Engaging the community and non-traditional partners to create healthier neighborhoods: Manchester, NH HEAL Innovation Fund Project

Background: Physical and social environments are critical contributing factors to the development of chronic diseases. In the city of Manchester, NH, coronary heart disease (CHD) mortality is 1.5 to 2.0 times greater in high deprivation neighborhoods than low deprivation neighborhoods. Furthermore, 70% of this variation in CHD mortality rates is associated with neighborhood poverty. To address these health inequities, the City of Manchester Health Department (MHD) is collaborating with multi-field sectors, community partners, and neighborhood residents to identify policy and environmental change strategies to create safe and healthy neighborhoods that support physical activity as part of everyday life. Methods: With the support of the Prevention Research Center at Dartmouth, MHD has utilized quality improvement methods for ongoing performance measurement and evaluation, and adopted a research-established theoretical framework (Behavioral Model of Environment, Moudon, A.V. et.al.) to guide the practical exploration of known attributes of walkability at the level of local public health practice. Results: MHD has successfully applied research frameworks and quality improvement tools to establish a neighborhood-based methodology for assessing known attributes of walkability, identifying policy and environmental change recommendations, and developing neighborhood-specific action plans. Core to this methodology is Community Based Participatory Research, the engagement of neighborhood residents as empowered partners in the community health improvement process. Conclusions/Discussion: The city is committed to improving its capacity for intentional community design through replication of this methodology within other neighborhoods, and will continue to address place-based factors affecting health as a means to creating health-promoting environments for all residents.