Health Equity in a New Urbanist Environment: Land Use Planning and Community Capacity Building in Fresno, CA By Miriam Zofith Zuk A dissertation submitted in partial satisfaction of the requirements for the degree of Doctor of Philosophy In City and Regional Planning in the Graduate Division of the University of California, Berkeley Committee members: Professor Jason Corburn, Chair Professor Karen Chapple Professor Rachel Morello-Frosch Spring 2013 Abstract Health Equity in a New Urbanist Environment: Land Use Planning and Community Capacity Building in Fresno, CA by Miriam Zofith Zuk Doctor of Philosophy in City and Regional Planning University of California, Berkeley Professor Jason Corburn, Chair A tale of two cities. The Mason-Dixon line. The Berlin Wall. Fresnans have evoked a variety of metaphors to describe the spatial divide between the rich, clean and white neighborhoods in the north and the southern areas housing the poor, polluting industries and communities of color that has characterized urban development in the city since its inception. The narrative explaining this spatial inequality has been remarkably consistent over time - sprawl fueled by aggressive developers, corrupt city councilmen and the market pushed the city limits ever farther northeast, abandoning the older neighborhoods to the south where the poor and immigrant communities settled and were too disorganized to counter the government’s neglect. The spatial concentration of the poor, people of color and unwanted land uses can be seen in cities around the country and is identified by public health scholars to be a key driver of the disparities in health between racial and socio-economic groups. City governments are increasingly returning to their core and investing in New Urbanist and Smart Growth strategies to transform these older, more densely developed neighborhoods as the drive for environmental sustainability, walkable neighborhoods, and the attraction of creative urban residents grows. The potential effects of such efforts on the health and wellbeing of the existing residents, however, remains under explored. This dissertation asks if and how the new planning paradigms that use public health as a goal and organizing principle significantly change planning practice and lead to the re-distribution of environmental risks and resources to reduce health disparities? I investigate this question through three case studies of in Fresno a) a downtown revitalization plan, b) the general plan update, and c) a foundation based community development effort to increase the power of South Fresno residents to engage in planning. Following a year of fieldwork I find that everyone is talking about healthy neighborhoods, however for whom and how to achieve them appear to be quite different. While community groups seek to improve the living conditions of the poor residents of South Fresno and ensure their ability to stay in a revitalized downtown, planners are focusing on attracting wealthier residents and actively avoiding any talk about equity, affordable housing and public investment. Thus, although health seems to be providing a unifying framework in terms of a vision for the physical environment, it does not ultimately resolve the inherent tensions between community and economic development. 1 Table of Contents Chapter 1. Healthy Planning: An Introduction ............................................................................... 1 1.1 The Foundations of Healthy Planning .................................................................................. 3 1.1.1 The Intersection of Public Health and Urban Planning: A Brief History...................... 3 1.1.2 The Multiple Pathways between Place and Health Inequities....................................... 7 1.1.3 Healthy Planning Practice.............................................................................................. 9 1.2 Research Questions............................................................................................................. 17 1.3 The Fresno Case.................................................................................................................. 18 1.3.1 Environmental Inequalities .......................................................................................... 21 1.3.2 Fresno Health Disparities............................................................................................. 23 1.4.3 Healthy Land Use Planning in Fresno ......................................................................... 24 1.5 Methodology....................................................................................................................... 25 1.6 Overview of the dissertation ............................................................................................... 26 Chapter 2 Planning and the Production of Race, Place and Environmental Health Inequities .... 28 2.1 “The other side of the tracks”: Fresno’s Racial and Ethnic Segregation, 1880-1940......... 30 2.1.1 Planning for Environmental Inequalities: The General Plan of 1918.......................... 32 2.1.2 Redlining, exclusionary zoning, and the reinforcement of segregation...................... 33 2.1.3 Siting of Noxious Industries: The Case of the Meat Rendering Plant........................ 35 2.2 Postwar Sprawl, Redevelopment, and Community Organizing ......................................... 37 2.2.1 Renewing the Core....................................................................................................... 41 2.2.2 Unearthing Community Voice: Fresno Becomes a Model City................................. 43 2.2.3 Sprawl and the 1974 General Plan.............................................................................. 45 2.2.4 Redevelopment of the Fruit-Church industrial area.................................................... 46 2.3 Fresno’s Demographic Transition and Neoliberal Turn, 1980-2010................................. 49 2.3.1 Setting the Stage for Revitalization and Smart Growth.............................................. 53 2.3.2 The Fruit-Church industrial area in the 21 st century.................................................... 54 2.4 Conclusions........................................................................................................................ 56 Chapter 3 Framing the Health Equity and Land Use Agenda ...................................................... 58 3.1 Establishing the Land Use and Health Connection in Fresno............................................ 59 3.1.1 Air Quality Activism................................................................................................... 60 3.1.2 Environmental Injustices in Southwest Fresno............................................................ 64 3.1.3 Health Disparities, Obesity and the Built Environment............................................... 66 3.2 Unifying a Health Equity Frame: Building Healthy Communities ................................... 69 3.2.1 Fresno Becomes a Healthy Community ..................................................................... 71 3.2.2 Setting the Healthy and Equitable Land Use Agenda in Fresno................................. 74 3.2.3 Tackling Environmental Racism in Southwest Fresno............................................... 77 3.2.4 Healthy Land Use and Affordable Housing................................................................ 78 3.3 Conclusions........................................................................................................................ 79 Chapter 4 Incorporating Health into Fresno’s Comprehensive Plans........................................... 81 4.1 Downtown Revitalization to Create Healthy Communities............................................... 83 4.1.1 New Urbanism to Revitalize Downtown Fresno ........................................................ 83 4.1.2 Framing Health for the Downtown Neighborhoods Community Plan ....................... 85 4.1.3 Tensions between Revitalization and Health Equity .................................................. 88 4.1.4 The Public Draft of the Downtown Neighborhoods Community Plan....................... 90 4.2 Smart Growth Planning for Health ..................................................................................... 91 i 4.2.1 The Built Environment and Health Agenda of the General Plan................................ 93 4.2.2 Acknowledging Health Disparities............................................................................. 94 4.3 Convergence? Comparing the Built Environment and Health Equity Frames.................. 98 Chapter 5 Community Engagement to Achieve Health Equity.................................................. 101 5.1 The Diverse Goals of Community Engagement in Fresno’s Land Use Planning............ 102 5.1.1 Building Community Power to Transform Planning................................................ 103 5.1.2 Educating Community on the Downtown Neighborhoods Community Plan........... 107 5.1.3 Garnering Support for the General Plan Update....................................................... 109 5.2 When Frames Align: Leveraging Community Support for Smart Growth...................... 111 5.3 Communication and Conflicting Frames.......................................................................... 114 5.3.1 Discounting Concerns................................................................................................ 114 5.3.2 Reframing Social Issues with Physical Solutions.....................................................