Health equity and the built environment

From reduced opportunities to travel by bike or foot to a lack of parks and green spaces, our built environment actively contributes to the state of our physical and mental well-being, and nowhere is its negative impact felt more than in Black and Brown communities.

A row of identical houses in a suburban neighborhood
(Taylor Flowe, Unsplash)

It has been well documented that Black and Latinx households face higher risks of developing physical ailments including asthma, diabetes, and cardiovascular diseases, and experiencing a heart attack or stroke compared to white households. These physical health outcomes are compounded by the mental health disparities seen in Black and Brown communities. Residents are experiencing higher rates of social isolation (a key factor contributing to the national loneliness epidemic.) This increases the risk of experiencing dementia, heart disease, premature death, depression and/or anxiety.

Much of the blame for poor health outcomes in communities of color lies with our built environment and the policies that shape it, including zoning regulations.

Since the 1920s, zoning has not only been used as a tool to separate land uses, but also a means to socially separate people along the lines of wealth, class, and race. This can be seen through the racist practice of redlining, where the government published maps that designated neighborhoods based on their “residential security” into categories of “best” (green) to “hazardous”(red). Areas marked in red were generally places with higher populations of people of color. This land designation was an intentional tool used to spur widespread disinvestment in Black and Brown communities, further destabilizing neighborhoods and depriving residents of necessary resources such as grocery stores and supermarkets. Residents of redlined neighborhoods were additionally denied access to financial services including mortgages and insurance loans, causing disparities in homeownership rates, locking in patterns of residential segregation, and contributing to the racial wealth gap.

Despite efforts to disallow the inequitable practices of the past, zoning has largely continued to reinforce this reality, and it shows in the data: American neighborhoods are more residentially segregated today than ever before. In this way, zoning has not only created barriers to developing social connections but also has restricted our opportunities to build relationships with people who differ from ourselves. These relationships have strong ripple effects in communities, helping to build social trust and strengthen mental health outcomes by reducing loneliness and increasing an individual’s socialness and sense of empathy—all factors that lead to healthier, more socially connected communities.

Today, the most common form of zoning in the U.S., often referred to as Euclidean zoning, tends to separate uses, leading to areas where only low-density single-family housing can be built. People who live in communities that are designed this way often have to travel long distances and take solo trips by car to get to work or go to the store. As a result, they have fewer opportunities for informal social interactions that can lead to deeper relationships, as well as fewer chances to organically engage in physical activity like walking or biking to school or work.

Public realm disparities

Residents of majority-Black and Brown neighborhoods often have a deficit of people-centered infrastructure including sidewalks and safe crosswalks, as well as substantially less access to green spaces. Black people are 52 percent more likely to live in a census block group with heat-risk conditions compared to white people. Heat risk can include having little to no green space, and a high volume of impervious surfaces like asphalt and concrete pavements. These conditions create a higher risk for heat-related deaths and illnesses.

These combined factors have created spaces that discourage physical activity, increase surface temperatures (leading to more extreme heat events), and expose residents to toxic air pollution levels (which has been linked with developing asthma, cognitive development delays, and premature death). And though everyone experiences these health impacts on some level, the people who are most at risk are people of color.

What can be done?

Zoning got us into this crisis, and it can get us out. Zoning is a tool that yields different built environment results depending on how it is leveraged. Enacting zoning reforms that prioritize more equitable, people-centered, smart growth development can help to reverse the inequitable trend in our built environment. For example, zoning regulations that prioritize affordable housing production can improve access to housing, and studies show that having safe, affordable housing helps to promote better health outcomes. Additionally, zoning that prioritizes green spaces like parks can encourage an active lifestyle, reduce risk of heat-related deaths and illnesses, and even reduce stress, anxiety, and depression for community residents.

Land use regulations have encouraged a built environment that fails to serve everyone’s needs for far too long. But it doesn’t have to be this way. By making changes to outdated, harmful zoning regulations, community leaders can help ensure that all residents can experience stronger health outcomes, particularly for residents that are most vulnerable.

Looking to learn more about zoning reform? Check out our Reshaping the City report (co-authored with the Urban Land Institute) and take a look at how form-based codes (an alternative land use regulation) can shape a city’s built environment.

Advancing Racial Equity Land Use and Development