HEALTH IMPACT ASSESSMENT Predicting Effects AD DURALEIGH OAOADO ER GE R RRID E LUE ROAD of BLUEBLUUrban RIDGE ROAD Design REEDY CREEK ROAD THE HEALTHon Public Health: & WELLNESS DISTRICT BOOBO T A LAKELAL BOONE TRAIL AD DURALEIGH OAOADO ER GE R A Case Study inRRID Raleigh, E LUE ROAD BLUEBLU RIDGE ROAD REEDY CREEK ROAD NorthBLUE RIDGE ROAD Carolina EDWARDS MILL ROAD THE ARTS & RESEARCH DISTRICT THE HEALTH & WELLNESS DISTRICT LAKELAL BOONEBOOBO TRAILT A DURALEIGH AD OAOADO WADE AVENUE ER GE R RRID E LUE ROAD BLUEBLU RIDGE ROAD THE ENTERTAINMENT & REEDY CREEK ROAD EDUCATION DISTRICT BLUE RIDGE ROAD TRINITY ROAD EDWARDS MILL ROAD THE ARTS & THE HEALTH RESEARCH & WELLNESS Jacqueline MacDonaldDISTRICT Gibson, PhD DISTRICT LAKELAL BOONEBOOBO TRAILT A Daniel Rodriguez, PhD Taylor Dennerlein, MSEE, MCRP, EIT SOUTH OF WADE AVENUE HILLSBOROUGHHILLSBOROUGH STREET Jill Mead,H MPH BLUE RIDGE ROAD Steve Bevington,THE ENTERTAINMENT MS & EDWARDS MILL ROAD THE ARTS & EDUCATION DISTRICT RESEARCH WESTERN BOULEVARD Above: District Character Sketches DISTRICT TRINITY ROAD To the right: District Diagram University of North Carolina, Chapel Hill WADE AVENUE THE ENTERTAINMENT & Introduction / 1 EDUCATION DISTRICT SOUTH OF HILLSBOROUGHHILLSBOROUGH STREET H TRINITY ROAD Executive Summary xv WESTERN BOULEVARD Above: District Character Sketches To the right: District Diagram SOUTH OF HILLSBOROUGHHILLSBOROUGH STREET H WESTERN BOULEVARD Above: District Character Sketches To the right: District Diagram Executive Summary xv Executive Summary xv » The Blue Ridge Road Corridor Health Impact Assessment (HIA) was led by professors Jacqueline MacDonald Gibson, PhD, and Daniel Rodriguez, PhD, from the University of North Carolina, Chapel Hill, in close cooperation with members of the Blue Ridge Road Corridor Work Group and Project Advisory Board. Throughout the course of this HIA, the stakeholder group, advisory board, and neighborhood residents provided valuable techni- cal and logistical assistance, information, and direction to the project team. Input from residents, employees, and visitors was invaluable in helping the project team to understand and focus on the expressed needs of the Blue Ridge Road Corridor community. The project team would like to extend a special thanks to Dr. Stuart Levin for all of his help and work towards a healthier Blue Ridge Road Corridor. Finally, this work would not have been possible without the generous funding of the BlueCross BlueShield of North Carolina Foundation. Their funding made it possible to research and test new methods for understanding the health impacts of urban planning decisions. Project Advisory Board Stuart Levin, MD, Chair, Blue Ridge Road Corridor Work Group Speros Fleggas, PE, Deputy Secretary for Buildings and Construction, N.C. Department of Administration Daniel Gottlieb, MA, Director of Planning, N.C. Museum of Art Trisha Hasch, MUEPP, Project Manager and Urban Planner, Raleigh Urban Design Center Sig Hutchinson, MEd, Chair, Open Space and Parks Advisory Committee of Wake County David King, MBA, General Manager, Triangle Transit Sue Lynn Ledford, BSN, MPA, Public Health Division Director, Wake County, N.C., Human Services Chad Lefteris, MHA, Vice President of Operations, Rex Healthcare/UNC Healthcare System Grant Meacci, PLA, LEED LP, Planning and Design Manager, Raleigh Urban Design Center Paul Morris, FASLA, Deputy Secretary (Emeritus), N.C. Department of Transportation Tom Skolnicki, RLA, ASLA, University Landscape Architect, N.C. State University Betsy Vetter, American Heart Association/American Stroke Association Mid-Atlantic Affiliate G. Kent Yelverton, PE, N.C. Department of Agriculture and Consumer Services Project Team Jacqueline MacDonald Gibson, PhD, Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill Daniel Rodriguez, PhD, Department of City and Regional Planning, College of Arts and Sciences, University of North Carolina, Chapel Hill Steve Bevington, MS, Built Environment Coordinator, N.C. Division of Public Health Taylor Dennerlein, MSEE, MCRP, EIT, Graduate student, Gillings School of Public Health, Department of City and Regional Planning, University of North Carolina, Chapel Hill Jill Mead, MPH, Graduate student, Gillings School of Public Health, Department of City and Regional Planning, University of North Carolina, Chapel Hill Predicting Effects of Urban Design on Public Health A Case Study in Raleigh, North Carolina Jacqueline MacDonald Gibson, PhD Daniel Rodriguez, PhD Taylor Dennerlein, MSEE, MCRP, EIT Jill Mead, MPH Steve Bevington, MS University of North Carolina, Chapel Hill » HEALTH IMPACT ASSESSMENT / FEBRUARY 2014 CONTENTS EXECUTIVE SUMMARY 5 1. BACKGROUND & SCREENING 8 What is a Health Impact Assessment? 8 Overview of Raleigh 9 Overview of the Study Area 10 Origins of the Project 12 Project Timeline 16 Significance of the BRRC HIA 17 2. SCOPING 18 Geography and Population 18 Health Concerns 18 3. ASSESSMENT 23 Understanding Current Physical Activity Levels 23 Measuring Walkability 24 Predicting Changes in Walking from Increased Walkability 28 Predicting the Health Effects of Increased Walking 30 4. FINDINGS 35 Survey Findings 35 Changes in Walking from Increased Walkability 38 How Will the Proposed Plan Affect Health? 38 Limitations 46 5. RECOMMENDATIONS 47 6. APPENDICES 56 Appendix A: Active Transportation Health Impact Assess- ments in the United States 56 HEALTH IMPACT ASSESSMENT / PREDICTING EFFECTS OF URBAN DESIGN ON PUBLIC HEALTH: A CASE STUDY IN RALEIGH, NORTH CAROLINA / 2 Appendix B: BRRC Resident Survey 62 Appendix C: Articles Included in Walkability Literature Review 65 Appendix D: Demographic Characteristics of BRRC Survey Respondents 66 Appendix E: Method for Calculating Health Benefits 67 Frequently used acronyms BRRC Blue Ridge Road Corridor CHD coronary heart disease FAR floor area ratio HEAT Health Economic Assessment Tool HIA health impact assessment WHO World Health Organization Frequently used terms » Active transportation: Any active method of getting from place to place, like walking, biking, jogging, or skating. » Blue Ridge Road Corridor: Blue Ridge Road is a major north-south arterial road at the western edge of the City of Raleigh. The Blue Ridge Road Corridor refers to the neigh- borhoods along Blue Ridge Road from Glen Eden Drive to the north, Hillsborough Street to the south, Edwards Mill Road to the west, and I-440 to the east. » Small area plan: A small area plan is a type of plan that addresses a set of issues at a smaller geographic scale within a city. Small area plans are created for areas which share relevant characteristics such as districts, corridors, or neighborhoods. Contents / 3 Executive Summary his report presents results of a Health Impact Assessment (HIA) to quantify the Thealth benefits of a small area plan proposed as a result of the Blue Ridge Road District Study1, which focuses on increasing density, diversifying land use, and en- hancing connectivity within the Blue Ridge Road Corridor (BRRC) in Raleigh, N.C. Blue Ridge Road, located at the western edge of the city, is a major north-south thor- oughfare. In spite of the substantial number of residents, employees, and visitors who travel within the BRRC, the area lacks pedestrian infrastructure and has few attrac- tions, residential areas, and retailers that are easy to visit on foot. Focus group dis- cussions indicated that BRRC residents wanted the ability to walk more comfortably and safely within the corridor to a greater number of destinations than currently exist. In 2011, the BRRC Work Group, made up of representative landowners and users of the BRRC neighborhood (including Rex Healthcare, N.C. State University, the N.C. Museum of Art, the N.C. Department of Health and Human Services, the N.C. Depart- ment of Transportation, and others), commissioned the creation of a small area plan that advocated for changes in zoning to allow for mixed-use development at higher densities and the addition of bike lanes and sidewalks to all existing streets, as well as the addition of new streets to increase road network connectivity. In order to increase support for the adoption of the plan, the group solicited funding from the BlueCross BlueShield of North Carolina Foundation and technical assistance from a team of pro- fessors from the University of North Carolina, Chapel Hill, to conduct an HIA in order to demonstrate the scope of the health benefits expected from the project. Based on stakeholder input and priorities, this HIA focused on quantifying the benefits expected from increasing the suitability of the BRRC neighborhood for trans- portation via walking (termed “walkability”) throughout the corridor. The HIA focused on the approximately 10,000 current residents of the BRRC (those living within 1.5 miles of the N.C. Museum of Art, at the center of the BRRC neighborhood) and esti- mated health benefits for the years 2028 (when health benefits are expected to begin accruing if the redesign is completed by 2023) through 2048 (the end of a typical 20- year planning horizon). 1 City of Raleigh. (2012). Blue Ridge Road District Study. http://www.raleighnc.gov/content/PlanUrbanDesign/ Documents/BlueRidge/BlueRidgeRoadDistrictStudyFinalReport.pdf Executive Summary / 5 The project team used data collected from a survey of 386 randomly selected BRRC residents, previous studies quantifying the effect of neighborhood walkability on time spent walking for transportation, baseline health data from