At the Intersection of Air Quality and Health

The intersection of air quality and community health was explored at the Cleaner Air Partnership quarterly meeting on September 23, 2016. Ashley Brand, Director of Community Health and Outreach with Dignity Health, provided an overview of the requirements of nonprofit hospitals for community benefit programs and Community Health Needs Assessments (CHNA). Valley Vision’s Giovanna Forno and Alan Lange shared highlights of regional priority health needs based on an analysis of aggregate CHNA data and discussed health needs that intersect with air quality. Teri Duarte, an air quality planner for the Sacramento Metropolitan Air Quality Managment District, shared her perspective on how the built environment can be designed to improve health outcomes.

Since 2007, Valley Vision has been conducting Community Health Needs Assessments on behalf the Capital Region’s nonprofit health systems as part of a collaborative effort. Valley Vision’s CHNA team recently completed the 2016 Community Health Needs Assessment project. Conducted over a period of 18 months, the 2016 CHNA process involved the collection of qualitative and quantitative data on community health needs through 89 key informant interviews and 42 focus groups with a total of 412 participants. Data on over 170 quantitative indicators of health were collected through the process.

The CHNA team completed 17 Community Health Needs Assessment reports for 17 specific health services areas. Health systems are in the process of publishing their individual CHNA reports associated with each of their hospital service areas; all 17 reports are expected to be publicly available by the end of calendar year 2016. The CHNAs help health systems prioritize where community benefit investments are most needed for each hospital service area.

From a regional perspective, an analysis of aggregate CHNA data identifies 8 priority health needs. These priority health needs are:

1.            Access to Behavioral Health Services

2.            Active Living and Healthy Eating

3.            Disease Prevention, Management, and Treatment

4.            Access to High Quality Health Care Services

5.            Safe, Crime- and Violence-Free Communities

6.            Basic Needs

7.            Affordable and Accessible Transportation

8.            Pollution-Free Living and Work Environments

Several of the region’s priority health needs intersect with air quality. Pollution-Free Living and Work Environments is the health need most obviously connected with air quality. But there are other intersections as well. For example, when air quality is poor the need for “Active Living and Health Eating” is impacted because sensitive groups – including seniors, children, and expectant mothers – aren’t able to participate in active outdoor activities that would otherwise be of benefit to their health. In the health need labeled “Disease Prevention, Management, and Treatment” poor air quality manifests in health indicators such as “percentage of adults with asthma” and “asthma-related visits to the emergency room.”

Less obvious as a health-related concern is the need for Affordable and Accessible Transportation. In conducting focus groups across the region, the CHNA team learned that lack of affordable, accessible public transportation can curtail needed medical attention, particularly in rural areas. Furthermore, indicators used to measure this health need have a strong link with air pollution. For example, the indicator “percent of workers commuting alone in a car” contributes to the region’s air quality problems. El Dorado, Nevada, Placer, Sacramento and Solano counties are all above the California statewide average 73.3% of workers commuting solo. These commutes are major contributors to the number one source of air pollution in our region: exhaust from mobile sources such as cars and trucks.

We can improve the health of our region by designing our communities to be more walkable, bikeable and transit-friendly. Implementing smart growth principles such as compact and mixed-use developments that shorten commute times, reduce traffic congestion, lessen dependence on automobiles, and improve air quality will be important to our health as the region prepares for future growth.


The Cleaner Air Partnership is a joint-project of Breathe California of Sacramento-Emigrant Trails, the Sacramento Metro Chamber of Commerce and Valley Vision to help the region meet clean air standards through measures that protect public health and promote economic growth.

Tammy Cronin is a Valley Vision Project Leader working on the Cleaner Air Partnership and other initiatives within the clean/green economy portfolio.

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