Massachusetts Department of Public Health

This rapid HIA examined the potential health impacts of new development and redevelopment, including providing public space in the transit station areas along the planned Chelsea Silver Line Extension, a new bus rapid transit (BRT) line. The assessment considered residents living within ½ mile of the four proposed BRT stations in the City of Chelsea. The city has a population of 31,000 people, of which 75% identify as nonwhite, 62% identify as Latino, and 24% live at or below the poverty level. Forty percent of households within ½ mile of the proposed transit stations do not have cars. The City of Chelsea is using the HIA findings and recommendations to guide their decisions about proposed zoning changes near transit stations.

MDPH developed the methodology for and piloted HIA Sprints, a streamlined approach of integrating HIA into the planning process. HIA Sprints are structured around a 2-hour scoping session and a 1-day assessment and recommendations workshop. The Metropolitan Area Planning Council and MDPH provided technical assistance to two regional planning agencies to complete the two HIA Sprint projects described below. The HIA Sprint process increases understanding and capacity of non-HIA practitioners to use a health lens in their current and future project work by familiarizing them with the steps, methods, and data used in HIAs.

• Egremont Complete Streets Improvements: This HIA Sprint focused on the Town of Egremont’s Complete Streets Prioritization Plan, required by the Massachusetts Department of Transportation Complete Streets Funding Program. The HIA Sprint was conducted as a partnership between the Metropolitan Area Planning Council, Berkshire Regional Planning Commission, and municipal officials from the Town of Egremont. Participants assessed the impact of implementing Complete Streets projects on three health determinant pathways, access to green space, safety from traffic, and social cohesion, with a special emphasis on older adults. The HIA made multiple recommendations for each pathway, including pedestrian and bicyclists infrastructure improvements, increasing connections to green space, education and enforcement campaigns, and outreach to the Council on Aging
• Newburyport Route 1 Rotary: This HIA Sprint focused on redesign of the U.S. Route 1 Rotary, or traffic circle, to improve bicycle and pedestrian travel in Newburyport. The Route 1 Rotary is adjacent to the recently approved “smart growth” district near the commuter rail station and provides a connection between an existing and future Rail Trail. The HIA Sprint was conducted as a partnership between the Metropolitan Area Planning Council, Merrimack Valley Planning Council, and municipal officials from the City of Newburyport. Participants assessed the impact of four design options on three health determinant pathways, active transportation/physical activity, safety from traffic, and social cohesion, and made design recommendations for each pathway. The HIA recommended that the City make low-cost, immediate pedestrian crossing improvements (e.g., addition of pedestrian signals and accessible curb cuts) to the Route 1 Rotary.

This HIA assessed how proposed infrastructure investments could affect the health of current and future residents and users of Pleasant Street. One current resident described Pleasant Street as “ill-defined, bipolar, car-centric, and unpleasant.” The City of Northampton is in the process of taking over a portion of Pleasant Street from the state highway department and requested an HIA before beginning the street redesign work. This HIA, conducted by the Pioneer Valley Planning Commission in partnership with MDPH and the Metropolitan Area Planning Commission, assessed the potential health impacts of several streetscape design features, including increased pedestrian and bicycle infrastructure, low impact design storm water infrastructure, and parklets in crosswalk bump-outs. The city used the HIA recommendations to prioritize which aspects of the streetscape deserve the most budgetary and design attention based upon potential health impacts.

The Commonwealth of Massachusetts’ “Plan Ahead for Growth” process identifies areas for growth or preservation, referred to as “Priority Development Areas (PDA)” and “Priority Protection Areas (PPA),” respectively. This HIA focused on potential health impacts of PDA and PPA designations for the Pioneer Valley Planning Commission Region, which is made up of 43 cities and towns with a total population of 625,000 people. The HIA recommends enhancing the PDA/PPA mapping process. Before finalizing the HIA report, MDPH is waiting to learn whether the new state administration plans to continue the “Plan Ahead for Growth” process so the report and recommendations can be framed appropriately.

This HIA examined the impacts of proposed development standards in South Hadley, MA, including proposed revisions to the town’s subdivision regulations and recently adopted design guidelines for a new “smart growth” district. The proposed development standards will shape most future development in the town, including urban infill, new neighborhoods, multifamily housing, and commercial development. The Pioneer Valley Planning Commission (PVPC) conducted this HIA with support from MDPH and the Metropolitan Area Planning Council and in collaboration with stakeholders, such as the Town’s planning director, public works director, and health director. The HIA assessed how street design, vegetation in public spaces, design of the public realm, and new housing developments affect health determinants such as active transportation, safety from traffic, green space, and emergency response. PVPC and stakeholders used the HIA to support health-promoting changes to South Hadley’s development standards. The HIA process elevated understanding and consideration of public health in municipal decision making by other city departments, such as public works and planning.

Under Massachusetts regulation, the MDPH Determination of Need (DoN) program must review applications from health care facilities that are planning substantial capital expenditures or changes in service. As part of this process, applicants provide plans for providing primary care and preventive services, known as Community Health Initiatives (CHI). The MDPH Commissioner requested an HIA of the DoN–CHI program. The purposes of the HIA were to assess the effectiveness of the DoN-CHI program, discover opportunities for alignment with other department and state initiatives, and recommend ways to enhance the program’s impact on community health. The HIA determined that the DoN-CHI program is an effective way to invest in community health and identified several areas for improvement. Based on the HIA recommendations, MDPH developed new guidance for the DoN-CHI program and worked to integrate DoN with the Attorney General’s Community Benefits Program.

The Montachusett Regional Planning Commission, in conjunction with the Montachusett Opportunity Council (MOC) and with support from MDPH, conducted an HIA on the City of Fitchburg’s proposals for redeveloping vacant lots under 5,000 square feet. The HIA examined the health effects of three strategies to transform vacant lots into community and cultural play spaces, urban agriculture sites, or off-street parking. MOC used the HIA findings as a foundation for identifying and prioritizing appropriate sites for redevelopment. In addition, MOC included the HIA findings in a successful funding application that earned them a US Environmental Protection Agency (EPA) environmental justice grant in 2014. One aspect of the funded project will convert a city-owned vacant lot into a “green infrastructure outdoor museum” to educate community members about methods for mitigating stormwater pollution.

The Conservation Law Foundation and the Massachusetts Housing Investment Corporation proposed creating a private equity fund, called the Healthy Neighborhoods Equity Fund (HNEF), to support transit-oriented development (TOD) projects. MDPH, the Conservation Law Foundation, and the Metropolitan Area Planning Council conducted an HIA to describe the potential health outcomes commonly associated with TOD. This HIA examined three TOD projects in the Roxbury neighborhood of Boston (Bartlett Place, Madison Park/Tropical Foods, and Mission Hill/Parcel 25) as case studies to define health metrics for the HNEF. Based on the HIA recommendations, the Conservation Law Foundation selected 10 health metrics that they will use to select HNEF projects and to evaluate and monitor the health impacts of funded projects. In addition, the Conservation Law Foundation is using health data provided by MDPH to identify neighborhoods that will be benefit the most from future HNEF development projects.

The Codman Square Neighborhood Development Corporation (CSNDC) asked MDPH to conduct an HIA to examine the potential health and equity impacts of the proposed site design for the “Oasis on Ballou” project. The project involved transforming several vacant adjacent land parcels at 100 Ballou Avenue in Boston’s Dorchester Codman Square neighborhood. The HIA found that the proposed multi-use site design would positively affect food access, physical activity, and safety among nearby residents. CSNDC purchased the land from the City of Boston in 2014 to develop the site based on the HIA recommendations.

The City of Fall River asked MDPH to conduct an HIA on Phase II of the Quequechan River Rail Trail extension project. The HIA specifically focused on the following health impacts: physical activity, safety from collisions, crime, economic development, air quality, and social cohesion. Recommendations from the HIA addressed the engineering, design, and maintenance of the trail to improve city and regional connectivity and to maximize health benefits. Work on Phase II of the Quequechan River Rail Trail Project is on track for completion in the summer of 2016.

This pilot HIA was a collaboration between MDPH and the Pioneer Valley Planning Commission (PVPC). The HIA explored ways to incorporate the public health effects of climate change into existing municipal and regional planning efforts. The HIA advisory committee chose to focus the HIA on two of the 19 strategies from the Pioneer Valley Climate Action Clean Energy Plan: (a) providing cooling centers and assisting vulnerable populations during heat events and (b) implementing energy efficiency measures in city buildings. Local health officials have used the HIA findings to develop comprehensive adaptation plans to prevent and mitigate climate change-related health impacts in their communities.

MDPH and the Metropolitan Area Planning Council conducted an HIA to examine the connections between health and school building design and construction. In the feasibility phase of the HIA, the team identified school building projects and chose the Plymouth South High School redevelopment project as a case study. The purpose of the HIA was to inform school districts and local Mass in Motion (MiM) coalitions about ways to integrate health considerations into the local planning process to build or reconstruct schools. MDPH presented the HIA recommendations to the Massachusetts School Building Authority (MSBA), the Plymouth School District, and community members prior to the design plans being finalized. The HIA also presented a healthy school building framework that MSBA, school districts, designers and architects, and community stakeholders can use as a resource. The framework recommends ways to incorporate health at various stages of the school building process to create healthy school environments for students, staff, and community residents.

MDPH, in partnership with the Metropolitan Area Planning Council, examined potential health impacts of proposed state legislation that would lower the default speed limit on all local roads in Massachusetts from 30 mph to 25 mph. The HIA found that the proposed change in speed limit could prevent an estimated 2,200 crashes, 18 fatalities, and 1,200 injuries per year, translating into $210 million annual savings in medical payments and work loss. The HIA received much attention from decision makers and other stakeholders, leading to a day-long speed limit forum where researchers, transportation officials, and legislators discussed the wide-ranging impacts of speed on local residents and communities.

The City of Worcester brought together multiple city departments to develop a comprehensive neighborhood revitalization strategy for the distressed Union Hill neighborhood. Worcester Division of Public Health (DPH), in cooperation with other city agencies and with support from MDPH, conducted a rapid HIA of the proposed revitalization strategy for Union Hill. The HIA examined six health factors (community violence, social cohesion, housing safety, traffic safety, access to parks, and physical activity) linked with four revitalization strategies (housing, code enforcement, infrastructure, and public safety). Worcester DPH presented the HIA to the city council and other stakeholders and is using the HIA recommendations to support health-promoting activities in the distressed neighborhood of Union Hill. The city plans to refine the revitalization strategy and apply it to other Worcester neighborhoods.