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Comprehensive Plan
2019-2040

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Community Health

GOAL

PRESERVE THE HEALTH OF ALACHUA COUNTY RESIDENTS AND PROMOTE HEALTH IN ALL POLICIES AND SERVICE INITIATIVES AFFECTING ALL ASPECTS OF THE BUILT ENVIRONMENT, BY FACILITATING HEALTH CARE DELIVERY, IMPROVING THE EQUITY AND LIVABILITY OF THE COMMUNITY, AND PROVIDING ALL ALACHUA COUNTY RESIDENTS OPPORTUNITIES FOR ACTIVE LIVING.

OBJECTIVE 1.1

Promote coordination among local health systems and entities.

Policy 1.1.1     Alachua County will promote and support community health and wellness through policy coordination with national, state and local health programs and the local provision of health services, including coordination with municipalities, with the County Health Department, Alachua County Fire Rescue, higher education institutions, School Board of Alachua County (SBAC), and other community based health care providers including but not limited to safety net providers. Develop ongoing channels for cross-department collaboration, including interdepartmental task forces, cross-sector trainings, and formal and ad-hoc working groups; coordinate Plan implementation with all relevant departments.

Policy 1.1.2   Promote co-location of health programs and services, particularly in underserved areas and in Transit Oriented Development areas, thru county facilities project plans and including incentives in community funding programs.  Alachua County will support and promote equitable access to health care services and the safety net system for the County’s underserved population with transportation systems and transportation-assistance programs that enable low-income residents to access comprehensive health care including mental health, dental health and primary care.

Policy 1.1.3     Utilize the Health Needs Assessment [HNA] and other data to identify areas in need of facilities to meet such needs as a community health centers to provide outpatient medical, dental, and mental health services for low-income populations and other special populations in need; based on this analysis assist with grant efforts to obtain adequate funding.

Policy 1.1.4     Planning for public health clinics should include provision of complementary services, such as mental health, dental health, maternal health, OB/Gyn services providing Well Child medical care and related social services.

Policy 1.1.5     Promote coordination among providers of housing and transportation assistance with health care service providers to address special health needs of the homeless and the transportation disadvantaged upon release from hospital.

Policy 1.1.6     The Future Land Use Element shall include provisions in land use categories for mixed uses to allow co-location for senior housing, nursing homes, assisted living facilities and group homes for special needs population in proximity to health services.

Policy 1.1.7     Alachua County and community based health care providers shall pursue grant funding to ensure evidence-based health promotion, reproductive health, community para-medicine, and chronic disease self-management programs are carried out at the community level through schools, public library branches, senior centers, nutrition programs, senior housing projects, private residences,  faith-based groups, and other community based health care providers.

Policy 1.1.8     Alachua County shall promote Public Safety for a healthy community through coordinating with the Community Traffic Safety Team and the Bicycle Pedestrian Advisory Board to pursue funding for a Pedestrian Safety Action Plan to address safety issues and disabled access, and to minimize traffic hazards and reduce crashes, injuries and fatalities through design of complete streets.  To the maximum extent feasible, Alachua County will assist community and private efforts in applying GIS-enabled pedestrian walkability audit tools to collect and quickly analyze pedestrian infrastructure characteristics so that planners, health organization partners and practitioners, policy makers, and community members can make more effective decisions to improve safe environments for walkability.

OBJECTIVE 1.2

Develop and maintain ongoing County programs and infrastructure designed to support sustainable community health.

Policy 1.2.1     Promote a healthy community by planning for and implementing a connected system of  walkways and bikeways which will provide alternative modes of transportation while also encouraging recreation, fitness, physical activity and exposure to the natural environment.

Policy 1.2.2     Develop and encourage civic engagement and volunteer opportunities in community projects that promote community health. Examples of such programs include health care provider volunteerism, creek and lake clean-ups, walk-to-school groups, Habitat for Humanity, and helpers for the elderly or disabled.

Policy 1.2.3     Increase access to health-promoting foods and beverages in the community. Form partnerships with organizations or worksites, such as employers, health care facilities and schools, to encourage healthy foods and beverages.  Connect with UF/IFAS Extension Office for support in nutrition, horticulture, seasonal produce information and healthy lifestyle programming. 

Policy 1.2.4     Promote a healthy community by providing for Aging in Place in residential development designs by allowing a mix of housing types and housing units that take into account visitability criteria and encourage Universal Design.

Policy 1.2.5     Incorporate CPTED (Crime Prevention Through Environmental Design) principles in designing new parks or renovating existing ones, and in County facilities exterior spaces.

OBJECTIVE 1.3

Promote a healthy community by providing for healthy weight management and prevention of obesity and other chronic conditions by addressing nutrition and the built environment.

Policy 1.3.1     Alachua County shall promote access to healthful, affordable and nutritious food.

Policy 1.3.1.1 Promote food security and public health by encouraging locally-based food production, distribution, and choice in accordance with the Future Land Use Element.

Policy 1.3.1.2 Alachua County shall consider programs to encourage property owners to make use of vacant properties as community gardens.

Policy 1.3.1.3 Continue to offer support for home and community gardening through programs offered by USDA Farm to School Programs and the Alachua County Extension Office and target low-income and populations at high-risk for health disparity for programs promoting gardening, healthy food access and nutrition improvement.

Policy 1.3.1.4 Alachua County shall discourage the sale of less healthy foods and beverages as defined by Institute of Medicine within local government facilities including recreational areas.

Policy 1.3.1.5 Support food banks, pantries, and other sources that help provide food assistance to low income residents so that all families, seniors, schools, and community-based organizations are able to access, purchase, and increase intake of seasonal and fresh fruits, vegetables, and other nutritious foods.

Policy 1.3.2     Alachua County shall partner with local organizations and develop standards to promote community food systems.

Policy 1.3.2.1 Standards for community agriculture shall be developed in coordination with the UF IFAS and Extension agents and local and regional agricultural organizations.  Existing standards will be utilized to the greatest extent possible.

Policy 1.3.2.2 As provided in the Future Land Use and Energy Elements, Alachua County shall promote and develop standards for uses, including produce stands, farmers markets and food cooperatives, to facilitate location of fresh produce providers within or in close proximity to residential areas.

Policy 1.3.2.3 Alachua County shall utilize economic development tools including public/private partnerships, and site facilitation, to promote location of grocery stores and Farmers Markets in proximity to underserved areas.

(a)          Coordinate with Regional Transit System [RTS] and other public transit providers to facilitate access to food shopping for transportation disadvantaged residents through incentives.

(b)         Encourage farmers’ markets and other healthy food retailers to accept federal nutrition programs such as WIC and SNAP (food stamps) and encourage information distribution via county offices and website.  Continue to work with local organizations to offer incentives for utilizing the nutrition programs.

(c)          Alachua County shall consider a program for partnerships for healthy corner stores, and incentives to attract grocers to food deserts.  

Policy 1.3.2.4 Alachua County shall work to implement the 2009 Hunger Abatement Plan and future updates, and shall provide technical assistance for community food access studies. Seek to eliminate food insecurity in Alachua County by 2050, and in the next 5 years increase community partnerships to meet food security goals.  Encourage public and private efforts that support culturally appropriate food opportunities, including grocery stores, farmers markets, food banks and nutrition programs, especially to meet the nutritional needs of infants, children, elders, and other vulnerable populations in their neighborhoods. [Preliminary measures subject to refinement in study required by Economic Element Policy 1.7.1.]

Policy 1.3.2.5 Alachua County should encourage edible landscaping (i.e., fruit trees and shrubs) for landscaping requirements through appropriate policy and standards of the ULDC.

Policy 1.3.2.6 Alachua County community planning efforts and community support programs will encourage participation by health coalitions and networks to create environments that support enjoyable, healthy eating, physical activity and a positive self-image.

Policy 1.3.3     Alachua County shall implement a Health in All Policies approach in order to use the built environment to promote the health and wellbeing of its citizens and reduce chronic disease.

Policy 1.3.3.1 As a part of implementing a Health in All Policies approach, Alachua County should continue to include local health agencies in developing county planning policies and development standards for the built environment in order to address health impacts.

Policy 1.3.3.2 Alachua County will promote children's health by encouraging and supporting land uses in the environment surrounding schools and parks and on travel routes to schools and parks that complement and strengthen other formal programs, such as Safe Routes to Schools and Safe Routes to Parks.

Policy 1.3.3.3 Alachua County will promote a healthy community by developing convenient, safe, and attractive opportunities for physical activity for residents of all ages and income, as part of their daily activities.

OBJECTIVE 1.4

Promote a healthy community by enhancement of school-based health promotion and activities, including for persons with special needs.

Policy 1.4.1     The County should partner with education and governmental organizations to encourage community access to health information and education. Examples include the School Board of Alachua County, higher education institutions, Alachua County Library District, the Children’s Trust of Alachua County, the State of Florida, and the various private and public educational and health programs available to the Alachua County community.  Alachua County should help promote participation in the Teen Safe Driving Coalition.

Policy 1.4.2     Alachua County will assist efforts to promote Safe Routes To Schools consistent with the Transportation Mobility and Public Schools Facilities Elements.

Policy 1.4.3     Co-location of Schools and parks shall be encouraged consistent with the Recreation Element.

Policy 1.4.4     Community partnerships for children’s advocacy will be a focus of County programs.  Promote the use of schools as food distribution sites to increase food security for students and families. Examples include back-pack programs and school-based food pantries.

OBJECTIVE 1.5

Develop a reporting and monitoring system of indicators designed to assess Alachua County’ progress toward sustainable community health, including patient centered primary and hospital care, dental, mental, substance abuse and vision care.

Policy 1.5.1     To assist in planning and coordinating the delivery of countywide healthcare services, Alachua County Health Care Advisory Board, County departments and community partners shall utilize the Health Needs Assessments [HNA], the Alachua County Health and Human Services Master Plan and Alachua County Health Department DOH Strategic Plan, to provide policy-makers with findings and recommendations that help strengthen local partnerships and achieve health equity, and apply this information in decision making processes.

Policy 1.5.1.1 Develop geographically indexed community health indicators designed to measure the County’s progress toward a sustainable, efficient and effective community partnership system for community health.  These indicators should also include data to help ensure appropriate services in convenient locations to address the health needs of different segments of the County population in a culturally responsive manner.

Policy 1.5.1.2 Use these community health indicators to inform long-term, mid-term (strategic), and budgetary decision-making.  Recognize the importance of County services to local community character and sustainability by planning for and integrating public safety and health services into both short- and long-term planning and the budgeting process.  Include consideration of health criteria and impacts as part of capital projects planning, to ensure consideration of health equity. [For example, by improving safe and active transportation].

Policy 1.5.1.3 Alachua County will work with Health Department and other health agencies and non-profit health organizations to assess impacts on public health as part of analysis of planning policies that affect things such as community design, mobility, aging in place, and health equity.

OBJECTIVE 1.6

Reduce the prevalence and incidence of substance abuse and strive for a drug-free community.

Policy 1.6.1     The County should partner with agencies and community organizations for education, prevention, harm reduction and treatment programs to reduce substance abuse in all neighborhoods and workplaces.

Policy 1.6.2     Alachua County shall coordinate substance abuse programs and policies with local health organizations including Tobacco Free Alachua, University of Florida Health Street, and the HPW Coalition.

Policy 1.6.3         Alachua County will reduce and maintain low nicotine, tobacco, alcohol, and drug abuse, and drug related crime rates.

Policy 1.6.4     Support efforts to reduce exposure to second‐hand tobacco smoke in indoor and outdoor areas, particularly where vulnerable populations, such as children and seniors are likely to be present.

Policy 1.6.4.1 Encourage and support local jurisdictions in establishing smoke-free parks and recreational areas.

Policy 1.6.4.2 Encourage and support cities, workplaces, and multiunit housing to reduce residents' exposure to secondhand smoke by banning use on government property and public spaces and events, including outdoor dining and service areas, entryways, farmers' markets, plazas, and community street fairs. 

Policy 1.6.5     Coordinate with cities and other stakeholders to establish tobacco free housing, and prohibit smoking including electronic delivery systems in multi-family residential housing.

Policy 1.6.5.1 Promote tobacco free multiunit housing which shares common walls, such as apartments, duplexes, townhouses, row houses, and condominiums.

Policy 1.6.6     Create a tobacco retail licensing policy that earmarks a portion of the license fee for compliance checks. 

Policy 1.6.7   Consider the potential negative impacts of proposed uses involving selling or serving alcohol, tobacco products, electronic delivery systems, or any other controlled substance of a similar nature when a proposed site's proximity to other such uses and to youth serving facilities would result in negative impacts.  Establish standards for mitigation of impact or restriction of sales.

Policy 1.6.7.1 Encourage and support cities to restrict the number of tobacco and electronic delivery systems retailers near schools, other youth-populated areas, and areas with a high density of existing tobacco retailers.

Policy 1.6.8     Encourage and support cities, workplaces, and multiunit housing to include limitations or restrictions on electronic smoking devices in all (existing) smoking and tobacco policies, regulations, and educational programs.

Policy 1.6.8.1 Support the elimination of the sale and distribution of mentholated cigarettes and/or other flavored tobacco including electronic nicotine delivery products.

Policy 1.6.9     Support and increase the number of programs, clinics, and social service agencies that implement evidenced-based tobacco cessation treatment services.

OBJECTIVE 1.7

Increase equitable access to affordable mental health services.

Policy 1.7.1     Alachua County shall coordinate with service providers and community organizations to promote Mental Health First Aid and other support programs for children, youth, seniors and at-risk populations.

Policy 1.7.2     Alachua County will support community efforts to provide mentoring of youth in partnership with SBAC, after school non-profit organizations, and the Institute for Workforce Innovation.

Policy 1.7.3    Alachua County will support efforts of health professionals to identify populations at-risk to target mental health services.

OBJECTIVE 1.8

Increase equitable access to affordable dental health services.

Policy 1.8.1     Alachua County shall coordinate with service providers and community organizations to promote and support dental health programs for children, youth, working-age adults, and older adults.

Policy 1.8.2     Alachua County will support efforts of health professionals to identify populations at high risk for dental diseases and conditions to target dental health services.

Policy 1.8.3       Alachua County shall support school-based dental screening, prevention, education and treatment programs in high-risk schools in collaboration with service providers and community organizations.

Policy 1.8.4     Alachua County shall support dental screening, prevention, education, and treatment programs for older adults in nursing homes, assisted living facilities, and other community centers.

Policy 1.8.5     Alachua County shall encourage County-wide community water fluoridation.

OBJECTIVE 1.9

Alachua County shall support programs to reduce poverty and its effects.

Policy 1.9.1     Encourage coordinated service delivery for food, housing, transportation, health and dental care, and other basic necessities for people and families in need, including support of the safety net.  Identify and support community based programs and services that address health risks resulting from abuse, poverty, homelessness, and untreated medical conditions.  Encourage collaboration between existing partners, prioritize funding initiatives, and organize community resources to intervene for vulnerable individuals to create a comprehensive safety net.

Policy 1.9.2     Contribute to efforts that help people meet their basic needs, maintain their independence as long as possible, and remain in their neighborhoods of choice.

Policy 1.9.3     Allow temporary shelter for those who are homeless and invest in services and programs that provide a pathway to permanent housing.

Policy 1.9.4     Develop an increased level of emergency preparedness among all segments of the population to help coordinate governmentalresponse and recovery efforts that seek to minimize the adversity of a major emergency or disaster.

COMMUNITY HEALTH ELEMENT DEFINITIONS

 

Complete Streets- Streets with safe travel facilities for all users—pedestrians, bicyclists, motorists and transit riders—of all ages and ability levels.  Facilities on a complete street include sidewalks, bike lanes, wide shoulders, crosswalks, refuge medians, bus pullouts or special bus lanes, raised crosswalks, audible pedestrian signals, sidewalk bulb-outs or other physical design details to promote mode choice.

Corner Store- Typically defined as a small-scale store that sells a limited selection of food and other products. These businesses are also referred to as convenience stores or bodegas. (United States Department of Agriculture, Healthy Corner Stores Guide)

Food desert - A geographic area where residents have limited access to affordable, healthy food options (especially fresh produce) determined by low income and distance to major supermarket locations. Food deserts are based on USDA data with low income census tracts determined by a poverty rate of 20% or higher, or tracts with a median family income less than 80% of median family income for the state or metropolitan area.  Food deserts are low-income census tracts where at least 500 people and/or at least 33 percent of the census tract's population reside more than 1 mile (urban) or 10 miles (rural) from the nearest supermarket.

Health Equity - Everyone has a fair and just opportunity to be healthier. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.

Health Needs Assessment  [HNA]- Health needs assessment (HNA) is a systematic method for reviewing the health issues facing a population, leading to agreed priorities and resource allocation that will improve health and reduce inequalities.  [Update for Alachua County and sub-geographies used to determine priority of local health service needs, March 2010]

Universal Design- Building design that is suitable for all ages and abilities, which includes criteria of equitable use (useful and marketable to everyone), flexible (accommodates many preferences and abilities), simple and intuitive (easy to understand), tolerance for error (minimizes hazards and accidents), and low physical effort (design maximizes efficiency and minimizes fatigue).

Visitability- Although less than the ideal of a universally designed home, visitability is actually universal design practiced through community and neighborhood planning. It ensures that a basic level of accessibility will be provided in all housing, and, it opens opportunities for participation in community life.  Key features of Visitability are (1) at least one zero-step entrance to homes; (2) all interior doors providing 32” passage space; and (3) at least a half bathroom on the main floor.

Walkability Audits- a community-based exercise intended to highlight opportunities, identify obstacles, and evaluate how easy it is to get around a neighborhood on foot.  Specifically, GIS based  walkability audit tools could apply unique sets of walkability measures to different types of walking environments [urban/rural]; perhaps focus auditing activities on major streets and intersections only (e.g. do not audit neighborhood streets where possible); include subjective as well as objective measures of the streetscape; verify the accuracy of digital base maps before widespread implementation; and continuously evaluate whether the simpler technology of pen and paper would be preferable alternatives.

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