Introduction

The Healthy Development Measurement Tool (HDMT) is a multi-objective, systematic evaluation metric for urban development plans and projects. Its goal is to support the inclusion and consideration of health needs in land use planning and project design. The HDMT is comprised of the following components:

Seven Elements that comprise a Healthy City.

Community Health Objectives that, if achieved, would result in greater and more equitable health assets and resources for San Francisco residents.

Health-based Rationales that describe the nexus between the objective and physical and mental health.

Measurable Indicators and Baseline Data to help evaluate progress towards the objectives and evaluate the benefits of projects, plans, and policies.

Development Targets that, if achieved by a project or plan, are a proxy for improvement of an indicator.

Policy and Design Strategies to support the achievement of development targets.

Background and Development

In November 2004, SFDPH convened over 20 organizations to carry out the Eastern Neighborhoods Community Impact Assessment (ENCHIA), an 18-month process to analyze how development in several San Francisco neighborhoods affected attributes of social and physical environments that are most important to health. Recognizing that there were no mandates, tools, or guidelines to systematically consider and mitigate health impacts in planning processes, the ENCHIA process conceived and advanced the concept of the HDMT as a standard assessment tool to assess “health” impacts. The vision of the ENCHIA process was that the use of the HDMT would ultimately become a regular part of the planning process in San Francisco, both serving as a way to shape plans and projects and as a way to track progress over time.

Over 20 national technical experts from diverse disciplines such as land use and transportation planning, public health, health impact assessment, environmental impact assessment, and health equity, reviewed the first version of the HDMT. In addition, seven city agencies reviewed and provided feedback on the HDMT, including Planning, Redevelopment, Recreation and Parks, Arts Commission, Building Inspection, Public Works, Mayor’s Office of Community Development, and the Public Utilities Commission. To date, the web-based version of the HDMT has undergone a number of revisions to improve its applicability and specificity.

Collaborations/Constituencies Involved

The content of the HDMT reflects the ENCHIA Community Council’s vision for a healthy city. The multi-stakeholder Community Council that guided the ENCHIA process consisted of over 20 diverse organizations’ whose work was affected by urban development. Public agencies, community organizations, and private sector groups were included on the Council. Public agencies included: recreation and parks, planning, redevelopment, police, transportation, parking and traffic, public health, and elected officials. Community organizations’ focus areas included: community planning and design, economic and neighborhood development, environmental justice, homelessness, open space, housing, transportation, bicycle advocacy, low-wage and union workers, food systems, local residents, child care, and childhood development. Private interests included: non-profit and private developers, property owners, architects, and small businesses.

Relevance to Health and Health Equity

The fundamental vision of the Community Council, and subsequent framework of the HDMT, is that all communities should have equal access to health resources, which are defined as the physical, economic, social and environmental resources needed to be healthy. As such, HDMT objectives and indicators explicitly call out the need for development that serves existing and new residents and workers. Data are disaggregated by neighborhood and are illustrated spatially in an effort to highlight disparities.

Applications and Policy Targets

Application of the HDMT is appropriate for urban land and community plans in dense, socially and economically diverse settings. It is also relevant to new residential, commercial, mixed-use, and industrial development projects. Application of the HDMT asks the following questions:

1) Does a place have healthy living and working conditions?

HDMT indicator data are used to assess baseline conditions

2) Does a plan or project advance health-related conditions?

Plans/projects are assessed to evaluate the extent to which they meet HDMT development targets

3) What recommendations for planning policies, implementing actions, or project design would advance community health objectives?

Concrete, specific recommendations are provided to the plan/project based on the evaluation

In San Francisco, SFDPH has primarily targeted use of the HDMT in communities experiencing health inequities as these communities are most likely to be impacted by new development. To date, three applications of the HDMT have been completed. The primary target for the Executive Park Subarea Plan, and Eastern Neighborhoods Area Plans applications were several local area plans under development by the SF Planning Department. The Bernal Heights Community Health Assessment targeted a decision-making process related to a local preschool. An application to the Western SoMa Community Plan is currently underway.

 

Please visit www.TheHDMT.org to access the tool, indicator data, the development target checklist and completed case studies.