UC Berkeley

The most pressing health problems of the 21st century - such as obesity, diabetes, osteoporosis, cancer, depression, and cardiovascular disease - cannot be addressed using traditional public health interventions. Population growth and climate warming are global challenges that threaten not just the health but perhaps the very survival of human beings. These, too, require innovative, "outside-the-box" solutions. At the root of these problems, and their solutions, lies the intimate relationship between where we live (our built environment) and how we live (our behavior). The separation of the disciplines has also been blamed, at least in part, for the failure to recognize the links between the built environment and the health disparities found among communities of color and of low socio-economic status. Correctly designed communities can improve their residents' health by encouraging physical activity, providing access to healthy food, and strengthening social networks and capital, while also decreasing waste and pollution, shortening commute times and the resulting stress, and addressing issues of social inequity.

A century ago, the relationships and dependencies between land use planning and public health were well understood - then, through the 20th century, the two disciplines evolved independently, and each lost its appreciation for the value of collaboration with the other. Before we can bring together the concerns of the built environment and public health, we must first reconnect the disciplines of land use planning and public health and reestablish the mutually beneficial relationship they once enjoyed.

This study explores the current state of collaboration between public health and land use planning agencies in California, in order to identify contextual factors that can act as either incentives or barriers for collaboration. The study consists of 18 in-depth, semi-structured interviews with land use planners and public health professionals that explored the relationship between the disciplines. By using Grounded Theory Methods and Social Exchange Theory, a Five Stage Model for Collaboration has been elaborated and the central theoretical construct of Cost-Benefit Analysis has been identified. A Cost-Benefit Audit tool (the Collaboration Manual for Public Health and Planning) based on the study results has been developed; a social ecologic model approach was used, and it suggests ways to improve and promote collaboration between public health and land use planning. The study proposes that a transdisciplinary approach to collaboration may be the most appropriate means to address the complex health problems that result from, and can be influenced by, the interaction of the built environment and the individual.