Table 3. Sample Comments by Participants and Number of Participants Who Mentioned Theme, by Discipline of Participants and Theme, in Qualitative Study of Cross-Sector Perspectives on the Contributions of Local Health Departments in Land-Use and Transportation Policy, 2015.
| Land-Use Planning (n = 13) | Transportation/Public Works (n = 11) | Public Health (n = 19) | Othera (n = 6) |
|---|---|---|---|
| Theme: Physical Activity and Health Perspective | |||
| n = 12 | n = 10 | n = 16 | n = 6 |
| [H]aving a public health perspective broadens the conversation and I’ve found it’s gotten people to take notice. When we first started to do community engagement, we didn’t get a lot of people when we were talking about brownfields in a technical way. When we shifted the conversation to talk about public health and started holding meetings at the local hospital, people got more interested and that group probably grew from five people to thirty — just by using that language. | I think it takes a lot of effort and education to create policy — to get politicians to create different policies, and you need a large support base. So I think health departments could set the foundation and groundwork for establishing or getting established the policy that we need. | [W]hen you put a health framework on it, it helps residents and people become more engaged and more invested in the process and understand why it matters. | [I]t also has broadened us as a movement, transportation folks — getting us outside of our box a little bit in terms of roads and streets and fighting with the local traffic engineer to build a sidewalk. We’ve figured out a different way to talk about it. |
| Theme: Data Analysis and Assessment | |||
| n = 10 | n = 10 | n = 17 | n = 4 |
| What would further that conversation at the local level and the policy level, especially among the decision makers is to have better data, more localized data of what the actual obesity rate is and being able to match that up with areas that don’t have any sidewalks or trails — the roads are not safe, they don’t provide a space for bicycles or pedestrians — access to transit. | A lot of this is based on political will, as far as the direction that we go in, and if there’s information out there that the health department can provide that would show, or more substantiate the benefit and utilization of these types of facilities, the more information we have, the more data we have, it helps us when we’re trying to prioritize things throughout the county. | They have a lot of access to data. Health statistics, you know, where the cities can bring the crash data and all of that, health departments can bring BMI and heart . . . chronic disease rates, or how many people are getting the physical activity . . . all of that BRFSS information. | The health departments understanding that, and then facilitating and saying to the other departments or boards “here is something that can be utilized to help all of us make better decisions for the health of the community.” |
| Theme: Partnerships | |||
| n = 7 | n = 7 | n = 16 | n = 5 |
| [B]roadening the outreach through different partners and public health in particular does have a lot of fingers out there. | [T]here’s been a very significant push by local health agencies over the last ten years here, in this local area, bringing together partnerships. I think that’s had a lot of crossbreeding benefits. It’s helped planners become more familiar with the different agencies that are out there and what the emphasis is for each agency. It’s certainly brought together coalitions where we never saw them before. | [I]f you can show how cross-cutting all of these issues are, it gives it a little bit more depth, so it’s not just DPW going in and saying, “Well, we really need to do this.” It’s other experts in the field. I think that our role is to help assemble those people and get them to the table to help inform with data. | Working with public health gave transportation advocates a whole different set of leverage points and relationships with not just public health people, but people in a community that were being served by the public health agencies, who we wouldn’t normally interact with in our somewhat closed transportation world. So I think it really expanded the universe of people and groups that I was able to work with. |
| Theme: Public Education | |||
| n = 7 | n = 4 | n = 13 | n = 3 |
| They could really help with that public education piece in terms of pointing out why certain land use or certain transportation actions or focuses are so important from a public health standpoint. That’s something that planners and to an even greater degree engineers aren’t particularly good at, but public health officials could more effectively make that argument. | Being that interface with the community to say . . . to help with the stakeholder involvement. | [T]he city planning department and even the public works department, they’re not, in their role, they can’t spend time cultivating the champions of the community and so I think that’s, you know, an appropriate place for us to be. And I imagine that most health departments historically probably have more experience trying to identify and support advocates. | A lot of times when boards are trying to adopt health policies there’s some pushback from the public and if the public were indoctrinated ahead of time by the state health department or the LHD it would make our job at the local governance level a lot easier. |
| Theme: Knowledge of Evidence Base and Best Practices | |||
| n = 11 | n = 4 | n = 6 | n = 2 |
| [P]lanners will incorporate public health concepts to the level they know them, but I don’t think they’ll know them as well as public health experts. So that’s where I think you need public health experts to be involved, but not necessarily to be involved from A to Z. It might be they’re involved from A to L, and then let planners do the M to Z portion while public health folks start focusing on other public health concepts. | [I]f it’s their voice at the table that’s saying “this project will have these benefits,” I think that carries a lot more weight than if it’s an engineer or even a planner saying: “here’s what we think the benefits are.” | [They] provide the science, the evidence-based science, behind why this is an important public health initiative. | [T]he public health agencies have been really the key state and local agencies that were willing to fund doing training and assessments and really getting people thinking about these issues in communities. I think that stems from both the long tradition of saying “we need people to get more exercise so they’re healthier,” but the more recent realizations say, within the last decade, that it just isn't enough to tell people they need to get more exercise. We need to make it possible and safe and convenient for them to go out and get more exercise. So if it’s not safe to bike or walk, or if there’s no place for them to bike or walk in their communities, they’re just not going to do it. |
| Theme: Resource Support | |||
| n = 4 | n = 2 | n = 11 | n = 3 |
| If we had more people from that [health] side coming to testify, coming to participate on behalf of the kinds of things that we are doing — the transition that we’re trying to make from being an auto-dominated suburb to a place where walking is a priority, pedestrians are a priority — the health and social life of our residents — something that we care about. If it weren’t just us carrying a message of human health, but actual health practitioners here also singing that song that would allow us to power through some of the troubles that we have. | [A health director] was very visionary in that and brought us in — what can we do to augment some of the resources that were limited in certain ways because some of the grants that were coming in. | We have two analysts . . . and a GIS person, that I think, the three of them could easily be brought into discussions about how various developments might impact health. And so, I think we’re kind of, in that sense, maybe an underutilized resource that perhaps if they just understood and developed more relationships with us, then that would become a sort of an extra resource for them. | The opportunity to leverage funding is always a benefit. I know whenever we apply for grant funding they’re looking for local commitment, local match or in-kind investment, and so I think when you have multiple agencies working together, limited resources are able to be expanded beyond what you’d be able to do by yourself so there’s some synergy there when two or more organizations are working together in terms of being able to do more with less. |
| Theme: Health Equity | |||
| n = 1 | n = 3 | n = 4 | n = 0 |
| The potential impact that they can have on helping people have more access to opportunities that would keep them healthier and access to opportunities that the literature says this is what’s good for people. I found when you open up that sense of possibility for people, you can generate a level of excitement in the room that the people are really looking for. | We put low-income housing at a place that had very poor transportation access for people who mostly didn’t own cars. And so that [relationship with LHD] really in my mind brought forward this issue of transportation equity. All things that I normally wouldn’t have thought about. | [W]e can contribute by bringing the voices to the table that aren’t often represented in the political process. And, you know, if they can’t be engaged, at least being a proxy for those . . . the needs of those tacit users. | (No quotes coded for this discipline.) |
a
Other disciplines include municipal administration and bike and pedestrian advocacy.