PHEAL Principle #1

COMMUNITY HEALTH AND REGENERATION

Actively and intentionally do the hard work to plan, design, and build healthy and equitable communities.

 Uplift Health Equity

  • Heal. Acknowledge that historical and current planning and design policies have contributed to health inequities, particularly in historically overburdened communities with health inequities. Then prioritize efforts that redress these harmful practices, which have created patterns of toxic stress and community trauma. Work with communities, respond to a community’s needs, repair broken relationships, and build a culture of health and dignity. Hold organizations and individuals accountable in a constructive, forward-thinking way.

  • Collaborate.  No one single profession, practice, or organization can solely resolve the greatest challenges of our time. Working across disciplines is necessary to achieve health equity. Seek support from mission-driven health equity organizations at the outset of any planning effort.

  • Evaluate. Measure the holistic success of a community based on the social determinants of health, such as health systems and services, employment, housing, transportation, education, social environment, public safety, physical environment, arts and culture, and income and wealth. Work in partnership with public health professionals in developing community plans, policies, and implementation procedures.

  • Shift. Reallocate public resources and services to allow all members of society the opportunity to attain their full health potential, beginning with historically overburdened communities with health inequities.

  • Reinvest. Finance public health infrastructure, including scientific and community research centers, that will reduce existing health inequities and prevent and mitigate future crises of chronic and infectious disease.

  • Prevent. Alleviating and eliminating the struggle of overburdened communities entails preventing the intentional or unintentional placement of more layers of stress. Provide aid, solutions, interventions, and investments to lessen the burdens and trauma—especially for children—until they are no longer an obstacle for optimal health in historically overburdened communities with health inequities.

Develop Healthy and Just Places

  • Create Healthy Communities. The holistic physical, mental, spiritual, and social wellbeing of a community is the measure by which we evaluate success. Specifically, historically overburdened communities with health inequities benefit when community design considers public health across the lifespan and the varying functional levels of community residents at the onset of any planning effort. The design and provision of infrastructure, land use, open space, and transportation options ensure equitable access to high-quality employment, education, healthy food, health care services, safe housing, arts and culture offerings, and social opportunities to achieve optimal health outcomes. Aim not only for improving population health, but also for reducing health disparities.

  • Affirm Basic Rights. Community planning must uphold our fundamental constitutional and human rights to clean air, water, land, housing, food, safety, accessible and safe means of transportation, creative expression, and a fair democratic political system with policies reflected in ordinances, resolutions, maps, blueprints, design guidelines, and other planning documents.

  • Safeguard Ecosystem Health. Healthy and protected ecosystems promote biodiversity, human health, and climate resilience. Greenspaces and vegetation create healthy habitats, reduce the urban heat island effect, filter air and water pollution, manage stormwater flooding, benefit human health and wellness, and provide spaces to grow food. Ensure that neighborhoods and regions are equitably provided with greenspaces throughout, and that greening efforts take priority in those areas that are park- and greenspace-deficient. 

  • Instill Climate Resilience. Climate change, racial justice, health, and generational equity are interconnected. Invest in and co-empower the communities most impacted by climate change to lead efforts that create resilient places. Design climate features into landscapes, such as creating an urban tree canopy and developing low-impact stormwater facilities, to mitigate and adapt to climate change and protect human health. 

  • Reflect a Sense of Belonging for All. Public places should reflect a welcoming atmosphere, so as to not cause social stress or the continuation of community trauma. Consider whose values or what themes or histories are being portrayed in public spaces. This can be manifested through the appropriate naming of plazas or streets, or honoring someone or a culture with artwork. The naming of places or the visualization of an idea or person in a public place should be vetted through the community and researched through historical and cultural lenses. This is particularly important where historically overburdened communities with health inequities exist. Community approaches to creating and honoring places may need to be revisited periodically as communities, values, and cultures change over time.

  • Anticipate and Monitor Consequences. Anticipate potential unintended negative consequences of planning interventions and identify actions to prevent or mitigate against them. In particular, actively reduce the risk of evictions and displacement resulting from investments in housing, transportation, and green spaces, particularly before a major natural disaster or outbreak of a contagious and deadly virus like COVID-19. Regular monitoring of plans and policies' effectiveness will facilitate making the necessary adjustments to avert and rectify a negative outcome. A useful tool to consider is the Health Impact Assessment (HIA).

Establish Safe and Prosperous Communities

  • Rethink Community Spaces. The design and management of public spaces must reflect the local community's culture, needs, and aspirations. Community spaces must be welcoming and inclusive for users of all ages and abilities, especially for historically overburdened communities with health inequities. Reconsider the merits of Crime Prevention through Environmental Design (CPTED) guidelines, defensible space, and architecture and urban design practices that can be hostile to communities. Invest in placekeeping, believing that the people who live and work in a community are best suited to care for a place and its social fabric. 

  • Reimagine Community Safety. Promote community-based safety measures, such as the expansion of access to social resources, mental health support, and other models that promote care, recovery, and personal resilience rather than punishment, alienation, and disenfranchisement. Reimagine resource allocation from traditional policing models toward models that reinvest in programs that support community well-being and health. Achieving a socially just system requires building trust within communities and creating a community-based crime prevention model that builds community resilience through the use of community bonds and networks. Integrate equity into emergency response plans and protocols, especially during natural disasters and health crises such as pandemics like COVID-19, and prioritize the most vulnerable community members, including older adults, children, and people with disabilities.

Make Economic Liberation Essential.

Invest in historically marginalized communities in a way that builds enduring grassroots wealth within. This need is particularly acute for Black communities where building generational wealth is nearly impossible due to long-standing, racist land use, housing, and lending policies. Achieving a just economy requires centering health equity and people over profits, implementing restorative fiscal policies, and reshaping inequitable taxation systems. Recognize the legitimate value of the informal economy that supports microenterprises as essential contributors to community vitality and growth.