Planning refers to how policymakers design, regulate, and manage the built environment. Guided by citizen input and with elected official approval, planners use land use, zoning, and developer requirements and incentives to guide development patterns. This then influences other outcomes. Good planning helps the population age in place, live healthy lives, and contribute to environmental sustainability.
For example, planners can use developer requirements or incentives to promote the creation of livable communities where residents of all ages, backgrounds, and ability levels can easily get to commercial and business opportunities (see also this chapter’s section on Creating Livable and Sustainable Communities). Such requirements and incentives can, for instance, increase affordable housing in new developments. Doing so allows people from a wider range of income levels to benefit from a community’s employment opportunities, education, and amenities.
Some communities have put in place “inclusionary zoning,” which requires developers of market-rate housing to also include housing for people with low and moderate incomes in their housing developments. In some cases, communities allow developers to pay fees in lieu of building the affordable housing units on-site. These fees can then be used to build affordable housing elsewhere. Some argue that this can sometimes allow more units to be built because the cost of building housing off-site is lower. But fees paid may be too low, with developers paying less than they would on-site. In addition, the housing may not be in the same community as the market-rate development. This can perpetuate segregation. Planners also can create age-friendly communities. These communities are well-designed and livable. They promote health and sustain economic growth for residents of all ages and ability levels.
Poor planning, on the other hand, can tie a person’s mobility to the ability to drive a car. This is especially problematic for those who cannot afford a vehicle or who no longer drive. Poor planning can also limit housing options. And it can decrease access to vital amenities and services such as jobs, health care, and supermarkets.
Land-use patterns, housing, and transportation systems influence public health and environmental quality in a variety of ways. Failure to adequately plan land use and infrastructure creates a vicious cycle. Residents who spend hours traveling long distances have less time for leisure, family, and civic activities. They may suffer the health consequences of being more sedentary or isolated, including depression, dementia, heart disease, obesity, and diabetes. And the cost of long commuting can effectively add to the cost of housing.
For the most part, planning has not included an evaluation of the full spectrum of health implications related to planning alternatives. But this is beginning to change. Public health practitioners have begun to work collaboratively with planners to use a health impact assessment (HIA). HIA translates data into practical information decision makers can use to anticipate and address the health effects of proposed programs, policies, or projects. By integrating relevant health information into their assessment of a new proposal, decision makers can advance well-informed policies that avoid unintended consequences and unexpected costs.
Health in All policies are another tool to improve population health. They embed health considerations into collaborative decision-making processes across a broad array of sectors, such as transportation and economic development. The goal is to ensure that policymakers understand the health, equity, and sustainability consequences of their policy options and decisions.
EFFECTIVE PLANNING: Policy
Policymakers should enact comprehensive planning statutes, regulations, and incentives that promote:
- coordinated land use,
- sustainable and resilient infrastructure investment,
- a wide range of affordable and accessible housing and transportation options,
- positive health outcomes, and
- effective access to amenities and delivery of services.
Planning activities and goals should be inclusive and equitable, supporting all members of the community, including residents of all ages and ability levels. This includes by creating age-friendly communities that promote the independence and active community engagement of older adults.
In working to promote affordable and accessible housing options, policymakers should provide sufficient flexibility to enable innovative housing and transportation options. They also should utilize inclusionary zoning, requiring market-rate housing developers to include some units that are affordable for those with low and moderate incomes. Those units should be developed on-site. However, to the extent that developers are allowed to pay fees into a housing trust fund to develop affordable housing elsewhere, those fees should be at least as high as the full cost of developing the affordable housing on-site and should be used to build affordable housing in the community where the market-rate development is located.
The public should have ample opportunity to provide input before policymakers make decisions on land use, housing, and transportation.
State policymakers should require local governments to plan for a variety of affordable and appropriate housing options interspersed throughout the community.
State and local policymakers should periodically publicly review infrastructure and zoning requirements to assess their impact on the availability of affordable housing and mixed-use development.
Comprehensive land-use plans that address housing and transportation should guide community design and development decisions. These plans should address related issues, including public health, pollution, and climate change.
Policymakers should conduct a Health Impact Assessment for land-use, transportation, and community design projects. They should support coordinated efforts to improve population health by adopting a Health In All Policy.
Zoning: Policymakers should utilize affordable housing districts, inclusionary zoning, density bonuses, and other zoning regulations that promote the construction of good-quality affordable housing.
States should encourage changes in local zoning regulations to permit the development and location of accessory dwelling units, manufactured homes, multifamily projects, shared housing, and other alternative housing arrangements consistent with appropriate planning practices and fair housing laws.