Health Impact Assessment an analysis of potential sites for a regional recreation center to serve North Aurora, Colorado Background This is a Health Impact Assessment (HIA) created to inform a policy decision about the specific location of a regional recreation center in North Aurora. This center is one of three, with two others planned for Central and South Aurora at Vassar Park and Aurora Reservoir. After a series of public meetings facilitated by the Aurora Residents for Recreation Task Force, four city-owned properties were eliminated as potential sites for the North 26th Ave. NW Aurora Montview Blvd. Colfax Ave. 3 2 1 Aurora recreation center due to limited acreage and/ or conflicting uses. Currently, one city-owned property, Bicentennial Park, and three privately-owned properties, Mt. Nebo, Fitzsimons Centerpiece, and Monterey Point are still under consideration. The impetus for these facilities arose from the City of Aurora’s Community Needs Assessment that identified a need for 400,000 square feet of new indoor recreation facilities to accommodate Aurora’s current population (Aurora Residents for Recreation Task Force 2009). The new facilities are meant to address the square footage per capita deficit in Aurora as compared to other cities along the Front Range. These facilities increase opportunities for physical activity which is known to help reduce obesity, heart disease, diabetes and related conditions, as well as improve mental health. Good access to parks and recreation facilities provides additional benefit as it increases the amount of physical activity by both children and adults. 6th Ave. 4 225 -I North Aurora Alameda Ave. N. Chambers Rd. Sable Blvd. Peoria St. Havana St. Mississippi Approximate boundaries for North Aurora (dashed red line), NW Aurora (yellow) and the four potential recreation center sites (green): 1) Mt. Nebo, 2) Fitzsimons Centerpiece, 3) Monterey Point, 4) Bicentennial Park. This HIA identifies impacts to health and provides recommendations for the Aurora Residents for Recreation Task Force (ARRTF), City Planners, and City Council based on credible community-level data and supporting research regarding health status, risks, and disparities, as well as access and affordability. This information can assist with thoughtful, equitable, and informed decisionmaking that provides the most benefit to the health and well-being of North Aurora residents, particularly those with the greatest need, in the Northwest (NW) Aurora neighborhood. NW Aurora is roughly bounded by E. 26th Ave. to the north, Peoria St. to the east, E. Colfax Ave. to the south, and Yosemite St. to the west. prepared by Karen Roof with EnviroHealth & Alisha Brown, Felicia Hilton, & Lisa Schott with the Stapleton Foundation’s be well initiative , July 2010 HIA: a study of potential sites for a regional recreation center in North Aurora The HIA addresses three primary questions: 1. What is the current health status of populations within North Aurora and how is it affected by the sites under consideration? 2. In addition to health, what other factors should be considered in the site decision for the North Aurora recreation facility? 3. What are the recommendations and expected outcomes to support overall health in relation to health status, access, and affordability for all North Aurora residents, particularly those most in need? What is the current health status of populations within North Aurora and how is it affected by the sites under consideration? Health Status According to Tri-County Health Department (TCHD) as well as national experts, “several demographic groups face special barriers to getting enough physical activity or are more likely to be injured while being physically active”, including seniors, children, people of low income, people of color, and people with disabilities.” For example, “being poor is associated with a higher risk of chronic disease and obesity, as well as with lower levels of physical activity (TCHD 2007) (Frank 2003).” When NW Aurora is compared with other areas including North Aurora, City of Aurora, Denver, Adams County, Arapahoe County, and Colorado, data consistently illustrates that NW Aurora has higher percentages of demographic groups at risk for disease and for getting too little physical activity. Overall its residents are less healthy than many of their more economically stable counterparts. The 2006-2008 Taking Neighborhood Health to Heart (TNHTH) community based participatory research study funded by a grant from the National Heart, Lung and Blood Institute and conducted by a partnership between the TNHTH resident coalition, the University of Colorado Denver, Stapleton Foundation and 2040 Partners for Health, asked respondents from five neighborhoods in Denver and Aurora, including NW Aurora, about their 2 health. Survey results are reported below. Other surveys that collected similar data in other cities, neighborhoods and statewide are also included for comparison. These include North Aurora, Commerce City (high minority, 2006-07 data, reported in TCHD 2007) and South Lincoln Park, Denver (low income, 2007 data, reported in Roof 2009). Results revealed the following statistics and trends: NW Aurora has a higher and growing percentage of minority populations. NW Aurora is about 13% the size of North Aurora and houses 21,159 people, 24% of North Aurora’s population. Between 1990 and 2000, the Hispanic population in NW Aurora grew from 796 persons to 11,938 persons, a 1400% increase, while the White Only population grew 56%. In North Aurora, the Hispanic population increased 496%, and its White Only population grew 1%. In 2000, 42% of NW Aurora’s population was foreign born, a 1134% increase from 1990, compared to a 27% foreign born population in North Aurora in 2000, a 506% increase from 1990. The language spoken at home in NW Aurora and North Aurora was 90% English in 1990, with 5% Spanish in NW Aurora, and 4% Spanish in North Aurora. In 2000, NW Aurora had 53% English speaking and 42% Spanish speaking, while North Aurora had 69% English speaking and 24% Spanish speaking. Overall, NW Aurora’s population, as well as its minority population, grew more rapidly than North Aurora’s between 1990 and 2000 (US Census Bureau 1999) (US Census Bureau 2000). As of 2007, 54% of NW Aurora adults were Hispanic, 25% White and 16% Black (TNHTH 2007). NW Aurora has less access to health care and lower incomes. Only 59% of NW Aurora residents have some type of health insurance (TNHTH 2007). This compares with 83% of adults statewide and 62% within South Lincoln (CDC 2007) (Roof 2009). Forty-six percent of NW Aurora residents said they needed to see a doctor within the past year but delayed because of cost compared to 12.9% statewide (TNHTH 2007) (CDC 2005), 10.3% in Commerce City, CO (TCHD 2007) and 20% in South Lincoln (Roof 2009). Between 1989 and 1999, poverty rates were up for Aurora, North Aurora and NW Aurora. During that time, the percent of persons below the poverty line increased from 7% to 9% in Aurora, and from 13% to 16% in North Aurora. NW Aurora experienced the highest rates prepared by Karen Roof with EnviroHealth & Alisha Brown, Felicia Hilton, & Lisa Schott with the Stapleton Foundation’s be well initiative, July 2010 HIA: a study of potential sites for a regional recreation center in North Aurora 3 How is your general health? / 45.0 BRFSS TNHTH NW Aurora 39.2 40.0 36.0 36.0 Percentage / Porcentaje 35.0 30.0 28.3 26.8 26.9 25.0 20.0 24.0 19.8 19.6 14.0 15.0 10.3 10.0 6.3 6.3 5.0 3.0 3.4 0.0 Excellent / Excelente Very good / Muy bien Good / Bien Fair / Normal Poor / Mal 2007 Colorado BRFSS data compared to 2007 Taking Neighborhood Health to Heart data. TNHTH includes Stapleton, East Montclair, Park Hill, NE Park Hill, and NW Aurora neighborhoods. and the most growth of poverty stricken individuals, increasing from 23% to 27%. “Consistent with national trends, the City of Aurora community has increasing numbers of residents and households at the extreme end of the income spectrum (City of Aurora 2006).” In 1999, the median household income for NW Aurora was $30,827, over $6,500 (18%) less than that of North Aurora and over $15,500 (33%) less than that of Aurora. Households with incomes above $50,000 increased from 25% in 1989 to 46% in 1999 for Aurora, from 15% to 31% in North Aurora, and from 9% to 21% in NW Aurora. However, despite these increases, in 1999 2 out of 5 (39%) NW Aurora households had a household income less than $25,000, compared to 30% in North Aurora and 20% in Aurora (US Census Bureau 1990) (US Census Bureau 2000). In 2007, 24% of NW Aurora residents who responded to the Taking Neighborhood Health to Heart survey had incomes less than $15,000 and 50% made less than $25,000 while only 11% made over $50,000. Statewide, 20% made less than $25,000 while 54% made more than $50,000 (TNHTH 2007) (CDC 2007). Public health data indicate that the burden of illness is higher among minorities and low income communities. Those withapproximate lower incomesboundary and educati levels are known Map: ofon North Aurora and to have lower quality housing, and lack opportuniti es for four potential recreation center sites outdoor activities or healthy food options (Scinivasan 2003). “People with disabilities may have fewer options for physical activity such as access to recreational facilities because of barriers in the built environment. They are also more at risk of a collision in difficult traffic situations (DRCOG 2007).” “Lower income children suffer more traffic injuries and fatalities than those from higher income families. Nationwide, pedestrian injuries and fatality rates for Hispanic and Black people are several times higher than those among White people. Researchers believe these rates may stem from a higher probability of being a pedestrian, road design in areas where minority persons walk, and cultural factors like not being accustomed to high-speed traffic (Frank 2003) (TCHD 2007).” NW Aurora residents give worse self-reports on health status. A third (34%) of NW Aurora residents described their overall health as poor or fair in comparison to good or excellent. Statewide, the percentage of those who reported fair or poor health status was 11.6% (TNHTH 2007) (CDC 2007). In Commerce City, 19.7% reported fair or poor health status, and in South Lincoln, 39.7% (TCHD 2007) (Roof 2009). This question elicits a very powerful self-assessment and research has shown that responses to this question are valid in predicting a person’s quality of health. NW Aurora has higher incidences of chronic health problems. One of every four people (24%) in NW Aurora who completed the TNHTH survey had been told they have high blood pressure. Of those people, 58% currently take medicine for their high blood pressure (TNHTH 2007). According to the American Heart Association, high blood pressure is particularly prevalent in African Americans, middle-aged and elderly people, and obese people (AHA 2009). Also, only one out of every three respondents in NW Aurora (33%) in 2007-2008 met the national physical activity recommendations of moderate intensity exercise of at least 30 minutes (e.g., walking, vacuuming) five or more days per week, or 20 minutes or more of vigorous physical activity on three or more days per week, compared to 28% in South Lincoln and 55% statewide. Obesity rates show similar disparities in Colorado - 19% of adults were obese and 45% were either overweight or obese. NW Aurora rates were higher, with 33% of adults being obese, and 66% overweight or obese (TNHTH 2007) (CDC 2007) (Roof 2009). prepared by Karen Roof with EnviroHealth & Alisha Brown, Felicia Hilton, & Lisa Schott with the Stapleton Foundation’s be well initiative, July 2010 HIA: a study of potential sites for a regional recreation center in North Aurora Access Programming for the North Aurora recreation center is largely independent of the site selection, making access to the facility the primary difference between the four potential sites. Access is a significant contributor to health outcomes since being able to quickly and safely access a recreation facility is a key determinant of usage. According to the Aurora Community Needs Assessment, access was a significant barrier for many residents. The top reason adults gave for rarely or never using City of Aurora recreational facilities is that they are “too far from my home.” For youth it was the third highest response after “not being aware of programs offered” and “no transportation (ARRTF 2009)”. These results indicate two challenges related to access: 1) the physical distance between residences and facilities is too great, and 2) the existing routes and supporting transit modes are not accommodating everyone, particularly children. While it is true that all of Aurora needs more recreation facilities in order to decrease the distance between residences and facilities, NW Aurora is disproportionately deficient both in existing recreation facilities and open spaces compared to North Aurora. Moorhead is the only existing recreation center in NW Aurora and it is very small (4,000 sq. ft.), housing only a half gym, a cramped fitness area, and a multi-purpose room for indoor games. The facility currently operates over capacity with limited expansion opportunities. Park acreage in NW Aurora Average Travel Times (in minutes) by Mode from North Aurora Schools to Potential Recreation Center Sites 70 Mt. Nebo 60 Fitzsimons Centerpiece 50 65 55 Bicentennial Park Monterey Point 37 40 30 20 10 30 31 30 min 15 min 7 8 4 5 17 20 30 21 8 10 Bike totals 26.6 acres, which is only 5% of the total park acreage in North Aurora. The large majority, 78%, of park acreage in North Aurora lies south of 6th Avenue (City of Aurora). According to the National Recreation and Parks Association Guidelines, 10 acres of open space (i.e., parks) per 1,000 persons is the benchmark for adequate open space (San Francisco Dept. of Public Health 2006)). NW Aurora falls the furthest below at 1.26 acres/1,000, while the area north of 6th (excluding NW Aurora) has 7.53 acres/1,000, and the area south of 6th Avenue to Mississippi has 8.78 acres/1,000 (City of Aurora). Ideally, this goal of planning citywide recreational facilities is to ensure equal access for all persons regardless of income or ability. This necessitates consideration of travel distances and times by a variety of modes. Nationwide, “persons in households without access to vehicles made 37 percent of their trips on foot and another 20 percent by transit. This compares with 8 percent and 1 percent by foot and transit, respectively, by households with at least one vehicle (USDOT 2003).” Data on current travel behaviors reveals that 19% of NW Aurora residents do not have motor vehicles, compared to 12% of North Aurora residents, and 7% for all of Aurora. The percentage of NW Aurora residents sixteen and over who use public transportation for their commute is 12%, compared to 8% of North Aurora residents and only 4% of all Aurora residents (Census 2000). This suggests that NW Aurora residents have a disproportionate need to use alternative modes of travel to access recreational facilities. Bicycling is largely inhibited throughout North Aurora as there are limited bike lanes, bike paths and bike routes. Those that exist do not offer continuous or connected routes to the potential recreation sites (Planning and Development Services Dept). In 2000, only two percent of residents in NW Aurora, North Aurora, and City of Aurora reported commuting by walking or bicycling (Census 2000). 16 0 Drive 4 Bus Walk Mt. Nebo and Fitzsimons Centerpiece offer shorter travel times and more convenient mode choices than Monterey Point and Bicentennial Park from North Aurora schools. An established benchmark to increase physical activity levels and social engagement states that recreational facilities should be within a ¼ to ½ mile of the surrounding community (SFDPH 2006). This is equivalent to about a 2 minute drive or a 10 minute walk. The needs of Aurora residents are comparable, with the majority, 60%, stating they are willing to travel a maximum of up to 15 minutes to use a new recreation center, and another prepared by Karen Roof with EnviroHealth & Alisha Brown, Felicia Hilton, & Lisa Schott with the Stapleton Foundation’s be well initiative, July 2010 5 HIA: a study of potential sites for a regional recreation center in North Aurora 33% willing to travel up to 30 minutes (ARRTF 2009). Based on calculations of average travel times from North Aurora schools to the potential sites, the Mt. Nebo and Fitzsimons Centerpiece sites offer the most equitable access for all travel modes and minimize travel times, while Bicentennial Park and Monterey Point are the least equitable and require longer travel times (Google Maps 2010). In addition to health, what other factors should be considered in the site decisions for the North Aurora recreation center? Recreation centers are known to have positive safety, social, and economic impacts in their surrounding communities in addition to improvements in overall health. Recreation centers can significantly improve community safety because they are a large provider of after school programs (National Recreation and Parks Association). They can also create jobs. Studies have shown that for every $1 million invested in parks and recreation infrastructure, 20 jobs are created. Using the projected cost of $20,000,000 per regional recreation center, that would translate into 400 new jobs in North Aurora (Finkleman 2010). Parks and recreation services also motivate business relocation (Tahoe City PUD 2009) and can increase property values for homes in close proximity (Finkleman 2009). Further, they can help “reduce the high costs associated with police services such as responding to vandalism and other criminal activity (Tahoe City PUD 2009)” as they provide positive alternative outlets for youth engagement. A look at current conditions on these topics in North Aurora indicates: NW Aurora perceives more crime and unsafe streets. Fifty-eight percent of TNHTH respondents from NW Aurora believe that there is high crime in their neighborhood, compared to only 37% in the four other neighborhoods surveyed (East Montclair, Stapleton, Park Hill, and NE Park Hill). Not surprisingly, 62% in NW Aurora feel that crime makes it unsafe to go on walks at night versus 40% for the other four neighborhoods mentioned above. Forty-one percent do not feel that their neighborhood streets are well lit at night compared to 25% in the other four neighborhoods. When asked if they felt it unsafe to walk in their neighborhood during the day, the responses were 30% versus 14%, respectively (TNHTH 2007). NW Aurora has less social cohesion. Two out of five NW Aurorans surveyed (41%) believe that people in their neighborhood can be trusted, while 67% from the other four neighborhoods surveyed (East Montclair, Stapleton, Park Hill, and NE Park Hill) believe the same. Additionally, 41% of NW Aurorans feel their neighborhood is closeknit compared to 62% for the other four neighborhoods mentioned above (TNHTH 2007). What are the recommendations and expected outcomes to support overall health in relation to health status, access and affordability for all North Aurora residents, particularly those in most need? General Recommendations To maximize the health benefits of a regional North Aurora recreation center, we recommend that the following criteria be incorporated regardless of which site is selected: • • • • • • • • Reduce levels of overweight/obesity and disease by increasing physical activity Increase the amount and types of exercise that are available (i.e., swimming, etc.) Provide safe and convenient access to the facility within 30 minutes, preferably 15 minutes, for all transportation modes including car, bus, walking and biking. This may necessitate discussions with RTD if new stops or routes need to be created. Increase the number of people getting to recreation centers by walking and biking on connected, direct routes Implement the NW Aurora Bike and Pedestrian Plan Ensure adequate pedestrian amentities (seating, shade, etc.) and aesthetics (public art, landscaping, etc.) Address economic and service inequities Improve neighborhood social connections and cohesion prepared by Karen Roof with EnviroHealth & Alisha Brown, Felicia Hilton, & Lisa Schott with the Stapleton Foundation’s be well initiative, July 2010 HIA: a study of potential sites for a regional recreation center in North Aurora • • Reduce crime and fear of crime Create job opportunities Site-Specific Recommendations Mt. Nebo (E. 13th Ave. and Peoria St.) is a privatelyowned property that would offer the best access for all North Aurorans, making it an ideal site for the recreation facility. Unfortunately, through this HIA process, it has been determined that the owners of the property are not willing to sell and are not interested in subleasing the property to the City of Aurora. Fitzsimons Centerpiece (E. Colfax Ave. and Ursula St.) is a 16 acre privately-owned property that offers ample space for the recreation facility and parking, as well as good access for all North Aurorans. Average travel times from schools to the site are within 30 minutes by all modes except walking and are shortest for NW Aurora residents, with travel times of less than 15 minutes for all modes except walking. This is a prime development area with high density, convenient transit access and connections, and close proximity to the Fitzsimons medical campus with potential workforce growth of up to 45,000 people who would also have access to this nearby facility. The Urban Land Conservancy (ULC) has determined that the owners of the property are willing to sell and it is a good option for leasing to the City. To foster success, a public private partnership could be formed between the City of Aurora and entities such as the Urban Land Conservancy, Trust for Public Land, and the Colorado Health Foundation to offset the cost of the land acquisition and development. There may also be federal funding available through the Community Putting Prevention to Work grant for which Tri-County Health Department has been awarded 10.5 million dollars to support policy and environmental change in the Aurora area. Initial contact has already been made with the organizations listed above, all of which have expressed interest in the project. [Note: After numerous calls and meetings with those leading the Fitzsimons Health and Wellness Center effort, it has been determined that this center, scheduled to open in 2011, is not a viable alternative recreation facility for NW Aurora residents and others. The Center will function primarily as a research/clinical facility with a fitness center component accessible only to those who participate 6 in health and nutrition studies. Based on the project’s scope and projected capacity, the facility will be able to accommodate about 3,500 total memberships, of which 1,000 will be available to community members. Stapleton Foundation will continue to enhance the collaborative partnership with the Center when it opens by providing referrals for health clinics, and assisting with messaging to reach the residents in NW Aurora about opportunities to participate at the Center.] Bicentennial Park (E. Alameda Ave. and S. Potomac St.) is a 36 acre city-owned property that can accommodate the regional recreation center without additional investment for land acquisition. Access, however, is relatively poor for North Aurora residents, especially for NW Aurora residents who are outside a 2 mile radius. The average travel times from Northwest Aurora schools to Bicentennial Park is 8 minutes by car, 39 minutes by bus, 23 minutes by bike and 74 minutes walking (Google Maps 2010). Given the large percentage of NW Aurorans that do not have access to a vehicle, and that there are no safe routes for bicycling from NW Aurora to Bicentennial Park, the most convenient mode choice is bus, which takes longer than 90% of what Aurora residents are willing to travel (ARRTF 2009). As such, if this site were to be selected, it is recommended that significant access improvements be made that decrease the average travel time by bus from North Aurora to 30 minutes or less (preferably 15 minutes), and create safe and continuous bicycle routes throughout North Aurora to the facility. Access improvements between NW Aurora and Bicentennial Park should be prioritized. These access improvements are generally costly and can take many forms, but may include the following: • • Connectivity Improvements - Improving connectivity can be accomplished by filling gaps in existing street, transit route, and biking/walking paths, or by creating additional routes from parts of North Aurora, particularly NW Aurora, to Bicentennial Park. Bicycle route improvements should be prioritized and implemented in NW Aurora as specified in the NW Aurora Bicycle and Pedestrian Plan. Traffic Safety Enhancements - Traffic safety can be enhanced by engineering new streets for lower speeds or by altering existing streets with traffic calming measures such as center pedestrian refuge prepared by Karen Roof with EnviroHealth & Alisha Brown, Felicia Hilton, & Lisa Schott with the Stapleton Foundation’s be well initiative, July 2010 7 • HIA: a study of potential sites for a regional recreation center in North Aurora islands or improved street crossings for pedestrians. It may also be necessary to increase the visibility of pedestrians by installing exclusive pedestrian signal phasing. Personal Safety Improvements - Instituting measures that increase the intensity of roadway lighting for both vehicles and pedestrians can improve levels of personal safety. Increasing the number of eyes on the street also helps, and can be accomplished by increasing the volume of pedestrian traffic and police surveillance along pedestrian routes. Other Crime Prevention Through Environmental Design (CPTED) strategies should also be considered. recreation facility. Final Recommendations Based on the extensive data presented in this HIA about current health trends in North Aurora, be well Northwest Aurora Partners, a partnership of the Stapleton Foundation’s be well Health and Wellness initiative funded primarily by the Stapleton Foundation, Gary Williams Energy Company and LiveWell Colorado, concludes that a new regional recreation facility in North Aurora will have a positive health impact on the community. As such, be well Northwest Aurora Partners supports the facility regardless of which site is selected. However, in light of the unique health disparities that NW Aurorans face, along with the potential cost to the City to provide equitable access to all North Aurora residents, be well Northwest Aurora Partners recommends the Fitzsimons Centerpiece site for the regional recreation facility because it best supports the health, safety, and well being of North Aurora, specifically NW Aurora, by improving access and equity for all residents, while offering more affordability for the City of Aurora. Acknowledgements This walking school bus helps children engage in regular physical activity. It is part of be well Northwest Aurora’s work to improve healthy eating and active living in the community. Monterey Point (E. Colfax Ave. and N. Chambers Rd.) is a 26 acre, privately-owned property that the ULC has investigated as a potential option to purchase and then lease to the City of Aurora. Access to this site prioritizes NW Aurora, but travel times by bike average 20 minutes, and times by bus range from 27 to 36 minutes, capturing only the third of North Aurorans that are willing to travel upwards of 15 minutes to a recreation facility (Google Maps 2010). In sum, although this property is for sale and is an option, like Bicentennial Park, it still has many access issues that would need to be addressed. Because there is not only a cost to the City to provide access for all residents but also for the cost of the property, it is not recommended as the preferred option for a regional The Stapleton Foundation expresses appreciation to the numerous organizations below that support a recreation center location that is highly accessible to NW Aurora because its population faces disproportionate risks for a variety of health problems: 2040 Partners for Health Councilwoman Melissa Miller Gary Williams Foundation LiveWell Colorado Metro Organizations for People Northwest Aurora Neighborhood Organization Past Councilwoman Deborah Wallace Past Councilwoman Nadine Caldwell Piton Foundation Stapleton Foundation Stapleton Transportation Management Association Tri-County Health Department prepared by Karen Roof with EnviroHealth & Alisha Brown, Felicia Hilton, & Lisa Schott with the Stapleton Foundation’s be well initiative, July 2010 HIA: a study of potential sites for a regional recreation center in North Aurora References American Heart Association. “Understand Your Risk for High Blood Pressure.” 23 June 2010. 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