Guide for Municipal Planning Commissions wishing to incorporate health-related language into their town plans
Compiled by the Two Rivers-Ottauquechee Regional Commission
and Mt. Ascutney Prevention Partnership
Health Chapter Template
Note: This template contains guiding text to help the reader navigate the template, as well as example language that can be customized and placed within the Health Chapter of the Town Plan.
[Guiding text that helps you navigate the template is placed within brackets]
Example language that can be inserted into Town Plans is italicized.
Possible Chapter Titles
[An appropriate title should be chosen to reflect the elements contained within the chapter.]
Health & Human Services
Health & Emergency Services
Community Health & Wellness
Fostering Healthy Communities
Healthy & Safe Community
[May contain Town’s definition of health]
The health and safety of TOWN residents is of the utmost importance. TOWN’s vision for health, wellness and safety is that all citizens in the community have access to high quality, affordable, physical and mental health services through local providers; that employers and individuals support healthy lifestyles and environments; that the well-being of children is a central focus; that prevention, personal wellness and reduction of pain are strong areas of focus from birth to death; that domestic violence and substance misuse are unacceptable in our families and community; that the elderly and disabled citizens have adequate health and wellness support to remain in their homes and remain integrated in their community; and that all residents have access to prompt and effective services in the event of an emergency.
[May contain a note on the purpose of including a Health Chapter.]
The Town of TOWN seeks to elevate the vitality of its citizens by including a comprehensive element dedicated to health and wellness in its Town Plan. Although the Community Health and Wellness Element is not a state-mandated element, the Town believes that its inclusion in the Plan ensures that public health and wellness remains a top Town priority.
[May contain a note on Health in other Chapters]
Many other elements of this Town Plan also have an impact on health, including preservation of green space; clean water; sidewalks that encourage walking; and design of new development to promote human interaction, reduce the use of vehicles, and support local and healthy food.
[Each bullet point listed in this Elements Section may make up the body of the Health Chapter. Towns should include Elements they believe are worthy of inclusion within their Plans. These Elements will guide the Goals, Policies, and Recommendations that come next. Note: these Element Topics may guide the Goals, Policies, and Recommendations without necessarily having a devoted section of narrative within the chapter text.]
- Population Profile: [a description of health-related issues in the Town, including any relevant significant burdens.]
TOWN contains a more rapidly increasing proportion of older citizens.
TOWN experiences a lack of access to specialist care.
- Town Health Officer: [By law, every town has a local board of health, consisting of the Town Health Officer and selectboard or city council. Town Health Officers are given authority by the Vermont statutes (18 VSA §§601-624) to investigate and mitigate any potential or existing public health hazard in his/her town. The health officer conducts an investigation upon receipt of information regarding a condition that may be a public health hazard and enforces the rules and permits issued by the Vermont Department of Health. The Town Health Officer may be contacted through the Town Hall.]
- Town or Community Nurse: [Some towns in Vermont have a town nurse. The nurse position may be supported by private funds, public funds, or a mix. The role of a town nurse is typically to assist residents with tasks such as coordinating care across providers, connecting people to resources, assisting with following health care advice, assessing safety in the home, and providing support to family members. Town nurses do not provide direct hands-on medical care. Many town nurses focus largely on the elderly population to help them age in place safely and in comfort.]
- Access to Health Care and Health-Related Facilities and Services: Health care facilities are essential in the prevention, treatment, and management of illness, and in the preservation of mental and physical well-being through the services that they offer. Rural locations such as TOWN are served by small facilities that can assist residents with general health care needs but are not suited for more complex acute care services that require specialized services and equipment. [If your Town does not have its own facilities, the plan can discuss the importance of reliable transportation to access facilities in nearby towns.]
- Healthy Food Access: [Food access is not simply a health issue but also a community development and equity issue. For this reason, access to healthy, affordable, and culturally appropriate food is a key component not only in a healthy, sustainable local food system, but also in a healthy, sustainable community.] Stores, farm stands and farmers markets, community meals, and the food shelf in town are all opportunities to create access to healthy foods.
- Healthy Homes: Housing is the best-known predictor of health. Lead exposure can lead to significant abnormalities in cognitive development; asbestos and radon exposure can increase the chance of developing lung cancer; uncontrolled moisture, mold, pests, and other triggers cause or exacerbate asthma and other respiratory dysfunction; inadequate heat can lead to use of inappropriate heating sources potentially resulting in fires or carbon monoxide poisoning; and poorly maintained stairwells and other structures can cause injuries. The risk of falls for older adults is another healthy home concern, particularly when these adults are living in old housing stock that may have uneven floors, narrow stairs, or other potentially hazardous features.
- Environmental Quality: Safe air, land, and water are fundamental to a healthy community environment. An environment free of hazards, such as secondhand smoke, carbon monoxide, allergens, lead, and toxic chemicals, helps prevent disease and other health problems. Implementing and enforcing environmental standards and regulations, monitoring pollution levels and human exposures, building environments that support healthy lifestyles, and considering the risks of pollution in decision-making can improve health and quality of life.
- Substance Misuse Prevention: Building a positive town culture that promotes healthy behaviors also significantly reduces risky behaviors such as substance misuse. Town policies are an important mechanism for creating healthy culture because citizens, especially youth, get “messages” from what they see in their communities, thereby influencing their choices.
- Active Living & Active Transportation: [As the built environment has become increasingly car-centric, levels of physical activity have correspondingly declined. Reduced physical activity has resulted in population weight gains. To counter these trends, it is necessary to make communities more conducive to physical activity once again, particularly walking and cycling.] Bicycles are used both for transportation and recreation. Many bicyclists can be seen riding throughout TOWN and the region. Bicycle transportation is used for work, school, or conducting errands. Recreational users include local residents who see the health benefits of the sport and visitors who come to Vermont to experience the outstanding scenery. Walking is an important part of community life and, much like bicycling, actively contributes to our roads’ vitality, reduces our dependence on the automobile, and provides a healthy recreational opportunity. The Town and private developers build roads based on anticipated vehicle traffic volumes; likewise, the Town should promote the construction of sidewalks and other pedestrian amenities based on anticipated and desired pedestrian traffic volumes and needs.
- Age-Friendly Environment: [Age-friendly environments cultivate well-being and the participation of people of all ages.] Well-being can be promoted through sustainable aging in place, which involves helping older residents remain in their community while also addressing the long-term economic, social, and health needs of both current and future generations at every age.
- Child care: [Child care serves as a critical component in the raising of a child or children from working families. Good quality child care helps prepare children for schooling or may even supplement a child’s school curriculum, and it provides them with opportunities for socialization. Many children also rely on child care services for meals. Vermont has a program called STARS (Step Ahead Recognition System) for child care, preschool, and afterschool programs. Programs that participate in STARS are stepping ahead — going above and beyond state regulations to provide professional services that meet the needs of children and families. STARS can help parents find a quality program for their children.]
- Social Inclusion & Sense of Community: [Social inclusion represents a vision for a “society for all” in which every individual has rights, responsibilities and an active role to play. Creating accessible spaces for people young, old and with varying degrees of abilities is imperative to helping create healthy communities.]
- Faith, Wisdom, and Spirituality: TOWN is a place where a wide variety of traditions, values, and spiritual practices are honored. Residents are able to seek inner peace, meaning, purpose, connectedness, wisdom, and guidance for right action in our own ways. Faith- and values-based communities actively seek to understand and support one another.
Goals, Policies, and Recommendations
[The Health Chapter needs to contain related Goals, Policies, and Recommendations. A GOAL represents the state of affairs that a plan is intended to achieve. A POLICY is an expression of how to meet a goal. A RECOMMENDATION is a means by which to implement a policy, through an action by a person or group. (GROUP does ACTION which implements POLICY)]
[A timeline could also be included to show a goal period for when a recommendation will be achieved. The following table shows how Goals, Policies, Recommendations, and Timelines relate and can be displayed within the chapter.]
|GOAL A: Healthy eating and physical activity are ingrained in TOWN.|
|Policy 1: Support and enable access to healthy food.|
|Recommendation 1.1: GROUP should promote and expand farmers’ markets and community gardens.|
|Recommendation 1.2: GROUP should support local Farm to School efforts.|
|Policy 2: Promote a built environment and programs that support physical activity.|
|Recommendation 2.1: GROUP should conduct health impact assessments for proposed developments.|
|Recommendation 2.2: GROUP should implement Safe Routes to Schools programs and Vermont’s Complete Streets program.|
[Alternatively, the Goals, Policies, and Recommendations may just be listed, as shown below:]
Goals, Policies, and Recommendations
- Promote health and wellness in TOWN.
- Increase access to healthy foods.
- Maintain sufficient affordable housing.
- Minimize the risks to human health and the environment posed by hazardous sites.
- Promote active transportation through walking and biking.
- Improve parks, recreation facilities, and open spaces for accessibility and community mingling.
- Reduce concentrated exposure to alcohol, drugs, and tobacco.
The town should:
- Promote and expand farmers markets and community gardens.
- Work with local housing authorities to create a variety of housing types and maintenance options.
- Protect water quality of rivers, streams, lakes, and wetlands.
- Promote use of park and recreation facilities.
- Consider accessibility when developing public spaces and recreational opportunities.
- Raise awareness of the nature and seriousness of substance misuse with the help of community organizations.
[It may be helpful to include a page that contains definitions for any unclear terms used throughout the chapter.]
This is the end of the Health Chapter Template. The next sections included in this document provide information about Town Ordinances and Planning Resources.
Below is a list of additional resources provided for the writers of the Health Chapter during its formation:
- TRORC Regional Plan (accessible at http://www.trorc.org/trorc-regional-plan/)
Chapter 3: Fostering Healthy Communities
- East Central Vermont: What We Want (accessible at http://www.trorc.org/ecv-what-we-want/)
Healthy Communities Section
- Department of Health – Vermont Healthy Community Design Resource: http://www.healthvermont.gov/sites/default/files/documents/2016/11/active_living_healthy_eating_community_design_resource.pdf
- Supporting Healthy Communities: What Can Towns Do? (accessible at: http://www.trorc.org/wp/wp-content/uploads/2016/10/SupportingHealthyCommunities-2016.pdf)
- TRORC Health page: https://www.trorc.org/health/
- Health Impact Assessments: HIAs are a tool that can help communities, decision makers, and practitioners make choices that improve public health through community design. HIA is a process that helps evaluate the potential health effects of a plan, project, or policy before it is built or implemented. HIA brings potential positive and negative public health impacts and considerations to the decision-making process for plans, projects, and policies that fall outside traditional public health arenas, such as transportation and land use. An HIA provides practical recommendations to increase positive health effects and minimize negative health effects. HIAs are flexible and can range from simple to complex, depending on the project or policy being evaluated. Vermont Department of Health Offices of Local Health may be able to assist Towns with conducting HIAs.
- Rural Community Health Toolkit: https://www.ruralhealthinfo.org/toolkits/rural-toolkit
Town Ordinances to Support Health & Wellness
The Health Chapter may include recommendations to pass ordinances that support healthy communities. Examples of such ordinances include:
Alcoholic Beverage Control Ordinance:
Pass an ordinance prohibiting people from consuming or possessing opened containers of alcoholic beverages in public places.
Pass an ordinance prohibiting the use and disposal of tobacco, tobacco substitute, and marijuana products and equipment on town-owned land.
Pass an ordinance establishing limits on retail advertising. Such ordinances must be content-neutral but can serve a dual purpose of preserving the rural character of a town while protecting youth and vulnerable populations from advertising that encourages substance use.
Pass a zoning ordinance restricting the location and/or density of retailors of age-restricted products such as alcohol, tobacco, vaping products, and marijuana.