: http://rvz.net/uploads/docs/ Achtergrondstudie_-_Governance_tools_and_framework.pdf
This white paper issued by the Norwegian health services administration in 1987, as discussed in St-Pierre, recognizes the merit of including health in all public policies.
Adelaide recommendations on healthy public policy. World Health Organization. (1988, April 5-9).
Adopted at the Second International Conference on Health Promotion, Adelaide, South Australia. Available at: http://www.who.int/healthpromotion/conferences/previous/adelaide/en/index1.html This set of recommendations highlights the influence of non-health sectors’ policies on health and calls for a political commitment to health by all sectors.
The New Zealand health strategy. New Zealand Ministry of Health. (2000, December). Wellington, NZ:
Ministry of Health. Available at: http://www.health.govt.nz/publication/new-zealand-health-strategy.
New Zealand’s National Health Strategy presents intersectoral action as an essential lever for improving health and reducing health inequalities, both across sectors and within local government and community groups. This document serves as a map for developing healthy public policies and action plans in a coordinated way.
Public Health Act, R.S.Q. 2001, c. S-2.2. (Quebec, Canada). Available at: http://www.canlii.org/en/qc/ laws/stat/rsq-c-s-2.2/latest/rsq-c-s-2.2.html
Quebec’s Public Health Act of 2001 requires that government departments and agencies in Quebec collaborate with the Department of Health and Social Services to ensure the measures they enforce have no harmful effects on population health.
Public Health Objective Bill (Government Bill 2002/03:35). (Sweden) [in Swedish]. (As cited in: Hogstedt, C., Lundgren, B., Moberg, H., Pettersson, B., & Agren, G. (2004). The Swedish public health policy and the National Institute of Public Health. Scandinavian Journal of Public Health, Supplement, 64, 6–64.) With the aim of creating the societal conditions that guarantee an equal level of health for the entire population, the Swedish National Public Health Policy of 2003 declared a focus on the social determinants of health and intersectoral public health partnerships.
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Health in All Policies: Prospects and potentials. (2006). Stahl, T., Wismar, M., Ollila, E., Lahtinen, E., and Leppo, K., eds. Finland: Finnish Ministry of Social Affairs and Health. Available at: http://www.euro.who.int/__ data/assets/pdf_file/0003/109146/E89260.pdf
Recognizing increasing wealth inequality and the connections between health and economics, the 2006 Finnish Presidency of the European Union highlighted the social determinants of health as its priority and supported implementation of the Health in All Policies approach throughout the European Union.
South Australia’s Strategic Plan…through a health lens. (2007). Department of the Premier and Cabinet.
Adelaide: Government of South Australia. Available at: http://www.health.gov.au/internet/nhhrc/publishing. nsf/Content/458/$FILE/458%20-%20O%20-%20SA%20Health%20-%20SASP%20...through%20a%20 health%20lens.pdf
The South Australian government engaged a wide spectrum of governmental partners to apply a health lens to the South Australia Strategic Plan. This paper examines the health outcomes of the six interrelated objectives of the Strategic Plan, highlighting the evidence-based linkages between health and policies in “non-health” sectors.
National Health Act, B.E. 2550. (2007) (Thailand). Available at: http://en.nationalhealth.or.th/node/123 The Thai National Health Act allows residents to require a health impact assessment (HIA) be conducted of any project that could seriously impact environmental quality, natural resources, or community health.
Further, the Act allows community participation in the HIA process and mandates the development of HIA guidelines for the National Health Committee.
Partnership for Sustainable Communities. Department of Housing and Urban Development, Department of Transportation, and Environmental Protection Agency. Available at: http://www.sustainablecommunities.gov The Partnership for Sustainable Communities is a collaborative effort of the U.S. Department of Housing and Urban Development, the U.S. Department of Transportation, and the U.S. Environmental Protection Agency to help incorporate six livability principles into federal housing, transportation, water, and other infrastructure investments. This website provides resources for local communities interested in creating prosperous neighborhoods that protect the environment.
Council conclusions on Health in All Policies (HiAP). Council of the European Union. (2006, November 30-December 1). Adopted at the 2767th Employment, Social Policy, Health, & Consumer Affairs Council Meeting, Brussels. Available at: http://www.consilium.europa.eu/ueDocs/cms_Data/docs/pressData/en/ lsa/91929.pdf
This document invited the European Parliament to consider health impacts of decisions across all sectors.
National Prevention, Health Promotion, and Public Health Council. U.S. Department of Health and Human Services, National Prevention Council. Office of the Surgeon General. Available at: http://www. surgeongeneral.gov/initiatives/prevention/about/index.html Created in 2010 by the Affordable Care Act, this intersectoral Council provides leadership at the federal level to advance prevention, wellness, and health promotion by coordinating all executive departments and agencies in the United States. In 2011, the National Prevention Strategy was released, followed by the National Prevention Plan in 2012.
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Adelaide statement on Health in All Policies: Moving towards a shared governance for health and well-being: Report from the International Meeting on Health in All Policies, Adelaide 2010. World Health Organization & Government of South Australia. (2010). Available at: http://www.who.int/social_ determinants/hiap_statement_who_sa_final.pdf
The Adelaide Statement provides an overview of the Health in All Policies approach, discusses the role of health in social, economic, and environmental development, and calls upon leaders from all levels of government to take action.
For the public’s health: Revitalizing law and policy to meet new challenges. Institute of Medicine, Committee on Public Health Strategies to Improve Health. (2012). Washington, DC: The National Academies Press. Available at: http://www.iom.edu/Reports/2011/For-the-Publics-Health-Revitalizing-Law-and-Policy-toMeet-New-Challenges.aspx This report recommends that federal and state governments utilize a Health in All Policies approach to consider the health impacts of policy, legislation, and regulation implementation.
Rio political declaration on social determinants of health. World Health Organization. (2011, October 19- 21). Adopted at the World Conference on Social Determinants of Health, Rio de Janeiro, Brazil. Available at:
http://www.who.int/sdhconference/declaration/Rio_political_declaration.pdf The World Health Organization’s Rio Political Declaration on Social Determinants of Health affirmed Health in All Policies’ legitimacy as an approach to increase both accountability among other sectors for health and guide the development of inclusive, productive, and equitable societies.
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Part II. The Nuts and Bolts of Health in
All Policies
SECTION 2: GETTING STARTED
2.1 FINDING OPPORTUNITIES FOR CHANGE
Intersectoral action on health: A path for policy-makers to implement effective and sustainable action on health. World Health Organization, The WHO Centre for Health Development. (2011). Kobe, Japan.
Available at: http://www.who.int/entity/kobe_centre/publications/ISA-booklet_WKC-AUG2011.pdf This document presents ten steps which policymakers can take to promote intersectoral health initiatives and includes several international examples of intersectoral action on health as well as a review of lessons learned in using this approach.
Partners for public health: Working with local, state, and federal agencies to create healthier communities. Bay Area Regional Health Inequities Initiative, Public Health Law & Policy. Available at:
http://www.barhii.org/resources/downloads/partners_for_public_health.pdf This guide provides information about the public agencies that make policy decisions and implement projects related to physical environments that affect health. It includes information on each agency’s structure, decision-making process, and oversight and accountability at local, regional, state, and federal levels.
2.2 EXPLORING THE BENEFITS OF COLLABORATION
Collaboration Multiplier. Prevention Institute. (2011, July). Oakland, CA. Available at: http://www. preventioninstitute.org/component/ jlibrary/article/download/id-686/127.html The Prevention Institute collaboration multiplier worksheets can be used to identify common goals within an intersectoral collaboration and see how each party’s expertise and resources can be leveraged to achieve those goals.
SECTION 3: PARTNERS AND ROLES
3.1 GOVERNMENTAL PARTNERS, FACILITATORS, AND BACKBONE STAFF Health in All Policies across jurisdictions: A snapshot from Sweden. Pettersson, B. (2010, July). Public Health Bulletin South Australia. 7(2), 17-20. Available at: http://www.health.sa.gov.au/pehs/publications/ publichealthbulletin-pehs-sahealth-1007.pdf
This article discusses the “across-government” approach adopted by Sweden following the passage of a policy aimed at addressing the determinants of health. In addition to providing a case study of Sweden’s experience, this article also discusses some of the key lessons learned from collaborating across government sectors to address social determinants of health.
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3.2 ENGAGING STAKEHOLDERS
Community engagement in public health. Morgan, M.A., & Lifshay, J. (2006, March). Martinez, CA: Contra Costa Health Services, Public Health Division. Available at: www.barhii.org/resources/downloads/community_ engagement.pdf
This brief article provides an introduction to the Contra Costa Health Services experience with community engagement and offers a framework for planning and implementing community engagement approaches.
Community organizing handbook. Whitcher, J., Coyne, F., McCauley, S., & Rauenhorst, S. (2009-2010).
Denver, CO: University of Denver, Center for Community Engagement & Service Learning. Available at:
http://www.du.edu/ccesl/media/documents/community_handbook.pdf This handbook on community engagement provides a section on relationship-building that covers one-onone relational interviews, self-interest assessment, and making contact with stakeholders.
International Association for Public Participation. Available at: http://www.iap2.org International Association for Public Participation (IAP2) provides technical assistance to improve public participation within governments, institutions, and other entities that affect public interest in nations throughout the world.
Public Engagement Program. Institute for Local Government. Available at: http://www.ca-ilg.org/publicengagement The Institute for Local Government offers resources for partnering with youth and immigrant populations, developing community leadership, and building sustained engagement at the local level.
SECTION 4: WORKING TOGETHER ACROSS SECTORS
4.1 THE SPECTRUM OF COLLABORATION
A Health in All Policies approach to large-scale redevelopment: The Fort McPherson BRAC case study.
Georgia State University, Georgia Health Policy Center. Atlanta, GA. Available at: http://aysps.gsu.edu/sites/ default/files/documents/The_Fort_McPherson_BRAC_Case_Study.pdf As part of a case study on redevelopment at a former Army base, the Georgia Health Policy Center describes a spectrum within which Health in All Policies can occur.
A review of collaborative partnerships as a strategy for improving community health. Roussos, S.T., & Fawcett, S.B. (2000). Annual Review of Public Health. 21: 369-402.
This article defines “collaborative partnership” and reviews evidence for the effects of collaborative partnerships on community and systems change, community-wide behavior change, and population-level health outcomes. The article discusses conditions that affect effective collaboration and suggests research and practice recommendations for improving community health.
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National Network for Collaboration Framework. Bergstrom, A., Clark, R., Hogue, T., Iyechad, T., Miller, J., Mullen, S., & Perkins, D…Thurston, F. (1995). Collaboration framework: Addressing community capacity.
Available at: http://www.uvm.edu/extension/community/nnco/collab/framework.html This document describes a framework for collaboration and clarifies process and contextual factors that can promote or inhibit effectiveness. The Levels of Collaboration scale, based on the work of other collaboration researchers, measures progress over five stages of collaboration: networking, cooperation/alliance, coordination/partnership, coalition, and collaboration.
Resources for Learning Circle Five. National Resource Center for Permanency and Family Connections. Available at: http://www.hunter.cuny.edu/socwork/nrcfcpp/pass/learning-circles/five/ LearningCircleFiveResources.pdf
This short piece provides definitions, descriptions, and discussions of collaboration, and links to additional resources that support collaborative efforts.
Understanding the spectrum of collaborative governance practices. Carlson, C. In A Practical Guide to Collaborative Governance (pp. 9-11). Policy Consensus Initiative & National Policy Consensus Center.
Available at: http://www.policyconsensus.org/publications/practicalguide/collaborative_spectrum.pdf This publication is intended for government actors interested in collaborating with community members to improve policy and governance. The excerpt available on their website explores various levels of engagement with the community, and begins to outline the components of collaborative decision-making.
The full guide provides instructions and tips on each phase of the collaboration process.
4.2 TIPS FOR BUILDING INTERSECTORAL RELATIONSHIPS
Collective Impact. Kania, J., & Kramer M. (2011, Winter). Stanford Social Innovation Review. 9(1). Available at: http://www.ssireview.org/articles/entry/collective_impact, and Channeling change: Making collective impact work. Hanleybrown, F., Kania, J., & Kramer, M. (2011, January 26). Stanford Social Innovation Review Blog. Available at: http://www.ssireview.org/blog/entry/channeling_change_making_collective_impact_work The authors argue that large-scale social change requires the “collective impact” of a group of actors from different sectors, rather than the “isolated impact” of one organization. Both articles describe the conditions under which a collective impact initiative is most likely to thrive. The Hanleybrown et al. article focuses specifically on how to begin an initiative, sustain it, and create alignment.
The Community Tool Box. University of Kansas, Work Group for Community Health and Development. (2012). Available at: http://ctb.ku.edu/
This resource contains a broad range of information for building healthy communities, including information on developing group facilitation skills, problem solving, and securing financial resources.
4.3 DECISION-MAKING
Facilitator’s guide to participatory decision-making (2nd ed.). Kaner, S., Lind, L., Toldi, C., Fisk, S., & Berger, D. (2007). San Francisco, CA: Jossey-Bass.
This book provides tools, training, and tips for group leaders on the dynamics and processes of group decision-making, group process skills, agenda design, and discussion techniques. It also provides guidance on how to convene multiple stakeholder teams.
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SECTION 5: STRUCTURES TO SUPPORT HEALTH IN ALL POLICIES
5.1 EMBEDDING HEALTH INTO GOVERNMENT PRACTICES
Stepping it up: Moving the focus from health care in Canada to a healthier Canada. Health Council of Canada. (2010). Toronto, ON. Available at: http://www.healthcouncilcanada.ca/rpt_det.php?id=162 This report reviews federal and provincial government efforts in Canada to address the social determinants of health. It describes various strategies that have been used, discusses intersectoral approaches to improving health, and provides a summary of recommendations set forth by the Canadian Senate.
Health in All Policies: An EU literature review 2006-2011 and interview with key stakeholders. Howard, R. & Gunther, S. (2012, May). Equity Action. Available at:http://www.equitychannel.net/uploads/HiAP%20%20 Final%20Report%20May%202012.pdf
This report identifies opportunities and barriers for implementation of Health in All Policies and identifies key themes and tips for improving future implementation.
5.2 STRUCTURE AND FORMALITY
Getting agencies to work together: The practice and theory of managerial craftsmanship. Bardach, E. (1998). Washington, D.C.: Brookings Institution Press.
Using diverse policy areas as examples, this book diagnoses difficulties of collaboration between government agencies, explains how they are sometimes overcome, and introduces ideas for public managers, advocates, and others interested in developing interagency collaborative networks.
Intersectoral governance for Health in All Policies. (2012). McQueen, D. V., Wismar, M., Lin, V., Jones, C.
M., & Davies, M. (Eds.). Copenhagen, Denmark: European Observatory on Health Systems and Policies, World Health Organization. Available at: http://www.euro.who.int/__data/assets/pdf_file/0005/171707/ Intersectoral-governance-for-health-in-all-policies.pdf This book provides an overview of structures used internationally to support Health in All Policies, including case studies of Health in All Policies initiatives.
Moving forward to equity in health: Partnership and intersectoral action conference working document. Solar, O., Valentine, N., Rice, M., & Albrecht, D. (2009). Presented at the 7th Global Conference on Health Promotion, Nairobi, Kenya: World Health Organization. Available at: http://www.gchp7.info/ resources/downloads/t4.pdf
This document establishes a political and technical basis for intersectoral action in global development strategies. It includes a discussion of the relationship between health and other sectors, the vision of health and society that supports health and health action, and the mechanisms for implementing intersectoral work at all government levels.
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5.3 RESOURCES
Foundation Center. Available at: http://foundationcenter.org The Foundation Center provides information on philanthropy through five regional library/learning centers and a network of more than 450 Cooperating Collections, where free local access to resources and trainings can be found. They provide training courses (both online and in the classroom), self-paced courses, tutorials, and webinars. They also maintain a database of grantmakers and their grants.
Grants.gov. Available at: http://grants.gov/
This is the main website to find and apply for federal grants. Those interested can subscribe to the site and receive daily notifications of new grant opportunities.
SECTION 6: CREATING HEALTHY PUBLIC POLICY
6.1 CHOOSING WHAT TO WORK ON AND IDENTIFYING POTENTIAL SOLUTIONS A practical guide for policy analysis: The eightfold path to more effective problem solving (2nd ed.).
Bardach, E. (2000). Washington, DC: CQ Press.
This book provides an overview of the steps involved in policy analysis, laying out Bardach’s frequently-used “Eightfold Path.” It also provides an overview of government responsibilities.
Action strategies toolkit: A guide for local and state leaders working to create healthy communities and prevent childhood obesity. Robert Wood Johnson Foundation, Leadership for Healthy Communities. (2009). Princeton, NJ. Available at: www.rwjf.org/pr/product.jsp?id=42514 This guide introduces evidence-based policy options in the areas of healthy eating, active living, and the built environment. It sets forth a series of recommendations under each topic area and identifies potential stakeholders, existing policies and programs, ways to get started, and helpful resources.
Beyond the USDA: How other government agencies can support a healthier, more sustainable food system. Gosselin, M. (2010, February). Minneapolis, MN: Institute for Agriculture and Trade Policy. Available at: http://www.iatp.org/files/258_2_107172.pdf
This report summarizes the various roles that key federal agencies—other than the U.S. Department of Agriculture—can play in America’s food system. The report lists important grant programs, resources, and ideas for policy changes. The report also includes examples of specific issue areas and the entities that influence them.
Condensed list of collected recommendations: Health in All Policies Task Force report to the Strategic Growth Council, Appendix 3. California’s Health in All Policies Task Force. (2010, December 3). Available at:
http://sgc.ca.gov/hiap/docs/publications/HiAP_Task_Force_Report.pdf In developing a final list of recommendations, the California Health in All Policies Task Force collected over 1,200 suggestions from Task Force members, stakeholder input workshops, public comment, key informant interviews, and documents submitted to the Task Force. This appendix to the Task Force’s 2010 report contains a condensed list of approximately 600 recommendations sorted by topic area.
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ENACT local policy database. Prevention Institute, Strategic Alliance for Healthy Food and Activity Environments. Available at: http://eatbettermovemore.org/sa/policies This online database catalogs promising policies in nutrition and physical activity to provide examples of local policies that have been tried and adopted.
General plans and zoning: A toolkit for building healthy, vibrant communities. Feldstein, L. M., ChangeLab Solutions. (2007). Sacramento, CA: California Department of Health Services. Available at:
http://changelabsolutions.org/sites/default/files/documents/finalbook.pdf This toolkit is designed for public health professionals to provide a basic introduction to how land use decisions are made and the methods for influencing and participating in those decisions.
Getting to smart growth: 100 policies for implementation. Smart Growth Network. (2005). Available at:
http://www.smartgrowth.org/pdf/gettosg.pdf
This report describes techniques that policymakers can use to put smart growth principles into practice. The report presents successful policies and guidelines in the United States, ranging from formal legislative or regulatory efforts to informal approaches, plans, and programs. Ten smart growth principles are described, and each principle is accompanied by a series of practice tips and specific policy examples.
Making connections: Developing a food system for a healthier New York State. New York State Council on Food Policy. (2009, December). Available at: http://www.nyscfp.org/docs/NYS_CFP_Final_Report_2009.pdf This report provides a list of food system recommendations for New York State, in the areas of: maximizing participation in food and nutrition assistance programs, strengthening the connection between local food and consumers, supporting efficient and profitable food production and retail food infrastructure, increasing consumer awareness and knowledge about healthy eating, and improving consumer access to safe and nutritious food.
Nutrition and physical activity: A policy resource guide. Lamson, E., & Colman, V. (2005, February).
Olympia, WA: Washington State Department of Health, Office of Community Wellness and Prevention, Chronic Disease Prevention and Risk Reduction. Available at: http://www.doh.wa.gov/portals/1/Documents/ Pubs/345-239-PolicyResourceGuide.pdf
This comprehensive guide can help groups develop nutrition and physical activity policies at state, local, and private jurisdictions. Evidence of policy effectiveness is provided when possible.
The guide to community preventive services: What works to promote health. Community Preventive Services Task Force. (2012). Available at: http://www.thecommunityguide.org This online tool contains systematic reviews of program and policy interventions that have been proven to be effective, including whether interventions are right for particular communities, possible related costs, and likely return on investment.
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6.2 LOOKING THROUGH A HEALTH AND EQUITY LENS
A guide for health impact assessment. Bhatia, R. (2010, October). California Department of Public Health.
Available at: http://www.cdph.ca.gov/pubsforms/Guidelines/Documents/HIA%20Guide%20FINAL%2010-19-
10.pdf
This guide provides background on health impact assessment, outlines key steps, activities, and issues that may be faced, and identifies additional resources for health impact assessment.
A health impact assessment toolkit: A handbook to conducting HIA (3rd ed.). Human Impact Partners. (2011, February). Oakland, CA. Available at: http://www.humanimpact.org/component/jdownloads/ finish/11/81
This toolkit provides hands-on tools for organizations interested in conducting a Health Impact Assessment (HIA). In addition to describing the steps of the actual HIA process, it provides guidance on how to decide whether an HIA is appropriate, how to determine the scope and management of a HIA, and how to collaborate with stakeholders during the process.
Health Economic Assessment Tools (HEAT) for walking and for cycling. World Health Organization, Transport, Health and Environment Pan-European Programme. (2011). Available at: www.heatwalkingcycling.org This online tool allows users to estimate the economic savings from mortality reductions that result from regular walking or bicycling.
Health impact assessment: A tool for promoting health in all policies. Gottlieb, L., Egerter, S., & Braveman, P. (2011, May). Princeton, NJ: Robert Wood Johnson Foundation. Available at: http://www.rwjf. org/content/dam/farm/reports/issue_briefs/2011/rwjf70449 This document provides a brief overview of health impact assessment, with examples of how it has been used and how it can support Health in All Policies. It also provides brief examples of how health impact assessment has been used in the United States.
Minimum elements and practice standards for health impact assessment (Version 2). North American HIA Practice Standards Working Group. (Bhatia, R., Branscomb, J., Farhang, L., Lee, M., Orenstein, M., & Richardson, M.). (2010, November). Oakland, CA. Available at: http://www.humanimpact.org/doc-lib/ finish/11/9
This reference document gives guidance on health impact assessment (HIA) from two angles: 1) standards on the “minimum elements” that an HIA must include and 2) practice standards that help to “best conduct” an HIA.
Racial equity impact assessment toolkit. Keleher, T. (2009). Applied Research Center. Available at:
http://www.arc.org/content/view/744/167/
This toolkit discusses a method for identifying how racial and ethnic groups are likely to be differentially impacted by decisions or proposed policies, including questions that can be used to consider potential racial equity impacts of proposed actions.
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Rapid Assessment Tool for small-area health needs. Dunn, J. (2009). Toronto, Canada: Center for Research on Inner City Health, St. Joseph’s Health Centre. Available at: http://www.stmichaelshospital.com/ crich/reports/rapid-assessment-tool/
This tool can be used for assessing small-area health status and health needs. Also available is a presentation that describes tool development and a case study of its use.
South Australia’s Strategic Plan…through a health lens. Government of South Australia, Department of the Premier and Cabinet. (2007). Presented at the Health in All Policies conference, Adelaide, South Australia. Available at: http://www.health.gov.au/internet/nhhrc/publishing.nsf/Content/458/$FILE/458%20 -%20O%20-%20SA%20Health%20-%20SASP%20...through%20a%20health%20lens.pdf This document illustrates how a health lens was applied to a number of target areas in the South Australia Strategic Plan, including volunteering, broadband usage, and a sustainable water supply.
Urban Health Equity Assessment and Response Tool (Urban HEART). World Health Organization, Centre for Health Development. (2010). Available at: http://www.who.int/kobe_centre/measuring/urbanheart/en/ Urban HEART is a tool to help people and organizations identify and analyze health inequities, find the evidence to support particular interventions, and think about health in the policy-making process.
6.3 EVIDENCE AND DATA
County health rankings & roadmaps. Robert Wood Johnson Foundation, University of Wisconsin Population Health Institute. Available at: http://www.countyhealthrankings.org This interactive website showcases rankings that assess the overall health of almost all counties in the United States. The rankings consider health behavior, clinical care, social and economic factors, and physical environment.
Sustainable Communities Index. San Francisco Department of Public Health, Environmental Health Section’s Program on Health, Equity, and Sustainability. (2012). Available at: http://www.sustainablesf.org The Sustainable Communities Index (formerly known as the Healthy Development Measurement Tool) is a set of indicators identified by the City of San Francisco as important components of a healthy city. The indicators span a variety of topics related to the physical, social, and economic environments of a city. The site provides a step-by-step guide to users on how the Index can be used to assess community health, gives guidance on potential policy initiatives to achieve objectives, and includes links to further resources on applying the Index.
The Campbell Collaboration. Available at: www.campbellcollaboration.org The Campbell Collaboration specializes in producing systematic reviews of social interventions in crime and justice, education, international development, and social welfare, including both international and unpublished research. The Collaboration’s Resource Center provides training materials and links to additional tools for practitioners searching for evidence-based interventions.
The Cochrane Collaboration. Available at: www.cochrane.org The Cochrane Collaboration is dedicated to publishing systematic reviews of health care and health policy interventions. These reviews help health care providers and consumers identify effective, evidence-based ways to improve health, and span a broad range of interventions, including health education, policy initiatives, and community-based programs.
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6.4 EVALUATING OUR COLLABORATIVE EFFORTS
Developing an effective evaluation plan. (2011). Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; Division of Nutrition, Physical Activity, and Obesity. Available at: http://www.cdc.gov/obesity/downloads/CDCEvaluation-Workbook-508.pdf This workbook was designed to complement the CDC Framework for Program Evaluation in Public Health.
It guides users through each step of creating an evaluation plan, with accompanying worksheets, exercises, and checklists.
Evaluating comprehensive community change: Report of the Annie E. Casey Foundation’s March 1997 Research and Evaluation Conference. Annie E. Casey Foundation. (1997). Available at: http://www.aecf. org/upload/PublicationFiles/community%20change.pdf
With a focus on childhood outcomes, this document supports community-level change by addressing ways to improve evaluation of community-based initiatives, common challenges in data collection, and how to engage community stakeholders.
Evaluating health impact assessment: Learning from practice bulletin. Taylor, L., Gowman, N., & Quigley, R. (2003). Yorkshire, UK: National Health Service, Health Development Agency. Available at: http://www.who. int/hia/evidence/en/practice.pdf
This brief, part of a larger series on health impact assessment (HIA) presents case studies of HIA evaluation, discusses some of the major challenges to evaluating HIAs, distinguishes between process and impact evaluation of HIAs, and provides guidance on how to successfully execute an evaluation.
Framework for program evaluation in public health. Centers for Disease Control and Prevention. (1999).
Morbidity and Mortality Weekly Report, 48(RR-11). Available at: ftp://ftp.cdc.gov/pub/Publications/mmwr/rr/ rr4811.pdf
CDC’s Framework for Program Evaluation in Public Health is a foundational guide to the essential components, methods, standards, and procedures involved in public health evaluation. It emphasises engaging stakeholders, integrating evaluation into program practice, and addressing complex public health concerns like chronic disease and health disparities.
Learning what works: Evaluating complex social interventions: Report on the symposium held on October 22, 1997. The Brookings Institution Governmental Studies Program, and Harvard University Project on Effective Interventions. (1998). Available at: http://www.brookings.edu/~/media/research/files/ articles/1998/3/01politics%20mann/learningwhatworks
This report summarizes a discussion among experts about how to effectively evaluate interventions addressing complex issues like neighborhood poverty and teen pregnancy, including a discussion of major challenges and tensions in improving evaluation methods, reports on current practices, and potential next steps.
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SECTION 7: TALKING ABOUT HEALTH IN ALL POLICIES
7.1 HOW DO WE TALK ABOUT HEALTH IN ALL POLICIES?
Media advocacy and public health: Power for prevention. Wallack, L., Dorfman, L., Jernigan, D., & Themba, M. (1993). Newbury Park, CA: Sage Publications.
This textbook places media advocacy in the context of public health by articulating fundamental tensions between strategies focused on individual behavior change and those addressing the environments in which health decisions are made. It describes strategies for agenda setting, framing, and media advocacy and is illustrated with a number of short case studies.
Meta messaging: Framing your case and reinforcing your allies. Berkeley Media Studies Group and The Praxis Project. (2005, January). Available at: http://www.bmsg.org/sites/default/files/bmsg_report_meta_ messaging.pdf
This memo discusses “meta messaging,” a concept that can help organizations working on a range of issues to construct messages that serve their own immediate strategic needs while also echoing one another’s larger goals for social change.
Mobilizing public will for social change. Salmon, C.T., Post, L.A., Christensen, R.E. (2003, June). Communications Consortium Media Center. Available at: http://www.ncdsv.org/images/ MobilizingPublicWillSocialChange.pdf
This paper describes campaigns to mobilize public will and introduces key theories, challenges, strategies, evaluation, and relevant case studies.
News for a change: An advocate’s guide to working with the media. Wallack, L., Woodruff, K., Dorfman, L., & Diaz, I. (1999). Thousand Oaks, CA: Sage Publications.
Written for practitioners, this workbook describes essential skills for media advocacy, including how to integrate media advocacy into an overall strategy, capture journalists’ attention, write letters to the editor and op-eds, and evaluate media advocacy. It incorporates worksheets and case studies for self-guided study or for working with groups.
Putting policy into health communication: The role of media advocacy. Dorfman, L., & Wallack, L. (2001).
In R.E. Rice & C.K. Atkin (Eds.), Public communication campaigns (4th ed.). (pp. 337-350). Thousand Oaks, CA: Sage Publications.
In this book chapter, Dorfman and Wallack argue that traditional public health communications campaigns often focus on personal choice, ignoring the wide range of social and economic forces that influence health. Dorfman and Wallack find this strategy to be misdirected and they highlight how media advocacy campaigns can support policy change that can lead to broader public health outcomes at the population level.
What surrounds us shapes us: Making the case for environmental change. Berkeley Media Studies Group. (2009, May). Available at: http://www.bmsg.org/pdfs/Talking_Upstream.pdf This framing brief can help organizations explain to the public how our surroundings—our neighborhoods, schools, and workplaces—influence our health, and why policies that improve those places make sense.
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Part III. Case Study: California Health in All
Policies Task Force
California Assembly Bill 1467 § 43. (2012, June 13). Available at: http://www.leginfo.ca.gov/pub/11-12/ bill/asm/ab_1451-1500/ab_1467_bill_20120627_chaptered.pdf AB 1467 established the Office of Health Equity within the California Department of Public Health, and directed the Office of Health Equity to work in alignment with the Health in All Policies Task Force. Priorities outlined in the bill include developing a “comprehensive, cross-sectoral strategic plan to eliminate health and mental health disparities and inequities” and assisting state agencies to consider population health impacts in the development of policies.
California Executive Order S-04-10. (2010, February 23). Available at: http://sgc.ca.gov/hiap/docs/ about/Executive_Order_S-04-10.pdf
This executive order, issued by former California Governor Arnold Schwarzenegger, established a Health in All Policies Task Force under the auspices of the Strategic Growth Council and identified the California Department of Public Health as the facilitator.
California Senate Bill 732. § 4. (2008, September 30). Available at: http://www.leginfo.ca.gov/pub/07-08/ bill/sen/sb_0701-0750/sb_732_bill_20080930_chaptered.pdf Senate Bill 732 added Chapter 13 (commencing with Section 75120) to Division 43 of the Public Resource Code to create the Strategic Growth Council. The Strategic Growth Council coordinates state programs that protect air, water, and natural resources; encourage sustainable land use planning; and support the California Global Warming Solutions Act of 2006.
California Senate Concurrent Resolution 47, ch. 56. Relative to Health in All Policies. (2012, June 21).
Available at: http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml;jsessionid=2f45db1d823e85da7ba0f a24f5a2?bill_id=201120120SCR47
This bill established legislative support for the California Health in All Policies Task Force. The Resolution encourages Task Force member agencies to provide leadership on recommendations put forth by the Task Force, supports interagency collaboration, endorses the consideration of health impacts and costs of proposed legislation, and calls on leaders at all levels of government to consider health impacts in policy development.
Health in All Policies 2010 public workshops summary and participants. California Health in All Policies Task Force. (2010). Available at: http://sgc.ca.gov/hiap/docs/input/HiAP_2010_Public_Workshops_Summary_ and_Participants.pdf, and Health in All Policies 2011 workshops summary and participants. California Health in All Policies Task Force. (2011). Available at: http://sgc.ca.gov/hiap/docs/input/2011_Public_ Workshop_Summary.pdf
These summaries include information on workshop locations and dates, attendees, themes, regional differences, and prioritization of Health in All Policies recommendations.
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Health in All Policies Task Force priorities for near-term implementation. California Health in All Policies Task Force. (2011). Available at: http://sgc.ca.gov/meetings/20110601/june2011-hiappriorities.doc This document provides rationale for the prioritization of eleven recommendations for action, considerations for implementation, and potential agencies to work together on implementation.
Health in All Policies Task Force report to the Strategic Growth Council. California Health in All Policies Task Force. (2010, December 3). Available at: http://sgc.ca.gov/hiap/docs/publications/HiAP_Task_Force_ Report.pdf
This report outlines 34 recommendations for “improving the efficiency, cost-effectiveness, and collaborative nature of State government, while promoting both health and other goals of the SGC.” An Executive Summary of this Report is also available: http://sgc.ca.gov/hiap/docs/publications/HiAP_Task_Force_Executive_ Summary.pdf.
Implementation plans. California Health in All Policies Task Force. (2012). Available at: http://sgc.ca.gov/ hiap/publications.html
Eight implementation plans have been developed by the California Health in All Policies Task Force, and new plans will continue to be posted at this site as they are developed and endorsed by the Strategic Growth Council.
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1 Ritsatakis A., et al. (2000). Exploring health policy development in Europe. Copenhagen: World Health Organization, Regional Office for Europe. 2 Dodd, J. D., & Boyd, M. H. (2000). Capacity building—linking community experience to public policy. Halifax, Canada: Population and Public Health Branch, Atlantic Regional Office, Health Canada.
3 Peters, B. G. (1999). American public policy: Promise and performance. New York, NY: Chatham House/Seven Rivers. 4 Cochran, C. E., Mayer, L. C., Carr, T. R., & Cayer, N. J. (2009). American public policy: An introduction (9th ed.). Boston, MA: Wadsworth Cengage Learning. 5 Cochran, C. L., & Malone, E. F. (1995). Public policy: Perspectives and choices. New York, NY: McGraw Hill. 6 Dye, T. (1984). Understanding public policy. Englewood Cliffs, NJ: Prentice Hall. 7 Virginia Department of Health. (2012, January). What is health inequity? Retrieved from: http://www.vdh.virginia.gov/healthpolicy/healthequity/unnaturalcauses/healthequity.htm 8 United Nations World Commission on Environment and Development. (1987). Our common future. Oxford: Oxford University Press. 9 California Health in All Policies Task Force. (2010, December 3). Health in All Policies Task Force Report to the Strategic Growth Council. Retrieved from: http://sgc.ca.gov/hiap/docs/ publications/HiAP_Task_Force_Report.pdf
10 Ståhl, T., Wismar, M., Ollila, E., Lahtinen, E., & Leppo, K. (Eds.). (2006). Health in All Policies: Prospects and potentials. Finland: Ministry of Social Affairs and Health, Finland, & European Observatory on Health Systems and Policies. Retrieved from: http://www.euro.who.int/__data/assets/pdf_file/0003/109146/E89260.pdf 11 Rittel, H. W. J., & Webber, M. M. (1984). Dilemmas in a general theory of planning. In N. Cross (Ed.), Developments in design methodology (pp. 135-144). Chichester, England: J. Wiley & Sons. (Reprinted from Policy Sciences, (1973), 4(2), 155–169). 12 Ackoff, R. L. (1974). Redesigning the future: A systems approach to societal problems. New York: Wiley. 13 Kickbusch, I., & Buckett, K. (Eds.). (2010). Implementing Health in All Policies, Adelaide 2010. Rundle Mall, South Australia: Government of South Australia, Department of Health.
Retrieved from: http://www.who.int/sdhconference/resources/implementinghiapadel-sahealth-100622.pdf 14 Horn, R. E., & Weber, R. P. (2007). New tools for resolving wicked problems: Mess mapping and resolution mapping processes. Strategy Kinetics, LLC. Retrieved from: http://www. strategykinetics.com/New_Tools_For_Resolving_Wicked_Problems.pdf 15 McKinlay, J. (1979). A case for refocusing upstream: The political economy of illness. In J. Gartley (Ed.), Patients, physicians and illness: A sourcebook in behavioral science and health (pp. 9-25). New York, NY: Free Press.
16 Marmor, T. R., Barer, M. L., & Evans, R. G. (Eds.). (1994). Why are some people healthy and others not? The determinants of health of populations. New York, NY: Aldine Transaction. 17 McGinnis, J. M., Williams-Russo, P., & Knickman, J. A. (2002). The case for more active policy attention to health promotion. Health Affairs, 21(2), 83. 18 Robert Wood Johnson Foundation, Commission to Build a Healthier America. (2012). What drives health. Retrieved from: http://www.commissiononhealth.org/WhatDrivesHealth.aspx 19 Williams, D. R., Costa, M. V., Odunlami, A. O., & Mohammed, S. A. (2008, November). Moving upstream: How interventions that address the social determinants of health can improve health and reduce disparities. Journal of Public Health Management Practice Supplement, 14, S8-S17. 20 Commission on Social Determinants of Health. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health (Final Report of the Commission on Social Determinants of Health). Geneva: World Health Organization. Retrieved from: http://whqlibdoc.who.int/publications/2008/9789241563703_eng.pdf 21 Keppel, K. G., Pearcy, N. J., & Wagener, K. G. (2002, January). Trends in racial and ethnic-specific rates for the health status indicators: United States, 1990–98. Healthy People 2000 Statistical Notes, 23, 1–16.
22 Virginia Department of Health. (2012, January). What is health inequity? Retrieved from: http://www.vdh.virginia.gov/healthpolicy/healthequity/unnaturalcauses/healthequity.htm 23 Braveman, P. A., Egerter, S. A., & Mockenhaupt, R. E. (2011). Broadening the focus: The need to address the social determinants of health. American Journal of Preventive Medicine, 40(1 Suppl 1), S4–18.
24 Bottle, A., Gnani, S., Saxena, S., Aylin, P., Mainous, A. G., & Majeed, A. (2008). Association between quality of primary care and hospitalization for coronary heart disease in England:
National cross-sectional study. Journal of General Internal Medicine, 23(2), 135–141. 25 Raphael, D. (2006). Social determinants of health: An overview of concepts and issues. In: D. Raphael, T. Bryant, M. Rioux (Eds.), Staying alive: Critical perspectives on health, illness, and health care (pp. 115–138). Toronto, ON: Canadian Scholars’ Press. 26 Woolf, S. H. (2007). Future health consequences of the current decline in US household income. Journal of the American Medical Association, 298(16), 1931–1933. 27 Adler, N. E., & Newman, K. (2002). Socioeconomic disparities in health: Pathways and policies. Health Affairs, 20(2), 60–76. 28 Dooley, D., Fielding, J., & Levi, L. (1996). Health and unemployment. Annual Review of Public Health, 17, 449-65. 29 Kaplan, G. A. (2009, September). The poor pay more: Poverty’s high cost to health. Robert Wood Johnson Foundation. Retrieved from: http://www.rwjf.org/content/dam/farm/reports/ reports/2009/rwjf47463
30 Emerson, R. W. (1860). The conduct of life. Cambridge, MA: Riverside Press. 31 Olshansky, S. J., Antonucci, T., Berkman, L., Binstock, R. H., Boersch-Supan, A., Cacioppo, J. T.,…Rowe, J. (2012). Differences in life expectancy due to race and educational differences are widening, and many may not catch up. Health Affairs, 31(8), 1803–1813. 32 WestEd, Philip R. Lee Institute for Health Policy Studies, and University of California, San Francisco. (2009). The critical connection between student health and academic achievement:
How schools and policymakers can achieve a positive impact. Retrieved from: http://www.calendow.org/uploadedFiles/Publications/By_Topic/Access/General/Critical%20 Connection%20between%20Student.pdf
33 Baltimore Education Research Consortium. (2011, February). Destination graduation: Sixth grade early warning indicators for Baltimore City Schools. Baltimore, MD: Author. 34 Jackson, S. L., Vann, W. F., Kotch, J. B., Pahel, B. T., & Lee, J. Y. (2011). Impact of poor oral health on children’s school attendance and performance. American Journal of Public Health, 101(10), 1900–1906.
35 Ibid.
36 Baltimore Education Research Consortium. (2011, February). Destination graduation: Sixth grade early warning indicators for Baltimore City Schools. Baltimore, MD: Author. 37 Chang, H. N., & Romero, M. (2008, September). Present, engaged & accounted for: The critical importance of addressing chronic absence in the early grades. New York: National Center for Children in Poverty.
38 U.S. Census Bureau. (2011). Income, poverty, and health insurance coverage in the United States: 2010. (Report P60-239, Table B-2). Retrieved from: www.census.gov/prod/2011pubs/ p60-239.pdf
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39 California Pan-Ethnic Health Network. (2009, June). The landscape of opportunity: Cultivating health equity in California. Oakland, CA: Author. Retrieved from: http://www.cpehn.org/ pdfs/LandscapeOfOpportunity.pdf
40 Jones, C. P. (2000). Levels of racism: A theoretic framework and a gardener’s tale. American Journal of Public Health, 90(8), 1212-1215. 41 Commission on Social Determinants of Health. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health (Final Report of the Commission on Social Determinants of Health). Geneva, Switzerland: World Health Organization. Retrieved from: http://whqlibdoc.who.int/publications/2008/9789241563703_eng.pdf 42 Glanz, K., & Bishop, D. B. (2010, April). The role of behavioral science theory in development and implementation of public health interventions. Annual Review of Public Health, 31, 399–418.
43 Babey, S. H., Brown, E. R., & Hastert, T. A. (2005, December). Access to safe parks helps increase physical activity among teenagers. Los Angeles, CA: UCLA Center for Health Policy and Research. Retrieved from: http://www.lchc.org/documents/AccestoParksandTeenPhysicalActivity.pdf 44 Larson, N. I., Story, M. T., & Nelson, M. C. (2009). Neighborhood environments: Disparities in access to healthy foods in the U.S. American Journal of Preventive Medicine, 36(1), 74–81. 45 Stewart, K. How alcohol outlets affect neighborhood violence. Prevention Research Center, Pacific Institute for Research and Evaluation. Retrieved from: http://resources.prev.org/ documents/AlcoholOutletsAffectViolence.pdf
46 Pettit, K. L. S., Kingsley, G. T., & Coulton, C. J. Neighborhoods and health: Building evidence for local policy: Executive summary. The Urban Institute. Retrieved from: http://aspe.hhs. gov/hsp/neighborhoods-health03/execsum.htm
47 Bay Area Regional Health Inequities Initiative (BARHII). (2008). Health inequities in the Bay Area. California: Author. Retrieved from: http://www.barhii.org/press/download/barhii_ report08.pdf
48 Larson, N., Story, M., Nelson, M. C. (2008, July). Bringing healthy foods home: Examining inequalities in access to food stores. Robert Wood Johnson Foundation. Retrieved from:
http://www.healthyeatingresearch.org/images/stories/her_research_briefs/her%20bringing%20healthy%20foods%20home_7-2008.pdf 49 Strife, S. & Downey, L. (2009, March). Childhood development and access to nature: A new direction for environmental inequality research. Organization & Environment, 22(1), 99–122. 50 Larson, N. I., Story, M. T., & Nelson, M. C. (2009). Neighborhood environments: Disparities in access to healthy foods in the U.S. American Journal of Preventive Medicine, 36(1), 74–81. 51 LaVeist, T. A., & Wallace, J. M., Jr. (2000). Health risk and inequitable distribution of liquor stores in African American neighborhood. Social Science & Medicine, 51(4), 613–617. 52 Larson, N. I., Story, M. T., & Nelson, M. C. (2009). Neighborhood environments: Disparities in access to healthy foods in the U.S. American Journal of Preventive Medicine, 36(1), 74–81. 53 LaVeist, T. A., Gaskin, D., & Trujillo, A. J. (2011, September). Segregated spaces, risky places: The effects of racial segregation on health inequalities. Washington, DC: Joint Center for Political and Economic Studies. Retrieved from: http://www.jointcenter.org/research/segregated-spaces-risky-places-the-effects-of-racial-segregation-on-health-inequalities 54 Ibid.
55 Crowder, K., Pais, J., & South, S. J. (2012). Neighborhood diversity, metropolitan constraints, and household migration. American Sociological Review, 77(3), 325–353. 56 Fry, R., & Taylor, P. (2012, August 1). The rise of residential segregation by income. Pew Research Center. Retrieved from: http://www.pewsocialtrends.org/2012/08/01/the-rise-ofresidential-segregation-by-income 57 Wilkinson, R. G., & Pickett, K. (2011). The spirit level : Why greater equality makes societies stronger. New York, NY: Bloomsbury Press. 58 Brown, V., Grootjans, J., Ritchie, J., Townsend, M., & Verrinder, G. (2005). Sustainability and health: Supporting global ecological integrity in public health. Earthscan Publications. 59 Calif. Safe Drinking Water, Water Quality and Supply, Flood Control, River and Coastal Protection Bond Act, SB 732 § 729 (2008). 60 Martin, A. B., Lassman, D., Washington, B., Catlin, A., & National Health Expenditure Accounts Team. (2012, January). Growth in US health spending remained slow in 2010; Health share of gross domestic product was unchanged from 2009. Health Affairs, 31(1), 208–219. 61 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. (2009). The power to prevent, the call to control: At a glance 2009.
Retrieved from: http://www.cdc.gov/chronicdisease/resources/publications/aag/pdf/chronic.pdf 62 Levi, J., Segal, L. M., St. Laurent, R., & Kohn, D. (2011, July). F as in fat: How obesity threatens America’s future. Washington, D.C.: Trust for America’s Health. Retrieved from: http:// healthyamericans.org/assets/files/TFAH2011FasInFat10.pdf 63 Gaziano, T. A. (2007). Reducing the growing burden of cardiovascular disease in the developing world. Health Affairs, 26(1), 13. 64 Ormond, B. A., Spillman, B. C., Waidmann, T. A., Caswell, K. J., & Tereshchenko, B. (2011). Potential national and state medical care savings from primary disease prevention. American Journal of Public Health, 101(1), 157–164.
65 Millennium Ecosystem Assessment. (2003). Ecosystems and human well-being. Washington, D.C.: Island Press. 66 Trust for America’s Health. (2008, July). Prevention for a healthier America: Investments in disease prevention yield significant savings, stronger communities. Retrieved from: http:// healthyamericans.org/reports/prevention08/Prevention08Exec.pdf 67 Waidmann, T. A., Ormon, B. A., & Spillman, B. C. (2012, April). Potential savings through prevention of avoidable chronic illnesses among CalPERS state active members. Urban Health Institute, Health Policy Center. Retrieved from: http://www.calpers.ca.gov/eip-docs/about/press/news/health/urban-institute-health-policy.pdf 68 David, K., Collins, S. R., Doty, M. M., Ho, A., & Holmgren, A. L. (2005, August). Health and productivity among U.S. workers. The Commonwealth Fund. Retrieved from: http://www. commonwealthfund.org/usr_doc/856_Davis_hlt_productivity_USworkers.pdf 69 Ibid.
70 Witters, D., & Agrawal, S. (2011, October 17). Unhealthy U.S. workers’ absenteeism costs $153 billion. Gallup. Retrieved from: http://www.gallup.com/poll/150026/unhealthy-workersabsenteeism-costs-153-billion.aspx 71 Field Research Corporation. (2012, August). CA4Health: Findings from the baseline survey of registered voters in the 12 California Community Transformation Initiative counties. San Francisco, CA: Public Health Institute. Retrieved from: http://www.phi.org/uploads/application/files/63q9h8uit5tk3ql29n0rmxw1a37347vusrtyjdpcgp35pmywpa.pdf 72 Levi, J., Segal, L. M., St. Laurent, R., & Kohn, D. (2011, July). F as in fat: How obesity threatens America’s future. Washington, D.C.: Trust for America’s Health. Retrieved from: http:// healthyamericans.org/assets/files/TFAH2011FasInFat10.pdf 73 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. (2011). Obesity: Halting the epidemic by making health easier: At a glance 2011. Retrieved from: http://www.cdc.gov/chronicdisease/resources/publications/aag/obesity.htm 74 Olshansky, S. J., Passaro, D. J., Hershow, R. C., Layden, J., Carnes, B. A., & Brody, J.,…Ludwig, D. S. (2005). A potential decline in life expectancy in the United States in the 21st century.
New England Journal of Medicine, 352(11), 1138–1145.
75 World Health Organization. (1946, June 19-22). Constitution of the World Health Organization. Retrieved from: http://whqlibdoc.who.int/hist/official_records/constitution.pdf 76 Kingdon, J. W. (1995). Agendas, alternatives, and public policies. Boston, MA: Addison-Wesley. 77 Ibid.
78 World Health Organization, The WHO Centre for Health Development. (2011). Intersectoral action on health: A path for policy-makers to implement effective and sustainable action health. Kobe, Japan: Author. Retrieved from: http://www.who.int/entity/kobe_centre/publications/ISA-booklet_WKC-AUG2011.pdf 79 D. Hubsmith, personal communication, August 30, 2012. 80 Cowan, D., Hubsmith, D., & Ping, R. (2011). Safe Routes to School local policy guide. Safe Routes to School National Partnership. Retrieved from: http://www.saferoutespartnership.org/ sites/default/files/pdf/Local_Policy_Guide_2011.pdf
81 P. Rumble, personal communication, April 13, 2012.
82 J. Prochaska, personal communication, April 20, 2012.
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83 Government of South Australia. (n.d.). Adelaide thinkers in residence. Retrieved from: http://www.thinkers.sa.gov.au/thinkers/kickbusch 84 Williams, C., Lawless, A., & Parkes, H. (2008, March). The South Australian Health in All Policies model: The developmental process. Public Health Bulletin South Australia, 5(1), 30–34. 85 Thornton, R. L. J., Fichtenberg, C. M., Greiner, A., Feingold, B., Ellen, J. M., & Jennings, J. M.,…Black, M. (2010, August). Zoning for a healthy Baltimore: A health impact assessment of the TransForm Baltimore comprehensive zoning code rewrite. Baltimore, MD: Johns Hopkins University Center for Child and Community Health Research. Retrieved from:
http://activelivingresearch.org/files/2011_HIA_Fichtenberg.pdf 86 Salkin, P. E., & Ko, P. (2011, October 1). The effective use of health impact assessment (HIA) in land-use decision making. Zoning Practice, 28(10), 2-7. Retrieved from: http://www.doh. state.fl.us/Planning_eval/HIA/Examples/ZoningPracticeIssue.pdf 87 Parthasarathy, P., Dailey, D. E., Young, M. E. D., Lam, C., & Pies, C. (2013, June). Building Economic Security Today: Making the health–wealth connection in Contra Costa County’s maternal and child health programs. Maternal and Child Health Journal. 88 Institute for Local Government. (2010). Understanding the basics of land use and planning: A glossary of land use and planning terms. Sacramento, CA: Author. Retrieved from:
http://www.ca-ilg.org/sites/main/files/file-attachments/2010_-_LandUseGlossary_w.pdf 89 Bardach, E. (2000). A practical guide for policy analysis: The eightfold path to more effective problem solving (2nd ed.). Washington, DC: CQ Press. 90 Institute for Local Government. (2010). Understanding the basics of land use and planning: A glossary of land use and planning terms. Sacramento, CA: Author. Retrieved from:
http://www.ca-ilg.org/sites/main/files/file-attachments/2010_-_LandUseGlossary_w.pdf 91 Federal, Provincial and Territorial Advisory Committee on Population Health, Canada. (1999, September). Toward a healthy future: Second report on the health of Canadians. Ottowa, ON: Provincial and Territorial Ministries of Health. Retrieved from: http://publications.gc.ca/collections/Collection/H39-468-1999E.pdf 92 New York City, Office of the Mayor. (2011, December 15). Bucking national trends, Mayor Bloomberg announces significant drop in New York City childhood obesity rates [Press release].
Retrieved from: www.nyc.gov/html/om/html/2011b/pr440-11.html 93 Pettersson, B. (2010, July). Health in All Policies across jurisdictions: A snapshot from Sweden. Public Health Bulletin South Australia, 7(2), 17-20. Retrieved from: http://www.health. sa.gov.au/pehs/publications/publichealthbulletin-pehs-sahealth-1007.pdf 94 Kania, J., & Kramer, M. (2011, Winter). Collective impact. Stanford Social Innovation Review, 9(1). Retrieved from: http://www.ssireview.org/articles/entry/collective_impact 95 Ibid.
96 E. Salem, personal communication, April 20, 2012.
97 J. Prochaska, personal communication, April 20, 2012. 98 U.S. Department of Health and Human Services, National Prevention Council. (n.d.). National Prevention, Health Promotion, and Public Health Council. Office of the Surgeon General.
Retrieved from: http://www.surgeongeneral.gov/initiatives/prevention/about/index.html 99 St-Pierre, L., & Gauvin, F. (2010, July). Intersectoral governance for Health in All Policies: An integrated framework. Public Health Bulletin South Australia, 7(2), 31-36. Retrieved from:
http://www.health.sa.gov.au/pehs/publications/publichealthbulletin-pehs-sahealth-1007.pdf 100 Howard, R., & Gunther, S. (2012, May). Health in All Policies: An EU literature review 2006-2011 and interview with key stakeholders. Equity Action. Retrieved from: http://www. equitychannel.net/uploads/HiAP%20%20Final%20Report%20May%202012.pdf 101 K. Hanni, personal communication, November 14, 2012. 102 State of Queensland, Australia. (2011). GetInvolved toolkit. Retrieved from: http://www.qld.gov.au/web/community-engagement/tools/online-consultation-toolkit.html 103 K. Bennett, personal communication, February 10, 2012. 104 Atlanta Regional Commission. (2008). Fifty Forward: Health. Atlanta, GA: Author. Retrieved from: http://www.atlantafiftyforward.com/documents/ARCFF_health_web.pdf 105 Rheingold, H. (2007). Using participatory media and public voice to encourage civic engagement. In W.L. Bennett (Ed.), Civic life online: Learning how digital media can engage youth (The John D. and Catherine T. MacArthur Foundation series on digital media and learning) (pp. 97–118). Cambridge, MA: The MIT Press. 106 Morgan, M. A., & Lifshay, J. (2006, March). Community engagement in public health. Martinez, CA: Contra Costa Health Services, Public Health Division. Retrieved from: www.barhii.org/ resources/downloads/community_engagement.pdf
107 Chess, C., Hance, B. J., Sandman, P. M. (1995). Improving dialogue with communities: A short guide for government risk communication. New Brunswick, NJ: New Jersey Department of Environmental Protection, Division of Science & Research. Retrieved from: http://mss3.libraries.rutgers.edu/dlr/showfed.php?pid=rutgers-lib:31712 108 Arnstein, S. (1969). Ladder of citizen participation. Journal of the American Institute of Planners, 35(4), 216-224. 109 Davidson, S. (1998, April). Spinning the wheel of empowerment. Planning, 1262(3), 14–15. 110 Breuer, D. (1999). Community participation in local health and sustainable development: A working document on approaches and techniques: European Sustainable Development and Health series. Copenhagen, Denmark: World Health Organization. Retrieved from: http://www.euro.who.int/__data/assets/pdf_file/0013/101065/E78652.pdf 111 Keast, R., & Mandell, M. P. (2011). Power and collaboration: Fact sheet 13. Australian Research Alliance for Children & Youth. Retrieved from: http://www.aracy.org.au/publicationsresources/command/download_file/id/242/filename/Advancing_Collaboration_Practice_-_Fact_Sheet_13_-_Power_and_collaboration.pdf 112 Carlson, C. (n.d.) Understanding the spectrum of collaborative governance practices. In A Practical Guide to Collaborative Governance (pp. 9-11). Policy Consensus Initiative & National Policy Consensus Center. Retrieved from: http://www.policyconsensus.org/publications/practicalguide/collaborative_spectrum.pdf 113 International Association for Public Participation. (2007). IAP2 spectrum of public participation. Retrieved from: http://www.iap2.org/associations/4748/files/spectrum.pdf 114 Carlson, C. (n.d.) Understanding the spectrum of collaborative governance practices. In A Practical Guide to Collaborative Governance (pp. 9-11). Policy Consensus Initiative & National Policy Consensus Center. Retrieved from: http://www.policyconsensus.org/publications/practicalguide/collaborative_spectrum.pdf 115 The White House, Office of the First Lady. (2010). First Lady Michelle Obama launches Let’s Move: America’s Move to raise a healthier generation of kids [Press release]. Retrieved from http://www.whitehouse.gov/the-press-office/first-lady-michelle-obama-launches-lets-move-americas-move-raise-a-healthier-genera 116 Kania, J., & Kramer, M. (2011, Winter). Collective impact. Stanford Social Innovation Review, 9(1). Retrieved from: http://www.ssireview.org/articles/entry/collective_impact 117 Keast, R., & Mandell, M. P. (2010). Key elements of collaboration: Fact sheet 5. Australian Research Alliance for Children & Youth. Retrieved from: http://www.aracy.org.au/publicationsresources/command/download_file/id/234/filename/Advancing_Collaboration_Practice_-_Fact_Sheet_5_-_Key_elements_of_collaboration.pdf 118 Costello, A., Abbas, M., Allen, A., Ball, S., Bell, S., Bellamy, R., . . . Patterson, C. (2009, May). Managing the health effects of climate change. The Lancet, 373(9676); 1693–1733. 119 California Climate Change Center (2006, March). Public health-related impacts of climate change in California. Retrieved from: www.energy.ca.gov/2005publications/CEC-500-2005-197/ CEC-500-2005-197-SF.PDF
120 Karl, T. R., Melillo, J. M., and Peterson, T. C. (Eds), (2009). Global climate change impacts in the United States. New York, NY: Cambridge University Press. 121 Centers for Disease Control and Prevention. Climate and health program. Retrieved from: http://www.cdc.gov/climateandhealth/default.htm 122 Maizlish, N., Woodcock, J., Co, S., Ostro, B., Fanai, A., Fairley, D. (2013, April). Health cobenefits and transportation-related reductions in greenhouse gas emissions in the San Francisco Bay Area. American Journal of Public Health, 103(4); 703–709. 123 U.S. Environmental Protection Agency. (2008, October). Reducing urban heat islands: Compendium of strategies. Retrieved from: http://www.epa.gov/heatisland/resources/pdf/ TreesandVegCompendium.pdf
124 Pandita, R., & Labandb, D. N. (2010, April 1). Energy savings from tree shade. Ecological Economics, 69(6); 1324–1329. 125 Loukaitou-Sideris, A., & Eck, J. E. (2007, March/April). Crime prevention and active living. American Journal of Health Promotion, 21(4s), 380-389. 126 McConnell, V. & Wiley, K. (2010, May). Infill development: Perspectives and evidence from economics and planning. Resources for the Future Discussion Paper.
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127 Curtis, J., Creamer, N., & Thraves, T. E. (2010, April). From Farm to Fork: A Guide to Building North Carolina’s Sustainable Local Food Economy. Raleigh, N.C.: Center for Environmental Farming Systems.
128 Ecological Society of America. (2000, Summer). Ecosystem services. Washington, DC: Author. Retrieved from: http://www.esa.org/esa/wp-content/uploads/2012/12/ecosystemservices.pdf 129 Kleinman, R. E., Hall, S., Green, H., Korzec-Ramirez, D., Patton, K., Pagano, M. E., & Murphy, J. M. (2002). Diet, breakfast, and academic performance in children. Annals of nutrition & metabolism, 46(Suppl 1), 24–30.
130 Florence, M. D., Asbridge, M., & Veugelers, P. J. (2008). Diet quality and academic performance. The Journal of School Health, 78(4), 209–215; quiz 239–241. 131 The Los Angeles Food Policy Task Force. (2010, July). The Good Food for All agenda: Creating a new regional food system for Los Angeles. Los Angeles, CA: Author. Retrieved from:
http://goodfoodlosangeles.files.wordpress.com/2010/07/good-food-full_report_single_072010.pdf 132 Safety. (2009). Thefreedictionary.com. Farlex, Inc. Retrieved from: http://www.thefreedictionary.com/safety 133 Kaner, S., Lind, L., Toldi, C., Fisk, S., & Berger, D. (2007). Facilitator’s guide to participatory decision-making (2nd ed.). San Francisco, CA: Jossey-Bass. 134 Hampton, K. (2011, July 10). School-grown food for lunch: Against the law? HealthyCal. Retrieved from: http://www.healthycal.org/archives/4951 135 California Department of Education. (2002). A child’s garden of standards: Linking school gardens to California education standards. Sacramento, CA: Author. Retrieved from:
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139 Wikimedia Foundation. (2011, January 26). Paradoxes. eM Publications. Retrieved from: http://books.google.com/books?id=smjPg2ts1MQC&lpg=PP1&pg=PP2#v=onepage&q&f=false 140 World Health Organization & Government of South Australia. (2010). Adelaide Statement on Health in All Policies: Moving towards a shared governance for health and well-being:
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141 Partnership for Sustainable Communities. (n.d.). Partnership for Sustainable Communities: An interagency partnership of HUD, DOT, and EPA. Available at: http://www. sustainablecommunities.gov
142 St-Pierre, L., & Gauvin, F. (2010, July). Intersectoral governance for Health in All Policies: An integrated framework. Public Health Bulletin South Australia, 7(2), 31-36. Retrieved from:
http://www.health.sa.gov.au/pehs/publications/publichealthbulletin-pehs-sahealth-1007.pdf 143 McQueen, D. V., Wismar, M., Lin, V., Jones, C. M., & Davies, M. (Eds.). (2012). Intersectoral governance for Health in All Policies. Copenhagen, Denmark: European Observatory on Health Systems and Policies, World Health Organization. Retrieved from: http://www.euro.who.int/__data/assets/pdf_file/0005/171707/Intersectoral-governance-for-health-in-all-policies.pdf 144 St-Pierre, L., & Gauvin, F. (2010, July). Intersectoral governance for Health in All Policies: An integrated framework. Public Health Bulletin South Australia, 7(2), 31-36. Retrieved from:
http://www.health.sa.gov.au/pehs/publications/publichealthbulletin-pehs-sahealth-1007.pdf 145 The White House, Office of the Press Secretary. (2010, June 10). Executive Order 13544: Establishing the National Prevention, Health Promotion, and Public Health Council [Press release]. Retrieved from: http://www.whitehouse.gov/the-press-office/executive-order-establishing-national-prevention-health-promotion-and-public-health 146 Governor’s Interagency Council on Health Disparities, Washington State Board of Health. (2010, June). State Policy Action Plan to eliminate health disparities. Olympia, WA: Author.
Retrieved from: http://healthequity.wa.gov/About/docs/ActionPlan.pdf 147 Governor’s Interagency Council on Health Disparities, Washington State Board of Health. (2013). Governor’s Interagency Council on Health Disparities. Retrieved from: http://healthequity. wa.gov/default.htm
148 J. Loy, personal communication, November 9, 2012.
149 King County, Washington, Ordinance 16948 (2010, October 11). 150 King County Equity and Social Justice. (2013). The Inter Branch Team (IBT). Retrieved from: http://www.kingcounty.gov/exec/equity/team.aspx 151 Government of South Australia, SA Health. (2012). Health in All Policies governance. Retrieved from: http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/ sa+health+internet/health+reform/health+in+all+policies/health+in+all+policies+governance 152 Gagnon, F., Turgeon, J., & Dallaire, C. (2008, October). Health impact assessment in Quebec: When the law becomes a lever for action. National Collaborating Centre for Healthy Public Policy. Retrieved from: http://www.ncchpp.ca/docs/GEPPS_HIAQu%C3%A9becANoct2008.pdf 153 N. Baer, personal communication, October 20, 2011.
154 J. Prochaska, personal communication, April 20, 2012. 155 M. Lipsett, personal communication, August 8, 2012. 156 U.S. Department of Transportation, Federal Highway Administration. (2012, October). Metropolitan area transportation planning for healthy communities. Washington, DC: Author.
Retrieved from: http://www.planning.dot.gov/documents/Volpe_FHWA_MPOHealth_12122012.pdf 157 E. Salem, personal communication, April 20, 2012.
158 L. Kim, personal communication, April 24, 2012.
159 T. Lin, personal communication, March 23, 2012.
160 Wash. Second Substitute Senate Bill 6197 (2006).
161 R. Fesahazion & S. Morris-Compton, personal communication, October 10, 2012. 162 Gagnon, F., Turgeon, J., & Dallaire, C. (2008, October). Health impact assessment in Quebec: When the law becomes a lever for action. National Collaborating Centre for Healthy Public Policy. Retrieved from: http://www.ncchpp.ca/docs/GEPPS_HIAQu%C3%A9becANoct2008.pdf 163 Department of Health, Government of South Australia. (2010). The South Australian approach to Health in All Policies: Background and practical guide. Rundle Mall, Australia: Author. 164 International Association for Impact Assessment (IAIA) Health Section. (2005, September 1). Clarification: Health impact assessment in Thailand [web log post]. Retrieved from: http:// healthimpactassessment.blogspot.com/2010/08/clarification-health-impact-assessment.html 165 C. Graffunder, personal communication, March 26, 2012. 166 Bhatia, R., & Wernham, A. (2008). Integrating human health into environmental impact assessment: An unrealized opportunity for environmental health and justice. Environmental Health Perspectives, 116(8), 991–1000.
167 Washington State Board of Health. (2010). Health impact reviews. Retrieved from: http://sboh.wa.gov/HIR/index.htm 168 San Francisco Department of Public Health. (2007, September). Eastern Neighborhoods community health impact assessment: Final report. San Francisco, CA: Author. Retrieved from:
http://www.sfphes.org/component/jdownloads/viewcategory/12 169 National Research Council. (2011). Improving health in the United States: The role of health impact assessment. Washington, DC: National Academies Press. 170 Human Impact Partners. (2011, February). A health impact assessment toolkit: A handbook to conducting HIA (3rd ed.). Oakland, CA: Author. Retrieved from: http://www.humanimpact. org/component/jdownloads/finish/11/81
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171 International Association for Impact Assessment (IAIA) Health Section. (2005, September 1). Clarification: Health impact assessment in Thailand [web log post]. Retrieved from: http:// healthimpactassessment.blogspot.com/2010/08/clarification-health-impact-assessment.html 172 Health Impact Project. (2009–2011). HIA program case study: Massachusetts. Retrieved from: http://www.healthimpactproject.org/resources/hia-program-case-study-massachusetts 173 UCLA Health Impact Assessment Clearinghouse Learning & Information Center. (n.d.). San Francisco living wage ordinance: Summary of the HIA. Retrieved from: http://www.hiaguide. org/hia/san-francisco-living-wage-ordinance
174 Health Impact Project. (2009–2011). Massachusetts low income energy assistance program. Retrieved from: http://www.healthimpactproject.org/hia/us/massachusetts-low-incomeenergy-assistance-program 175 Health Impact Project. (2009–2011). New Britain-Hartford Busway project rapid health impact assessment. Retrieved from: http://www.healthimpactproject.org/hia/us/a-rapid-healthimpact-assessment-of-the-new-britain-hartford-busway-project 176 Joshi, S., Hamberg, A., Cain, D., Douglas, J. P., Teshale, S., & Early-Alberts, J. (2013, March). Strategic health impact assessment on wind energy development in Oregon. Portland, OR:
Oregon Health Authority, Public Health Division. Retrieved from: http://public.health.oregon.gov/HealthyEnvironments/TrackingAssessment/HealthImpactAssessment/Documents/ Wnd%20Energy%20HIA/Wind%20HIA_Final.pdf
177 Department of Health, Government of South Australia. (2010). The South Australian approach to Health in All Policies: Background and practical guide. Rundle Mall, Australia: Author. 178 Kemm, J. (2008). Health impact assessment: an aid to political decision-making. Scandinavian Journal of Public Health, 36(8), 785–788. 179 Health in All Policies Unit, South Australia Health. (2009). Health in All Policies: The South Australian approach. Retrieved from: http://www.sahealth.sa.gov.au/wps/wcm/connect/ public+content/sa+health+internet/health+reform/health+in+all+policies 180 The Office for Water Security & SA Health. (2009, March). Water security: A health lens. Retrieved from: http://www.sahealth.sa.gov.au/wps/wcm/connect/ ea34818043aedab6b547fded1a914d95/waterreport-hiap-phcc-1004.pdf?MOD=AJPERES&CACHEID=ea34818043aedab6b547fded1a914d95 181 Department of Further Education, Employment, Science and Technology, & SA Health. (2009, December). Digital technology: A health lens. Retrieved from: http://www.sahealth.sa.gov. au/wps/wcm/connect/0f50cc8043aecfaeb519fded1a914d95/DIGITAL+TECHNOLOGY+REPORT+FINAL.pdf?MOD=AJPERES&CACHEID=0f50cc8043aecfaeb519fded1a914d95 182 Quigley and Watts Ltd. (2010, March). Regional migrant settlement: Health lens project. Report for Department of Trade and Economic Development, SA Health and Multicultural SA.
Retrieved from: http://www.sahealth.sa.gov.au/wps/wcm/connect/806b460043aee14eb58ffded1a914d95/Qualitative+research+on+migrant+settlement+Final+report.pdf?MOD=AJPE RES&CACHEID=806b460043aee14eb58ffded1a914d95
183 Department of Planning and Local Government, Department for Transport, Energy and Infrastructure, Department of Health, & Land Management Corporation. (n.d.). Transit-oriented developments...through a health lens. Retrieved from: http://www.sahealth.sa.gov.au/wps/wcm/connect/9b73728048965a969de8fd7675638bd8/transit-oriented-dev-healthlenshiap-20111006.pdf?MOD=AJPERES&CACHEID=9b73728048965a969de8fd7675638bd8 184 Center for Training and Research Translation, University of North Carolina at Chapel Hill. (2012). Active transportation funding policy: Nashville Area Metropolitan Planning Organization (MPO). Retrieved from: http://centertrt.org/content/docs/Intervention_Documents/Intervention_Templates/Nashville_MPO_ATFP_Template.pdf 185 Data. (2009). Merriam-Webster.com. Merriam-Webster. Retrieved from: http://www.merriam-webster.com/dictionary/data 186 Missouri Department of Health and Senior Services. (n.d.) Intervention MICA: What is evidence? Retrieved from: http://health.mo.gov/data/interventionmica/index_5.html 187 National Research Council and Institute of Medicine. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Committee on the Prevention of Mental Disorders and Substance Abuse Among Children, Youth, and Young Adults: Research Advances and Promising Interventions. Mary Ellen O’Connell, Thomas Boat, and Kenneth E. Warner, Editors. Board on Children, Youth, and Families, Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press.
188 Baron, J. (2012, Nov 29). Applying evidence to social programs. The New York Times. Retrieved from http://economix.blogs.nytimes.com/2012/11/29/applying-evidence-to-socialprograms/ 189 National Research Council and Institute of Medicine. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Committee on the Prevention of Mental Disorders and Substance Abuse Among Children, Youth, and Young Adults: Research Advances and Promising Interventions. Mary Ellen O’Connell, Thomas Boat, and Kenneth E. Warner, Editors. Board on Children, Youth, and Families, Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press.
190 Woodcock, J., Edwards, P., Tonne, C., Armstrong, B. G., Ashiru, O., Banister, D., . . .Roberts, I. (2009, December 5). Public health benefits of strategies to reduce greenhouse-gas emissions: Urban land transport. Lancet, 374(9705), 1930–1943. 191 Maizlish, N. A., Woodcock, J. D., Co, S., Ostro, B., Fairley, D., & Fanai, A. Health co-benefits and transportation-related reductions in greenhouse gas emissions in the Bay Area:
Technical report. Richmond, CA: Center for Chronic Disease Prevention and Health Promotion, California Department of Public Health. Retrieved from: http://www.cdph.ca.gov/ programs/CCDPHP/Documents/ITHIM_Technical_Report11-21-11.pdf 192 Minnesota Department of Health & Healthy Minnesota Partnership. Healthy Minnesota 2020: Statewide health improvement framework. (2012, December). Saint Paul, MN: Author.
Retrieved from: http://www.health.state.mn.us/healthymnpartnership/hm2020/1212healthymn2020fw.pdf 193 Baath, M., Sujeer, A., Peddycord, D., Fenstersheib, M., & Luna, R. (n.d.). Health disparities among the Asian Pacific Islander subgroups in Santa Clara County [Poster]. Santa Clara, CA:
Santa Clara County Public Health Department. Retrieved from: http://www.sccgov.org/sites/sccphd/en-us/Partners/Data/Documents/Asian%20subgroups%20poster%20combined%20 final.pdf
194 Highways, Metropolitan Transportation Planning, 23 U.S.C. § 134 (1962). 195 Human Impact Partners. (2011, August). Elevating health & equity into the Sustainable Communities Strategy (SCS) process. Oakland, CA: Author. Retrieved from: http://www. humanimpact.org/doc-lib/finish/7-policy-hias/132-scs-health-a-equity. 196 Ibid.
197 K. Hanni, personal communication, November 14, 2012. 198 Fuentes, A. (n.d.). Students and parents tell LA Truancy Task Force to end the tickets and fines. The California Endowment. Retrieved from: http://staging.calendow.org/Article. aspx?id=5643
199 Cody, S., Reed, D., Basson, D., Pedraza, J., Martin, E. S., Santos, B., & Smith, E. (2010, November 4). Simplification of health and social services enrollment and eligibility: Lessons for California from interviews in four states: Final report. Washington, DC: Mathematica Policy Research, Inc. Retrieved from: http://www.mathematica-mpr.com/publications/PDFs/family_ support/socialservices_CA.pdf
200 Ibid.
201 Hobson, J., & Quiroz-Martínez, J. (2002). Roadblocks to health: Transportation barriers to healthy communities. Oakland, CA: Transportation for Healthy Communities Collaborative.
Retrieved from: http://transformca.org/files/reports/roadblocks-to-health.pdf 202 Hall, L. (2011, June 30). State Fitnessgram saved from budget ax. OC Register. Retrieved from: http://healthyliving.blog.ocregister.com/2011/06/30/state-fitnessgram-saved-frombudget-ax/34805/ 203 Calif. Transportation Planning, AB 441 § 365 (2012). 204 Williams, C. (2010, November 18). Health in All Policies…South Australia’s experience: Health, wellbeing and HIA: Working better, working smarter. PowerPoint presented at the HIA 2010 3rd Asia and Pacific Regional Health Impact Assessment Conference. Retrieved from: http://www.iaia.org/hia2010/proceedings/HIA%202010%20Presentations%20PDFs/9%20 Thur%209am%20Plenary%20talks/Williams_keynote.pdf
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205 Taylor, L., Gowman, N., & Quigley, R. (2003). Evaluating health impact assessment: Learning from practice bulletin. Yorkshire, UK: National Health Service, Health Development Agency.
Retrieved from: http://www.who.int/hia/evidence/en/practice.pdfPlaceMatters. (n.d.). 206 Wallack, L., & Lawrence, R. (2005). Talking about public health: developing America’s “second language.” American Journal of Public Health. 95, 567–570. 207 Dorfman, L., Wallack, L., Woodruff, K. (2005, June). More than a message: Framing public health advocacy to change corporate practices. Health Education and Behavior, 32(4), 320–336. 208 Kickbusch, I. (2010). Health in All Policies: The evolution of the concept of horizontal governance. In: Kickbusch, I., & Buckett, K. (Eds.). Implementing Health in All Policies, Adelaide 2010 (pp.11–23). Rundle Mall, South Australia: Government of South Australia, Department of Health. Retrieved from: http://www.who.int/sdhconference/resources/implementinghiapadelsahealth-100622.pdf 209 Sihto, M., Ollila, E., & Koivusalo, M. (2006). Principles and challenges of Health in All Policies. In: T. Ståhl, M. Wismar, E. Ollila, E. Lahtinen, & K. Leppo (Eds.), Health in All Policies:
Prospects and potentials (pp.3-20). Finland: Ministry of Social Affairs and Health, Finland, & European Observatory on Health Systems and Policies. Retrieved from: http://www.euro.who. int/__data/assets/pdf_file/0003/109146/E89260.pdf
210 World Health Organization. (1988, April 5–9). Adelaide recommendations on healthy public policy. Adopted at the Second International Conference on Health Promotion, Adelaide, South Australia. Retrieved from: http://www.who.int/healthpromotion/conferences/previous/adelaide/en/index1.html 211 Ross, R. (n.d.). Introducing ‘Health Happens Here.’ The California Endowment. Retrieved from: http://staging.calendow.org/Article.aspx?id=5837. 212 Joint Center for Political and Economic Studies. (n.d.). Health Policy Focus Areas. Retrieved from: http://www.jointcenter.org/institutes/health-policy/focus-areas 213 PlaceMatters. (n.d.). PlaceMatters. Retrieved from: http://www.placematters.org 214 D. Wildgoose, personal communication, October 24, 2012. 215 Maibach, E., Nisbet, M., & Weathers, M. (2011). Conveying the human implications of climate change: A climate change communication primer for public health professionals. Fairfax, VA: George Mason University Center for Climate Change Communication. Retrieved from: http://www.climatechangecommunication.org/images/files/4C%20Communication%20 Primer%20-%20Conveying%20the%20Human%20Implications%20of%20Climate%20Change.pdf 216 Calif. Health and Safety Code § 38500 (2006).
217 Calif. Sustainable Communities and Climate Protect Act, SB 375 § 728 (2008). 218 Calif. Public Resources Code § 75120-75130 (2008).
219 Governor’s vision for a healthy California. (2005). Presented at the 2010 Summit on Health, Nutrition and Obesity: Actions for Healthy Living, Sacramento, CA. Retrieved from: http:// images.emaildirect.com/clients/govpressoffice847/HealthSummitGovernorsVisionFinal.pdf 220 Calif. Executive Order S-04-10. (2010, February 23). Sacramento, CA. Retrieved from: http://sgc.ca.gov/hiap/docs/about/Executive_Order_S-04-10.pdf 221 Ibid.
222 K. Belshé, personal communication, October 21, 2010. 223 California Health in All Policies Task Force. (2010, December 3). Health in All Policies Task Force Report to the Strategic Growth Council. Retrieved from: http://sgc.ca.gov/hiap/docs/ publications/HiAP_Task_ Force_Report.pdf
224 California Health in All Policies Task Force. (2010, December 3). Health in All Policies Task Force Report to the Strategic Growth Council. Retrieved from: http://sgc.ca.gov/hiap/docs/ publications/HiAP_Task_Force_Report.pdf
225 Institute of Medicine (IOM). (2009). Local government actions to prevent childhood obesity. Washington, DC: National Academies Press. 226 Robert Wood Johnson Foundation, Leadership for Healthy Communities. (2010). Action strategies toolkit: A guide for local and state leaders working to create healthy communities and prevent childhood obesity. Princeton, NJ: Author.
227 U.S. Department of Health and Human Services. (2009). The Surgeon General’s call to action to promote healthy homes. Rockville, MD: Office of the Surgeon General. Retrieved from:
http://www.surgeongeneral.gov/library/calls/healthyhomes/calltoactiontopromotehealthyhomes.pdf 228 Pastor, M., Morello-Frosch, R., Sadd, J., & Shonkoff, S. (2009). The climate gap: Inequalities in how climate change hurts Americans & how to close the gap. Los Angeles, CA: USC Program for Environmental and Regional Equity.
229 California Health in All Policies Task Force. (2010, December 3). Health in All Policies Task Force Report to the Strategic Growth Council. Retrieved from: http://sgc.ca.gov/hiap/docs/ publications/HiAP_Task_Force_Report.pdf
230 U.S. Department of Health and Human Services, Office of the Surgeon General. (2011). National Prevention Council, National Prevention Strategy. Washington, DC. Retrieved from:
http://www.surgeongeneral.gov/initiatives/prevention/strategy/report.pdf. 231 Chicago Department of Public Health. (2011). Healthy Chicago: A public health agenda for a healthy city, healthy neighborhoods, healthy people and healthy homes. Chicago, IL.
Retrieved from: http://www.cityofchicago.org/dam/city/depts/cdph/CDPH/PublicHlthAgenda2011.pdf 232 California Health in All Policies Task Force. (n.d.). Publications: Implementation plans. Retrieved from: http://www.sgc.ca.gov/hiap/publications.html 233 California Environmental Protection Agency, California Air Resources Board. (2005, April). Air quality handbook: A community health perspective. Retrieved from: http://www.arb.ca.gov/ ch/handbook.pdf
234 Calif. Sustainable Communities and Climate Protect Act, SB 375 § 728 (2008). 235 Calif. Health and Safety Code § 38500 (2006).
236 Harder+Company Community Research. (2012). California Health in All Policies (HiAP) Collaborative Process: Findings from an evaluation for The California Department of Public Health. Unpublished internal document.
237 Calif. Health in All Policies, SCR 47, § 56 (2012). 238 Let’s Get Healthy California Task Force. (2012, December 19). Let’s Get Healthy California Task Force Final Report. Retrieved from: http://www.chhs.ca.gov/Documents/Let%27s%20 Get%20Healthy%20California%20Task%20Force%20Final%20Report.pdf 239 Calif. Health and Safety Code § 131019.5 (2012).
240 Halter, G., Hitchcock, A., Kelly, T. (2010, November). 2010 California regional progress report. California Strategic Growth Council and California Department of Transportation (Caltrans), California Regional Blueprints. Retrieved from: http://www.dot.ca.gov/hq/tpp/offices/orip/Collaborative%20Planning/Files/CARegionalProgress_2-1-2011.pdf 241 Kania, J., & Kramer, M. (2011, Winter). Collective impact. Stanford Social Innovation Review, 9(1). Retrieved from: http://www.ssireview.org/articles/entry/collective_impact 242 Data. (2009). Merriam-Webster.com. Merriam-Webster. Retrieved from: http://www.merriam-webster.com/dictionary/data 243 Last, J. M. (Ed.). (2001). A dictionary of epidemiology (4th ed.). New York: Oxford University Press. 244 Missouri Department of Health and Senior Services. (n.d.) Intervention MICA: What is evidence? Retrieved from: http://health.mo.gov/data/interventionmica/index_5.html 245 Ibid.
246 World Health Organization. (1946, June 19-22). Constitution of the World Health Organization. Retrieved from: http://whqlibdoc.who.int/hist/official_records/constitution.pdf 247 Virginia Department of Health. (2012, January). What is health inequity? Retrieved from: http://www.vdh.virginia.gov/healthpolicy/healthequity/unnaturalcauses/healthequity.htm 248 Whitehead, M., & Dahlgren, G. (2006). Levelling up (part 1): A discussion paper on concepts and principles for tackling social inequities in health. Copenhagen, Denmark: World Health Organization. Retrieved from: http://www.who.int/social_determinants/resources/leveling_up_part1.pdf 249 National Research Council. (2011). Improving health in the United States: The role of health impact assessment. Washington, DC: National Academies Press.
Attachment 1
A GUIDE FOR STATE AND LOCAL GOVERNMENTS · 164
REFERENCES
250 Virginia Department of Health. (2012, January). What is health inequity? Retrieved from: http://www.vdh.virginia.gov/healthpolicy/healthequity/unnaturalcauses/healthequity.htm 251 U.S. National Library of Medicine, National Institutes of Health. (2012, April 17). Health economics information resources: A self-study course: Glossary of frequently encountered terms in health economics. Retrieved from: http://www.nlm.nih.gov/nichsr/edu/healthecon/glossary.html 252 Ritsatakis, A., Barnes, R., Dekker, E., Harrington, P., Kokko, S., & Makara, P. (Eds.). (2000). Exploring health policy development in Europe. Copenhagen: World Health Organization, Regional Office for Europe.
253 Dodd, J.D., & Boyd, M.H. (2000). Capacity building—linking community experience to public policy. Halifax, Canada: Population and Public Health Branch, Atlantic Regional Office, Health Canada.
254 Australian Government Management Advisory Committee. (2004). Connecting government: Whole-of-government responses to Australia’s priority challenges. Commonwealth of Australia.
255 Association of State and Territorial Health Officials (ASTHO). (2013, January). Health in All Policies: Strategies to promote innovative leadership. Arlington, VA: ASTHO. Retrieved from:
http://www.astho.org/Programs/Prevention/Implementing-the-National-Prevention-Strategy/HiAP-Toolkit 256 McQueen, D. V., Wismar, M., Lin, V., Jones, C. M., & Davies, M. (Eds.). (2012). Intersectoral governance for Health in All Policies. Copenhagen, Denmark: European Observatory on Health Systems and Policies, World Health Organization. Retrieved from: http://www.euro.who.int/__data/assets/pdf_file/0005/171707/Intersectoral-governance-for-health-in-all-policies.pdf 257 National Association of County & City Health Officials (NACCHO). Health in All Policies (HiAP): A path to promoting environmental public health. Retrieved from: http://www.naccho. org/topics/environmental/HiAP/upload/HiAP-one-page-FINAL.pdf 258 Department of Health, Government of South Australia. (2010). The South Australian approach to Health in All Policies: Background and practical guide. Rundle Mall, Australia: Author. 259 Ibid.
Attachment 1
A Guide for State and Local Governments
AN INTRODUCTION TO
HEALTH IN ALL POLICIES
Health in All Policies: A Guide for State and Local Governments was created by the Public Health Institute, the California Department of Public Health, and the American Public Health Association in response to growing interest in using collaborative approaches to improve population health by embedding health considerations into decision-making processes across a broad array of sectors. The Guide draws heavily on the experiences of the California Health in All Policies Task Force and incorporates information from the published and gray literature and interviews with people across the country.
WHY DO WE NEED HEALTH IN ALL POLICIES?
Health in All Policies is based on the recognition that our greatest health challenges—for example, chronic illness, health inequities, climate change, and spiraling health care costs—are highly complex and often linked.
Promoting healthy communities requires that we address the social determinants of health, such as transportation, education, access to healthy food, economic opportunities, and more. This requires innovative solutions, a new policy paradigm, and structures that break down the siloed nature of government to advance collaboration.
A MESSAGE FROM THE AMERICAN PUBLIC HEALTH ASSOCIATION
The environments in which people live, work, learn, and play have a tremendous impact on their health. Responsibility for the social determinants of health falls to many nontraditional health partners, such as housing, transportation, education, air quality, parks, criminal justice, energy, and employment agencies. Public health agencies and organizations will need to work with those who are best positioned to create policies and practices that promote healthy communities and environments and secure the many co-benefits that can be attained through healthy public policy.
This guide follows in that tradition: We believe it will be of great value as the implementation of Health in All Policies expands and evolves to transform the practice of public health for the benefit of all.
Georges C. Benjamin, MD
Executive Director
Adewale Troutman, MD, MPH, MA, CPH
President
Attachment 2
WHAT IS HEALTH IN ALL POLICIES?
Health in All Policies is a collaborative approach to improving the health of all people by incorporating health considerations into decision-making across sectors and policy areas.
The goal of Health in All Policies is to ensure that decision-makers are informed about the health, equity, and sustainability consequences of various policy options during the policy development process. A Health in All Policies approach identifies the ways in which decisions in multiple sectors affect health, and how better health can support the goals of these multiple sectors. It engages diverse governmental partners and stakeholders to work together to promote health, equity, and sustainability, and simultaneously advance other goals such as promoting job creation and economic stability, transportation access and mobility, a strong agricultural system, and educational attainment. There is no one “right” way to implement a Health in All Policies approach, and there is substantial flexibility in process, structure, scope, and membership.
FIVE KEY ELEMENTS OF HEALTH IN ALL POLICIES
Promote health, equity, and sustainability. Health in All Policies promotes health, equity, and sustainability through two avenues: (1) incorporating health, equity, and sustainability into specific policies, programs, and processes, and (2) embedding health, equity, and sustainability considerations into government decision-making processes so that healthy public policy becomes the normal way of doing business.
Support intersectoral collaboration. Health in All Policies brings together partners from the many sectors that play a major role in shaping the economic, physical, and social environments in which people live, and therefore have an important role to play in promoting health, equity, and sustainability. A Health in All Policies approach focuses on deep and ongoing collaboration.
Benefit multiple partners. Health in All Policies values co-benefits and win-wins. Health in All Polices initiatives endeavor to simultaneously address the policy and programmatic goals of both public health and other agencies by finding and implementing strategies that benefit multiple partners.
Engage stakeholders. Health in All Policies engages many stakeholders, including community members, policy experts, advocates, the private sector, and funders, to ensure that work is responsive to community needs and to identify policy and systems changes necessary to create meaningful and impactful health improvements.
Create structural or process change. Over time, Health in All Policies work leads to institutionalizing a Health in All Policies approach throughout the whole of government. This involves permanent changes in how agencies relate to each other and how government decisions are made, structures for intersectoral collaboration, and mechanisms to ensure a health lens in decision-making processes.
Attachment 2
The Healthy Community Framework was developed by the California Health in All Policies Task Force, based upon discussion with community, government, and public health leaders in response to the question, “What is a healthy community?” A Healthy Community provides for the following through all stages of life:
Meets basic needs of all
· Safe, sustainable, accessible, and affordable transportation options · Affordable, accessible and nutritious foods, and safe drinkable water · Affordable, high quality, socially integrated, and location-efficient housing · Affordable, accessible and high quality health care
· Complete and livable communities including quality schools, parks and recreational facilities, child care, libraries, financial services and other daily needs · Access to affordable and safe opportunities for physical activity · Able to adapt to changing environments, resilient, and prepared for emergencies · Opportunities for engagement with arts, music and culture Quality and sustainability of environment
· Clean air, soil and water, and environments free of excessive noise · Tobacco- and smoke-free
· Green and open spaces, including healthy tree canopy and agricultural lands · Minimized toxics, greenhouse gas emissions, and waste · Affordable and sustainable energy use
· Aesthetically pleasing
Adequate levels of economic and social development
· Living wage, safe and healthy job opportunities for all, and a thriving economy · Support for healthy development of children and adolescents · Opportunities for high quality and accessible education Health and social equity
Social relationships that are supportive and respectful · Robust social and civic engagement
· Socially cohesive and supportive relationships, families, homes and neighborhoods · Safe communities, free of crime and violence
California Health in All Policies Task Force. (2010, December 3). Health in All Policies Task Force Report to the Strategic Growth Council. Retrieved from:
http://sgc.ca.gov/hiap/docs/publications/HiAP_Task_Force_Report.pdf. Used with permission. HEALTHY COMMUNITY FRAMEWORK Attachment 2
To download Health in All Policies: A Guide for State and Local Governments, visit one of these websites:
http://www.apha.org/hiap
http://www.phi.org/resources/?resource=hiapguide
For more information, write to [email protected].
WHAT’S IN HEALTH IN ALL POLICIES: A GUIDE FOR STATE AND LOCAL GOVERNMENTS?
· A discussion of why Health in All Policies approaches are necessary to meet today’s health and equity challenges
· Five key elements of Health in All Policies, and how to apply them to your work · Stories of cities, counties, and states that are implementing Health in All Policies · “Food for Thought”—Lists of questions that leaders of a Health in All Policies initiative might want to consider
· Tips for identifying new partners, building meaningful collaborative relationships across sectors, and maintaining those partnerships over time
· A discussion of different approaches to healthy public policy, including applying a health lens to “non-health” policies
· Reflections on funding, evaluation, and the use of data to support Health in All Policies · Information about messaging and tips on how to talk about Health in All Policies · A case study of the California Health in All Policies Task Force · Over 50 annotated resources for additional information · A glossary of commonly used terms
Attachment 2
10/19/2023 12:40:54 PM
C:\Program Files\eSCRIBE\TEMP\12405199189\12405199189,,,Report - Workforce Housing.docx Agenda Report
MEETING DATE: Tuesday, October 24, 2023
TO: City Council
FROM: CITY MANAGER MENDEZ
SUBJECT: UPDATE ON WORKFORCE HOUSING DEVELOPMENT AND
PARTNERSHIPS
RECOMMENDED ACTION:
Receive the Update on Workforce Housing Development and Partnerships BACKGROUND:
This item is being presented to the Council as a follow-up to a request from Councilmember Orozco who requested staff explore opportunities to develop partnerships to address workforce housing needs.
DISCUSSION:
Staff is pleased to report that a working group comprised of PVUSD, Santa Cruz County, Cabrillo College, University of California Santa Cruz (UCSC), and the City is being established to develop opportunities for workforce housing in Watsonville. There was an initial meeting held, where information was exchanged and establishing a working group was discussed.
The lack of workforce housing is a significant need and challenge for our City and region.
It impacts our community in many ways, including:
Hampering recruitment efforts.
Making it challenging for our youth to come back to live and work. Being a huge barrier to economic development and growth makes it challenging to bring the jobs needed for our community to prosper.
As the Council is aware, the City’s Regional Housing Needs Allocation calls for 2,053 units allocated per the following table, which clearly illustrates the need for workforce housing.
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C:\Program Files\eSCRIBE\TEMP\12405199189\12405199189,,,Report - Workforce Housing.docx Income
Category
RHNA
Allocation
(Housing
Units)
Very Low 283 units
Low 186 units
Moderate 521 units
Above
Moderate
1,063 units
Total 2,053
With (a) the City currently working on the Housing Element and General Plan, (b) PVUSD, UCSC and Cabrillo interested in the development of workforce housing, and (c) the County evaluating some of their sites for the potential of workforce housing; the time is now to develop the partnerships and joint efforts necessary. As I am sure the Council can appreciate these efforts are neither quick nor easy, but I am pleased to inform you that all the partners are committed to working together on this important issue.
Updates will be brought forward as this collaboration develops further.
STRATEGIC PLAN:
As this collaboration on workforce housing development moves forward and projects are developed this will address several strategic priorities including 1) economic development, 2) infrastructure & environment, 3) housing, 4) fiscal health, 5) public safety, and 6) community engagement and well-being.
FINANCIAL IMPACT:
There is no fiscal impact because of this item.
ALTERNATIVE ACTION:
This is an informational item only.
ATTACHMENTS AND/OR REFERENCES (If any):
Not applicable.
10/18/2023 4:33:09 PM
C:\Program Files\eSCRIBE\TEMP\16325976284\16325976284,,,ORDINANCE TO RESCIND ARTICLE 17.docx Agenda Report
MEETING DATE: Tuesday, October 24, 2023
TO: City Council
FROM: POLICE CHIEF ZAMORA
ASSISTANT CHIEF SIMS
THROUGH: CITY MANAGER MENDEZ
SUBJECT: INTRODUCTION OF ORDINANCE TO RESCIND ARTICLE 17 (CRUISING) OF CHAPTER 5 (TRAFFIC) WITHIN TITLE 4 (PUBLIC
SAFETY) OF THE WATSONVILLE MUNCIPAL CODE
RECOMMENDED ACTION:
Move to introduce by title only and waive further reading of an Ordinance to rescind Article 17 (Cruising) of Chapter 5 (Traffic) within Title 4 (Public Safety) of the Watsonville Municipal Code.
BACKGROUND:
On September 26, 2023, the Watsonville Police Department presented a report to City Council discussing Article 17 (Cruising) and alternative enforcement statutes that the Police Department utilizes to ensure the safe operation of vehicles on City streets. At the conclusion of the study session, City Council directed staff to prepare an ordinance to rescind Article 17 (Cruising) of the Watsonville Municipal Code.
DISCUSSION:
The ordinance was adopted in 1986 and is no longer utilized by the Watsonville Police Department. It is more practical for a law enforcement officer to employ the California Vehicle Code when necessary.
STRATEGIC PLAN:
The recommended action supports the Council’s objective of 5-Public Safety.
FINANCIAL IMPACT:
None
ALTERNATIVE ACTION:
The Council may choose not to rescind the ordinance and allow WMC 4-5.1701 to remain as is.
10/18/2023 4:33:09 PM
C:\Program Files\eSCRIBE\TEMP\16325976284\16325976284,,,ORDINANCE TO RESCIND ARTICLE 17.docx ATTACHMENTS AND/OR REFERENCES (If any):
None.
1 Ord No. ______ (CM)
Meeting Date: 102423 SWZ ______ RM ______ WPD ______
ORDINANCE NO. (CM)
AN ORDINANCE OF THE CITY COUNCIL OF THE CITY OF WATSONVILLE RESCINDING ARTICLE 17 (CRUISING) OF CHAPTER 5 (TRAFFIC) WITHIN TITLE 4 (PUBLIC SAFETY) OF THE WATSONVILLE MUNICIPAL CODE Rescinds Ordinance No. 696-86(C-M)
WHEREAS, Ordinance 696-86 (C-M) was adopted in 1986 and is no longer utilized by the Police Department; and
WHEREAS, the City Council conducted a study session on September 26, 2023 to consider Article 17 (Cruising) and discuss some of the alternative enforcement statutes that the Police Department utilizes to ensure the safe operation of vehicles on City streets; and
WHEREAS, at the conclusion of the study session, the City Council gave direction to prepare an ordinance to rescind Article 17.
Table of Contents
SECTION 1. ARTICLE 17. CRUISING -RESCINDED …………………………………… 1 SECTION 2. PUBLICATION…………………………………………………………………..1
SECTION 3. EFFECTIVE DATE……………………………………………………………...2
SECTION 4. CALIFORNIA ENVIRONMENTAL QUALITY ACT…………………………..2 o-0-o
NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF WATSONVILLE, CALIFORNIA, DOES HEREBY ORDAIN AS FOLLOWS:
SECTION 1. ARTICLE 17. CRUISING -RESCINDED.
Article 17 (Cruising) of Chapter 5 (Traffic) within Title 4 (Public Safety) of the Watsonville Municipal Code is hereby rescinded in its entirety.
SECTION 2. PUBLICATION.
This ordinance shall be published in the Watsonville Register-Pajaronian in compliance with the provisions of the Charter of the City of Watsonville.
2 Ord No. (CM)
Meeting Date: 102423
SECTION 3. EFFECTIVE DATE.
This ordinance shall be in force and take effect thirty (30) days after its final adoption.
SECTION 4. CALIFORNIA ENVIRONMENTAL QUALITY ACT.
This Ordinance is not subject to review under the California Environmental Quality Act (CEQA) pursuant to Public Resources Code Section 21000, et seq. and the CEQA Guidelines (14 Cal. Code Regs. §§ 15000 et. seq.), including without limitation, Public Resources Code section 21065 and California Code of Regulations 15378 as this is not a “project” that may cause a direct, or reasonably foreseeable indirect, physical change in the environment.
******************************
10/19/2023 4:48:00 PM
C:\Program Files\eSCRIBE\TEMP\16473612938\16473612938,,,Report - EIR, Airport Master Plan, Airport Layout Plan.docx Agenda Report
MEETING DATE: Tuesday, October 24, 2023
TO: City Council
FROM: AIRPORT DIRECTOR WILLIAMS
AIRPORT OPERATIONS MANAGER ROSAS
THROUGH: CITY MANAGER MENDEZ
SUBJECT: RESOLUTIONS APPROVING AND ADOPTING THE 2023
WATSONVILLE MUNICIPAL AIRPORT CEQA ADDENDUM TO
2003 AIRPORT EIR, MASTER PLAN DATED AUGUST 2023
UPDATE AND AIRPORT LAYOUT PLAN DATED JULY 2023
RECOMMENDATION:
Staff recommends the City Council accept, adopt, and direct the Airport Management to implement the Watsonville Municipal Airport’s CEQA Addendum to the 2003 EIR, the Federal Aviation Administration (FAA) approval of the 2023 Master Plan update and FAA approved Airport Layout Plan 2023 update.
DISCUSSION:
ADDENDUM to 2003 Airport Environmental Impact Report as required by CEQA.
The first Watsonville Municipal Airport Master Plan and accompanying CEQA Initial Study were prepared and adopted in 1986. A process to revise the 1986 Airport Master Plan was initiated in 1993, as was preparation of an EIR. During this process, a State-listed endangered plant, the Santa Cruz tarplant (Holocarpha macradenia), was found on Airport property.
As a result, work on the revised Airport Master Plan and EIR were delayed so that the City could consult with the California Department of Fish and Wildlife (CDFW) regarding mitigation and recovery options. Based on consultation with the CDFW, a Mitigation Plan was completed for the Santa Cruz tarplant and coastal terrace prairie habitat.
Subsequently, work on the updated Airport Master Plan and EIR resumed in 1998. This effort culminated with the approval of the Watsonville Municipal Airport Master Plan, 2001- 2020, and accompanying EIR in 2003.
10/19/2023 4:48:00 PM
C:\Program Files\eSCRIBE\TEMP\16473612938\16473612938,,,Report - EIR, Airport Master Plan, Airport Layout Plan.docx The objective of the approved 2003 Airport Master Plan was to facilitate the orderly, flexible, and
environmentally sensitive expansion and development of the Airport.
The approved 2003 Airport Master Plan consists of a comprehensive and integrated package of improvements to airside and landside facilities at the Airport, such improved facilities having the design capacity to fully accommodate the forecast demand for general aviation services in a comfortable and efficient manner.
As described in Sections 4.1-4.9, of the Addendum the updated 2023 Master Plan would not result in new or more severe project-level impacts than those disclosed in the 2003 EIR.
Additionally, as described in Section 5.3, the Project would not result in new or more severe cumulative impacts than those disclosed in the 2003 EIR. As a result, no new analysis of Project Alternatives is required.
2003 Airport Master Plan Update
An Airport Master Plan is a long-range planning document that describes the future aviation and non-aviation needs of the airport and community. Master Plans are updated periodically in accordance with the federal Aviation Administration (FAA) guidance. The document provides a road map for efficiently meeting aviation demand while preserving the flexibility to respond to changing industry conditions.
The Municipal Airport applied for a grant to fund an Airport Master Plan updates in December 2019. The previous Master Plan Update was adopted by the City Council in June of 2003. Several of the plan’s inputs, configurations and conditions changed over time. Additionally, over the past two decades, the economy has fluctuated, advances in the aviation industry and regional markets have occurred, and the FAA has implemented new guidance and standards.
The purpose of the Master Plan updates is to address those changes and enhance the long-term operational sustainability by establishing an updated framework. The FAA's San Francsico Airports District Office approved Watsonville Airport Master Plan submission in August 2023 and now provides the city with an FAA determined comprehensive, organized, and rational plan for developing Airport facilities over the next 20 years. This update would extend the planning horizon year and operational demand forecasts of the Airport Master Plan from 2020 to 2040, incorporate a set of airfield configuration changes, and update the layout and sizing of various airport facilities to adequately serve the projected 2040 demand.
2013 Airport Layout Plan Update
An Airport Layout Plan (ALP) is effectively a “blueprint” depicting existing and future airport facilities, their location on airport property, and relevant information for the operations and development of the airport. The ALP is a critical planning tool that must be approved by the FAA for airport development at federally obligated airports.
10/19/2023 4:48:00 PM
C:\Program Files\eSCRIBE\TEMP\16473612938\16473612938,,,Report - EIR, Airport Master Plan, Airport Layout Plan.docx The Municipal Airport applied for a grant to fund an Airport Layout Plan update in December 2019. The previous Airport Layout Plan Update was completed in 2013. Several of the plan’s configurations and conditions changed over the last ten years. Similarly, to the Master Plan over the past decade advances in the aviation industry and changes in airport design standards have occurred impacting the airport’s configuration.
The purpose of the Airport Plan Layout updates is to address those changes and enhance the long-term operational sustainability by establishing an updated airport blueprint. The Airport Layout Plan update was approved in August 2023 and now provides the city with a comprehensive, organized, and rational plan for developing Airport facilities over the next 20-years.
STRATEGIC PLAN:
CEQA Addendum
Approval of this recommendation supports Section Three, (Infrastructure & Environment), sub section 3.3 of the airport’s strategic plan by (a) updating the aviation demand forecasts and shift the planning horizon year from 2020 to 2040, (b) modifying certain components of the airfield to reduce hazards in compliance with current FAA standards and (c) modifying future facilities requirements at the Airport to reflect updated demand forecasts.
Airport Master Plan and Airport Layout Plan
Approval of this recommendation supports four major elements of the Airport portion of the City’s 2023-2025 Strategic Plan. First, Section Four, (Fiscal Health), Sub section 2 “Other” (Airport Enterprise Fund Self-sustaining) is supported as approval of this recommendation will ensure continued funding for capital improvements.
Secondly, Section Two, (Infrastructure & Environment), sub section 3.3 is implemented by reduction of the airport’s carbon footprint.
A tertiary point supporting a resolution is the subsequent development of a 2024 Economic Benefit Analysis (Section Four).
Finally, the Airport Master and Airport Layout Plans continue to support and employ actions of Section Five (Engagement and Well-being) driving such events as elementary school students’ outreach, community blood drives and the annual airport open house.
FINANCIAL IMPACT:
CEQA Addendum
The Municipal Airport’s Addendum to the 2003 Environmental Impact Report, ($120,000) has been funded by the Airport Enterprise fund as CEQA efforts such as this are not funded in part or whole by the FAA.
10/19/2023 4:48:00 PM
C:\Program Files\eSCRIBE\TEMP\16473612938\16473612938,,,Report - EIR, Airport Master Plan, Airport Layout Plan.docx Airport Master Plan and Airport Layout Plan
The Municipal Airport Master Plan update has been funded through a 95% grant from the Federal Aviation Administration. The total project cost $550,000; with 95% funding through FAA Airport Capital Improvement Program (ACIP) and Coronavirus Aid, Relief and Economic Security (CARES) act and the remaining 5% funded by Caltrans.
ALTERNATIVES:
The City Council may choose not to accept the Airport Master Plan update.
ATTACHMENTS:
None.
1 Reso No. ______ (CM)
Meeting Date: 102423 SWZ ______ RM ______ WMA ______
RESOLUTION NO. _________ (CM)
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
WATSONVILLE, CALIFORNIA ADOPTING AN ADDENDUM TO THE
ENVIRONMENTAL IMPACT REPORT FOR THE WATSONVILLE
MUNICIPAL AIRPORT MASTER PLAN (STATE CLEARINGHOUSE NO.
2002062089), DATED AUGUST 2002, FOR A PROPOSED AMENDMENT TO THE 2003 AIRPORT MASTER PLAN PROJECT (APNs: 015-221-01, 02, 03)
WHEREAS, in August 2020 the Municipal Airport commenced an effort to update the 2003 Airport Master Plan, including an updated Airport Layout Plan, and to evaluate the 2003 Environmental Impact Report and the need for additional, subsequent environmental review and analysis; and
WHEREAS, the purpose of the Watsonville Airport Master Plan is to facilitate the orderly, efficient, flexible, and environmentally sensitive management and development of the Watsonville Municipal Airport over the next twenty years; and WHEREAS, an Addendum to the 2003 Environmental Impact Report (FEIR) is required in accordance with the California Environmental Quality Act (CEQA) has now been prepared by David J. Powers and Associates for the City of Watsonville, as lead agency; and
WHEREAS, CEQA recognizes that between the date an environmental document is certified and the date the project is fully implemented, one or more of the following changes may occur: 1) the project may change; 2) the environmental setting in which the project is located may change; 3) laws, regulations, or policies may change in ways that impact the environment; and/or 4) previously unknown information can arise; and WHEREAS before proceeding with a project, CEQA requires the Lead Agency or Responsible Agency to evaluate these changes to determine whether or not they affect the conclusions in the environmental document; and
2 Reso No. ______ (CM)
Meeting Date: 102423
WHEREAS, CEQA Guidelines Section 15162 states that when an EIR has been certified or a negative declaration adopted for a project, no subsequent EIR shall be prepared for that project unless the Lead Agency or Responsible Agency determined, on the basis of substantial evidence in light of the whole record, one or more of the following:
1. Substantial changes are proposed in the project which will require major revisions of the previous EIR or negative declaration due to the involvement of new significant environmental effects or a substantial increase in the severity of previously identified significant effects; or
2. Substantial changes occur with respect to the circumstances under which the project is undertaken which will require major revisions of the previous EIR or Negative Declaration due to the involvement of new significant environmental effects or a substantial increase in the severity of previously identified significant effects; or
3. New information of substantial importance, which was not known and could not have been known with the exercise of reasonable diligence at the time the previous EIR was certified as complete of the Negative Declaration was adopted, shows any of the following:
a. The project will have one or more significant effects not discussed in the previous EIR or negative declaration;
b. Significant effects previously examined will be substantially more severe than shown in the previous EIR;
c. Mitigation measures or alternatives previously found not to be feasible would in fact be feasible and would substantially reduce one or more
3 Reso No. ______ (CM)
Meeting Date: 102423
significant effects of the project, but the project proponents decline to adopt the mitigation measure or alternative; or
d. Mitigation measures or alternatives which are considerably different from those analyzed in the previous EIR would substantially reduce one or more significant effects on the Watsonville Municipal Airport 2 Addendum to the Airport Master Plan EIR environment, but the project proponents decline to adopt the mitigation measure or alternative; and
WHEREAS, CEQA Guidelines Section 15164 states that the Lead Agency or Responsible Agency shall prepare an addendum to a previously certified EIR if some changes or additions are necessary, but none of the conditions described in CEQA Guidelines Section 15162 (see above) calling for preparation of a subsequent EIR have occurred.
NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF WATSONVILLE, CALIFORNIA HEREBY FINDS, DETERMINES, AND RESOLVES AS FOLLOWS:
1. The City Council hereby specifically finds that all of the facts set forth in the above recitals are true and correct and incorporated herein.
2. The City Council has independently reviewed, analyzed and considered the Addendum dated October 2023, the staff report and all attachments thereto, as well as all written documentation and public comments thereto; and
3. The Addendum to the Environmental Impact Report for the Watsonville Municipal Airport Master Plan, dated October 2023 (the “Addendum”), was prepared and reviewed in compliance with the provisions of CEQA and the CEQA Guidelines; and
4. The information and analysis contained in the Addendum dated October
4 Reso No. ______ (CM)
Meeting Date: 102423
2023, reflects the City’s independent judgment as to the environmental consequences of the proposed modifications to the Airport Master Plan; and
5. That, based upon substantial evidence demonstrated by the analysis included in the Addendum dated October 2023, none of the conditions described in Sections 15162 or 15163 of the CEQA Guidelines calling for the preparation of a subsequent or supplemental EIR or negative declaration have occurred; specifically:
a. There have not been any substantial changes in the 2003 Airport Master Plan Project (“Project”) that require major revisions of the FEIR because of new significant environmental effects or a substantial increase in the severity of previously identified significant effects;
b. There have not been any substantial changes with respect to the circumstances under which the Project is undertaken that require major revisions of the FEIR due to the involvement of new significant environmental effects or a substantial increase in the severity of previously identified significant effects; and c. There is no new information of substantial importance, which was not known and could not have been known with the exercise of reasonable diligence at the time the FEIR was certified, that shows any of the following: (a) the Project will have one or more significant effects not discussed in the FEIR; (b) significant effects previously examined will be substantially more severe than shown in the FEIR; (c) mitigation measures or alternatives previously found not to be feasible would in fact be feasible and would substantially reduce one or more significant effects of the Project, but the project proponents decline to adopt the mitigation measure or alternative; or (d) mitigation measures or alternatives which are
5 Reso No. ______ (CM)
Meeting Date: 102423
considerably different from those analyzed in the FEIR would substantially reduce one or more significant effects on the environment, but the Project proponents decline to adopt the mitigation measure or alternative; and BE IT FURTHER RESOLVED, based on the above findings, the City Council determines that the previously-certified Final EIR, together with the Addendum dated October 2023, are adequate to serve as the required environmental documentation for the Project as modified and thus approves and adopts the Addendum dated October 2023; and
BE IT FURTHER RESOLVED, that the City Council shall consider the certified Final EIR, together with the approved Addendum dated October 2023, prior to making a decision on the Project, as modified.
*****************************
ADDENDUM
to the
ENVIRONMENTAL IMPACT REPORT
for the
WATSONVILLE MUNICIPAL AIRPORT
MASTER PLAN
SCH #2002062089
October 2023
Prepared for
CITY OF WATSONVILLE
Prepared by
DAVID J. POWERS & ASSOCIATES
1871 The Alameda, Suite 200
San Jose, CA 95126
Phone: (408) 248-3500
Watsonville Municipal Airport 1 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
1.0 INTRODUCTION
1.1 PURPOSE OF THE ADDENDUM
The City of Watsonville (City), as the Lead Agency, has prepared this Addendum to the 2003 Final Environmental Impact Report for the Watsonville Municipal Airport Master Plan (2003 EIR) in compliance with the California Environmental Quality Act (CEQA) and the CEQA Guidelines for a proposed amendment to the 2003 Airport Master Plan (Project). The Project would extend the planning horizon year and operational demand forecasts of the Airport Master Plan from 2020 to 2040, incorporate a set of airfield configuration changes, and update the layout and sizing of various airport facilities to adequately serve the projected 2040 demand.
CEQA recognizes that between the date an environmental document is certified and the date the project is fully implemented, one or more of the following changes may occur: 1) the project may change; 2) the environmental setting in which the project is located may change; 3) laws, regulations, or policies may change in ways that impact the environment; and/or 4) previously unknown information can arise.
Before proceeding with a project, CEQA requires the Lead Agency or Responsible Agency to evaluate these changes to determine whether or not they affect the conclusions in the environmental document.
CEQA Guidelines Section 15162 states that when an EIR has been certified or a negative declaration adopted for a project, no subsequent EIR shall be prepared for that project unless the Lead Agency or Responsible Agency determined, on the basis of substantial evidence in light of the whole record, one or more of the following:
1. Substantial changes are proposed in the project which will require major revisions of the previous EIR or negative declaration due to the involvement of new significant environmental effects or a substantial increase in the severity of previously identified significant effects; or
2. Substantial changes occur with respect to the circumstances under which the project is undertaken which will require major revisions of the previous EIR or Negative Declaration due to the involvement of new significant environmental effects or a substantial increase in the severity of previously identified significant effects; or
3. New information of substantial importance, which was not known and could not have been known with the exercise of reasonable diligence at the time the previous EIR was certified as complete of the Negative Declaration was adopted, shows any of the following:
a. The project will have one or more significant effects not discussed in the previous EIR or negative declaration;
b. Significant effects previously examined will be substantially more severe than shown in the previous EIR;
c. Mitigation measures or alternatives previously found not to be feasible would in fact be feasible and would substantially reduce one or more significant effects of the project, but the project proponents decline to adopt the mitigation measure or alternative; or d. Mitigation measures or alternatives which are considerably different from those analyzed in the previous EIR would substantially reduce one or more significant effects on the
Watsonville Municipal Airport 2 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
environment, but the project proponents decline to adopt the mitigation measure or alternative.
CEQA Guidelines Section 15164 states that the Lead Agency or Responsible Agency shall prepare an addendum to a previously certified EIR if some changes or additions are necessary, but none of the conditions described in 15162 (see above) calling for preparation of a subsequent EIR have occurred.
Watsonville Municipal Airport 3 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
2.0 PROJECT BACKGROUND
2.1 PROJECT LOCATION AND CHARACTERISTICS
The Watsonville Municipal Airport (Airport) is a non-towered, general aviation (GA) airport located in the City of Watsonville in Santa Cruz County, California. The Airport is owned and operated by the City of Watsonville. The Airport is the only airport in Santa Cruz County and is one of five public-use airports in the Monterey Bay area.
The Airport is bordered by the City of Watsonville on its southern and eastern sides, while the unincorporated community of Freedom, which is under the jurisdiction of Santa Cruz County, surrounds the northern and western edges of the Airport. Residential land uses are present north and east of the Airport around Freedom and in narrow strips along Manfre Road and Buena Vista Drive west and north of the Airport, respectively. A more extensive residential area is located to the east, and light industrial development is located southeast of the Airport. Except for the bands of residential development described above, most of the land uses along the runway approaches to the north, west, and south are agricultural. The airfield, consisting of two runways and associated taxiways, as well as hangars and all landside facilities, are situated on a parcel of land that covers approximately 291 acres.
The Airport owns an additional 53 acres of land, off-Airport, within the runway protection zones (RPZs) for Runways 2, 9, and 27. The total acreage of the Airport is approximately 344 acres.
The Airport is served by two intersecting runways, Runway 02-20 and Runway 09-27. Runway 02-20 is 4,501 feet long by 149 feet wide and is constructed with an asphalt surface. Runway 09-27 is 3,998 feet long by 98 feet wide and has an asphalt surface. Both runways were last rehabilitated in 2018 and 2019. Runway 02-20 is instrument approach capable and is considered the primary runway at the Airport.
There is a single-story administration/terminal building located along Aviation Way that pilots and Airport users can access during the Airport’s operating hours. There are several hangar configurations at the Airport including T-hangars, conventional box hangars, and mini-hangars, as well as commercial hangars that are reserved for maintenance and corporate aircraft. The hangars are fairly spread out at the Airport across the aircraft operating area, with a cluster of hangars located in the northeast portion and another cluster of hangars located in the southeast portion of the Airport. In addition to covered aircraft storage, the Airport is also equipped with apron parking, also referred to as aircraft tiedowns.
Regional, vicinity, and aerial maps showing the Airport are provided on Figures 2.1-1, 2.1-2, and 2.1- 3, respectively.
Base Map: ESRI, ArcGIS.
Monterey Bay
Watsonville
Gilroy
San Juan
BauƟsta
Castroville
Morgan Hill
Santa Cruz
ScoƩs
Valley
Ben Lomond
Monterey Bay
Watsonville
Gilroy
San Juan
BauƟsta
Castroville
Morgan Hill
Santa Cruz
ScoƩs
Valley
Ben Lomond
152 152
101
101
25 1
1 9
17 1
156
156
129
Project Site
Project Site
Pacific Ocean
Monterey Bay
San Francisco
Sacramento
Santa Cruz Morgan Hill
Monterey
Salinas
Gonzales
Paso Robles
San Luis
Obispo
Monterey Salinas
Gonzales
Paso Robles
San Luis
Obispo
Watsonville
Fresno
San José
0 2345 1 7 Miles
REGIONAL MAP FIGURE 2.1-1
Harkins Slough Road
East Lake Avenue
Beach Street
Main Street
Stanford St
TuƩle Ave
Buena Vista
D rive
San Andreas Road
Paulsen Road
Calabasas Road
Harkins Slough Road
East Lake Avenue
Beach Street
Main Street
Stanford St
TuƩle Ave
Buena Vista Drive
San Andreas Road
Paulsen Road
Calabasas Road
Harkins Slough
Gallighan Slough
West Branch Struve Slough
Hanson Slough
Harkins Slough
Gallighan Slough
West Branch Struve Slough
Hanson Slough
U.P.R.R. .P.R.R.
Base Map: ESRI, ArcGIS
0 500 2,000 3,000 5,000 Feet
Project Site
VICINITY MAP FIGURE 2.1-2
Trabing Road
Manfre Road
Bradford Road
Calabasas Road
Freedom Boulevard
Green Valley Road
Loma Prieta Avenue
Airport Road
Pennsylvania Drive
Clifford Avenue
Hope Drive
Holm Road
Anna Street
Holly Drive
Ranport Road
Buena Vista Drive
AviaƟon Way
Trabing Road
Manfre Road
Bradford
Road
Calabasas Road
Freedom Boulevard
Green
Valley Road
Loma Prieta Avenue
Airport Road
Pennsylvania Drive
Clifford Avenue
Hope Drive
Holm Road
Anna Street
Holly Drive
Ranport Road
Buena Vista Drive
AviaƟon Way
Struve Slough
Struve Slough
Corralitos Creek
Harkins Slough
Struve Slough
Struve Slough
Corralitos Creek
Harkins Slough
1 1
Photo Date: Sep. 2021
0 200 1,200 1,600 2,400 Feet
Project Boundary
Aerial Source: Google Earth Pro, Jul. 11, 2023.
AERIAL PHOTO OF THE AIRPORT FIGURE 2.1-3
Watsonville Municipal Airport 7 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
2.2 BACKGROUND REGARDING THE AIRPORT MASTER
PLAN
2.2.1 Development and Approval of the Airport Master Plan The first Watsonville Municipal Airport Master Plan and accompanying CEQA Initial Study were prepared and adopted in 1986.
A process to revise the 1986 Airport Master Plan was initiated in 1993, as was preparation of an EIR.
During this process, a State-listed endangered plant, the Santa Cruz tarplant (Holocarpha macradenia), was found on Airport property.1 As a result, work on the revised Airport Master Plan and EIR were delayed so that the City could consult with the California Department of Fish and Wildlife (CDFW) regarding mitigation and recovery options. Based on consultation with the CDFW, a Mitigation Plan was completed for the Santa Cruz tarplant and coastal terrace prairie habitat. Subsequently, work on the updated Airport Master Plan and EIR resumed in 1998. This effort culminated with the approval of the Watsonville Municipal Airport Master Plan, 2001-2020, and accompanying EIR in 2003.
2.2.2 Approved 2003 Airport Master Plan
2.2.2.1 Objectives of the Airport Master Plan
The objective of the approved 2003 Airport Master Plan is to facilitate the orderly, flexible, and environmentally sensitive expansion and development of the Airport. The following are the planning objectives for the Airport that are addressed in the approved Airport Master Plan:
• Support the development of an efficient public use airport by:
o Remedying existing operational deficiencies by lengthening and improving the primary runway to more fully accommodate turbine-powered aircraft (75 percent fleet with 60 percent load).
o Remedying existing operational and safety deficiencies by installing a precision instrument landing system (ILS) to increase the number of hours each day that aircraft may operate in foggy conditions and to increase the overall safety of landings in all conditions.
o Remedying existing space deficiencies by providing for the expansion and enhancement of the terminal and hangar facilities, plus providing new and improved access to accommodate new facilities.
o Maintaining and enhancing natural resources on the site. o Facilitating the development of complementary light industrial and general commercial uses for affiliates of the Airport.
o Providing a fiscally responsible financial plan that will provide suitable facilities and generate revenues necessary for proper operation, management, and development of the Airport.
• Provide for the development of the Watsonville Municipal Airport consistent with the Master Plan while minimizing adverse effects on the natural physical setting by:
1 Santa Cruz tarplant (Holocarpha macradenia) was listed as a threatened species in 2000 under the federal Endangered Species Act.
Watsonville Municipal Airport 8 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
o Providing for development consistent with the resource protection regulations administered by the United States Army Corps of Engineers, United States Fish and Wildlife Service, the California Coastal Commission, and other agencies. o Protecting and enhancing wetlands and sensitive habitat areas. • Provide for the development of the Watsonville Municipal Airport consistent with the Master Plan while minimizing adverse effects on adjacent land uses, the local community, and the region by:
o Providing the basis for creation of a noise mitigation plan that ensures neighboring properties are not significantly affected by airport-generated noise. o Developing ancillary uses on the site that are designed to be compatible with existing and planned development in the area.
2.2.2.2 Projects Contained in the Approved Airport Master Plan The approved 2003 Airport Master Plan consists of a comprehensive and integrated package of improvements to airside and landside facilities2at the Airport, such improved facilities having the design capacity to fully accommodate the forecast demand for general aviation services in a comfortable and efficient manner. Table 2.2-1 lists all projects that are in the approved Airport Master Plan and their implementation status since 2003.
Table 2.2-1: Approved 2003 Airport Master Plan Projects Project
ID No.
Description Current Status
Phase I (2001-2006)
1 Complete instrumental landing system (ILS) Not completed 2 Runway extension 800’ to Runway 2-20 w/ taxiway extensions and lights (RW-1; TW-2) - (to meet recommended rwy length – safety)
Not completed
3 Relocated access road (Aviation Way) and construct main apron for automobile parking lot
Relocation of
Aviation Way
Completed
4 Construct airport maintenance shelter (east of 2-20 taxiway) Completed 5 Install underground utilities, top trees, and relocate threshold of Runway 2-20
Topping of trees
Completed
7 Security lighting at existing hangars south of Runway 8-26 Completed 8 New airport access road to commercial hangars from Airport Boulevard
Not completed
10 Terminal expansion Not completed
12 Install traffic light (Aviation Way and Airport Boulevard) Not completed 14 Construct access road with underground utilities connecting Manfre Rd. on south and Buena Vista/Bradford Road on north Not completed
2 Facilities at airports are typically classified as “landside” or “airside.” Airside facilities consist of the airfield and areas that are only accessible by passengers and employees. Landside facilities are accessible to the public.
Watsonville Municipal Airport 9 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
Table 2.2-1: Approved 2003 Airport Master Plan Projects Project
ID No.
Description Current Status
to provide access to commercial/industrial area (Industrial Area A; TE-A)
15A Construct airport related commercial/industrial development west of Runway 8-26 (Industrial Area A; TE-A)
Partially Completed
15B Construct airport-related commercial/industrial development south of Aviation Way (Industrial Area B)
Completed
16 Acquire additional clear zone property (west of State Route 1) --- 19 Tarplant mitigation program Ongoing
Phase II (2007-2011)
6 New airport access (Burchell Ave. northeast of Runway 8-26) Not completed 9A Pave runway blast pads (both ends of Runway 2-20) (SZ-1/ SZ2)Not completed 11 Hanger expansion plus taxiways (60 to 70 new hangars and ramp area north of Runway 8-26) (TE-B)
Not completed
13 Construct north parallel taxiway (North of Runway 8-26) (TW1)Not completed 19 Tarplant mitigation program Ongoing
Phase III (2012-2016)
9B Pave runway blast pads (both ends of Runway 8-26) (SZ-3/SZ4)Not completed 15C Construct airport-related commercial/industrial development north of Runway 8-26 (Industrial Area C)
---
15D Construct airport-related commercial/industrial development west of Runway 2-20 (Industrial Area D)
Partially Completed
19 Tarplant mitigation program Ongoing
Phase IV (2017 – 2020)
15E Construct airport-related commercial/industrial development west of Runway 2-20 (Industrial Area E; TE-A1)
Not completed
17 New hangars in Area TE-D Not completed
18 Construct parallel taxiway west of Runway 2-20 (TW-3) Not completed 19 Tarplant mitigation program Ongoing
Source: Kimley-Horn Associates (2023).
Watsonville Municipal Airport 10 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
3.0 PROJECT DESCRIPTION
The proposed Project consists of an amendment to the approved 2003 Airport Master Plan. The proposed Project would amend the Airport Master Plan as follows:
Update the aviation demand forecasts and shift the planning horizon year from 2020 to 2040 Modify certain components of the airfield to reduce hazards in compliance with current FAA standards
Modify future facilities requirements at the Airport to reflect updated demand forecasts As described previously, the approved Airport Master Plan was adopted in 2003. Several of the Master Plan’s inputs and conditions have changed since its adoption. Additionally, in the past two decades, the national and regional economy has fluctuated, changes in the aviation industry have occurred, and the FAA has implemented new guidance and standards. The purpose of this Airport Master Plan Update is to address those changes and enhance the long-term operational sustainability of the Airport by establishing an updated framework to guide land use and development decisions on and near the Airport. The Airport Master Plan Update provides the City and its stakeholders with a comprehensive, organized, and rational plan for developing Airport facilities over the next 20 years.
The Master Plan Update is intended to identify solutions for the Airport’s facility requirements and to ensure that the Airport remains consistent with FAA guidelines and standards while achieving the short- and long-term goals of the Airport. The Airport Master Plan Update aims to achieve compliance with all current FAA design and safety standards related to airfield facilities, including airfield dimensions, separation distances, protection zones, and obstacle clearance requirements. These design and safety standards work to balance interests at airports including safe operations, increased capacity and efficiency, economic viability, and environmental protection.
The proposed modifications to the Airport Master Plan are described below.
3.1 2021 FORECASTS AND SHIFT OF THE AIRPORT MASTER
PLAN HORIZON YEAR TO 2040
The approved Airport Master Plan evaluated in the 2003 EIR relied on forecasted activity levels over a 20-year planning horizon spanning the years 2000 through 2020. The Airport Master Plan includes improvements to airport facilities deemed necessary to accommodate the forecasted activity levels through this planning horizon.
The City updates the demand forecasts for the Airport from time-to-time to account for the latest changes in the aviation industry and in the economy. The updates provide critical information to the Airport regarding planning for the types and sizes of facilities needed to accommodate the demand at a reasonable level of service. The latest update to the aviation demand forecasts for the Airport was completed in 2021 as part of the current Master Plan Update effort. The updated forecasts project activity levels for a 20-year planning horizon, with 2020 as the base year and 2040 as the outmost forecast year. These forecasts are unconstrained, meaning that it is assumed that the requisite facilities
Watsonville Municipal Airport 11 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
proposed in the Master Plan Update will be developed to accommodate all aviation activity demand over the forecast period.
This forecasting effort identifies aviation demand that is anticipated to occur over the 20-year planning period using acceptable forecasting analysis techniques consistent with FAA guidance including Forecasting Aviation Activity by Airport (July 2001) and Guidance on Review and Approval of Local Aviation Forecasts (June 2008). The techniques or methods used to forecast demand consider a variety of factors that are aviation and non-aviation related, including changes that have occurred in the aviation industry in recent years, both on a broad national level and in the region. Data were collected from various FAA and other sources, including the Airport’s operations tracking system and Automated Dependent Surveillance - Broadcast (ADS-B) database, the FAA’s Terminal Area Forecast (TAF), the FAA’s Traffic Flow Management System Counts (TFMSC) database, the FAA’s Form 5010-1 Airport Master Record for WVI (5010 Airport Master Record), and the FAA’s National Based Aircraft Inventory Program. Additionally, socioeconomic data for the Santa Cruz-Watsonville Metropolitan Statistical Area (MSA) and the State of California were evaluated to identify conditions and trends that may impact demand at the Airport.
The 2021 aviation demand forecasts, which are shown in Table 3.1-1, below, identify the projected number of aircraft based at the Airport along with counts of overall aircraft operations for categories of aircraft utilizing the Airport.
Table 3.1-1: Existing and Forecasted Activity Levels at Watsonville Airport Current
Activity
Level
2003 EIR
Forecast
Current
Forecast
Date of Forecast → 2020 2003 2021
Forecast Horizon Year → n/a 2020 2040
Based Aircraft 280 381 327
Annual Aircraft Operations
Single-Engine Prop.
Multi-Engine Prop.
Helicopter
Turboprop.
Turbine/Jet
Total
41,410
2,525
6,060
n/a
505
50,500
126,003
13,949
0 2,971
1,580
144,503
71,900
4,500
10,800
n/a
2,700
89,900
Sources:
• 2003 Airport Master Plan EIR
• Summary of Aviation Demand Forecasts (Kimley-Horn Associates, 2021)
Watsonville Municipal Airport 12 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
Completion of the revised forecasts was followed by a review of the yet-to-be-constructed projects in the Airport Master Plan. The purpose of the review was to determine if changes (i.e., modifications, deletions, additions) to the projects were needed so that the Airport will be able to accommodate the revised forecast demand in a comfortable and efficient manner. Please see the following section for a list of those proposed changes.
3.2 PROPOSED MODIFICATIONS TO AIRPORT MASTER PLAN
PROJECTS
Table 3.2-1 lists the projects to be constructed if the proposed amendment to the 2003 Airport Master Plan (the Project) is approved. The projects fall into one of three categories:
• Project is included in the 2003 Airport Master Plan and no changes to its scope are proposed. • Project is included in the 2003 Airport Master Plan and revisions to its scope are proposed. • Project is new (i.e., it was not included in the 2003 Airport Master Plan).
Note that a number of uncompleted projects in the 2003 Airport Master Plan are not listed in Table
3.2-1. Those projects are being dropped and are no longer planned for implementation.
Figure 3.2-1 depicts the location of each project that would be constructed under the proposed amendment. Detailed descriptions of each project are included below the table.
Table 3.2-1: To-Be-Completed Projects in the Airport Master Plan Project
Number
On
Figure 3.2-1
Description Under
Existing
2003 Airport Master Plan
Description Under
Proposed
Airport Master Plan Amendment
Runway Projects
1 Extend Runway 2-20 by 800 feet to
achieve full length of 5,301 feet
Extend Runway 2-20 by 680 feet to
achieve full length of 5,181 feet
2 Not included Relocate Runway 27 Threshold by 870
feet to meet Runway Visibility Zone
(RVZ) standards
3 Extend Runway 9-27 by 255 feet to the
west
No change
Taxiway Projects
4 Not included Reconfigure fence line along Taxiway A
to meet FAA design standards
5 Not included Widen existing paved shoulders on
Taxiway C to meet FAA design
standards
6 Not included Reconfigure Taxiways A and C to
address non-standard runway
Watsonville Municipal Airport 13 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
Table 3.2-1: To-Be-Completed Projects in the Airport Master Plan Project
Number
On
Figure 3.2-1
Description Under
Existing
2003 Airport Master Plan
Description Under
Proposed
Airport Master Plan Amendment
intersection angles and acute-angle
runway entrance taxiways
7 Not included Reconfigure Taxiway A to modify wide
expanse of pavement at Runway 20
entrance
8 Not included Reconfigure Taxiways B, C, and D to
eliminate taxiways with direct access
from apron to runways
9 Not included Reconfigure apron and hangar area
taxilanes to meet FAA design and
separation standards
10 Not included Update signage for Taxiways B, D, and
E and runway entrance from Taxiways A
and C
11 Construct new taxilane to existing
hangar development
No change
Parachute Landing Area
12 Not included Move parachute landing area
approximately 600 feet to the south
Airspace
13 Not included Remove obstacles from the Runway 20
Threshold Siting Surface (TSS) in order
to remove 590-foot displaced threshold
General Aviation Facilities
14 Expand GA Terminal Building to meet
Airport and user needs
No change
15 Design/Construct East T-hangars in
Area 2
No change
16 Construct Apron in Storage Area 1 No change
17 Construct Apron and Hangar in
Storage Area 8
No change
18 Construct Apron in Storage Area 3 No change
19 Construct hangars in Storage Area 4 No change
20 Construct hangars west of Runway 2-
20 No change
21 Not included Construct Heliport and connector
taxilane
Watsonville Municipal Airport 14 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
Table 3.2-1: To-Be-Completed Projects in the Airport Master Plan Project
Number
On
Figure 3.2-1
Description Under
Existing
2003 Airport Master Plan
Description Under
Proposed
Airport Master Plan Amendment
Support Facilities
22 Construct 2,000 square-foot
Maintenance Equipment Storage
(MES) building
Construct 4,050 square-foot Maintenance
Equipment Storage (MES) building
23 Not included Construct aircraft wash rack based on
guidance from Airport Cooperative
Research Program (ACRP) Report 113
24 Not included Construct aircraft wash rack based on
guidance from ACRP Report 113
25 Not included Install aboveground fuel facilities to
replace underground tanks
26 Not included Relocate Compass Rose
Source: WVI Master Plan Update, City of Watsonville, 2022.
3.2.1 Runway Projects
The following runway improvements are part of the proposed Project:
Project 1 would extend Runway 2-20 by 680 feet to the southwest (i.e., Runway 2 end) with taxiway extensions and lighting, resulting in a runway length of 5,181 feet. The project would include the replacement of the existing Taxiway A entrance to Runway 2-20 with a new entrance configured to meet current FAA design standards.
Project 2 would shorten Runway 9-27 at the east end by 870 feet to meet FAA’s runway visibility zone standards. This would be accomplished by remarking the existing pavement on the Runway 27 end of Runway 9-27 for the purpose of relocating the runway threshold 870 feet to the west of the pavement end. The 870 feet of pavement beyond the relocated threshold would be remarked as a blast pad per FAA design standards. The existing Taxiway B and Taxiway C intersections with Runway 9-27 would be demolished and replaced to meet current FAA design standards.
Project 3 would extend Runway 9-27 to the west (i.e., Runway 9 end) by 255 feet. It would also include grading and a retaining wall to create Runway Safety Areas (RSAs) consistent with FAA design standards. The combination of Projects 2 and 3 would change the usable length of Runway 9-27 from 3,998 feet (existing) to 3,383 feet (future).
Watsonville Municipal Airport 15 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
3.2.2 Taxiway Projects
The following taxiway improvements are part of the Project:
Project 4 would relocate approximately 820 linear feet of existing chain link fence along Airport Boulevard near the Runway 2 end of Runway 2-20. The fence would be shifted horizontally approximately 11 feet east toward Airport Boulevard. Project 4 would require approximately 900 linear feet of new fencing to connect to the existing fence line at the Santa Cruz Animal Shelter. The shift in the fence alignment would bring the separation between the fence and Taxiway A into compliance with FAA criteria.
Project 5 would widen and pave the existing gravel shoulders along Taxiway C west of Runway 2-20.
Project 6 would demolish and reconstruct the existing taxiway entrances at the ends of Runways 2-20 and 9-27 to meet current FAA design standards.
Project 7 would demolish and replace the existing Taxiway A entrance to Runway 20. This project would include a new 3-space run-up area3 west of Taxiway A with four entrance/exit taxilanes and notaxi islands.
Project 8 would relocate existing Taxiways B and D to meet current FAA design standards.
Project 9 would remark taxilane and tie-town markings on the north tie-down ramp, transient ramp, and east transient tie-down ramp to ensure compliance with current FAA taxiway object free area and parallel taxiway separation standards.
Project 10 would replace existing airfield signage with updated taxiway designators. The project would include the installation of new electrical signage at the relocated Taxiways C and D entrances.
Project 11 would construct a new 100-feet long by 35-feet wide taxilane between the existing compass rose4and apron.
3.2.3 Parachute Landing Area
The following improvement related to the parachute landing area is part of the Project:
Project 12 would relocate the existing parachute landing area (PLA), which is located in the northwest part of the Airport adjacent to Runway 9. The PLA would be moved approximately 600 feet to the south. The diameter of this area would be reduced from 366 feet to 300 feet. 3 A run-up area is found near the end of a runway and is the location where pilots undertake a final check of engine performance just prior to initiating their takeoff.
4 A compass rose is a compass painted on an airport’s apron. A compass rose points to magnetic north and is used by airport Specialized Aviation Service Operators to verify the accuracy of an aircraft's magnetic compass.
Watsonville Municipal Airport 16 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
3.2.4 Airspace
The following improvement related to airspace protection is part of the Project:
Project 13 would underground various utilities, remove an on-Airport light pole and two utility poles, and remove two off-Airport palm trees at 21 Miller Avenue, all of which are considered obstacles on the approach to Runway 20. Removal would allow for the deletion of the existing 590-foot displaced threshold on Runway 20.
3.2.5 General Aviation Facilities
The following improvements to general aviation facilities are part of the Project:
Project 14 would expand the existing airport terminal building to a two-story configuration with 100,000 square feet of total internal floorspace. The expansion would extend east and north of the existing terminal building footprint.
Project 15 would construct two T-hangars for approximately 22 aircraft on the existing apron located adjacent to the terminal building.
Project 16 would construct an aircraft tiedown apron of approximately 30,000 square feet on the west side of Aviation Way just north of Airport Boulevard.
Project 17 would construct an approximately 31,000 square foot apron and approximately 2,500 square foot hangar just south of the Taxiway A/Taxiway E intersection. The project would include connector taxilanes to Taxiway A.
Project 18 would construct an approximately 37,000 square foot apron with eight tiedowns in the southeast corner of the Airport near Runway 27.
Project 19 would construct a new 387,500 square foot apron along the north side of Runway 9-27. The apron would accommodate new hangars totaling approximately 77,500 square feet. A new connector taxilane between the relocated Runway 27 and Taxiway A would also be constructed.
Project 20 would construct four conventional hangars of approximately 10,000 square feet each and taxilanes west of Runway 2-20. The project would include the construction a connector taxiway to Taxiway C west of Runway 2-20.
Project 21 would construct a heliport and connector taxilane. The improvement would consist of a small apron adjacent to Taxiway A between Taxiways D and E.
3.2.6 Support Facilities
The following improvements to support facilities are part of the Project:
Project 22 would construct a 4,050 square foot airport maintenance equipment shelter building adjacent to the existing Airport Operations Building.
Watsonville Municipal Airport 17 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
Project 23 would construct a 45’ x 45’ open-air aircraft wash rack in the south T-hangar area near the intersection of Airport Boulevard and Aviation Way. The project includes a wastewater containment system, as well as electrical and water utilities per guidance of Airport Cooperative Research Program (ACRP) Report 113.
Project 24 would construct a 45’ x 45’ open-air aircraft wash rack on the east transient ramp adjacent to the Airport Operations Building. The project includes a wastewater containment system, as well as electrical and water utilities per guidance of ACRP Report 113.
Project 25 would install two aboveground fuel tanks (12,000 gallons each) atop a 40’ x 45’ containment pad to replace the existing underground tanks of the same size. The location of the fuel tanks is on the north side of Aviation Way just east of the terminal building.
Project 26 would relocate the existing compass rose that is located approximately 350 feet northwest of the terminal building. The compass rose would be moved approximately 750 feet to the north and painted on existing pavement.
Source: Kimley-Horn, November 2022.
0 700350 1,400
GRAPHIC SCALE IN FEET
LOCATIONS OF FUTURE AIRPORT MASTER PLAN PROJECTS FIGURE 3.2-1
Watsonville Municipal Airport 19 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
4.0 ENVIRONMENTAL IMPACTS OF THE
PROPOSED CHANGES TO THE PROJECT
The discussions in the sections below describe the environmental impacts of the proposed Project as it compares with the impacts of the approved Airport Master Plan for all resource areas addressed in the 2003 EIR. Also noted are any changes that have occurred in the environmental setting that would result in new impacts or impacts of greater severity than those identified in the 2003 EIR.
Summary of Forecasted Activity Levels at the Airport
As described in Section 3.1, the approved Airport Master Plan evaluated in the 2003 EIR relied on forecasted activity levels over a 20-year planning horizon spanning the years 2000 through 2020. The 2003 EIR forecast estimated total annual aircraft operations of 144,503 for the 2020 Master Plan horizon year.
The latest update to the aviation demand forecasts for the Airport was completed in 2021 as part of the current Master Plan Update effort. The updated forecasts project activity levels for a 20-year planning horizon, with 2020 as the base year and 2040 as the outmost forecast year. The 2021 forecast estimated total annual aircraft operations of 89,900 for the 2040 Master Plan horizon year.
The annual aircraft operations associated with the updated Airport Master Plan horizon are forecasted to be approximately 38 percent lower than those analyzed in the 2003 EIR. Annual aircraft operations are closely correlated with the level of operational impacts associated with the Airport, such as air pollutants and noise emitted by aircraft, and vehicular traffic operated by airport patrons. As described in further detail in the impact sections below, the forecasted reduction in activity levels at the Airport, when compared to the 2003 EIR forecasts, would result in a corresponding reduction in operational impacts associated with Airport activity, primarily in the areas of air quality, noise, and transportation.
Summary of New and Modified Airport Master Plan Projects As described in Section 3.2, many of the projects in the 2003 Airport Master Plan have either already been constructed or are no longer planned for implementation. As a result, the impacts of those projects are not evaluated in this Addendum. Additionally, a number of uncompleted projects would remain unchanged under the proposed amendment to the 2003 Airport Master Plan. The impacts of these projects were already analyzed and disclosed in the 2003 EIR and are not discussed further in this Addendum, except to address whether there have been substantial changes to the circumstances under which the projects would be implemented.
The analysis of environmental impacts in the following sections focuses on projects that are: 1) new, meaning they were not included in the 2003 Airport Master Plan and were not analyzed in the 2003 EIR; or 2) previously proposed projects that would be modified under the proposed amendment, meaning their impacts may be different than those disclosed in the 2003 EIR. As shown in Table 3.2- 1, 15 new projects are proposed, and two previously proposed projects would be modified.
The 15 new projects are listed in Table 4.1-1, below. Two of the projects (Projects 10 and 26) involve only repainting paved surfaces and installation of signage, respectively, and are not considered to have
Watsonville Municipal Airport 20 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
any substantial environmental impacts. New taxiway projects (Projects 4 through 9) would include construction activities such as grading and paving. These activities would result in ground disturbance in areas that are currently undeveloped but are located within the active Airport area adjacent to existing runways and taxiways. Project 12 would relocate the parachute landing area within the same general area of the Airport and with a smaller footprint. Project 13 would consist of the undergrounding of existing utility infrastructure, resulting in temporary impacts associated with trenching and installation. Project 21 would construct a helipad and associated taxiway, resulting in grading and paving in a currently undeveloped area located directly adjacent to existing paved and developed areas.
Support facilities projects (Projects 23, 24, and 25) would involve construction of new facilities within existing developed areas at the Airport.
Table 4.1-1: New Projects in the Airport Master Plan Amendment Project
Number Description Under Proposed Airport Master Plan Amendment Runway Projects
2 Relocate Runway 27 Threshold by 870 feet to meet Runway Visibility Zone (RVZ) standards
Taxiway Projects
4 Reconfigure fence line along Taxiway A to meet FAA design standards 5 Widen existing paved shoulders on Taxiway C to meet FAA design standards 6 Reconfigure Taxiways A and C to address non-standard runway intersection angles and acute-angle runway entrance taxiways
7 Reconfigure Taxiway A to modify wide expanse of pavement at Runway 20 entrance 8 Reconfigure Taxiways B, C, and D to eliminate taxiways with direct access from apron to runways
9 Reconfigure apron and hangar area taxilanes to meet FAA design and separation standards
10 Update signage for Taxiways B, D, and E and runway entrance from Taxiways A and C
Parachute Landing Area
12 Move parachute landing area approximately 600 feet to the south Airspace
13 Remove obstacles from the Runway 20 Threshold Siting Surface (TSS) in order to remove 590-foot displaced threshold
General Aviation Facilities
21 Construct Helipad and connector taxilane
Support Facilities
23 Construct aircraft wash rack based on guidance from Airport Cooperative Research Program (ACRP) Report 113
24 Construct aircraft wash rack based on guidance from ACRP Report 113 25 Install aboveground fuel facilities to replace underground tanks 26 Relocate Compass Rose
Source: WVI Master Plan Update, City of Watsonville, 2023.
Watsonville Municipal Airport 21 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
The two modified projects are shown in Table 4.1-2, below. Project 1 would extend Runway 2-20 into a currently undeveloped area but would do so to a lesser extent than the project included in the 2003 Airport Master Plan, meaning impacts would generally be reduced compared to those disclosed in the 2003 EIR. Project 22 would increase the size of the Maintenance Equipment Storage (MES) building as compared to that proposed in the 2003 Airport Master Plan. The MES building would be constructed in an area of the Airport that is already developed with existing paving and structures.
Table 4.1-2: To-Be-Completed Projects in the Airport Master Plan Project
Number
Description Under
Existing
2003 Airport Master Plan
Description Under
Proposed
Airport Master Plan Amendment
Runway Projects
1 Extend Runway 2-20 by 800 feet to
achieve full length of 5,301 feet
Extend Runway 2-20 by 680 feet to
achieve full length of 5,181 feet
Support Facilities
22 Construct 2,000 square-foot Maintenance
Equipment Storage (MES) building
Construct 4,050 square-foot Maintenance
Equipment Storage (MES) building
Source: WVI Master Plan Update, City of Watsonville, 2023.
In summary, due to the nature of the proposed new and modified projects, impacts would primarily consist of: 1) temporary impacts associated with construction activities, both in undeveloped and developed areas (all projects except Projects 10 and 26); 2) permanent impacts associated with grading and paving in currently undeveloped areas located adjacent to existing developed areas (Projects 1-2, 4-9, 12-13, and 21); and 3) ongoing operational impacts associated with new facilities (Projects 1, 21, and 23-25).
The impact sections below describe these impacts in greater detail and evaluate whether new or more severe significant impacts would result from the proposed modifications to the Airport Master Plan projects compared to those disclosed in the 2003 EIR.
Watsonville Municipal Airport 22 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
4.1 GEOLOGY AND SOILS
4.1.1 Background
Section 4.1 of the 2003 EIR disclosed that, except for strong seismic shaking and constraints related to soils with poor drainage and perched water tables, the Airport is not located within areas subject to geological hazards. The 2003 EIR concluded that implementation of mitigation requiring that all future proposed structures be designed in accordance with the requirements of the Uniform Building Code, current edition, and designed in accordance with recommendations of a site-specific geotechnical report to be prepared at the time habitable structures are proposed and designed, would reduce impacts to a less-than-significant level.
4.1.2 Project Impacts in Relation to 2003 EIR
The Airport would continue to be subject to strong seismic shaking and constraints related to soils with poor drainage and perched water tables. Thus, the geologic and seismic conditions at the Airport are the same as described in the 2003 EIR.
The new and modified projects under the proposed amendment to the Airport Master Plan would be located in the same general areas of the Airport as those proposed in the existing Airport Master Plan, and do not include any new architectural features that would make them substantially more susceptible to geological hazards. As required by the mitigation measure identified in the 2003 EIR (Mitigation Measure 4.1-A), structures constructed under the Airport Master Plan will comply with current building and seismic safety codes and would be designed in accordance with recommendations of a site-specific geotechnical report to be prepared at the time they are proposed and designed. This would continue to be the case under the amended Airport Master Plan. Consistent with the 2003 EIR’s findings, these measures would reduce the Project’s impacts to a less-than-significant level.
4.1.3 Conclusion
The Project would not result in any new significant geologic or seismic impacts and/or geologic or seismic impacts that are substantially different from those described in the 2003 EIR. No new mitigation is required. There is no new information of substantial importance which was not known and could not have been known with the exercise of reasonable diligence. Finally, there are no changes to the circumstances under which the Project is undertaken that would result in more significant geologic or seismic impacts than were previously analyzed.
Watsonville Municipal Airport 23 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
4.2 DRAINAGE AND WATER QUALITY
4.2.1 Background
Section 4.2 of the 2003 EIR disclosed that the Airport is not within a Federal Emergency Management Agency (FEMA)-designated area subject to inundation by the one-percent annual chance flood. Since the time the 2003 EIR was prepared, FEMA updated the flood map covering the Airport. The updated flood map shows that the Airport is still not located in an area subject to inundation by the one-percent annual chance flood.
5 The 2003 EIR also disclosed that projects to be constructed under the Airport Master Plan would increase impervious surfaces at the Airport. The additional impervious surfaces would result in an increase in the volume of stormwater runoff, which in turn could impact the capacity of storm drains serving the Airport. The 2003 EIR included Mitigation Measures 4.2-A through 4.2-C requiring future development on the Airport to 1) include drainage infrastructure ensuring that post-project runoff would not exceed storm drain capacities, 2) incorporate drainage design aimed at reducing runoff from paved surfaces and 3) prepare a plan for conducting regular maintenance and cleaning of on-site drainage and detention facilities to ensure ongoing provision of adequate capacity. Implementation of the identified mitigation measures would reduce impacts to less-than-significant levels.
In addition, the 2003 EIR determined that proposed development under the Airport Master Plan could result in significant water quality impacts from erosion or surface water quality degradation. The 2003 EIR identified Mitigation Measures 4.2-D through 4.2-F requiring the City to 1) amend the Airport’s Stormwater Pollution Prevention Plan (SWPPP) prior to construction to account for the proposed development, 2) update the Hazardous Materials Management Plan as part of the SWPPP to ensure pollutants would not be discharged in storm water runoff and/or enter the ground water or drainage system, and 3) implement standard erosion control best management practices (BMPs) during future development. Implementation of the identified mitigation measures would reduce impacts to less-thansignificant levels.
Since completion of the 2003 EIR, the regulations pertaining to the control of both the volume and content of stormwater runoff have become substantially more stringent in an effort to improve water quality in California streams and bodies of water. The latest National Pollutant Discharge Elimination System (NPDES) permit issued by the Regional Water Quality Control Board (RWQCB) requires the City of Watsonville and other municipalities to reduce stormwater pollution through source control measures and stormwater treatment measures. Currently, projects that create or replace 5,000 square feet or more of impervious surface, which includes the Airport Master Plan, are required to use site design and source control measures and numerically-sized low impact development (LID) stormwater treatment measures. To summarize, the current stormwater pollution control requirements constitute mitigation beyond that identified in the 2003 EIR, so the net effect is that stormwater runoff from new projects is now having less impact than projects that would have complied with the mitigation required in the 2003 EIR. As described in the impact discussion below, the Project will implement the current (and more stringent) stormwater pollution control measures that are part of the latest NPDES permit. 5 Federal Emergency Management Agency. Flood Insurance Rate Map, Community Panel No. 06087C0391E. Map.
Effective Date: May 16, 2012.
Watsonville Municipal Airport 24 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
4.2.2 Project Impacts in Relation to 2003 EIR
The new and modified projects under the proposed amendment to the Airport Master Plan would include paving in areas that are currently undeveloped, but in most cases would either replace existing paved surfaces elsewhere on the Airport or would result in less paving than was proposed in the 2003 EIR. Project 1 would extend Runway 2-20 into a currently undeveloped area but would do so to a lesser extent than the project included in the 2003 Airport Master Plan. Projects 4 through 9 would reconfigure existing paved taxiways. Project 21 would construct a new helipad and associated taxiway.
The new and modified projects would result in a net increase in impervious surfaces and, therefore, would result in additional water quality impacts from erosion or surface water quality degradation.
However, as described below, stricter mitigation measures are now in effect, which would negate any increase in water quality impacts.
Impacts related to storm drainage would continue to be reduced with implementation of Mitigation Measures 4.2-A through 4.2-C. Additionally, as described above in Section 4.2.1, current stormwater regulations are more stringent than the mitigation provided in the 2003 EIR. Since the Project would disturb more than one acre of soil, it would be required to comply with the NPDES General Permit for Construction Activities. The Construction General Permit includes requirements for training, inspections, record keeping, and, for projects of certain risk levels, monitoring. The general purpose of the requirements is to minimize the discharge of pollutants and to protect beneficial uses and receiving waters from the adverse effects of construction-related storm water discharges. Post-construction, the Project would be subject to the General Permit for Storm Water Discharges associated with Industrial Activities (Industrial General Permit Order 2014-0057-DWQ as amended in 2015 and 2018). The Industrial General Permit requires the implementation of management measures that will achieve the performance standard of best available technology economically achievable and best conventional pollutant control technology. The Industrial General Permit also requires the development of a SWPPP and a monitoring plan. The site-specific SWPPP would identify site-specific sources of pollutants and describe the measures applied to reduce stormwater pollution.
Compliance with current stormwater permit requirements (construction and post-construction), along with continued implementation of Mitigation Measures 4.2A through 4.2-C, would reduce the Project’s impacts to less-than-significant.
4.2.3 Conclusion
The Project would not result in any new significant drainage or water quality impacts that are substantially different from those described in the 2003 EIR. No new mitigation is required. There is no new information of substantial importance which was not known and could not have been known with the exercise of reasonable diligence. Finally, there are no changes to the circumstances under which the Project is undertaken that would result in more significant drainage or water quality impacts than were previously analyzed.
Watsonville Municipal Airport 25 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
4.3 BIOLOGICAL RESOURCES
The discussion in this section is based in part on Biological Impacts Memorandum completed by Salix Consulting, Inc. in September 2023. This report is included as Appendix A to this Addendum.
4.3.1 Background
Section 4.3 of the 2003 EIR concluded that implementation of the improvement projects contained in the Airport Master Plan would result in the following significant biological effects:
▪ Impacts to Coastal Terrace Prairie Habitat
▪ Impacts to Santa Cruz Tarplant Habitat
▪ Impacts to Willow Riparian Habitat
▪ Impacts to Seasonal Wetland Habitat
The 2003 EIR described mitigation measures included in the project that would reduce these impacts to a less-than-significant level. Table 4.3-1 summarizes the impacts and mitigation measures.
Table 4.3-1: Significant Biological Impacts of the Approved Airport Master Plan Impact
Category
Impact
(acres)
Mitigation
(acres)
Mitigation
Description
Impacts to Santa Cruz
Tarplant Habitat 12.28 12.28 Tarplant
Mitigation
Plan Impacts to Coastal
Terrace Prairie Habitat 5.54 5.54
Impacts to Willow
Riparian Habitat 1.33 4.00 Wetland
Mitigation
Plan Impacts to Seasonal
Wetland Habitat 0.14 0.45
Note: Impacts to Santa Cruz Tarplant and coastal terrace prairie habitats are mitigated at a 1:1 ratio. Impacts to willow riparian and seasonal wetland habitats are mitigated at a 3:1 ratio.
Source: City of Watsonville, EIR for the Watsonville Municipal Airport Master Plan, 2003.
The 2003 EIR also disclosed that the commercial/industrial development that was part of the Airport Master Plan would result in significant indirect impacts to the California Red-legged Frog and other sensitive species. That component of the Master Plan is proposed to be dropped and, therefore, this impact will not be discussed further in this Addendum.
The mitigation measures identified in the 2003 EIR are described in further detail below.
Watsonville Municipal Airport 26 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
Tarplant Mitigation Plan
A Tarplant Mitigation Plan was prepared for the Airport in October 2001 and served as the basis for the mitigation strategy contained in the 2003 EIR’s mitigation measures for impacts to Santa Cruz Tarplant and Coastal Terrace Prairie habitat (refer to Mitigation Measure 4.3-A in the 2003 EIR). The Tarplant Mitigation Plan was subsequently updated in 2007. The Tarplant Mitigation Plan consists of the following components:
1. Designate 25.58 acres of Airport lands as permanent conservation easements, wherein existing habitat of Santa Cruz Tarplant and coastal terrace prairie will be protected and managed in perpetuity.
2. Establish and maintain new colonies of Santa Cruz Tarplant in permanent easement areas to achieve at least 1:1 replacement of both Tarplant numbers (allowing for 20% natural variability over time) and acreage to compensate for that lost by development. Avoid contamination of local gene pools of native vegetation. The mitigation target values will be based on data from the 1993 baseline survey.
3. Establish and maintain 5.54 acres of coastal terrace prairie in permanent easement areas to achieve at least 1:1 replacement of habitat lost to development. Avoid contamination of local gene pools of native vegetation by re-planting with seed stock from on-site. The 1998 baseline survey of coastal terrace prairie acreage will provide the basis for determining mitigation target values.
4. Design and implement a program for maintenance and protection of Airport lands, including but not limited to permanent easement areas. The program will describe and formalize grassland management practices (primarily mowing), outline methods to control populations of invasive exotic weeds, and provide protection of sensitive habitat areas.
To date, development associated with the current Airport Master Plan has not resulted in impacts to Santa Cruz Tarplant or Coastal Terrace Prairie habitat. As a result, no mitigation actions have been required.
Wetland Mitigation Plan
A Wetland Mitigation Plan was prepared for the Airport in March 2022 and served as the basis for the mitigation strategy contained in the 2003 EIR’s mitigation measures for impacts to wetlands (refer to Mitigation Measures 4.3-B and 4.3-C in the 2003 EIR). The overall goal of the mitigation program is to compensate for the proposed fill of approximately 1.47 acres of wetlands that will result from planned Airport improvements by replacing them at a 3:1 ratio.
The site for the creation of new wetlands has been designated on a 13-acre parcel owned by the Airport.
The site is located within Harkins Slough, just south of Highway 1. The creation of the new wetlands will occur in three phases: site preparation, revegetation, and monitoring and maintenance.
The mitigation site lies at a relatively low elevation, and thus will not require extensive grading. Prior to agricultural uses of the property, the area had been part of the Harkins Slough wetland. Some minor soil contouring will occur to create the lower elevation riparian inundation area and the slightly higher elevation seasonal wetland. A portion of the Harkins Slough waterway will be realigned to a more natural sinuous channel, with an outlet structure constructed at the south end. Finally, a berm will be
Watsonville Municipal Airport 27 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
constructed from the existing farm access road to function as a water control structure to prevent flood waters from entering adjacent parcels.
The re-establishment of wetland vegetation is expected to happen naturally after the site has been restored. However, in order to increase the speed of revegetation, provide substantial plant diversity, and to prevent the establishment of non-native invasive species, active revegetation will take place as part of the Wetland Mitigation Plan. An attempt to restore the site to its historical wetland state will be made by planting some species that have been extirpated in the Watsonville Sloughs.
Monitoring and maintenance will be ongoing for at least a five-year period following revegetation of the new wetlands. If performance standards are not met, the monitoring will continue beyond the fiveyear period. Maintenance practices will include inspection and repair (if necessary) of hydraulic structures, inspection of vegetation, erosion control, trash and debris removal, and exotic species eradication.
To date, development associated with the current Airport Master Plan has not resulted in impacts to wetlands. As a result, no mitigation actions have been required.
4.3.2 Project Impacts in Relation to 2003 EIR
Table 4.3-2 summarizes the 2003 baseline condition, the impacts disclosed in the 2003 EIR, the updated 2023 baseline conditions, and the impacts associated with the buildout of the updated Airport Master Plan. A detailed discussion of impacts and mitigation is included below.
Table 4.3-2: Summary of Biological Resource Impacts
Habitat Type
2003
Baseline
2003 Impacts
(Approved
Master Plan)
2023
Baseline
2023 Impacts
(Proposed
Amendment
To Master Plan)
SCT Habitat Acreage 42.70 12.28 24.19 5.90
Coastal Terrace Prairie
Acreage
22.10 5.54 22.10 1.88
SCT Individuals (2001
survey)
2,491,465 Not Known 900,480 147,780
Seasonal Wetlands Not Available 0.14 0.36 0.02
Willow Riparian Habitat Not Available 1.33 Not included 0 Wetland Swale Not included N/A 1.14 0.33
Ephemeral Stream Not included N/A 0.12 0.02
Ditch Not included N/A 0.56 0.04
SCT = Santa Cruz Tarplant
Source: Salix Consulting, Inc., 2023
Watsonville Municipal Airport 28 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
Santa Cruz Tarplant and Coastal Terrace Prairie Habitats Impacts
Based upon the 2023 Santa Cruz Tarplant census, there are 24.19 acres of Santa Cruz Tarplant habitat on the Airport property. At full buildout of the updated Airport Master Plan, there would be 5.90 acres of Santa Cruz Tarplant habitat impacted based upon the habitat acreage identified in the 2023 census.
As discussed above, the approved Airport Master Plan would result in impacts to 12.24 acres of Santa Cruz Tarplant habitat. The updated Airport Master Plan would, therefore, result in a reduction in impacts to Santa Cruz Tarplant habitat.
The 2003 EIR identified 22.10 acres of Coastal Terrace Prairie Habitat on the Airport property. The acreage of Coastal Terrace Prairie habitat has not changed since preparation of the 2003 EIR. The updated Master Plan would impact 1.88 acres of Coastal Terrace Prairie habitat. As discussed above, the approved Airport Master Plan would result in impacts to 5.54 acres of Coastal Terrace Prairie habitat. The updated Airport Master Plan would, therefore, result in a reduction in impacts to Coastal Terrace Prairie habitat.
Mitigation
As described above, a Tarplant Mitigation Plan was prepared for the Airport in 2001 and subsequently updated in 2007. Implementation of the Tarplant Mitigation Plan in accordance with EIR Mitigation Measure 4.3-A would continue to adequately mitigate impacts to Santa Cruz Tarplant and Coastal Terrace Prairie habitat. It provides suitable guidance on how to replace the functions and services of impacted Santa Cruz Tarplant habitat, Coastal Terrace Prairie habitat, and individual Santa Cruz Tarplant plants. It also provides success criteria and adaptive management principles for ongoing stewardship. Due to the age of the Tarplant Mitigation Plan, updates and minor revisions to the Plan are recommended to ensure current baseline conditions at the Airport are reflected in the Plan, and to ensure the Plan reflects the current standards and practices of the California Department of Fish and Wildlife (CDFW) and the United States Fish and Wildlife Service (USFWS). With the recommended updates to the Tarplant Mitigation Plan, which are included in Appendix A to this Addendum, the Plan would continue to adequately mitigate impacts to Santa Cruz Tarplant and Coastal Terrace Prairie habitat. No new mitigation is required.
Wetland Habitat
Impacts
The 2003 EIR determined that 1.33 acres of Willow Riparian Wetland and 0.14 acre of Seasonal Wetland habitat would be impacted by buildout of the Airport Master Plan. An updated aquatic resources delineation was prepared by North Fork Associates in 2008 (and verified by the U.S. Army Corps of Engineers in 2009). The results of the 2008 delineation were confirmed to still reflect 2023 baseline conditions by Salix Consulting, Inc (refer to Appendix A to this Addendum). Where the Willow Riparian Habitat is depicted in the Jurisdictional Wetlands Figure in the 2003 EIR (Figure
4.3.3), North Fork Associates did not identify any aquatic resources. The 2008 delineation did identify a single 1.71-acre Willow Scrub Wetland but in an entirely different location on the site. Based upon this most recent aquatic resources delineation, there is no Willow Riparian Wetland Habitat present on the Airport property. The 2008 aquatic resources delineation identified 0.36 acre of seasonal wetlands,
Watsonville Municipal Airport 29 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
but the location of these wetlands is different than what was shown in the 2003 EIR. The 2003 EIR did not identify wetland swale, ephemeral stream, and ditch as aquatic resources present within the project boundary. The 2008 delineation did identify these resources on the Airport property (refer to Table
4.3-2, above).
Based upon the most recent aquatic resources delineation prepared in 2008 and confirmed in 2023, the updated Airport Master Plan would result in impacts to 0.02 acre of Seasonal Wetland, 0.33 acre of Wetland Swale, 0.02 acre of Ephemeral Stream, and 0.04 acre of Ditch. The updated Master Plan would impact a total of 0.41 acre of wetland habitat, which is less than the 1.47 acres impacted by the approved Airport Master Plan. The updated Airport Master Plan would, therefore, result in a reduction in impacts to wetland habitat.
Mitigation
As described above, a Wetland Mitigation Plan was prepared for the Airport in 2002. Implementation of the Wetland Mitigation Plan in accordance with EIR Mitigation Measures 4.3-B and 4.3-C would continue to adequately mitigate impacts to wetland habitat. It provides suitable guidance on how to replace the functions and services of impacted wetland habitat. Due to the age of the Wetland Mitigation Plan, updates and minor revisions to the Plan are recommended to ensure the Plan reflects the current standards and practices of the U.S. Army Corps of Engineers and the Regional Water Quality Control Board. With the recommended updates to the Wetland Mitigation Plan, which are included in Appendix A to this Addendum, the Plan would continue to adequately mitigate impacts to wetland habitat. No new mitigation is required.
4.3.3 Conclusion
The Project would not result in any new significant impacts to biological resources that are substantially different from those described in the 2003 EIR. No new mitigation is required. There is no new information of substantial importance which was not known and could not have been known with the exercise of reasonable diligence. Finally, there are no changes to the circumstances under which the project is undertaken that would result in more significant biological resources impacts than were previously analyzed.
Watsonville Municipal Airport 30 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
4.4 CULTURAL RESOURCES
The discussion in this section is based in part on an Archaeological Literature Review completed by PaleoWest in February 2023.6
4.4.1 Background
Section 4.4 of the 2003 EIR disclosed that there were no cultural or historical resources recorded in the California Inventory of Historical Resources for the Project area. No archaeological sites were recorded within a 0.6-mile radius of the Project area and no prehistoric archaeological resources were identified during a field survey. The 2003 EIR determined, however, that impacts to previously unknown and unidentified cultural resources could occur during construction associated with buildout of the Airport Master Plan. To address that potential, the 2003 EIR included a recommendation to halt all work within 150 feet (50 meters) of the find until evaluated by a qualified archaeologist, who would then provide appropriate mitigation measures if the find were deemed significant. With this recommendation, the 2003 EIR determined that impacts related to unique archaeological resources would be less-than-significant.
4.4.2 Project Impacts in Relation to 2003 EIR
To ensure that no cultural resources were identified on or near the Airport since preparation of the 2003 EIR, a Literature Review was completed for the Project in February 2023 by PaleoWest. A records search request of the California Historical Resources Information System submitted to the Northwest Information Center identified several documented historic resources within a one-half mile radius of the Airport property boundaries:
• A segment of Old Highway 1 in the vicinity of the current Highway 1 on Airport property was identified in 1999 and thus does not represent new information that was not available at the time the 2003 EIR was prepared. The Project would not affect this resource. • Artifacts and a fence associated with a former driving range were identified in 2008 subsequent to preparation of the 2003 EIR. The resources were determined not to be eligible for the National Register of Historic Places or the California Register of Historical Resources.
Additionally, the resources are located south of Highway 1 and are separated from the active Airport area by the highway. Since no Airport Master Plan projects are proposed south of Highway 1, these resources would not be impacted by the Project. • Eleven resources were identified within one-half mile of the Airport boundaries. Of these resources, one is associated with the prehistoric period and 10 are associated with the historic period. These resources were identified between 1986 and 1999, and thus do not represent new information that was not available at the time the 2003 EIR was prepared. Importantly, these resources would not be impacted by the Project.
Based on the results of the records search described above, the Literature Review determined that the Project site is not in an archaeologically sensitive area and that historical resources are not present onsite. As a result, the Project would not impact any known cultural or historical resources, which is 6 Due to the sensitive nature of the information contained in the Literature Review, the report is not included as an Appendix to this Addendum. A copy of the report is on file at the City of Watsonville Community Development Department, Planning Division, and can be viewed by qualified individuals.
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the same conclusion as the 2003 EIR. However, as acknowledged in the 2003 EIR, structures and improvements constructed under the Airport Master Plan may result in the inadvertent discovery of unknown buried cultural resources. This would continue to be the case under the proposed amendment to the Airport Master Plan. The new and modified projects would include shallow ground disturbing activities in the same general areas of the Airport that were analyzed in the 2003 EIR. The Project would be subject to the 2003 EIR recommendation to halt work when a resource is identified and to consult a qualified archaeologist to evaluate the find. Additionally, the Project would be subject to all provisions of California Health and Safety Code Sections 7054 and 7050.5 and Public Resources Code Sections 5097.9 through 5097.99, as amended per Assembly Bill 2641. In accordance with these regulations, if human remains are discovered during construction, there shall be no further excavation or disturbance of the site or any nearby area reasonably suspected to overlie adjacent remains. With implementation of recommendations in the 2003 EIR and relevant regulatory requirements, potential impacts to unknown buried cultural resources would remain less-than-significant.
4.4.3 Conclusion
The Project would not result in any new significant cultural or historical resource impacts that are substantially different from those described in the 2003 EIR. No new mitigation is required. There is no new information of substantial importance which was not known and could not have been known with the exercise of reasonable diligence. Finally, there are no changes to the circumstances under which the Project is undertaken that would result in more significant cultural or historic resource impacts than were previously analyzed.
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4.5 TRAFFIC AND CIRCULATION
4.5.1 Background
Section 4.5 of the 2003 EIR determined that, while the Airport Master Plan would generate new additional traffic, it would not reduce the Level of Service (LOS) at the study intersections in the vicinity of the Airport to an unacceptable level. All study intersections would continue to operate at an acceptable LOS C or higher.
The 2003 EIR determined that industrial/commercial development associated with the Airport Master Plan (i.e., Project 15-C) would increase traffic significantly at the intersection of Buena Vista Drive and Bradford Road. Mitigation was proposed but was not implemented because Project 15-C was not built and has been eliminated from the Airport Master Plan.
For access and circulation impacts, the 2003 EIR disclosed that traffic operations on Airport Boulevard, Aviation Way, Burchell Avenue, and Freedom Boulevard would be degraded due to an increased number of vehicle trips or rerouting of existing traffic. However, such impacts were determined to be less-than-significant.
The 2003 EIR determined that there would be no impacts to bicycle and pedestrian facilities since these facilities would not change due to the Airport Master Plan. The 2003 EIR determined that the Airport Master Plan would have a potentially significant parking impact because the parking supply would remain the same even with the proposed expansions. EIR Mitigation Measure 4.5-A requires the Project to provide parking in accordance with the City of Watsonville parking requirements. It was determined that implementation of EIR Mitigation Measure 4.5-A would reduce parking impacts to a less-than-significant level.
The 2003 EIR concluded that cumulative impacts would be less-than-significant since the traffic associated with the Airport Master Plan would not decrease LOS to unacceptable levels under cumulative conditions.
4.5.2 Project Impacts in Relation to 2003 EIR
As described in Section 4.0, the annual aircraft operations associated with the updated Airport Master Plan horizon are forecasted to be approximately 38 percent lower than those analyzed in the 2003 EIR.
Annual aircraft operations are closely correlated with overall activity levels at the Airport, including vehicle trip generation. As a result, the amended Airport Master Plan would generate substantially fewer vehicle trips than the 2003 Airport Master Plan, meaning impacts associated with traffic and parking would be less than those disclosed in the 2003 EIR. Additionally, the new and modified Airport Master Plan projects do not include any changes to the roadway, bicycle, or pedestrian infrastructure surrounding the Airport and, therefore, would not result in new or more severe impacts in those areas.
4.5.3 Conclusion
When compared to the volume of traffic disclosed in the 2003 EIR, the volume of traffic under the Project would be substantially lower. Therefore, the Project would not result in any new significant traffic and circulation impacts that are substantially different from those described in the 2003 EIR. No
Watsonville Municipal Airport 33 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
new mitigation is required. There is no new information of substantial importance which was not known and could not have been known with the exercise of reasonable diligence. Finally, there are no changes to the circumstances under which the project is undertaken that would result in more significant traffic and circulation impacts than were previously analyzed.
Watsonville Municipal Airport 34 Addendum to the Airport Master Plan EIR City of Watsonville October 2023
4.6 AIR QUALITY
4.6.1 Background
The analysis in Section 4.6 of the 2003 EIR determined that implementation of the Airport Master Plan would result in an incremental increase of regional operational emissions, but the impacts would be less-than-significant. The 2003 EIR also determined that the Airport Master Plan would not conflict with the Monterey Bay Air Resources District (formerly known as the Monterey Bay Unified Air Pollution Control District in the 2003 EIR) Air Quality Management Plan, nor would it result in significant impacts related to odors.
The 2003 EIR concluded that emissions associated with the construction phase of the projects included in the Airport Master Plan could exceed the Monterey Bay Air Resources District criteria air pollutant thresholds. Implementation of Mitigation Measures 4.6-A through 4.6-C would, however, reduce fugitive dust and construction exhaust emissions, resulting in a less-than-significant impact.
4.6.2 Project Impacts in Relation to 2003 EIR
Operational Emissions
As described in Section 4.0, the annual aircraft operations associated with the updated Airport Master Plan horizon are forecasted to be approximately 38 percent lower than those analyzed in the 2003 EIR.
Corresponding to the projected decrease in flight activity under the updated Airport Master Plan, aircraft-related pollutant emissions would be less than what was analyzed in the 2003 EIR.
Additionally, with less aircraft activity, the updated Airport Master Plan would generate fewer vehicle trips compared to the 2003 EIR, resulting in lower emissions. Therefore, operational air quality emissions resulting from the Project would be less than those disclosed in the 2003 EIR.
Construction Emissions
Similar to the approved Airport Master Plan, construction of the remaining facilities under the updated Airport Master Plan would generate emissions that could exceed the Monterey Bay Air Resources District’s PM10 threshold of 82 pounds per day. The new and modified projects under the updated Airport Master Plan would require similar levels of construction activity when compared to the approved projects and would not add a substantial amount of new construction over the life of the Airport Master Plan horizon. Additionally, any new construction activities associated with the new and modified projects would be at least partially offset by the elimination of construction activities associated with those projects contemplated in the 2003 EIR that are proposed to be dropped.
The Project would be required to implement Mitigation Measures 4.6-A through 4.6-C in the 2003 EIR to reduce construction emissions. These measures restrict grading and earthmoving on the site to less than 2.2 acres per day (unless monitoring shows that PM10 levels do not exceed 82 pounds per day) and require implementation of dust control measures. With implementation of required mitigation measures, the Project’s construction emissions would be less-than-significant.