SAN TAN VALLEY – SPECIAL AREA PLAN HEALTH IMPACT ASSESSMENT ADVISORY COMMITTEE

MEETING #1 MEETING SUMMARY

1

MMEETING INFORMATION: San Tan Valley – Special Area Plan HIA Meeting #1 Monday, December 5, 2016 2:00PM – 4:00PM San Tan Valley Public Health Clinic

MEETING ATTENDEES: Rachel Zenuk, Pinal County Steve Abraham, Pinal County Lindsey Wicks, Pinal County Naomi Murrietta, Pinal county Jan Vidimos, Pinal County Anne Rubel, Pinal County Matt Klyszeiko, Michael Baker International Jenna Tourje, Michael Baker International Kim Bentley, CAC Pam Kavathas, Compassion Queen Creek

Wendy O’Donnell, AZ Living Well Institute Darcy McCraken, Sun Life Family Health Center Kenneth Steel, Arizona Alliance for Livable Communities Lori Lieder, UANN Dean Brennan, AZDHS Gail Blanchard, J.O. Combs Unified School District Jeanine L'Ecuyer, Vitalyst Adele Taylor, Banner Ironwood Hospital Steven Baldwin, Banner Ironwood Hospital

MEETING INTRODUCTION: Pinal County along with project consultant, Michael Baker International (MBI) kicked-off the initial meeting of the Health Impact Assessment Advisory Committee (HIA) for the San Tan Valley (STV) Special Area Plan on December 5th, 2016.

Matt Klyszeiko, the STV Project Manager with MBI, began the meeting by thanking the HIA members for their attendance and participation with the STV Special Area Plan. Mr. Klyszeiko then introduced the project team members; Rachel Zenuk – Pinal County Assistant Director Public Health (HIA Project Manager), Steve Abraham – Pinal County Planning Manager (STV Project Manager) and Jenna Tourje – MBI Senior Planner. Following these introductions Ms. Zenuk was invited to share a few opening remarks about the Public Health Departments intentions and aspirations for this health initiative. Ms. Zenuk shared that this effort represents the first formal HIA to be conducted in Pinal County and therefore the Public Health Department is excited to work with committee members to ensure health is considered within the larger STV planning effort. Following Ms. Zenuk’s brief comments, HIA members in attendance were then asked to introduce themselves and identify their affiliations.

PRESENTATION SUMMARY: Following introductions, Mr. Klyszeiko presented committee members with a brief project background of the overarching San Tan Valley Special Area Plan project. The background presentation included an explanation of the project purpose, study area context, what the San Tan Valley Special Area Plan IS and IS NOT, introduction of project stakeholders, and identification of

SAN TAN VALLEY – SPECIAL AREA PLAN HEALTH IMPACT ASSESSMENT ADVISORY COMMITTEE

MEETING #1 MEETING SUMMARY

2

the general project process (work plan) and expected timeline. Please see Appendix A – HIA Meeting #1 Presentation, for more detailed information regarding each of these discussion topics.

After establishing the project background information, Mr. Klyszeiko then turned the meeting over to Ms. Tourje to review the link between planning and health and ultimately what the HIA Committee’s role and responsibilities will be within the larger STV Special Area Plan project. Within her presentation Ms. Tourje reviewed, What is Health, What Determines Health, How Planning and the Built Environment Impacts Health, What is a HIA, what are the steps associated with completing a HIA, how the HIA process will be incorporated into the overall STV work plan and timeline, and finally how committee members will specifically contribute to the HIA effort.

GGROUP EXERCISE:

With the completion of the introductory presentation and committee members being informed of the link between planning and health, Mr. Klyszeiko then took committee members through the following interactive exercises that focused on the first two (2) steps, Screening and Scoping, of the formal six (6) step HIA process.

SCREENING – SHOULD WE PROCEED WITH AN HIA?

In the first exercise, Mr. Klyszeiko led the HIA Committee through a list of five (5) pre-determined questions that were prepared to screen or determine if an in-depth health impact assessment is necessary and if an HIA adds value to the decision-making process.

The HIA members had the opportunity to “vote” for their preferred response to each question by using electronic hand held polling devices. These hand held pollers allowed voting to be anonymous (if they so choose) and allowed for a 100% participation rate. From the real-time responses, the HIA committee was then able to discuss the choices and provide further input as desired. Ultimately, based on group polling responses, the committee collectively determined that conducting an HIA as part of the STV Special Area Plan would add value to the decision-making process and thus it is beneficial to move forward with the initiative. The screening checklist and poll results are summarized below.

SAN TAN VALLEY – SPECIAL AREA PLAN HEALTH IMPACT ASSESSMENT ADVISORY COMMITTEE

MEETING #1 MEETING SUMMARY

3

SCREENING QUESTIONS AND RESPONSES:

11) Will this STV Area Plan likely impact health?

2) Does the decision-making process allow for input from an HIA?

SAN TAN VALLEY – SPECIAL AREA PLAN HEALTH IMPACT ASSESSMENT ADVISORY COMMITTEE

MEETING #1 MEETING SUMMARY

4

3) Will an HIA bring new information to the decision-making process?

4) Are the needed time, resources and information available to complete the HIA?

SAN TAN VALLEY – SPECIAL AREA PLAN HEALTH IMPACT ASSESSMENT ADVISORY COMMITTEE

MEETING #1 MEETING SUMMARY

5

5) Do you think decision makers will pay attention to the results?

SCOPING – WHAT HEALTH EFFECTS SHOULD THE HIA ADDRESS?

After completing the screening checklist exercise with the committee, Mr. Klyszeiko took the group through a scoping exercise. He explained the goal of the scoping exercise was to identify the “universe” of health related issues that could be impacted by the broad STV project and then determine what specific health issue(s) the HIA should focus on to keep the effort manageable and attainable. To facilitate this effort, Mr. Klyszeiko guided the committee through the completion of a Pathway Diagram Brainstorming Exercise.

Step 1 - On a large wall sized poster, committee members were first provided with a list of key elements that will be addressed within the STV plan (Land Use, Circulation, Parks & Open Space, Economic Development, Housing, and Public Facilities). They were then provided with an initial list of direct impacts or outcomes that could be anticipated as a result of addressing these key elements in the STV plan. With this groundwork, committee members were invited to utilize post-it-notes to share additional direct or proximal impacts that might occur as a result of addressing these key elements within the overall STV planning effort.

Step 2 - After identifying direct impacts, committee members were asked to utilize the post-it-notes to identify health determinants or the range of factors that are caused by the direct impacts listed in Step 1 and ultimately influence ones health status.

Step 3 – Once the health determinants were identified, committee members were asked to use post-it-notes again to record the primary health outcomes that are most commonly associated with the health determinants listed in Step 2.

NOTE: Please see Appendix C – HIA Pathway Diagram Brainstorming Worksheet for a copy of the results of this exercise.

SAN TAN VALLEY – SPECIAL AREA PLAN HEALTH IMPACT ASSESSMENT ADVISORY COMMITTEE

MEETING #1 MEETING SUMMARY

6

Following the completion of Steps 1-3, Mr. Klyszeiko guided the committee through a group discussion to cull the results of the Pathway Diagram and identify one or two health impacts/outcomes that the STV HIA should focus on. The committee reviewed the main themes of the Pathway Diagram by considering the availability of data, identifying the health issues that were of greatest concern to the community and what health issues had the highest potential for change within the scope of the STV project.

Main themes that were discussed included “mental illness and services”, “obesity and chronic disease”, “access to goods and services”, and “access to parks and public facilities”. However, based on the group discussion, the general consensus amongst HIA Advisory Committee members identified “improving physical activity” within the study area (with an emphasis on children) as the best opportunity to affect change in the community. Furthermore, committee members agreed this health focus also had a high “trickle down” effect on many of the other health impacts/outcomes that were identified within the Pathway Diagram.

At the completion of this group discussion, committee members were informed of next steps in the project process and the meeting was adjourned.

NOTE: Following the HIA Committee meeting, the Pathway Diagram Brainstorming Worksheet was digitally organized by project team members to further evaluate/validate the comments and results that are summarized above. Beyond graphically showing the overlapping link between planning and health, completion of this additional analysis confirmed the HIA Committee’s observation that “improving physical activity” in the study area, offers the most direct and indirect opportunities to influence the highest number of health outcomes than any other health determinant identified within the STV Pathway Diagram. Please see Appendix D – Final HIA Pathway Diagram for a copy of this formal analysis.

SAN TAN VALLEY – SPECIAL AREA PLAN HEALTH IMPACT ASSESSMENT ADVISORY COMMITTEE

MEETING #1 MEETING SUMMARY

Appendix A: HIA Meeting #1

Presentation

− Project Team & HIA Members

− Project Purpose & Study Area

− Project Work Plan & Timeline

− What is Health & Health Determinants− Health & the Built Environment− What is a HIA & Steps in the process− HIA Role & Responsibility

County Staff: Rachel Zenuk, MPH; Assistant Director Public Health (HIA Project Manager)Steve Abraham, AICP; Planning Manager (STV Project Manager)

Michael Baker International: Over 40 years of combined public and private sector experience in the preparation of local government comprehensive and specific area plans, policies and ordinances in Arizona

Matt Klyszeiko, AICP; Project ManagerJenna Tourje, AICP; HIA Task Lead

Advisory Committee Members: Please share your name and organization

Owner Acreage PercentPrivate 26,232.72 66.96%State Trust 12,281.93 31.35%BLM 478.77 1.22%Bureau of Reclamation 183.80 0.47%Total 39,177.22 100.00%

‒

‒

‒‒‒

Phas

e I PROJECT INITIATION

Phas

e II PLAN ALTERNATIVES

Phas

e III PREFERRED PLAN

Phas

e IV 60-DAY PUBLIC

REVIEW DRAFT

Phas

e V PUBLIC HEARINGS

/ ADOPTION

Oct - Dec Jan -Mar

Apr -June

July -Sept

Oct -Dec

Planning

Built Environment

Options

Behaviors / Lifestyle

Public Health

Screening

• Determines whether a proposal is likely to have health impacts and,

• Whether the HIA will provide useful information

Scoping

• Establishes the scope of health impacts that will be included in the HIA,

• The populations affected,

• The sources of data and,

• Methods to be used

Assessment

• First describes the baseline health status of the affected population

• Then assess potential impacts

Recommendations

• Suggest alternatives that could be implemented to improve health or,

• Identify actions that could be taken to manage health effects

Reporting

• presents findings and recommendations to stakeholders and decision-makers

Monitoring and Evaluation

• Includes monitoring the implementation of recommendations

• Evaluates process, impact or outcomes

2010 Census

ACS 2010-2014

ESRI

ESRI2010 Census

ACS 2010-2014

2010 Census

2010 Census ACS 2010-2014

10101010

111100002222

1111

3333

5555

4444Total: 16Total: 16Total: 16Total: 16

16161616

111100002222

Total: 16Total: 16Total: 16Total: 16

16161616

111100002222

Total: 16Total: 16Total: 16Total: 16

16161616

111100002222

Total: 16Total: 16Total: 16Total: 16

15151515

1111

1111

2222Total: 16Total: 16Total: 16Total: 16

14141414

1111

2222

2222Total: 16Total: 16Total: 16Total: 16

San Tan Valley Special Area Plan

• Land Use• Circulation• Parks & Open Space• Economic

Development• Housing• Public Facilities

Direct/Proximal Impacts

• As a group review the direct/proximal impacts identified on the worksheet and add any additional impacts

Health Determinants

• Utilize post-it-notes to identify potential health impacts that are caused by the direct impacts identified in Step 1 and place them on the worksheet (one thought per post-it)

Health Outcomes

• Utilize post-it-notes to record the primary health outcomes that are most commonly associated with the health determinants identified in Step 2 and place them on the worksheet (one thought per post-it)

SAN TAN VALLEY – SPECIAL AREA PLAN HEALTH IMPACT ASSESSMENT ADVISORY COMMITTEE

MEETING #1 MEETING SUMMARY

Appendix B: TAC Meeting #1

Sign-In Sheet

SAN TAN VALLEY – SPECIAL AREA PLAN HEALTH IMPACT ASSESSMENT ADVISORY COMMITTEE

MEETING #1 MEETING SUMMARY

Appendix C: HIA Pathway Diagram

Brainstorming Worksheet

SAN TAN VALLEY – SPECIAL AREA PLAN HEALTH IMPACT ASSESSMENT ADVISORY COMMITTEE

MEETING #1 MEETING SUMMARY

Appendix D: Final HIA Pathway Diagram

Land Uses

Circulation

Economic Development

Housing

Public Facilities

San Tan Valley Special Area Plan

Direct/Proximal Impacts

Health Determinants

Health Outcomes

Parks & Open Space

Change Mixture of Land Uses

Change the Type and Amount of Housing (Density)

Change Access to Goods and Services(Grocery Store, Police)

Change Motorized/ Non-Motorized Connectivity

Change Availability of Jobs

Change Access to Parks and Trails

Change Utility

(Water, Sewer)

Increase Stressors

Financial Status / Income Security

Access to Health Services:- Emergency- Hospital- Clinic- Primary Care Physicians

Employment Opportunities for Teens

Long Commute Times (unsafe driving)Number and Severity of AccidentsEmergency Response / ETA

Better eating habits / Boost Immunity

Better quality food, more easily available

Socialization within Communities / Feeling of Belonging

Preventative Education Levels

Commencement Rates

Access to Ancillary Health Services- Specialists- Dental- Physical therapy- Social work/Case coordination

Access to Jobs

Bicycle and pedestrian activity

Reduced distance to health food options

Physical activity/inactivity

Access to recreation / outdoor activities

Access to Mental Illness / Behavioral Health Support

NoiseWater Quality

• Impact individual property values• Congested development could reduce open space /

result in less parks• Urban farming/agriculture

• Traffic Congestion• Levels of Transportation Options/Modes (walking,

biking, transit)• Safety Issues• Could ease necessity of driving long distances /

Local Travel

• Educational Availability• Retain money and local economy• Proximity to healthy food• Proximity to healthcare• Law enforcement (currently only 5 deputies per

100,000 people)• Emergency Preparedness / Public safety

• Preserves parks, trails and open space• Potential Increased damage to parks and trails• More activity and recreation by residents• More activities for kids/teens

• Economic impacts- Local Spending- Sales Tax Collection- Disposable Income of Community

• Support for Businesses• Student working / Internships

• Improved housing quality• Increased interest, more desirable community • More Homeowners• More Kids • Need for Schools

• Water / Sewer demand• Population growth causes strain on infrastructure

• Healthier water supply Cost of water/sewer services

Strengthen Immune System

Air Quality- Dust, Pesticides, Pollution

Domestic Violence / Overcrowding

Overall Home Environment / Living Conditions

Access to Early Childhood Programs- Immunizations- Preschool- Day Care

Pregnancy/Birth Rates

CHANGE IN ACCESS TO HEALTH SUPPORTING RESOURCES

CHANGE IN PHYSICAL ACTIVITY

CHANGE IN NUTRITION

CHANGE IN EMPLOYMENT OPPORTUNITIES

CHANGE IN ENVIRONMENTAL HAZARDS

CHANGE IN TRAFFIC VOLUME

CHANGE IN COMMUNITY COHESION

CHANGE IN EDUCATION

EMS & ER Visits

MortalityHeat Stroke/Exhaustion

Intentional / Unintentional Injury

CHANGE ACCIDENT & INJURY LEVELS

Respiratory Illness/Asthma

Obesity

Cardiovascular Disease

Cancer

Stroke

Type II Diabetes

CHANGE OBESITY, RESPIRATORY & OTHER CHRONIC DISEASE LEVELS

Adult/Teen Substance Abuse (Tobacco, Drugs, Alcohol)

Mental & Behavioral Health Problems

Anxiety

Suicides

Depression

Overall wellness families and individuals

CHANGE MENTAL HEALTH & WELL BEING LEVELS

STD’sFlu

CHANGE COMMUNICABLE DISEASE LEVELS

CRIME