Will the Atlanta BeltLine Impact Community Health?

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While many people debate about the architectural style, density or purpose of a new development, everyone can agree that a development should contribute to the health of the people who live, work, and go to school there. But when we start a new development project are we building a healthy place? How do we understand the health impacts of a new development?

To answer these questions for the Atlanta BeltLine redevelopment project, Georgia Tech's Center for Quality Growth and Regional Development (CQGRD) has conducted a Health Impact Assessment (HIA). The Atlanta BeltLine would convert a 22-mile span of freight railway into a transit and trail loop, surrounded by parks and residential and commercial development. This ambitious redevelopment, once realized, would transform Atlanta into a city connected by transit, trails, and green space.

Due to the nature and scale of the project, it is likely to impact the lives of many people. Therefore, an HIA was conducted to investigate how changes in the built environment might affect the health of residents and visitors by examining such issues as air quality, access to parks and trails, and transit and pedestrian safety. The results of this work were initially released on May 29, 2007, at a meeting of Atlanta BeltLine, Inc., the entity charged with implementing the BeltLine.

"If Atlanta is truly to be a 'best in class' city, we must put the health of all residents first," said Atlanta Mayor Shirley Franklin. "From the beginning, we've recognized the transformative nature of the BeltLine, and now with this study we realize its role to help overcome some of our most serious health epidemics-obesity, heart disease-for Atlantans."

The BeltLine HIA is one of the first HIAs conducted in the United States, and evaluates one of the largest redevelopment projects (6,500 acres) in the nation. Using a variety of accepted methods to assess the potential health impacts, the research team concluded that the BeltLine would have a largely positive affect on the health of Atlantans by improving access to green space and healthy foods, creating opportunities for physical activity, and increasing transportation options.

"The BeltLine is truly an inspiring project and the results of the HIA reinforce that view," said Catherine L. Ross, Ph.D., executive director of CQGRD and the principal investigator of the BeltLine HIA. "Although we did identify some areas where the BeltLine's conceptual policies and designs were not fully supportive of good health, they are not fatal flaws," Ross said. "Instead, this research pinpoints the opportunities where new solutions and innovation can overcome potentially negative health impacts and make the BeltLine an even better next step for Atlanta."

The purpose of this HIA is to make clear the link between public decisions and future health consequences so that positive impacts can be realized and negative impacts avoided or mitigated. The BeltLine HIA makes health promotion an explicit part of the planning and decision-making vocabulary and gives officials the necessary resources to make informed decisions. Other cities can look to the BeltLine HIA as a template to follow as they make improving health and the opportunity for physical activity a primary consideration in redevelopment.

This and other HIAs being conducted across the country are beginning to forge a renewed relationship between public health experts and planners. One hundred years ago cities were unhealthy places to live due to poor sanitation, bad housing conditions, and lack of safety measures. At that time, city planners and engineers worked with public health officials to identify the root causes and find solutions, and they were successful. Today's new dialogue between health experts and planners focuses on creating places that promote healthy lifestyles, with the HIA serving as a useful tool.

Some of the health effects identified by the BeltLine HIA:

• The creation of a seamless transit system would substantially increase mobility and walkability within Atlanta. Users would be able to conveniently access essential services and physical activity would increase.
• The design of the BeltLine, access to parks, trails, transit, and redevelopment and the safety of these environments are crucial to ensuring equitable distribution of the health benefits of the BeltLine. If design, access or safety is neglected the health benefits of the BeltLine will not be realized.
• The Southeast, Southwest and Westside areas of Atlanta have high mortality rates from chronic diseases that are linked to a lack of physical activity. The BeltLine would create opportunities for physical activity, lessening the burden of chronic disease in these vulnerable populations.

"A well-designed infrastructure can promote the health of residents of a community," said Andrew L. Dannenberg, MD, MPH, medical officer at the Centers for Disease Control and Prevention's National Center for Environmental Health. "Health impact assessments provide a tool for city planners and public health officials to work together to identify the best ways to help community design support good health."

This comprehensive HIA was made possible by funding from the Robert Wood Johnson Foundation and technical assistance from the Centers for Disease Control and Prevention (CDC).


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    Joanie Chembars
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    Fletcher Moore
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