The built environment has a powerful influence on several public health objectives, including securing safe and affordable housing, ensuring nutritious food, increasing physical activity, preventing unintentional injuries, improving air and water quality, ensuring healthy childhood development, and preventing violence. Comprehensive planning considers all of society’s goals simultaneously. However, the lack of attention to many public health objectives in the course of land use planning has resulted in significant costs to public health and environmental quality. Using public health information and evidence to guide the design of communities can improve the health of the population, prevent disease and illness, save social resources, and anticipate and avoid environmental problems.

  1. Traditional regulatory guidance does not address trade-offs between competing health goals. Health Impact Assessment provides methods to consider competing objectives. 

    Environmental regulations and guidelines that tell us to situate housing away from traffic because of air quality and environmental noise should be balanced against the positive health outcomes associated with increased housing and quality employment. A public process of weighing competing health objectives may support a consensus for this balance.

  2. Good planning objectives are supported by public health evidence. In some cases, these benefits can be estimated quantitatively.

    Increasing residential density in urban areas is supported by research that shows positive relationships between increasing density and improvements in air quality and physical activity; and decreases in respiratory diseases, and traffic injuries.

    Preserving traffic flow through changes in circulation (two-way streets) and decreased road speeds decreases intensity of injuries, improves air quality and reduces noise effects.

    Increasing affordable housing is supported by research that illustrates the relationship of low quality housing and child cognitive development, hunger, and asthma.

    Public transit improvements are supported by data on increased health care utilization and access to healthy foods, as well as alleviation of stress.

    Community schools and child care centers are identified in child development research as ways to reduce traffic congestion, combat obesity, and increase sleep, foster family and community social relationships, and engage students in learning.

  3. Health research can inform community design in ways that promote health and prevent disease.

    Pedestrian injury and traffic safety research identifies several effective measures for pedestrian safety, including, pedestrian refuge islands, roadway lighting, advance stop lines, and street configurations.

    Researchers in the violence prevention field illustrate the relationship between environmental designs that enhance and create opportunities for people to observe the space around them. This includes building orientation and the placement and design of windows, entrances and exits, parking lots, walkways, guard gates, landscape trees and shrubs, fences or walls, signage and any other physical obstruction.

    Research on physical activity suggests community design elements, such as short blocks and grid-like street patterns, promote and increase walking to work and leisure trips among diverse age and racial populations.

    Research on the barriers to accessing nutritious food illustrate that the location of food resources and type of foods provided are key determinants of healthy eating.

    Transportation research illustrates that inadequate public transit impedes health care utilization and treatment.

    Research on air quality and respiratory illnesses can guide the location of land uses including schools, parks, and child care facilities, and their proximity to potential sources of pollution.

    Research on physical activity and community design can inform the number, location, design, and facilities for parks, public spaces, and streets that maximize routine physical activity among residents.

    Research on noise and its effects on childhood development, high blood pressure, and sleep patterns can inform residential design standards and the proximity of residential and commercial uses.

  4. Community health analyses can identify strategies that achieve multiple community objectives through urban design and land use decisions.

    Focusing on pedestrian safety may increase physical activity, reduce crime, and promote the success of local businesses.

    Given land scarcity, limited land is available for public facilities. Integrated planning can develop sites for multiple community purposes including schools, parks, child care, and community centers and health services.