Healthy Planning in California: Towards a Theory of Multi-level Frame Interaction

California has been identified as a national leader in public sector efforts to move the health debate away from a narrow focus on healthcare (i.e., insurance and medical services) towards addressing the root causes of disease, or social determinants of health. This effort to expand the definition of health includes policies that impact the places where people live, work and study. While this effort has historically been confined to debates within the health sector, recent calls for placing health at the center of all policies has sparked a movement that is expanding discursive spaces for health in the fields of city planning, transportation, housing and education. The focus of today's healthy planning movement is centered on addressing the rising rates of chronic diseases, or the diseases of the 21st century. These diseases include obesity, diabetes and cardiovascular disease.;While there is a burgeoning field of research on the efficacy of policies and interventions aiming to prevent chronic disease (i.e., improving road infrastructure, soda tax legislation), there are few studies on the dynamic interpretations of health found in public discourse. Perhaps in part due to its ubiquitous nature in planning and public policy, there is an assumption that health has a universal meaning in public discourses. Thus, health is often invoked as a goal of particular policies or programs without adequately addressing the implicit assumptions that frame its interpretation. Without sufficient understanding of the underlying assumptions on health, the healthy planning movement risks the danger of perpetuating existing silos between public health, planning and public policy. The lack of attention to the underlying assumptions framing health in public discourse provides the rationale for my qualitative study on healthy planning in California.;I posit that policy and planning choices are deeply embedded in the ways in which planners think and talk about health in public discourse. One pathway to understanding how planners think and talk about health is by identifying the interpretive frames used for sense-making and generation of meaning in healthy planning discourses. The supposition I am making is that language has both the ability to describe and shape policy and planning choices. Thus, the specific aims of my study are: (1) to identify and explore frames in California's healthy planning discourses; and (2) understand how frame interactions energize particular ways of thinking and talking that influence policy and planning choices in California.;The findings of my study show that there are four frames of health embedded in healthy planning discourses. I characterize them as sub-frames: (1) health as physical survival of individuals, (2) health as physical well-being of individuals, (3) health as social, or collective, well-being and (4) health as socially conscious well-being. My study also found that there is a complex arena of "frame interactions" that filter meaning-making in healthy planning discourses. These interactions occur within and between four levels of frames which range from micro-interpretations of health (sub-frames) to macro frames that embed worldviews and assumptions on human and organizational nature. The implications of these findings for a grounded theory rests on the foundation that frame construction is an outcome of a dynamic process of frame interactions. Thus, discursive spaces which maximize interactions between and within levels of frames provide an opportunity to re-frame health in public discourse.