At the start of 2025, PHEAL, the APA Health Equity and Planning Interest Group, and I co-hosted another webinar focused on transportation, where our speakers discussed how vastly different, and at times how very similar, transportation policies and advocacy can be across a region, and how advocates and practitioners often approach the same challenges from different angles.
Thank you again to Alex Baca and Dan Reed of Greater Greater Washington for joining us, and to Jaime Fearer, APA Health Equity and Planning Interest Group Chair, for facilitating this insightful conversation!
As a follow-up to our webinar, here are some responses to the Q&A and resources.
A personal note: My work as the Project Manager for PHEAL and as founder of A Healthy Blueprint is 100% volunteer-driven and unfunded. If you found this webinar valuable and want to support the continuation of these efforts, please consider making a donation to help sustain this work.
Q&A
Q: What would y’all say about still believing in the power of connecting our communities directly into the co-creation of these processes as a way forward? It seems like the issue with the engagement discussed is more in the realm of engagement checking the box but what about cultural relevance and truly having authentic and horizontal ways of engagement/participation/ownership of these projects/processes?
Alex: One of the challenges I’ve experienced with public engagement is that expectations and demands of it go well beyond boxes. Conceptually, that’s powerful, and understandable. But in practice, if the government does not clearly define what its process is, what can and cannot be incorporated into a project or a plan, and what constitutes sufficient public outreach, an outreach process is vulnerable to capture by those with the luxury of time and resources to participate early and often. If those interests are opposed to a proposal that is likely to make something more equitable—like removing parking for a bus lane—then you’ve hit the point that Dan, Jaime, and I were discussing: The reality that a project that could legitimately redistribute resources gets stymied through the weaponization of the public-outreach process. In the worst-case scenario, the people doing the weaponizing are the ones who are least likely to be harmed by a change.
I don’t know that an outreach process will ever be culturally relevant to all its participants, or truly authentic; I am not an expert on outreach methods, just in organizing around them and managing the impact of them on things that my organization is in favor of. I consider public outreach an opportunity to listen and to collect data; I try not to burden my conception of it with unrealistic assumptions of what it can deliver, and focus on how outreach will shape outcomes. Of course, public outreach is part of an outcome, but I’m skeptical that it should wholly determine it. More often than not, it does. I often think we’d be better off if there were more, and better, boxes to check, so that people know what they’re getting into when they show up for something. It is rare that participants in a public project are afforded that, which I think is deeply unfair.
Q: What can planners provide to policymakers to counter the public input which is not representative?
Alex: Public input is not, and never will be, representative. I am fine with this reality, though it runs alongside another: that decisionmakers—elected officials, in particular—struggle mightily to transcend what their most vocal constituents say to them. I do believe that non-standard approaches to outreach, like small-group stakeholder panels rather than open meetings, are becoming standard. That’s important work, but it’s not going to counter the squeaky wheels if a decisionmaker perceives less risk in giving them the grease. Planners, and advocates, need to work together to reduce those risk factors. Perhaps public input is a part of risk mitigation; perhaps it’s not. Planners are the people closest to the project, and can play an inside-outside game of telling advocates what’s effective, and telling decisionmakers what’s defensible. It’s on advocates to be strategic: Sometimes it’s worth banging pots and pans, and sometimes it’s better to play the inside game, even if it means a little less glory for the movement.
Q: What are your predictions on potential [federal funding] challenges with the incoming administration on advancing some planners’ and advocates’ goals to expand affordable housing, design more pedestrian-first neighborhoods, etc.?
Dan Hardy (PHEAL member): I expect federal funding for things labeled “equity” will disappear so two future ideas for PHEAL activities would be capacity-building for planners in transpo/health to focus more on other investment resources (state/local, private…) as well as ideas for how to achieve the same objectives using different terminology.
Q: How can public health practitioners contribute to health equity in the transportation space?
Jaime: Unfortunately, there’s often not the budget, or the time, to tackle an HIA or even a Rapid HIA in advance or concurrently with a planning process. We need to continue to develop and share tools like health equity reviews and checklists, while also being able to reliably access data that’s pertinent to health and equity. That data, and accompanying mapping, should be used to establish baseline data across communities – see the Health Equity Report for the District of Columbia 2018 and Greater Greater Washington’s Transportation, Racial Inequalities, and Public Health in Washington, DC Report for examples.
A few years back I worked on a health equity analysis pilot that was concurrent with DC’s Small Area Plan process for the Congress Heights neighborhood. My hope was that the resulting Health Equity Impact Review (HEIR) would influence the ways in which we approached health and equity in land use and transportation planning processes. While that hasn’t come to fruition, I do believe it could still serve as a model for future efforts, and there are numerous examples of Health in All Policies (HiAP) tools like health notes, checklists, matrices, and more. You can begin to get a sense of the breadth of those tools on SOPHIA’s site – SOPHIA is a great organization to connect with if you’re currently working at the intersection of health and the built environment or if you’d like to learn more about that work.
Ray Atkinson (PHEAL member): Doing health impact assessments. A rapid HIA is a way to reduce the stress of trying to do a full HIA.
Q: What about equitable funding decisions and timing of implementation? Budget priorities are also important.
*We recognize and do not claim to know everything, and at this time our speakers do not have an answer for this.
Resources
- Greater Greater Washington’s Transportation, Racial Inequalities, and Public Health in Washington, DC Report
- A recent example of toxic community feedback
- Health Equity vs. Social Determinants of Health: Why It’s Crucial to Understand the Difference: “Health equity goes beyond just addressing the social factors that impact health; it’s about confronting and dismantling the systems of inequity that cause those inequities in the first place…. This distinction isn’t just a matter of wording—it has significant implications for how we allocate resources, design policies, and build equitable healthcare strategies.”
- “Suburban Gentrification: Change, Stasis, and TOD along the Purple Line”
- How can the design of urban spaces contribute to the mental well-being of teenage girls?: “The Urban Minded research shows that successful urban development requires understanding how different groups experience the city. By considering teenage girls’ needs for ‘flow’, ‘being’, and ‘play’, we create not just a better city for them, but for everyone.”
- NYC’s Public Space Creates Health: “Clean, well-maintained, and attractive public space is essential to maximize the benefits to public health. Broken equipment and seating, and cracked and uneven sidewalks can make public spaces feel unsafe; trash, pests, and unsanitary items on the streets and in parks can spread disease. This can discourage neighborhood residents from playing in these spaces, impacting their mental health.”
- NYC 25×25: A CHALLENGE TO NEW YORK CITY’S NEXT LEADERS TO GIVE STREETS BACK TO PEOPLE report: “Open space improves mental health. In a nationwide study, researchers found that children who grew up with the least access to greenspace had a 55 percent higher risk of psychiatric disorders from adolescence into adulthood. In Los Angeles, a study showed that residents living within a quarter-mile of a greenspace had better mental health scores than anyone living at a greater distance, and that the mental health benefits of open space access were so significant as to be equivalent to decreasing local unemployment rates by two percentage points.”
Links shared by attendees in the chat:
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