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HIA Stories from the Field

This website is archived for historical purposes and is no longer being maintained or updated.

The Healthy Community Design Initiative, also known as the Built Environment and Health Initiative, is no longer a funded program and the information on this website is not being reviewed and updated on a regular basis.


Town of Davidson: Design for Life

Grandparents and granddaughter (4-5) walking on sidewalk

A Unique Outlook

Davidson Design for Life (DD4L), a local government initiative to promote better public health in Davidson, North Carolina, has the best of both worlds. The program is locally focused, with resourceful partners—the Health Department for Mecklenburg County and the North Carolina Department of Health—on its advisory commission. Working in a small town of less than 12,000 people, DD4L serves as a model for other small towns looking to form public health initiatives.

In 2011, the Town of Davidson was the only small town to be awarded a “Health Impact Assessment to Foster Healthy Community Design” grant from the Centers for Disease Control and Prevention (CDC). This grant helped DD4L start using Health Impact Assessment (HIA).

Shaping the Streets of Davidson

DD4L has already completed several HIA projects, including the Street Design Standards HIA. The Town of Davidson is rewriting its planning ordinance in 2013. DD4L conducted this HIA to investigate how rewriting street design standards—rules that govern street construction, including signs, sidewalks, and bike lanes—could make Davidson residents healthier. The HIA looks at how existing standards have impacted public health and recommends changes to improve air quality, promote more walking and biking, and reduce the number of people injured or killed by car accidents.

Besides supporting the ordinance re-write, the results also contributed to a related HIA on the town’s new Pedestrian and Active Transportation Plan. The Ped Plan HIA builds on the Street Design Standards HIA, pinpointing ways to improve health equity across all ages and abilities by increasing physical activity, mobility, and access to services.

“We look closely at equity in order to prioritize areas that need more attention,” says Katherine Hebert, DD4L Coordinator. A key focus of both HIAs is making transportation options available to those who cannot drive. “For example, I’ve worked with a committee on aging to see what older adults need, in terms of biking and walking, in order to get around. Biking and walking can really enhance older adults’ lives by allowing them to stay mobile and remain independent, active, and engaged. They can age in their own homes, surrounded by the neighbors they’ve known for decades.”

The Ped Plan HIA also explores some economic benefits of pedestrian-friendly streets. “Often, people don’t stop to think about health costs, but you can really put a price tag on them. Fewer people driving means less air pollution and therefore less asthma,” Hebert says. “When more people walk or bike, there is less chronic disease related to physical inactivity.”

Hebert continues, “We looked briefly, too, at how walkable communities draw residents into a town, improve their quality of life, and increase economic growth by attracting businesses. We can show decision-makers that while investing in healthy streets has certain costs, the benefits down the road are far greater.”

My Little Town

Although small towns sometimes face limited resources and staff, DD4L shows that these challenges to conducting HIA are manageable. In fact, Hebert believes that the large amount of public participation in Davidson is due to the town’s size.

“In a small town, it’s easier to get volunteers and support—everyone knows everyone else!” says Hebert. “There is a real sense of cooperation and neighbor-helping-neighbor attitude in Davidson. It’s also just easier to hold focus groups and distribute surveys and reports. Residents here can subscribe to a town newsletter that’s also distributed to libraries and other public places.” DD4L used the newsletter to deliver surveys and got more than 700 responses, an impressive participation rate for a town with less than 4,000 households.

A small town can also mean getting things done quicker. Hebert says, “It is usually just a matter of calling one person and setting off a chain of action. Decisions can be made rapidly and implemented swiftly.”

Another perk of doing HIA in a small town is the everyday face-to-face collaboration that is possible between local government bodies. DD4L operates out of the planning department at the Town of Davidson, and Hebert feels that the two organizations have built synergy, allowing both groups to use resources more efficiently.

“Anytime the planning department has a public meeting,” Hebert says, “DD4L is invited to talk to residents about the health impacts of planning. Because we work hand-in-hand with each other, we avoid duplicating our efforts and make the most out of our limited time and resources.”

All for HIA, and HIA for All

Hebert’s experience at DD4L shows that HIA is possible for small towns with limited resources. “There are dedicated practitioners out there willing to help newcomers to HIA,” she says. “Be creative—look for information, reach out to partners, join organizations like The Society of Practitioners of Health Impact Assessment. There are also baby steps people can take: they don’t need to conduct a full HIA to take health into account.” Some abridged HIA tools available for this purpose include the CDC’s Healthy Community Design Checklist [PDF – 331 KB], and Design for Health’s Preliminary HIA Checklist, HIA Rapid Assessment, and HIA Threshold Analysis. “For so long, health was not at the table in decision-making, so I think just having a conversation about health is a good start.”

HIA has certainly made an important impact for Davidson, North Carolina. “After the ordinance is revised, every street built here will follow our recommendations,” Hebert says. “This will affect generations—the average life of a road is 50 years, but its features can shape the development nearby for centuries! Yes, HIA takes time, resources, and commitment, but the work is worth it. We are potentially improving the lives of people who haven’t even been born yet.”

Also see Town of Davidson: Assesses a Big Rail Project  Top of Page

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  • Page last reviewed: August 8, 2013 (archived document)
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