Leveraging neighborhood-scale change for policy and program reform in Buffalo, New York.
BACKGROUND
The Healthy Communities Initiative (HCI) affects 8500 employees working in the Buffalo Niagara Medical Campus and 8925 residents of adjacent neighborhoods, where 37% of people live below the poverty line, and a majority (68.7%) identify themselves as African-American.


METHODS
The HCI partnership, which includes multi-sectoral and multi-disciplinary organizations and neighborhood residents, implemented the Active Living by Design community action model with greatest emphasis on achieving policy and planning changes to support active living behaviors.


RESULTS
The master plan of the campus now incorporates active living as a guiding principle. Physical improvements to support walking and bicycling in the target area have been planned and implemented through a $14 million federal transportation grant. The partnership facilitated the creation of a citywide Bicycle and Pedestrian Advisory Board and the passage and implementation of an ordinance to enhance bicycling infrastructure within the city.


CONCLUSIONS
Buffalo's experience suggests that to achieve lasting environmental change in the context of a medical campus and its surrounding neighborhoods, it is critical to: (1) engage neighborhood residents from the outset to build social capital; (2) cultivate a diverse partnership; (3) use a comprehensive approach; (4) balance long-term goals with short-term accomplishments; (5) integrate active living concerns within existing policy and planning mandates; and (6) make sustainability a priority.


CONCLUSIONS
Environmental changes in the public domain that support active living require collaboration among public, nonprofit, and private sectors; citizen engagement; and the presence of a legal and structural framework provided by government policies and plans to direct future development.
Raja
Samina
S
Department of Urban and Regional Planning, University at Buffalo, State University of New York, Buffalo, New York 14214, USA. sraja@buffalo.edu
Ball
Michael
M
Booth
Justin
J
Haberstro
Philip
P
Veith
Katherine
K
D001642:Bicycling; D019058:Community Networks / Q000458:organization & administration*; D003159:Community-Institutional Relations; D003299:Cooperative Behavior; D003469:Culture; D004779:Environment Design; D015444:Exercise; D005381:Financing, Organized / Q000458:organization & administration; D015438:Health Behavior; D006291:Health Policy; D006293:Health Promotion / Q000379:methods / Q000458:organization & administration*; D006801:Humans; D007373:Interinstitutional Relations; D009518:New York; D011203:Poverty; D015397:Program Evaluation; D044469:Racial Groups; D016138:Walking