Creating Healthy Neighborhoods

Evidence-Based Planning and Design Strategies

By Ann Forsyth, Emily Salomon, Laura Smead, AICP

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Good housing. Easy transit. Food access. Green spaces. Gathering places. Everybody wants to live in a healthy neighborhood. But creating one is more than a walk in the park. There’s so much to learn and so much to do. It’s hard to know where to begin.

Creating Healthy Neighborhoods shows the path to places designed for living well. Three Harvard scholars — Ann Forsyth, Emily Salomon, and Laura Smead — bridge the gap between research and practice. Together, they map out ways for cities and towns to help their residents thrive.

This practical guide approaches health from every side — physical, mental, and social. Eight overarching principles run the gamut from balance and connection to access and mobility. Twenty propositions suggest paths to explore in each of those areas, while 80 concrete actions lay out steps communities can take to get started.

A solid research base makes the book ideal for planners, designers, public health professionals, and course adoption. Its direct style, real-world illustrations, and helpful glossary open it up to civic leaders, social activists, and engaged citizens. Creating Healthy Neighborhoods is a must-read for everyone who wants to make fit places to live.



About the Authors

Ann Forsyth is a professor of urban planning at the Harvard Graduate School of Design. Emily Salomon formerly with the Health and Places Initiative, is associate housing planner in Cambridge, Massachusetts. Laura Smead, also formerly with the Health and Places Initiative, is town planner for Canton, Massachusetts.

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Date Published
March 1, 2017
APA Planners Press

Table of Contents

List of Figures

List of Tables


Introduction: Toward Healthy Neighborhoods

Principle 1. Importance: Assess how health matters in this place
Proposition 1: Figure out if there are good reasons for considering health
Proposition 2: Identify an initial list of neighborhood-relevant health issues
Proposition 3: Figure out if anyone else cares

Principle 2. Balance: Make healthier places by balancing physical changes with other interventions to appeal to different kinds of people
Proposition 4: Understand that tradeoffs are inherent in planning for health at all scales and this is true of neighborhoods as well
Proposition 5: Appreciate that there is no ideal size for a healthy community, but different dimensions of health relate to different scales

Principle 3. Vulnerability: Plan and design for those with the most health vulnerabilities and fewest resources for making healthy choices
Proposition 6: Create a variety of housing options to promote housing choices within the neighborhood
Proposition 7: Integrate universal design principles into neighborhood planning and design
Proposition 8: Increase choice, access, and exposure to high quality, diverse, and healthy food options, especially in low-income areas

Principle 4. Layout: Foster multiple dimensions of health through overall neighborhood layout
Proposition 9: Create mixed use neighborhoods with a balance of activities that support good health
Proposition 10: Provide enough density of population to support services for a healthy lifestyle
Proposition 11: Create a connected, "healthier" travel circulation pattern for pedestrians, bicyclists, and transit users — the vehicular pattern can be different
Proposition 12: Increase access to a variety of locally relevant recreational facilities and green spaces

Principle 5. Access: Provide options for getting around and increasing geographic access
Proposition 13: Coordinate land-use planning and urban design with transit to increase efficiency, access, and mobility
Proposition 14: Adopt policies and planning practices to create safe neighborhood transportation options for all types of road users
Proposition 15: Ensure adequate pedestrian and cyclist infrastructure and amenities

Principle 6. Connection: Create opportunities for people to interact with each other in positive ways
Proposition 16: Create publicly accessible neighborhood spaces, programs, and events to support healthy interactions and behaviors
Proposition 17: Design the public realm to reduce street crime and fear of crime

Principle 7. Protection: Reduce harmful exposures at a neighborhood level through a combination of wider policies and regulations along with local actions
Proposition 18: Reduce pollutants and chemicals at the source and separate people from toxins through buffers, technology, or design
Proposition 19: Separate people and infrastructure from areas vulnerable to natural disasters and build in resilience through technology or design
Proposition 20: Reduce unwanted local noise exposure at the source, and separate people from noise through buffers, technology, or design

Principle 8. Implementation: Coordinate diverse actions over time

Appendix A: Actions Checklist

Appendix B: Health Topics Addressed by Section





“In the 19th century, starting in Germany and Britain, health and hygiene concerns were instrumental in the development of planning legislations. There is now an urgency to shape our environments with a more comprehensive understanding of healthy environments and ways of shaping them. The eight principles presented in this book, based on extensive research and collected evidence within the Health and Places Initiative, provide us with carefully considered guidance for creating healthy neighborhoods.

“The framework created in this book, and the practical advice for connecting health and place, not only will be of utmost importance to practitioners and decision makers but also will provide the foundations for future research to test this guidance.

“I would expect this book to be on the shelves of all those in the environmental professions, and of all those who want to make better decisions to create healthy places. It must be included on the curriculum of all urban design, planning, architecture, and landscape architecture courses to ensure that the professionals of the future are better informed.”

— Taner Oc, Editor, Journal of Urban Design

“Action to protect and enhance human health in a rapidly densifying and urbanizing environment is an urgent global challenge. So too is the communication of practical ways to address the daily needs of diverse communities living, working and travelling in a myriad of cities, towns and neighbourhoods. Ann Forsyth, Emily Salomon and Laura Smead have risen to the challenge. They bring together a framework of propositions, organised under a set of clear guiding principles, which show us how to make health supportive built environments that are community relevant, well planned and appropriately designed. Based on a foundation of research excellence, this comprehensive, practice-based compendium will be the go-to manual for healthy built environment professionals who want to know how best to act — and how to do it now.”

— Susan Thompson, Professor of Planning and Associate Director (City Wellbeing), City Futures Research Centre, The University of New South Wales, Australia