Health Equity in a New Urbanist Environment: Land Use Planning and Community Capacity Building in Fresno, CA.

摘要

A tale of two cities. The Mason-Dixon line. The Berlin Wall. Fresnans have evoked a variety of metaphors to describe the spatial divide between the rich, clean and white neighborhoods in the north and the southern areas housing the poor, polluting industries and communities of color that has characterized urban development in the city since its inception. The narrative explaining this spatial inequality has been remarkably consistent over time—sprawl fueled by aggressive developers, corrupt city councilmen and the market pushed the city limits ever farther northeast, abandoning the older neighborhoods to the south where the poor and immigrant communities settled and were too disorganized to counter the government's neglect.;The spatial concentration of the poor, people of color and unwanted land uses can be seen in cities around the country and is identified by public health scholars to be a key driver of the disparities in health between racial and socio-economic groups. City governments are increasingly returning to their core and investing in New Urbanist and Smart Growth strategies to transform these older, more densely developed neighborhoods as the drive for environmental sustainability, walkable neighborhoods, and the attraction of creative urban residents grows. The potential effects of such efforts on the health and wellbeing of the existing residents, however, remains under explored. This dissertation asks if and how the new planning paradigms that use public health as a goal and organizing principle significantly change planning practice and lead to the re-distribution of environmental risks and resources to reduce health disparities? I investigate this question through three case studies of in Fresno a) a downtown revitalization plan, b) the general plan update, and c) a foundation based community development effort to increase the power of South Fresno residents to engage in planning.;Following a year of fieldwork I find that everyone is talking about healthy neighborhoods, however for whom and how to achieve them appear to be quite different. While community groups seek to improve the living conditions of the poor residents of South Fresno and ensure their ability to stay in a revitalized downtown, planners are focusing on attracting wealthier residents and actively avoiding any talk about equity, affordable housing and public investment. Thus, although health seems to be providing a unifying framework in terms of a vision for the physical environment, it does not ultimately resolve the inherent tensions between community and economic development.