Green Rx:

August 1, 2013The Livable City WorkshopLos Angeles

Bridging Public Health and the Urban Forest

1. Interactive Discussion

2. Quick Greenprint

3. How & Why Health

4. Green Rx

5. Health Partners

6. Resources

7. Recommendations Re-cap

The Flow

Our Mission

To build healthy, livable communities in the Sacramento Region by growing

the best urban forest in the nation.

→

Greenprint

Think Think RegionallyRegionally

5 Million Trees

$25M Air Pollution Clean-up/Year10M lbs of air pollution

$17.5M Stormwater Runoff Cost/Year1.75B gal of rainwater

Air

Water

Energy$50M Energy Savings/Year30% Summer Cooling Cost Savings

Next FrontierPublic Health

Anthony Iton, MD, JD, MPH

Senior Vice PresidentCalifornia Endowment

health ≠ healthcare

Urban Forest Perspective

trees health

The Reality

trees = life

Public Health

"the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals.“

It is concerned with threats to health based on population health analysis.

Public Health Terminology

• Public Health vs Clinical care / Primary Care

• Population Health

• Health Behaviors vs Health Outcomes

• Morbidities

• Chronic illnesses Lifestyle Choices

• California Health Interview Survey (CHIS)

• Causality vs Correlation or Association(Longitudinal studies vs snapshot)

Tree Foundation Health Projects

• Skin Cancer / CDPH (1990s)

• Urban Heat Island / NASA (1998 – 2001)

• Urban Forest for Clean Air /AQDs (2006)

• Fruit for Families / CDPH (2009)

• Green Rx / USFS (2010)

• Green Rx Expansion / CALFIRE (2012)

• Spreading the Canopy / Trees Forever (2012)

Trees & Health: Of Note

2011 Health In All Policies

Calif. Obesity Prevention Plan

2010

• Strategic Growth Council Project • SGC Grant Requirements

2014? Urban Footprint?

SGC Grant: Pacer Promenade

Green Rx Project Objective:

Conduct original research to determine

the association between urban greening

and

major health behaviors & outcomes

in the six-county Sacramento region of California.

Green Rx

Data sets:

1)Urban canopy cover (and grass) based on 2008 LiDAR and 2010 aerial imagery

2)California Health Interview Survey – adult, teen, and child.

3)CHIS is x, y data

4)Buffer around x, y -- 50m, 100m, 250m, 500m100m for asthma / 500m for physical activity

Green Rx

Associations investigated:• ADHD • Body Mass Index• Diabetes• General Health Status• High Blood Pressure• Neighborhood Social Cohesion• Overweight/Obesity• Physical Activity• Psychological Distress

Green Rx

Preliminary Results:• ADHD • Body Mass Index – Adult Teen Child• Diabetes• General Health Status – Adult Child• High Blood Pressure• Neighborhood Social Cohesion • Overweight/Obesity – Adult Child• Physical Activity• Psychological Distress

Green Rx Products

• Literature Review

• Findings summary report

• Research report(s) prepared for publication

• Policy brief(s)

• Interactive website

• Presentation tools

Expert Advisory Committee

Desirée Backman, DrPH, MS, RDChief Preventive Officer UC Davis Health System Teri Duarte, MPHExecutive DirectorWALKSacramento Greg McPherson, PhDProject LeaderUS Forest Service Pacific Southwest Research Station Dee Merriam, FASLALandscape Architect /Community Planner Centers for Disease Control/Prevention 

Mary E Northridge, PhD, MPHEditor-in-Chief, American Journalof Public HealthDepartment of Epidemiology & Health Promotion NYU College of Dentistry

Shannon RamsayCEO & Founding DirectorTrees Forever Iowa Ray TrethewayExecutive DirectorSacramento Tree Foundation 

Expert Advisory Committee Glennah Trochet, MD

Former Sacramento County Public Health Officer Aimee Sisson, MD, MPHAs of March 1, 2012:Organic Farming ApprenticeSoil Born Farms Formerly:Public Medical OfficerCalifornia Department of Public Health Kathy Wolf, PhDResearch Social Scientist Urban Forestry & Urban EcologyUniv of Washington - College of Forest Resources

Additional Advisors Janine Bera, MD

Kaiser PermanenteBoard Member, SacTree Lianne DillonPolicy Associate, Public Health InstituteHealth in All Policies Task ForceOffice of Health EquityCalifornia Department of Public Health

John MelvinState Urban ForesterCALFIRE

Robert WasteGovernment Relations DirectorUC Davis Health System

Lawrence D. Frank, PhDPresident, Urban Design 4 HealthDirector of the Health & Community Design Lab, University of British Columbia.

Research Project Lead:

Jared Ulmer, AICP, MPH. Project Manager and Data AnalystUrban Design 4 Health 

Fruit 4 Families Project Objective:

Provide Nutrition Education

and

Physical Activity Promotion

and

Free Fruit Trees

to

SNAP eligible familiesSNAP = Supplemental Nutrition Assistance Program

Fruit 4 Families

“The Fruit 4 Families program was affordable and effective, generating great interest by the attendees and exceeding expectations for participation.

The combination of food security with evidenced based nutrition and physical activity education is very powerful.

I found program staff responsive, motivated and invested in an excellent program.”

Vicki Sanderford-O’Connor, Program Manager Network for a Healthy California,

California Department of Public Health

Fruit 4 Families

Potential New Partners:

• Sierra Health Foundation

• Local Health Departments (SNAP funded)

• Fruit Tree Growers

• Health Education Council

• Walmart

• High Schools with greenhouses or gardens

• Sacramento Consolidated Charities - Bingo Hall

Grant High School Garden

Where Trees Meet Public Health

• Built Environment & Urban Form

• Active Design

• Active Living/Healthy Eating

• Walkability

• VMT – Vehicle Miles Traveled

• Urban Greening

MULCH

MADNESS

Community Health Groups

• California EndowmentBuilding Healthy Communities (14 in

state)

• Sacramento Area Council of Governments Sustainable Communities Planning

(HUD grant)

• Sierra Health FoundationHealthy Sacramento Coalition (CDC

grant)

Communities of Focus

15 Zip Codes

Community Health Groups

• Health Effects Task Force Breathe California – Sacramento

chapter

• American Planning Association Speakers

• National Leadership Academy for the Public’s Health (NLAPH)

• Community Needs AssessmentReport for 4 local healthcare

organizations

Recommendations1.Leverage your board – anyone – to

connect with health professionals.

2.Invite public health professionals to join boards, advisory committees, conferences.

3.Attend community meetings related to healthy urban design.

4.Get involved with APA, local university’s public health departments, local health foundations..

Recommendations5. Partner with community groups in

under-resourced neighborhoods.

6. Leverage research by ranked journals on proposals to government agencies and community foundations.

7. Reference HiAP and Calif. Obesity Plan – especially on proposals to government agencies.

Resources…• Green Cities:: Good Health – Human Health & Well-Being Research in relation to trees. Website - Kathy Wolf. http://depts.washington.edu/hhwb/

 • Environmental Protection Agency - Eco-Health Relationship Browser. PDF of bibliography on health and nature.http://www.epa.gov/research/healthscience/browser/introduction.html

See Laura Jackson video on this:http://dels.nas.edu/global/basc/uf-presentations

• California Obesity Plan 2010http://www.cdph.ca.gov/programs/COPP/Pages/default.aspx

• Health in All Policies http://www.sgc.ca.gov/hiap/about.html

Resources…

http://healthleadership.org/node/1894?utm_source=NLAPH&utm_campaign=f1fcb41cb3-Leadership_Learning_Network_Upcoming_Webinar_and_C&utm_medium=email&utm_term=0_5b21bf353f-f1fcb41cb3-

• Aug. 16, 2013Zoning for the Public's Health: Using Mixed-Use Zoning to Increase Walkability & Reduce Crime Nat’l Leadership Academy For The Public's Health

• March 2014Healthy Communities by Design Conference Loma Linda University.

http://www.llu.edu/public-health/hcbd/2012/videos.page

Thank you!

Questions? Call me…

Cindy Blaincindy@sactree.com(916) 974-4319

Next Greenprint Summit on Public Health: Thursday, January 30, 2014