Guest Post: Re-connecting Regional Planning and Health


While the connection between healthy cities and better lives was recognized in the first regional plan for metropolitan New York almost one hundred years ago, the Fourth Regional Plan re-connected regional planning and health.  The Plan emphasized the impact of urban systems on health, equity, prosperity and sustainability for all in the region.  Re-connecting regional planning and health:  The Fourth Regional Plan for Metropolitan New York was the focus of an invited presentation, with simultaneous translation into Chinese, at the 8th U.S.-China Health Summit in Chengdu, China in October 2018.  The summit was organized by the Chinese Academy of Medical Sciences, Peking Union Medical College, the Health and Family Planning Commission of Sichuan Province, and the China Center, Department of Population Medicine, Harvard Medical School, and attended by 1400 participants.

At a session on Healthy Cities, the story of how the Plan re-connected regional planning and health was related to an audience of Chinese health professionals and government officials.  The presentation covered the history of the RPA, the motivation and context of the plan, the major challenges to the region, and the potential solutions.  The associations of health metrics with “place” (where people live, work, and play) has increased awareness of the impact of urban systems on health regionally, nationally, and globally.  As a result, the connections of urban systems, health, and equity also now are highlighted in the Sustainable Development Goals of the United Nations.

RPA research on the Health of Region: How urban systems impact health provided an evidence base for re-connecting regional planning and health.  The RPA also sought to engage communities in developing the Plan.  Of the more than 60 recommendations, 20 recommendations across housing, transportation, governance, and climate change were rated as having a particularly high impact on health, while also advancing equity, sustainability and prosperity.  The potential impact of the Plan was illustrated with visuals of several current and future designs related to transit—use of street space, subway systems, light rail, and addressing disruptive highway sequences.

The Chinese have long valued health; and they now are expecting their government to do more to promote health and wellbeing.  The government recognizes that urban systems impact health and equity, and China currently is investing in the development of 38 Healthy Cities.  Many of the health and planning challenges in China mirror those in the US—the aging of the population, urbanization (migration to the cities from rural areas), environmental hazards due to prioritizing economic development over environmental protection and health, and a lack of equity (and opportunity for all).  Solutions from the Healthy Cities project will be replicated in other cities, with the potential to impact China more broadly.

There was much interest in RPA’s efforts to re-connect regional planning and health; and the story was said to have “inspired” those in the audience.  Of note, presentations by the Deputy Mayor of Luzhon City and the Mayor of Wenchuan (a city that was destroyed by an earthquake and is now being rebuilt) illustrated on-going efforts to create Healthy Cities in Sichwuan Province, a province of 90 million people.  Additionally, a presentation by the Chief Architect, National Residential and Environmental Engineering Center, illustrated the connections between housing and health in China.  Taken together, the presentations reflected the political and economic commitment to implement solutions needed to address some of the complex urban systems that impact the health of the public in China.

Health is a shared value globally.  Urban systems are complex and present multiple common challenges related to the creation and maintenance of healthy cities.  The RPA’s effort to re-connect regional planning and health in the Fourth Regional Plan has the potential to impact the health of the public not only in the metropolitan New York region but also in cities and regions globally, given the keen interest in knowing what is happening in civic society in New York.

David Siscovick, MD, MPH is a Senior Research Scientist at The New York Academy of Medicine and a Professor Emeritus of Medicine and Epidemiology at the University of Washington.  He was a member of the RPA Technical Advisory Committee on Health, the Planning and Design Committee, and the Committee for the Fourth Regional Plan.  He currently serves on the RPA New York Committee. Tom Wright, Chris Jones, and Mandu Sen of RPA made important contributions to the presentation at the Summit. 

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