Land Use Policy Statement

The American Public Health Association recognizes the contributory effects of land use on the health of individuals today and in future generations.

Planning should protect, control, and guide man's use of his environment. The development and rejuvenation of beneficial land uses involve economics, social considerations, environmental resources, and aesthetic preferences in addition to public health. The land is man's substratum—it supplies his shelter, his food and water, his fuels and resources, his clothing—in short, many of his physical needs. It should be used wisely. Historically, man has all too often misused this vital, life supporting resource. Disasters have resulted. Floods, famines, droughts can be compounded by human activities. Fortunately, they can also be ameliorated and even prevented by human action.

The recognized stewardship approach to land use is considered essential, namely that its use be determined primarily by the resultant benefits to society, including, most importantly, the health benefits.

The responsible use of land is not only critical to man's health; it is also essential to the protection of natural resources, including air, water, and all of the biosphere. No health plans should ignore the interrelationships of these environmental components, and appropriate land use standards are a prerequisite to protecting the public health. This paper presents the following nine categories of land use affecting human health: residential, commercial, industrial, institutional, recreational, transportation, agricultural, nonrenewable resources, and disposal.

By applying the stewardship principle, from a public health standpoint to each category of use, the beneficial or detrimental health consequences of such use are determined.

The health consequences of any planned land use should be analyzed for the potential benefits. For total use the primary health interest focuses on a balanced allocation of land among numerous uses to be compatible with the health of the community. The land use planning process should also consider and seek to minimize the impact of adverse health effects relative to the entire community.

Selected use should result from a comprehensive plan covering all aspects of land use and concerns, in addition to the health aspects. Therefore, APHA, emphasizing the impact of land use on public health, supports comprehensive and beneficial land use planning.

Outline of Guidelines
Using available data APHA has developed an outline of the many health consequences of selected land uses, including recommendations on how to develop these uses to improve health benefits to man and his environment. Detailed support of the recommendations appears in a supplementary document.

Factors affecting the use of land:

• Site opportunities and potentials
• Density
• Agricultural capacity of available land
• Accessibility of facilities, services, and employment
• Diversification of uses
• Aesthetics, broad and local
• By-product management—recycling
• Hazards to life and property
• Efficient utilization for chosen uses
• Conservation of all land resources
• Legal and other factors necessarily considered

All of these factors affect each category of land use to a greater or lesser extent. Comments which follow highlight the significant health implications of the nine related land uses.

A. Residential Use
The health aspects of residential land use involve density, accessibility, aesthetics, hazards, and legal and other factors in a major way. High density contributes but does not always generate harmful health conditions and hazards. The health hazards of home occupancy relate more specifically to building design than to land use. Per cent of land coverage is an important factor. Housing should be accessible to areas of work, commerce, recreation, and to certain institutions by way of convenient transportation. Legal and other limitations will be found as restraints. To a lesser extent, the factor of by-product management, i.e., pollution from residential uses, must be considered. Diversity of types of housing is desirable as is the conservation of land for recreation and other healthful purposes. The aesthetic quality of human dwellings is an important, if not easily measurable, factor in the healthful human response to the residential environment. As with all uses, the determination of available sites for housing and evaluation of their full potentials comes early in the process of land use planning. In the total, the health benefits of well-designed land use for housing can be significant in almost any community.

B. Commercial Use

1. Commercial establishments, essential sources of goods and services,
2. Accessibility in proportion to frequency, nature, and magnitude of goods and services purveyed,
3. Concentration together on the same basis,
4. Goals equal accessibility for all population groups,
5. Minimization of time, cost and nuisance of use,
6. Provision of dining, restroom, basic park and recreational, and similar life support systems for users,
7. Successful emphasis on making shopping a pleasant, healthful, and especially unstressful experience,
8. Substituting an aesthetically pleasing and planned use of land for the usual commercial clutter, and
9. Achieving complete, necessary control of noise and other undesirable by-products of commercial activity.

The emphasis here, as throughout environmental planning, should be one of supporting the human experience, improving its quality, and decreasing in time and intensity unnecessary stresses and demands on all users. Each of the above has to a substantial extent been achieved, often in combination, in some of the world's most successful attempts at planning commercial land use. Especially notable is the shopping area built on the ruins of central Rotterdam, with its pleasant pedestrian ways, aerial tramway, kiosks, dining facilities, and full range of highly successful basic and specialty shops. Such examples prove the practicality of the overall approach, and its desirability. All land use planning should be supportive of present and future generations, commercial uses are no exception.

C. Industrial Use

1. Nature of each type of industry must determine the opportunities and problems it presents.
2. Some industries fit well in almost any community.
3. For others, only certain locations are suitable, and communities that can supply work force must be located nearby.
4. Risks to the populations and environments external to the industry must be minimized, and
5. Risks to workers must also be minimized.

As appropriate, control disorder and land abuse through the development of industrial parks where health factors can be carefully monitored and controlled. Plan for regulation and control to minimize the effects of offensive industries; when necessary isolate them from other human activities. Locate for safe and easy accessibility by workers. Today many workers face hard long journeys to their jobs, stressing their mental and physical well-being. Locating planning, with other regulatory controls, can minimize adverse effects on mental and physical health.

D. Institutional Use
Major health factors in the use of land for schools, churches, hospitals, libraries, civic buildings and the like include density, accessibility, diversity, by-product management, and aesthetics. Concentration of institutions can result in some health hazards but the accessibility of health services institutions to the public in the total community is a counter-balancing factor. Planning should consider efficient use of available institutional land to avoid duplication of facilities. Diversity of function balances public utilization. The management of waste products from institutions is an important health factor. In design of land use, aesthetics has an important bearing on beneficial human response. Land planning should reflect comprehensive planning for health resources and consider the plans for all community services.

E. Recreation
The development of a system of readily accessible recreation areas is seen as of major importance in any land use. The health value of such facilities is important in terms of the physical and mental relaxation and exercise such areas provide. In urban areas where competition for land use is high, areas of land must be allocated for recreational uses. In addition to the planned urban recreation areas on a regional or national basis, land should be provided to ensure conservation of diverse aesthetically pleasing landscapes. Such areas tend to serve as public bastions of identity. Attempts should be made to combine uses of development, conservation, and recreation with diversity of form and function held as necessary health criteria.

F. Transportation Use

1. Transportation system must be accessible, economical, rapid, and safe.
2. Each transportation mode has different land use requirements.
3. Each mode derivatively and uniquely structures other land use.
4. The influences of transportation land use choices are among the most persistent known—thousands of years in the case of various ancient roads.
5. Land use choices, their implications, and other principal aspects of transportation systems can be considered under three interrelated headings:
   a. Cargo, its origins and destinationsanimate (e.g. auto occupants)inanimate (e.g. teacups)
   b. (Transportation) Modalanimate (e.g. pilots, drivers, stewardesses, bike operators)inanimate (e.g. vehicles, roads, runways, bridges, lighthouses, pipelines, roadside objects)
   c. Externalphysical (e.g. atmospheric, "heat islands" as at National Airport, air pollution, noise)biological (e.g. crop damage, human pulmonary disease)ecological, social, cultural (e.g. habitat disruption or alterations whether of man or other animals, facilitation of different patterns and distances of societal interactions as with submarine warfare, bombing, ICBM's, the spread of exotic species, and of plague bearing rats)
6. The effects, desirable and undesirable, on cargo and modal and external elements vary greatly between modes—as is illustrated by choosing to build a BART (Bay Area Rapid Transit) system as opposed to a major highway.

Since much of the land use planning must emphasize accessibility for the individual to the community, transportation is a very important consideration. Primary emphasis here is related to a comprehensive regional plan design, recognizing human values as well as machine requirements with emphasis on mass transit and pollution-free vehicles. Detrimental effects to health by the design of the complete system, as well as the mode of transportation, must be studied and minimized, as must the degree to which the individual must function as a control element thereby sacrificing his time in transit to a stressful and unnecessary function.

G. Agricultural Use

1. Nutritional aspects of arable land use
2. Farming methods related to healthy environments
3. Rehabilitation of abandoned and ruined lands
4. Temporary uses of unused farm lands
5. Develop the diverse growing potential of farm lands to ensure the availability of a healthy balanced diet to everyone. Plan for the prevention of pollution, erosion, and poor use through policies that encourage good farming practices. Rehabilitate abandoned and ruined lands where possible. Permit other temporary multiple uses of unused farm lands, until they are required for food production. Such uses could be mostly recreational, helping to fulfill mental and physical needs.

H. Non-Renewable Resources
The focus here is on extraction industries (minerals and petroleum) which influence land use through the depletion of our natural resources. The mining of natural resources should be controlled to protect the health of workers involved and to protect lands for the general public use. Decrease and control the wastes and pollution from such activities to avoid environmental damage and harmful health consequences. Conserve resources for future use.

I. Disposal Use

1. Uses of lands for waste disposal
2. Possible methods of refuse disposal to land use
3. Health factors of disposal

The goal in disposal land use planning is to conserve land for other uses, and prepare for the possibility that disposal lands will not be available. Present disposal methods include open dumps, incineration, deep-well injection, and sanitary land-fill. Open dumps and incinerators pose many threats to air, water, and health. Deep-well injection can seriously threaten the drinking water supply. Sanitary land-fill uses up large areas of land and, in some cases, can cause many environmental problems. Possible methods now being developed will use refuse for fuel, refuse composting for soil builders, and refuse recycling for resource conservation. These methods can decrease the amount of land used for disposal, decrease the threats to human health, and also reduce the depletion of our natural resources.

Methods for Control of Land Use
It is not the purpose of APHA to provide a total orientation in the field of land use control methods. We are not as interested in the methods used as in the final results and how they affect man's health. Any method must remain within legal and sensible bounds, but APHA concentrates on the consequences of land use on the health of man, and not primarily on specific methods of land use control.

Nevertheless, there appears to be a logical sequence of steps through which healthful land use might be accomplished. Using the recommendations of this position statement, the conclusion is that a land use plan is essential, starting with an inventory of existing land and applying the eleven health factors named in the process of evolving a complement land use plan. Following such a plan the usual devices of zoning and building ordinances, financial requirements, restricted grants or loans, and aesthetic controls can be applied. In addition, tax incentives for beneficial development and penalties for harmful uses can be imposed. Eventually, an extension of public ownership and licensing for use may become desirable. The stewardship approach supports any and all means of achieving beneficial land use.

Recommendation
APHA recognizes that policies for future land planning will require some form of a comprehensive plan. APHA feels that such policies require that health consequences be considered in the planning, design, and implementation stages of all future land use.

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